Cuida-dor (d)eficiente: las representaciones sociales de familiares acerca del proceso de cuidar

Este estudo objetivou analisar os significados do cuidar para cuidadores/familiares que compartilham o cuidado domiciliar de pessoas com deficiências físicas, por lesão medular traumática. Tendo como referencial metodológico a teoria das Representações Sociais (RS), a análise dos discursos obtidos por meio de entrevistas abertas, realizadas junto a oito cuidadores, apontou dois eixos condutores dos significados: o processo de sofrimento vivido pelos sujeitos na prática do cuidar e as águas turbulentas que permeiam sofrimento. Esses eixos, caracterizados como Núcleo Central e Sistema Periférico das RS, respectivamente, compuseram-se de temas como a visão da deficiência, a afetividade, a religiosidade, as mudanças socioeconômicas e a (falta de) suporte técnico-institucional. Os resultados desvelam um cuida-dor (d)eficiente, voltado para o cuidar de uma pessoa também com deficiência, tida como inválida, e esse cuidar realizado com muito sofrimento e privações, alicerçado na culpa e na religiosidade, suportado por ambigüidade afetiva e marcado por desgastantes mudanças socioeconômicas e falta de suporte técnico-institucional, para uma prática que pressupõe tantas especificidades. As alternativas de transformações do cotidiano desses cuidadores sinalizam, principalmente, para uma simbiose de invalidez com o outro - o viver pela pessoa com deficiência - ou, ainda, para poucos, um esboço de retomada dos projetos pessoais de vida - o viver com a pessoa com deficiência.La finalidad de este estudio fue evaluar los significados del cuidar para cuidadores/familiares que comparten el cuidado domiciliar de minusválidos físicos por lesión medular traumática. Utilizando como referencial metodológico la teoría de las Representaciones Sociales (RS), el análisis de las entrevistas abiertas, realizadas a ocho cuidadores, apuntó dos ejes conductores de los significados: el proceso de sufrimiento vivido por las personas en la práctica del cuidar y el de las aguas turbulentas que atraviesan este sufrimiento. Estos ejes, caracterizados como Núcleo Central y Sistema Periférico de las RS, respectivamente, fueron compuestos de temas como la óptica que se tiene de la minusvalía, la afectividad, la religiosidad, los cambios socio-económicos y (la falta de) soporte técnico-institucional. Los resultados revelan un cuidador incapacitado volcado al cuidar de una persona también incapacitada, tenida como inválida, y este cuidar realizado con mucho sufrimiento y privaciones, fundamentado en la culpabilidad y en la religiosidad, sostenido por una ambigüedad afectiva y marcado por extenuantes cambios socio-económicos y falta de apoyo técnico-institucional, para una práctica que supone tantas especificidades. Las alternativas de transformación del cotidiano de esos cuidadores señalan, principalmente, para una simbiosis de invalidez con el otro - el vivir por el minusválido - o aún para unos pocos, un boceto de retomada de los proyectos personales de vida - el vivir con el minusválido.This study aimed to analyze what looking after physically disabled persons with spinal cord injury by trauma means to their caregivers and family members. The analysis of the testimony of eight caregivers, obtained in open interviews, which was methodologically based on the Social Representations Theory (SR), pointed out two main routes: coping with the suffering process in care practice and the troubled waters that permeate this suffering process. These two routes, characterized as SR Central Core and Peripheral System, respectively, consisted of themes like the way of looking at impairment, affectivity, religiosity, social-economical changes and (lack of) technical and institutional support. The results show a handicapped caregiver dedicated to look after someone who is physically disabled, considered incapacitated, and who leads his or her chores with distress and privations, based on guilt and religiosity, supported by ambiguous affection and affected by deteriorating social-economical changes and (lack of) technical and institutional support to practice an activity that implies so many peculiarities. The transformation alternatives of these caregivers' daily life principally lead to a symbiosis of disability with the patient - to live for the physically disabled - or yet, for a few, a sketch to restart personal life projects - to live with the physically disabled

Nucleic Acids Extraction from Formalin-Fixed and Paraffin-Embedded Tissues

Formalin-fixed paraffin-embedded (FFPE) tissues are an important sample source for retrospective studies. Despite its ability to preserve proteins and cell morphology, formalin hinders molecular biology tests since it fragments and chemically modifies nucleic acids, especially RNA. Although several studies describe techniques that allow extracting nucleic acids from FFPE tissues, so far there is no consensus in the literature about the best protocol to be used in this type of material. Thus, the current chapter aims to describe the factors affecting the FFPE tissue nucleic acid extracting process, compare the available protocols and to describe the modifications developed by our group in some protocols. Such modifications enable nucleic acids obtainment in satisfactory quantity and quality for molecular biology studies

Pathophysiology and molecular aspects of diffuse large B-cell lymphoma

Diffuse large B-Cell lymphoma is the most common subtype of non-Hodgkin lymphoma in the West. In Brazil, it is the fifth cause of cancer, with more than 55,000 cases and 26,000 deaths per year. At Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP, diffuse large B-Cell lymphoma represents 49.7% of all non-Hodgkin lymphoma cases. Initially, the classification of non-Hodgkin lymphoma was based on morphology, but advances in immunology and molecular medicine allowed the introduction of a biological classification for these diseases. As for other cancers, non-Hodgkin lymphoma involves patterns of multi factorial pathogenesis with environmental factors, as well as genetic, occupational and dietary factors, contributing to its development. Multiple lesions involving molecular pathways of B-cell proliferation and differentiation may result in the activation of oncogenes such as the BCL2, BCL6,and MYC genes and the inactivation of tumor suppressor genes such as p53 and INK4, as well as other important transcription factors such as OCT-1 and OCT-2. A dramatic improvement in survival was seen after the recent introduction of the anti-CD20 monoclonal antibody. The association of this antibody to the cyclophosphamide, hydroxydaunorubicin, oncovin and prednisolone (CHOP) regimen has increased overall survival of diffuse large B-Cell lymphoma and follicular lymphoma patients by 20%. However, 50% of all diffuse large B-Cell lymphoma patients remain incurable, creating a demand for more research with new advances in treatment. Thus, it is important to know and understand the key factors and molecular pathways involved in the pathogenesis of diffuse large B-Cell lymphoma

Virulence Factors in Staphylococcus aureus and Quality of Raw Milk from Dairy Cows in a Semiarid Region of Northeastern Brazil

Background: Milk quality is considered unsatisfactory in Brazil due to factors of a social, economic, cultural, and climatic nature. Mastitis is the main disease that affects dairy herds. Microorganisms of the genus Staphylococcus are the most frequently isolated pathogens in cases of mastitis in bovines. Staphylococcus aureus requires more attention because they have the ability to develop resistance to antimicrobials used in the treatment of mastitis. Thus, the aim of the present study was to evaluate virulence factors in isolates of S. aureus as well as analyze the hygienic-sanitary quality of raw milk produced on dairy farms in a semiarid region of northeastern Brazil.Material, Methods & Results: Samples were taken from milk containers at 44 properties. Fifty-eight isolates of Staphylococcus spp. were analyzed and genotypically identified as S. aureus. In the phenotypic characterization, 56.8% (33/58) of the isolates demonstrated moderate biofilm production. In the genotypic characterization (icaA, icaD and bap genes), icaA was the most representative among the isolates. No resistance to cephalothin or oxacillin was found, but 62% (36/58) of the isolates exhibited resistance to ampicillin, amoxicillin, and penicillin. In the genotypic evaluation in response to β-lactam antibiotics, 50% (29/58) of the isolates exhibited the blaZ gene. Total bacterial counts were determined based on the standard plate count and flow cytometry, for which a significant positive correlation was found (r = 0.61, P < 0.01). The somatic cell count was also performed using flow cytometry and demonstrated that 6.8% (3/44) of the properties had values above one million cells per mL. The analysis of Staphylococcus spp. revealed that 20% (9/44) of the properties had significant counts for the production of staphylococcal enterotoxins. Regarding total coliforms, 56.8% (25/44) of the milk analyzed had counts above 1.0 x 103 CFUs/mL. There were no cases of the isolation of Pseudomonas spp. Streptococcus spp. was isolated on 6.8% (3/44) of the properties. The results of the sequencing revealed one isolate to be Lactococcus lactis and two to be Enterococcus spp.Discussion: None of the 58 isolates of S. aureus was classified as negative in the phenotypic characterization of biofilmforming capacity, which suggests the presence of genes involved in this process. Studies have shown that the molecular techniques used to identify ica genes encoding biofilm synthesis are very important for the identification of virulent strains. The isolates demonstrated resistance to β-lactam antibiotics of the class of penicillins, which are the most widely employed antimicrobial agents for the treatment of diseases in dairy herds. The presence of the blaZ gene in 50% of the isolates is in agreement with data reported in other studies developed in northeastern Brazil. In 50% (29/58) of the isolates, the presence of the blaZ gene was not observed. Of these, (8/29) were resistant to ampicillin, amoxicillin and penicillin. This is due to the existence of other bacterial mechanisms. Research has shown that some isolates possessed three mechanisms (blaZ, mecA and msrA) of antimicrobial resistance simultaneously. The results of the quality analyses demonstrate that some properties produce milk of low quality, which underscores the need for management strategies directed at reducing the contamination of the product

Phenotypic and Genotypic Characteristics and Resistance Profile of Staphylococcus spp. from Bovine Mastitis

Background: Bovine mastitis remains one of the health problems that cause the most damage to milk producers. The negative impact of mastitis is due to reduced milk production, early slaughter of females, reduced commercial value of the affected animals, losses in the genetic potential of the herd, expenses with medicines and veterinary medical assistance. Staphylococcus spp. stands out as the cause of this disease and has been able to remain in the mammary gland, becoming resistant to several antimicrobials. The aims of the present study were to characterize the phenotypes, genotypes and resistance profiles of Staphylococcus spp. isolates from bovine mastitis cases in the state of Pernambuco, Brazil.Materials, Methods & Results: These isolates were classified according to biochemical tests and the presence of the nuc gene.  The polymerase chain reaction (PCR) for amplification of the mecA and blaZ genes was used to analyze the genetic potentials of antimicrobial resistance. Isolates were also phenotypically tested for resistance to nine antimicrobials (ampicillin, doxicillin, erythromycin, gentamicin, rifampicin, cephalothin, amoxicillin, nalidixic acid and oxacillin). The genetic potentials for biofilm production were evaluated by the amplifications of the icaD, icaA and bap genes. The phenotypic test of gentian violet was used for biofilm formation analyzes. Ninety-three (93.0%) of the isolates among the Staphylococcus spp. samples were classified as Staphylococcus aureus. The lowest percentage of sensitivity observed was for amoxicillin (28.0%). All of the isolates were sensitive to erythromycin and gentamicin, and 15 (15%) exhibited sensitivity to all of the drugs tested. All of the isolates were negative for the mecA gene, and 36 (36%) were positive for blaZ. In the adhesion microplate tests, 44 (44%) of the isolates were capable of biofilm formation. Of these, seven (15.9%) were strong formers, whereas 16 (36.3%) and 21 (47.8%) were moderate and weak formers, respectively. The icaD gene was confirmed in 89 (89%) of the isolates. The icaA gene was confirmed in 61 (61%) samples, and the bap gene in 52 (52%) samples. One of the samples did not possess icaA, icaD or bap and exhibited moderate biofilm formation according to the microplate adherence test. Sixteen isolates simultaneously exhibited the three genes tested for biofilm production (icaA, icaD and bap) and were negative according to the microplate adherence test.Discussion:  The indiscriminate use of antibiotics to treat mastitis is a common practice in the study area, which may have contributed to the high proportion of herds (88.23%; 15/17) with multi-resistant isolates, constituting a selection factor for the dissemination of resistant bacteria among herds.  The absence of the mecA gene in the present study may be associated with the development of resistant bacteria through another mechanism, such as the overproduction of beta-lactamases. The results demonstrate that antimicrobial resistance occurs in Staphylococcus spp. that cause bovine mastitis in herds of Pernambuco and that these isolates have the a great capacity for biofilm formation. It is necessary to sensitize the professionals involved in the milk production chain of Brazil regarding the importance of the adequate use of antimicrobials for the treatment and control of mastitis, since studies in the country indicate the dissemination of resistant bacterial strains

CERVEJARIA COMO ESPAÇO EDUCADOR: : uma perspectiva interdisciplinar para a Educação Profissional e Tecnológica

O objetivo desta pesquisa foi promover um processo interdisciplinar entre professores de diferentes áreas do conhecimento, a saber, física, química, biologia e processos industriais, acerca das fases de produção cervejeira, a fim de desenvolver uma proposta de visitação técnica interdisciplinar ao ambiente de uma cervejaria. Esta pesquisa, caracterizada por uma abordagem qualitativa e de natureza exploratória-descritiva e propositiva, dividiu-se em quatro partes:&nbsp; I) a leitura de artigos e normativas&nbsp; e a Pesquisa de campo, com a participação no processo de produção de cerveja no Centro Multidisciplinar de Tecnologia Cervejeira do Instituto Federal de São Paulo (IFSP), campus Sertãozinho; II) a descrição dos conteúdos disciplinares, das ciências da natureza e processos industriais, presentes nos diferentes momentos do processo de produção de cerveja; III) a identificação dos potenciais interdisciplinares dos conteúdos listados e suas interfaces; IV) divulgação de um material que apresente as relações entre os conteúdos científicos e tecnológicos do processo de produção de cerveja, numa perspectiva interdisciplinar e contextualizada no mundo do trabalho, que auxiliarão docentes e discentes na elaboração de guias didáticos para visitação técnica no ambiente da cervejaria. A partir da leitura de artigos e normativas foram elucidados conceitos em diferentes âmbitos: tipos de cerveja e formas de produção, mundo do trabalho, logístico, jurídico e educativo. A pesquisa de campo aconteceu com a participação dos pesquisadores em todas as fases do processo de produção cervejeira. Foram elencadas doze fases: Malteação, Moagem, Mosturação, Filtração, Fervura, Whirlpool, Resfriamento, Fermentação, Maturação, Carbonatação, Envase e Pasteurização. Todas as fases do processo receberam uma completa descrição e, posteriormente, foi elaborada uma tabela de construção coletiva acerca dos conteúdos disciplinares que estão presentes nas grades curriculares das disciplinas e que aparecem de forma prática ao longo da produção de cerveja. A seguir, deu-se início ao processo interdisciplinar da pesquisa por meio de uma reunião presencial com os professores e pesquisadores envolvidos, ponto máximo de diálogo e interação para a criação do material norteador para planejamento e construção de atividades interdisciplinares no ambiente da cervejaria, apresentado no formato de um Diagrama de Venn. Ao final desta pesquisa, verifica-se que a pesquisa alcançou seus objetivos ao trazer uma vertente com inovação desafiadora: entender o ambiente da cervejaria como espaço educador, com potencialidades didáticas interdisciplinares para um ensino mais integral e contextualizado para a Educação Profissional e Tecnológica

Global Disruption of α2A Adrenoceptor Barely Affects Bone Tissue but Minimizes the Detrimental Effects of Thyrotoxicosis on Cortical Bone

Evidence shows that sympathetic nervous system (SNS) activation inhibits bone formation and activates bone resorption leading to bone loss. Because thyroid hormone (TH) interacts with the SNS to control several physiological processes, we raised the hypothesis that this interaction also controls bone remodeling. We have previously shown that mice with double-gene inactivation of α2A- and -adrenoceptors (α2A/2C-AR−/−) present high bone mass (HBM) phenotype and resistance to thyrotoxicosis-induced osteopenia, which supports a TH-SNS interaction to control bone mass and suggests that it involves α2-AR signaling. Accordingly, we detected expression of α2A-AR, α2B-AR and α2C-AR in the skeleton, and that triiodothyronine (T3) modulates α2C-AR mRNA expression in the bone. Later, we found that mice with single-gene inactivation of α2C-AR (α2C-AR−/−) present low bone mass in the femur and HBM in the vertebra, but that both skeletal sites are resistant to TH-induce osteopenia, showing that the SNS actions occur in a skeletal site-dependent manner, and that thyrotoxicosis depends on α2C-AR signaling to promote bone loss. To further dissect the specific roles of α2-AR subtypes, in this study, we evaluated the skeletal phenotype of mice with single-gene inactivation of α2A-AR (α2A-AR−/−), and the effect of daily treatment with a supraphysiological dose of T3, for 4 or 12 weeks, on bone microarchitecture and bone resistance to fracture. Micro-computed tomographic (μCT) analysis revealed normal trabecular and cortical bone structure in the femur and vertebra of euthyroid α2A-AR−/− mice. Thyrotoxicosis was more detrimental to femoral trabecular bone in α2A-AR−/− than in WT mice, whereas this bone compartment had been previously shown to present resistance to thyrotoxicosis in α2C-AR−/− mice. Altogether these findings reveal that TH excess depends on α2C-AR signaling to negatively affect femoral trabecular bone. In contrast, thyrotoxicosis was more deleterious to femoral and vertebral cortical bone in WT than in α2A-AR−/− mice, suggesting that α2A-AR signaling contributes to TH actions on cortical bone. These findings further support a TH-SNS interaction to control bone physiology, and suggest that α2A-AR and α2C-AR signaling pathways have key roles in the mechanisms through which thyrotoxicosis promotes its detrimental effects on bone remodeling, structure and resistance to fracture

“Catando e Reciclando Saúde”: Relatos do 1º. Encontro Universidade – Movimento Nacional de Catadores de Recicláveis

O catador de material reciclável desponta como uma profissão consolidada no século XXI, tanto por sua necessidade social quanto por legislação específica. Desde 2002, ela possui registro na Classificação Brasileira de Ocupação (CBO). Ainda são limitados os estudos a respeito desse profissional e de suas necessidades de saúde. Este relato apresenta resultados do 1º Encontro Universidade – Movimento Nacional dos Catadores de Materiais Recicláveis, oficina no formato World Café, realizado na Faculdade de Medicina da Universidade de São Paulo, com participação de 34 catadores, representantes de 16 unidades cooperativadas da Região Metropolitana de São Paulo. Previamente ao Encontro, foram realizadas também observações de campo nas cooperativas de material reciclável. As informações produzidas permitiram identificar uma visão ampliada de saúde dos catadores, envolvendo aspectos físicos, econômicos, sociais e culturais. Ficou evidenciado o uso do Sistema Único de Saúde (SUS) e das redes sociais no cuidado com sua saúde. Os catadores demonstraram entender seu valor para a sustentabilidade ambiental e manifestaram expectativas em relação à produção de conhecimento sobre sua saúde e manutenção dela, reconhecendo as fragilidades existentes e as lacunas no atendimento de suas necessidades pessoais e coletivas. O evento instrumenta a formulação de projetos de pesquisa interdisciplinares que gerem conhecimento sobre a saúde dos catadores, os riscos a que estão submetidos, e na proposição de respostas para suas necessidades de saúde

Formigas (Hymenoptera: Formicidae) como vetores na transmissão de Staphylococcus aureus em um hospital público

Objetivo: analisar o potencial de formigas como veículos mecânicos de bactérias do gênero Staphylococcus aureus no centro cirúrgico e unidade de terapia intensiva de um hospital público. Metodologia: trata-se de um estudo descritivo. As formigas foram coletadas utilizando-se iscas atrativas que ficavam expostas por três horas sendo, após a exposição, incubadas por 24h a 35ºC. A susceptibilidade aos antimicrobianos foi analisada através da técnica de disco-difusão. Os isolados de Cocos gram-positivos foram submetidos a Reação em Cadeia da Polimerase e observado os genes nuc, mecA blaZ e icaAD. Resultados: foram coletadas 592 formigas pertencentes à espécie Tapinoma melanocephalum e Pheidole sp. Todos os isolados apresentaram o gene mecA, 93,7% apresentaram resultado positivo para o gene blaZ e 12,5% para o gene icaA e icaD. Sete isolados apresentaram multirresistência. Conclusão: os resultados sugerem que as formigas podem agir como veiculadoras de bactérias multirresistentes no ambiente hospitalar. Abstract Objective: to analyze the potential of ants as mechanical vehicles of bacteria of the genus Staphylococcus Aureus in the surgical center and intensive care unit of a public hospital. Methodology: this was a descriptive study. The ants were collected using attractive baits that were exposed for three hours and, after exposure, incubated for 24 hours at 35ºC. The susceptibility to antimicrobials was analyzed using the disk-diffusion technique. Gram-positive Cocos isolates were subjected to Polymerase Chain Reaction and the nuc, mecA blaZ and icaAD genes were observed. Results: 592 ants belonging to the species Tapinoma melanocephalum and Pheidole sp. All isolates showed the mecA gene, 93.7% were positive for the blaZ gene and 12.5% for the icaA and icaD gene. Seven isolates showed multidrug resistance. Conclusion: the results suggest that ants can act as carriers of multidrug-resistant bacteria in the hospital environment