Saúde Global em tempos de globalização

O presente artigo apresenta definições, conceitos e princípios do campo de conhecimentos e práticas conhecido como “Saúde Global”, baseando-se em seu desenvolvimento histórico e em seu contexto contemporâneo, marcado pelo fenômeno da globalização. Mostra a evolução do conceito de saúde internacional para o de Saúde Global. A globalização econômica, que está aliada à globalização política, cultural, informacional e comunicativa, traz novas oportunidades e desafios, cujos benefícios e impactos adversos, que envolvem todas as dimensões das relações humanas, ainda carecem de análises compreensivas. Processos de interdependência planetária trazem benefícios e riscos para a saúde humana, de forma diferenciada ao redor do globo. Discute o que são problemas de Saúde Global no século XXI, caracterizado por problemas de saúde acumulados, problemas novos e problemas decorrentes de mudanças de paradigmas. Propõe uma agenda de pesquisa em Saúde Global para o presente e futuro próximo, exemplificando temas em três linhas principais: a distribuição desigual das doenças e agravos da saúde ao redor do mundo; os impactos das mudanças ambientais globais na saúde humana e formas de mitigação e adaptação; e políticas, instituições e sistemas de Saúde Global.This article presents definitions, concepts and principles of Global Health, based on its historical development and on the contemporary context, marked by globalization process. It shows the evolution of the concept of international health to Global Health. Economic globalization, together with political, cultural, informational and of communication globalization, presents new opportunities and challenges, but its benefits and risks to human health have been scarcely studied. The article discusses what are Global Health problems in the 21st Century, characterized by accumulated health problems, new health problems and problems related to new paradigms. It proposes a research agenda in Global Health for the present and near future, with examples of research themes in three main lines: unequal distribution of diseases around the world; impacts of global environmental changes on human health, mitigation and adaptation; Global Health policies, institutions and systems

Chronic treatment with ivabradine does not affect cardiovascular autonomic control in rats.

A low resting heart rate (HR) would be of great benefit in cardiovascular diseases. Ivabradine-a novel selective inhibitor of hyperpolarization-activated cyclic nucleotide gated (HCN) channels- has emerged as a promising HR lowering drug. Its effects on the autonomic HR control are little known. This study assessed the effects of chronic treatment with ivabradine on the modulatory, reflex and tonic cardiovascular autonomic control and on the renal sympathetic nerve activity (RSNA). Male Wistar rats were divided in 2 groups, receiving intraperitoneal injections of vehicle (VEH) or ivabradine (IVA) during 7 or 8 consecutive days. Rats were submitted to vessels cannulation to perform arterial blood pressure (AP) and HR recordings in freely moving rats. Time series of resting pulse interval and systolic AP were used to measure cardiovascular variability parameters. We also assessed the baroreflex, chemoreflex and the Bezold-Jarish reflex sensitivities. To better evaluate the effects of ivabradine on the autonomic control of the heart, we performed sympathetic and vagal autonomic blockade. As expected, ivabradine-treated rats showed a lower resting (VEH: 362 ? 16 bpm vs. IVA: 260 ? 14 bpm, p = 0.0005) and intrinsic HR (VEH: 369 ? 9 bpm vs. IVA: 326 ? 11 bpm, p = 0.0146). However, the chronic treatment with ivabradine did not change normalized HR spectral parameters LF (nu) (VEH: 24.2 ? 4.6 vs. IVA: 29.8 ? 6.4; p > 0.05); HF (nu) (VEH: 75.1 ? 3.7 vs. IVA: 69.2 ? 5.8; p > 0.05), any cardiovascular reflexes, neither the tonic autonomic control of the HR (tonic sympathovagal index; VEH: 0.91? 0.02 vs. IVA: 0.88 ? 0.03, p = 0.3494). We performed the AP, HR and RSNA recordings in urethane-anesthetized rats. The chronic treatment with ivabradine reduced the resting HR (VEH: 364 ? 12 bpm vs. IVA: 207 ? 11 bpm, p < 0.0001), without affecting RSNA (VEH: 117 ? 16 vs. IVA: 120 ? 9 spikes/s, p = 0.9100) and mean arterial pressure (VEH: 70 ? 4 vs. IVA: 77 ? 6 mmHg, p = 0.3293). Our results suggest that, in health rats, the long-term treatment with ivabradine directly reduces the HR without changing the RSNA modulation and the reflex and tonic autonomic control of the heart

Neuropsychological evaluation of adolescente with high skills/superdoted case study

Revista de Psicologia da Criança e do Adolescente. - ISSN 1647-4120. - V. 8, n. 2 (Julho-Dezembro 2017). - p. 133-155.O tema “Alunos com Altas Habilidades/Superdotado (AH/SD)” é de grande relevância no âmbito educacional e, considerando a importância do conhecimento referente a este público e às suas características, este trabalho refere-se a uma avaliação neuropsicológica, com o objetivo de traçar o perfil biopsicossocial de um adolescente de 12 anos com indicadores de altas habilidades. Este estudo foi feito em 11 sessões por uma estagiária de Neuropsicologia e a sua supervisora em uma clínica-escola de uma Universidade privada brasileira. Realizou-se uma anamnese detalhada com a mãe e depois com o paciente e os instrumentos utilizados foram de grande importância durante todo o processo para ser apresentada uma interpretação com dados substanciais e para isso foram aplicados alguns testes de atenção, percepção, memória, linguagem, raciocínio, funções executivas, como também alguns de personalidade. Após serem observados os aspectos emocionais, sociais e cognitivos do paciente, os resultados demonstraram que o adolescente se apresentava acima da média nas habilidades verbais, contudo, nas demais, encontrava-se na média esperada. Concluiu-se que, quanto ao aspecto socioemocional, o paciente precisava de acompanhamento psicológico e psicopedagógico devido à sua falta de motivação escolar. Considera-se, portanto, importante conhecer as especificidades dos alunos com altas habilidades/superdotação para que se possa ter um acompanhamento mais assertivo e um olhar mais sensível frente a esse público.The theme “Students with High Abilities / Gifted (AH / SD)” is of great relevance in the educational field and, considering the importance of the knowledge related to this public and its characteristics, this work refers to a neuropsychological evaluation, with the objective of tracing the biopsychosocial profile of a 12 - year - old adolescent with high skills indicators. This study did in 11 sessions by a Neuropsychology intern and her supervisor in a clinic-school of a private Brazilian university. A detailed anamnesis was carried out with the mother and then with the patient and the instruments used were of great importance throughout the process to be presented an interpretation with substantial data and for this were applied some tests of attention, perception, memory, language , reasoning, executive functions, as well as some personality. After observed the emotional, social and cognitive aspects of the patient, the results showed that the adolescent was above average in verbal skills, but in the others, he was in the expected average. It concluded that, regarding the socioemotional aspect, the patient needed psychological and psychopedagogical accompaniment due to his lack of school motivation. It therefore considered important to know the specificities of students with high skills / giftedness so that they can have a more assertive follow-up and a more sensitive look at this audience

Effect of a Hygiene Protocol on Denture-Related Stomatitis Remission, Local Inflammatory Factors, and Hemodynamic Responses by Arterial Pressure

Denture-related stomatitis (DRS) is frequent oral inflammation in complete denture wearers. This study evaluated the effect of a hygiene protocol on DRS remission, local inflammatory factors, and hemodynamic responses. Thirty-three individuals were enrolled in the study. The outcomes were measured before and after 10 days of a hygiene protocol treatment consisting of brushing the palate with a soft brush and water and denture brushing with a denture-specific brush and mild soap, as well as immersion of the denture for 20 min in a 0.25% sodium hypochlorite solution. Data were analyzed by paired Wilcoxon for biofilm removal and CFU count of microorganisms. The paired T test was used to assess salivary MUC 1, cytokines, and arterial pressure (p p p Candida spp. (p p Staphylococcus spp. (p S. mutans (p S. mutans (p p = 0.2) and pH (p = 0.97) did not change; there was an increase of MUC 1 (p = 0.049) and a decrease in IL-6 (p = 0.038), IL-2 (p = 0.04), IL-10 (p = 0.041), and IFNγ (p = 0.04). There was also a decrease in systolic (p = 0.012) and mean arterial pressure (p = 0.02). The current hygiene protocol reduced the inflammation degree of DRS and promoted an improvement of local inflammatory factors and a reduction in the systolic arterial pressure of the patients

Jornal Brasileiro de Nefrologia

p. 170-177INTRODUÇÃO: O hiperparatireoidismo secundário (HPT2) é uma complicação comum e precoce em pacientes com doença renal crônica (DRC). Estudos têm sugerido que os altos níveis de paratormônio (PTH) podem exercer efeitos deletérios no estado nutricional de pacientes com DRC. Assim, o objetivo deste estudo foi comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC) com e sem HPT2. OBJETIVO: O objetivo deste estudo é comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC) com e sem HPTS. MÉTODOS: Foram avaliados 74 pacientes, entre adultos e idosos, divididos em dois grupos, de acordo com os níveis de PTH. No grupo 1 (n = 18) os níveis de PTH eram maiores do que 300 pg/mL e, no grupo 2, menores ou iguais a 300 pg/mL. O estado nutricional dos pacientes foi avaliado através da antropometria, exames bioquímicos e avaliação subjetiva global (ASG). O consumo alimentar foi avaliado através do registro alimentar de 3 dias. Foram coletados também dados clínicos, como cálcio e fósforo séricos, e a presença de inflamação foi avaliada através da dosagem de proteína C reativa ultrassensível (PCR US). RESULTADOS: A média de idade da população estudada foi de 54,97 ± 17,06 anos, com predominância de pacientes adultos (58,1%) e do sexo feminino (56,8%). O tempo de DPC expresso em mediana foi de 17 meses (7,75-33). Através da ASG, demonstrou-se prevalência de 36,5% de desnutridos na população. Na análise de diferença entre os grupos, em relação à antropometria, indicadores bioquímicos e ASG, bem como ingestão alimentar, não foram evidenciadas diferenças entre os grupos estudados. CONCLUSÃO: Não houve diferenças no estado nutricional e na ingestão alimentar entre os pacientes com e sem HPT2

Laryngotracheobronchial papillomatosis: chest CT findings

ABSTRACT To evaluate the findings on chest CTs in 16 patients (8 men and 8 women) with laryngotracheobronchial papillomatosis. Methods: This was a retrospective study involving patients ranging from 2 to 72 years of age. The evaluation of the CT scans was independently performed by two observers, and discordant results were resolved by consensus. The inclusion criteria were presence of abnormalities on the CT scans, and the diagnosis was confirmed by anatomopathological examination of the papillomatous lesions. Results: The most common symptoms were hoarseness, cough, dyspnea, and recurrent respiratory infections. The major CT findings were nodular formations in the trachea, solid or cavitated nodules in the lung parenchyma, air trapping, masses, and consolidation. Nodular formations in the trachea were observed in 14 patients (87.5%). Only 2 patients had lesions in lung parenchyma without tracheal involvement. Only 1 patient had no pulmonary dissemination of the disease, showing airway involvement only. Solid and cavitated lung nodules were observed in 14 patients (87.5%) and 13 (81.2%), respectively. Masses were observed in 6 patients (37.5%); air trapping, in 3 (18.7%); consolidation in 3 (18.7%); and pleural effusion, in 1 (6.3%). Pulmonary involvement was bilateral in all cases. Conclusions: The most common tomography findings were nodular formations in the trachea, as well as solid or cavitated nodules and masses in the lung parenchyma. Malignant transformation of the lesions was observed in 5 cases