Adherence to medication before and after the use of a Drug-Dispensing System with usage control

;O objetivo deste estudo foi avaliar a adesão ao tratamento medicamentoso de pacientes polimedicados antes e após o uso de um Sistema de Dispensação de Medicamentos e Controle de Uso (SDMCU) e comparar os níveis dos parâmetros clínicos - pressão arterial, glicemia pós-prandial, hemoglobina glicada, triglicérides e colesterol. O SDMCU foi constituído por uma embalagem mensal de dispensação de medicamentos, em forma de ;blister; com calendário. Este estudo, do tipo quase-experimental, foi realizado em uma Unidade Básica de Saúde. Selecionaram-se 24 pacientes para utilizar o SDMCU por 4 meses. A adesão medicamentosa foi avaliada através do Teste de Morisky e Green. Entre os participantes do estudo, 62,5% eram mulheres e a idade média foi de 67 anos. Antes do uso do SDMCU, 83,3% dos pacientes foram considerados "menos aderentes". Após o uso do sistema, 100% foram considerados "mais aderentes" (p;The aim of the present work was to assess the adherence to medication from polymedicated patients before and after the use of a Drug-dispensing System with Usage Control (DDSUC) and compare the levels of the clinical parameters - blood pressure, postprandial glycemia, glycated hemoglobin, triglycerides and cholesterol. DDSUC consisted of a monthly drug-dispensing package, in the shape of a blister with a calendar. This quasi-experimental study was performed in a Basic Health Unit. Twenty four patients were selected to use DDSUC for 4 months. Medication adherence was assessed through Morisky-Green test. Among the participants of the study, 62.5% were women and the average age was 67 years old. Before the use of DDSUC, 83.3% of the patients were considered as "less adherent". After the use of the system, 100% were considered as "more adherent" (p < 0.01), the means of the systolic blood pressure decreased 23.7 mmHg (p=0.000), the diastolic blood pressure decreased 12.1 mmHg (p=0.004) and glycemia diminished 79.3 mg/dl (p=0.000). The use of DDSUC improved the adherence to medication and decreased the values of the clinical parameters, making patients safer when it comes to respecting the correct use of their medication.

Singularidades da educação popular do Paranoá-Itapoã (DF) : uma construção entre universidade de Brasília e movimento popular organizado

Este artigo trata das singularidades da Educação Popular constituídas desde 1985 entre a Universidade de Brasília e o movimento popular das cidades do Paranoá e Itapoã no Distrito Federal, Brasil. Para compreender essas especificidades, são realizadas análises bibliográficas de pesquisas acadêmicas que tratam do efeito desse processo educativo na vida de educandos, educadores populares, professores da rede pública e estudantes universitários. O resultado dessa análise indica como características desse projeto de Educação Popular: a constituição de sujeitos a partir do entrelaçamento do ser de amor-poder-saber; o aprendizado pelos educandos de que os problemas de seu cotidiano são oportunidades de superação e não de desistência; o aprendizado pelos educadores da importância da construção coletiva; e, por fim, o processo formativo dos estudantes da UnB que destaca a indissociabilidade da relação teoria-prática.This article deals with the singularities of Popular Education established since 1985 between the University of Brasília and the popular movement of the cities of Paranoá and Itapoã in the Federal District, Brazil. In order to understand these specificities, bibliographic analyzes of academic research are carried out that address the effect of this educational process on the lives of students, popular educators, public school teachers and university students. The result of this analysis indicates as characteristics of this Popular Education project: the constitution of subjects from the intertwining of the being of love-power-knowledge; the learning by students that the problems of their daily lives are opportunities to overcome and not give up; the learning by educators of the importance of collective construction; and, finally, the training process of UnB students, which highlights the inseparability of the theory-practice relationship.Este artículo trata sobre las singularidades de la Educación Popular establecida desde 1985 entre la Universidad de Brasilia y el movimiento popular en las ciudades de Paranoá e Itapoã en el Distrito Federal, Brasil. Para comprender estas especificidades se realizan análisis bibliográficos de investigación académica que abordan el efecto de este proceso educativo en la vida de estudiantes, educadores populares, docentes de escuelas públicas y estudiantes universitarios. El resultado de este análisis señala como características de este proyecto de Educación Popular: la constitución de sujetos a partir del entrelazamiento del ser amor-poder-conocimiento; los estudiantes aprenden que sus problemas diarios son oportunidades para superar y no darse por vencidos; el aprendizaje por parte de los educadores de la importancia de la construcción colectiva; y, finalmente, el proceso de formación de los estudiantes de la UnB, que destaca la inseparabilidad de la relación teoría-práctica

Metformin Reduces Potassium Currents and Prolongs Repolarization in Non-Diabetic Heart

Metformin is the first choice drug for the treatment of type 2 diabetes due to positive results in reducing hyperglycaemia and insulin resistance. However, diabetic patients have higher risk of ventricular arrhythmia and sudden cardiac death, and metformin failed to reduce ventricular arrhythmia in clinical trials. In order to explore the mechanisms responsible for the lack of protective effect, we investigated in vivo the effect of metformin on cardiac electrical activity in non-diabetic rats; and in vitro in isolated ventricular myocytes, HEK293 cells expressing the hERG channel and human induced pluripotent stem cells derived cardiomyocytes (hIPS-CMs). Surface electrocardiograms showed that long-term metformin treatment (7 weeks) at therapeutic doses prolonged cardiac repolarization, reflected as QT and QTc interval duration, and increased ventricular arrhythmia during the caffeine/dobutamine challenge. Patch-clamp recordings in ventricular myocytes isolated from treated animals showed that the cellular mechanism is a reduction in the cardiac transient outward potassium current (Ito). In vitro, incubation with metformin for 24 h also reduced Ito, prolonged action potential duration, and increased spontaneous contractions in ventricular myocytes isolated from control rats. Metformin incubation also reduced IhERG in HEK293 cells. Finally, metformin incubation prolonged action potential duration at 30% and 90% of repolarization in hIPS-CMs, which is compatible with the reduction of Ito and IhERG. Our results show that metformin directly modifies the electrical behavior of the normal heart. The mechanism consists in the inhibition of repolarizing currents and the subsequent decrease in repolarization capacity, which prolongs AP and QTc duration.This work was supported by The University of the Basque Country (Grant number PPG17/13), Gobierno Vasco (PIBA2018-58) and MICIIN (PID2020-118814RB-I00). V.Z.R. is recipient of a Fundación Alfonso Martín Escudero (SPAIN) postdoctoral fellowship

MOVIMENTO DA DIDÁTICA NA FORMAÇÃO DOCENTE: reverberações de nosso tempo

This article aims to inspire discussions about didactics as a movement in defense of quality teacher education, in the direction of the necessary changes that must occur for the consolidation of practices that may question the environment and thus build alternatives committed to the sovereignty of the people. That said, the study focused on the following question: What is the meaning of didactics in our time? To this end, it was presented as an objective to reflect on the circumstances that involve didactics today in the horizon of teacher education. Methodologically, the research followed the qualitative approach, and the bibliographic study was the method. The theoretical contribution was based on authors such as Candau (2020), Freire (2018; 2019), Marin (2018), Pimenta (2019) and Saviani (2008). Thus, it highlights the need for permanent discussions on pedagogical practices, when considering didactics in the context of critical conception as a way of modifying the current scenario that hinders social transformation.Este artículo tiene como objetivo inspirar discusiones sobre la didáctica como movimiento en defensa de la formación docente de calidad, en la dirección de los cambios necesarios que deben ocurrir para consolidar prácticas que cuestionen el medio ambiente y así construir alternativas comprometidas con la soberanía de los pueblos. Dicho esto, el estudio se centró en la siguiente pregunta: ¿Cuál es el significado de la didáctica en nuestro tiempo? Para ello, se planteó como objetivo reflexionar sobre las circunstancias que envuelven a la didáctica hoy en el horizonte de la formación docente. Metodológicamente, la investigación siguió el enfoque cualitativo y el estudio bibliográfico fue el método. El aporte teórico se basó en autores como Candau (2020), Freire (2018; 2019), Marin (2018), Pimenta (2019) y Saviani (2008). Así, destaca la necesidad de discusiones permanentes sobre las prácticas pedagógicas, al considerar la didáctica en el contexto de la concepción crítica como una forma de modificar el escenario actual que dificulta la transformación social.Este artigo visa a inspirar discussões acerca da didática como movimento em defesa de uma formação docente de qualidade, no rumo das necessárias mudanças que devem ocorrer para a consolidação de práticas que venham a questionar o meio e assim construir alternativas comprometidas com a dignidade do povo. Isto posto, o estudo debruçou-se sobre o seguinte questionamento: Qual o sentido da didática em nosso tempo? Para tanto, apresentou-se como objetivo refletir sobre as circunstâncias que envolvem a didática na atualidade no horizonte da formação docente. Metodologicamente, a pesquisa seguiu a abordagem qualitativa e teve como método o estudo bibliográfico. O aporte teórico baseou-se em autores como Candau (2020), Freire (2018; 2019), Marin (2018), Pimenta (2019) e Saviani (2008). Destarte, realça a necessidade de discussões permanentes sobre as práticas pedagógicas, ao considerar a didática no âmbito da concepção crítica como via de modificar o cenário atual que obstaculiza a transformação social. &nbsp

Practice of physical activity, a perception of the environment and the sociodemographic profile in the different SUS health districts of the city of Ribeirão Preto - SP

O conhecimento da percepção do ambiente das pessoas para a prática de atividade física e sua distribuição nos distritos de saúde no município contribui para o planejamento nas intervenções públicas em saúde. O objetivo do estudo foi analisar a percepção do ambiente para a prática de atividade física, e o perfil sociodemográfico dos usuários do SUS do município de Ribeirão Preto – SP, coletados nos cinco distritos de saúde da cidade. Dos 719 participantes, 71,20% são do sexo feminino e 28,80% do masculino. A maioria dos participantes tinha idade de 34 a 59 anos (40,80%), 40,80% pessoas com ensino fundamental incompleto, 51,90% das pessoas são da classe econômica C, 43,40% referiram estar com emprego e (70,10%) e apresentar DCNT. Em relação a prática de atividade física, 21,00% praticavam como deslocamento e 16,00% no lazer, em relação à recomendação. A maioria percebeu que o ambiente em relação ao acesso às conveniências, segurança no trânsito, segurança geral, apoio social para a prática de atividade física e poluição geral, era ruim ou regular. Foram encontradas diferenças na percepção do ambiente entre os distritos de saúde. Essas informações são necessárias para a elaboração de intervenções com trabalho multiprofissional para a educação em saúde. E, para repensarmos sobre o ambiente construído e políticas de incentivo e apoio social para a prática de atividade físicas das pessoas com e sem doenças crônicas que utilizam o Sistema Único de Saúde.The knowledge of people's perception of the environment for the practice of physical activity and its distribution in health districts in the municipality contributes to the planning of public health interventions. The objective of the study was to analyze the perception of the environment for the practice of physical activity, and the sociodemographic profile of SUS users in the city of Ribeirão Preto - SP, collected in the five health districts of the city. Of the 719 participants, 71.20% are female and 28.80% are male. Most of the participants were aged between 34 and 59 years (40.80%), 40.80% people with incomplete elementary education, 51.90% of people are from economic class C, 43.40% reported having a job and (70.10%) and have CNCD. Regarding physical activity, 21.00% practiced commuting and 16.00% at leisure, in relation to the recommendation. Most realized that the environment in relation to access to conveniences, traffic safety, general safety, social support for the practice of physical activity and general pollution, was bad or regular. Differences were found in the perception of the environment between health districts. This information is necessary for the elaboration of interventions with multiprofessional work for health education. And, to rethink about the built environment and policies of incentive and social support for the practice of physical activity of people with and without chronic diseases who use the Unified Health System.Fil: Hodniki, Paula Parisi. Universidade de Sao Paulo; BrasilFil: Teixeira, Carla Regina de Souza. Universidade de Sao Paulo; BrasilFil: Dias, Mirele Coutinho. Universidade de Sao Paulo; BrasilFil: Lima, Rafael Aparecido Dias. Universidade de Sao Paulo; BrasilFil: Lavin Fueyo, Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; ArgentinaFil: Binhardi, Barbara Aparecida. Universidade de Sao Paulo; BrasilFil: Istilli, Plinio Tadeu. Universidade de Sao Paulo; BrasilFil: Marques, Jennifer Vieira Paschoalin. Universidade de Sao Paulo; Brasi

Slow progression of pediatric HIV associates with early CD8+ T cell PD-1 expression and a stem-like phenotype

HIV non-progression despite persistent viraemia is rare among antiretroviral therapy (ART)-naïve adults, but relatively common among ART-naïve children. Previous studies indicate that ART-naïve paediatric slow-progressors (PSPs) adopt immune evasion strategies similar to those described in the SIV natural hosts. However, the mechanisms underlying this immunophenotype are not well understood. In a cohort of early-treated infants who underwent analytical treatment interruption (ATI) after 12 months of ART, expression of PD-1 on CD8+ T-cells immediately prior to ATI was the main predictor of slow progression during ATI (r=0.77, p=0.002). PD-1+ CD8+ T-cell frequency was also negatively correlated with CCR5 (r=-0.74, p=0.005) and HLA-DR (r=-0.63, p=0.02) expression on CD4+ T-cells and predicted stronger HIV-specific T-lymphocyte responses. In the CD8+ T-cell compartment of PSPs, we identified an enrichment of stem-like TCF-1+PD-1+ memory cells, whereas paediatric progressors and viraemic adults were populated with a terminally exhausted PD-1+CD39+ population. TCF-1+PD-1+ expression on CD8+ T-cells was associated with higher proliferative activity (r=0.41, p=0.03) and stronger Gag-specific effector functionality. These data prompt the hypothesis that the proliferative burst potential of stem-like HIV-specific cytotoxic cells could be exploited in therapeutic strategies to boost the antiviral response and facilitate remission in early-ART-treated infants with a preserved and non-exhausted T-cell compartment

Slow progression of pediatric HIV associates with early CD8 + T cell PD-1 expression and a stem-like phenotype

HIV nonprogression despite persistent viremia is rare among adults who are naive to antiretroviral therapy (ART) but relatively common among ART-naive children. Previous studies indicate that ART-naive pediatric slow progressors (PSPs) adopt immune evasion strategies similar to those described in natural hosts of SIV. However, the mechanisms underlying this immunophenotype are not well understood. In a cohort of early-treated infants who underwent analytical treatment interruption (ATI) after 12 months of ART, expression of PD-1 on CD8 + T cells immediately before ATI was the main predictor of slow progression during ATI. PD-1 + CD8 + T cell frequency was also negatively correlated with CCR5 and HLA-DR expression on CD4 + T cells and predicted stronger HIV-specific T lymphocyte responses. In the CD8 + T cell compartment of PSPs, we identified an enrichment of stem-like TCF-1 + PD-1 + memory cells, whereas pediatric progressors and viremic adults had a terminally exhausted PD-1 + CD39 + population. TCF-1 + PD-1 + expression on CD8 + T cells was associated with higher proliferative activity and stronger Gag-specific effector functionality. These data prompted the hypothesis that the proliferative burst potential of stem-like HIV-specific cytotoxic cells could be exploited in therapeutic strategies to boost the antiviral response and facilitate remission in infants who received early ART with a preserved and nonexhausted T cell compartment

The crude glycerin reduces losses fermentative and improves the nutritional value of marandu grass silage in a semiarid region / A glicerina bruta reduz perdas fermentativas e melhora o valor nutricional da silagem de capim marandu em uma região semiárida

The ensiling of marandu grass at the recommended time of management results in low dry matter (DM) content and nutritional value, but the addition of crude glycerin can compensate for these deficits if used during ensiling. Thus, the aim of this study was to evaluate the best level of inclusion of crude glycerin that can improve fermentation and the nutritional value of silages prepared with Urochloa brizantha cv. Marandu. The treatments consisted of five levels of inclusion of crude glycerin (0, 7.5, 15, 22.5, 30% of fresh forage) during ensiling of marandu grass with eight replications following the completely randomized design. For the evaluation of ruminal kinetics, four crossbred steers were used, cannulated in the rumen, following a randomized block design in a split plot scheme. For the percentage unit of inclusion of glycerin, there was a linear reduction of 0.34% in gas losses and increase of 0.45% and 0.55% in the recovery of DM (P &lt;0.01) and in the DM content (P &lt;0.01), respectively. The inclusion of up to 22.5% of crude glycerin in the silage of marandu grass is recommended to reduce losses during fermentation and improve the recovery of dry matter and the nutritional value of silage