A importância do controle de qualidade no laboratório de análises clínicas: Uma revisão bibliográfica

Trabalho de Conclusão de Curso (Graduação)Os laboratórios de análises clínicas auxiliam nas decisões médicas, e para isso os médicos e pacientes precisam ter confiança e segurança nos laudos fornecidos por esses laboratórios. O presente trabalho trata-se de uma revisão bibliográfica narrativa, que teve como objetivo buscar artigos que descrevessem a importância do laboratório de análises clínicas e suas problemáticas, bem como os meios de controle de qualidade destas empresas. Para coleta de dados foram utilizadas as bases de dados SciELO e PUBMED. Inicialmente foram encontrados 142 artigos, porém, apenas 38 foram selecionados para este estudo. As análises mostraram que, atualmente, a procura por qualidade é prioridade na escolha dos serviços de um laboratório clínico, tendo em vista a importância do exame laboratorial para tomada de decisão pelo médico. Desta forma, inúmeros questionamentos foram levantados com relação ao nível de qualidade dos serviços prestados por um laboratório clínico em suas diversas etapas, e o que levou ao surgimento de programas como o PELM, DIQC e PALC, com o objetivo de se obter uma forma de certificar a qualidade do laboratório. Os dados apresentados permitem concluir que, os programas de controle de qualidade definem o laboratório clínico com alto grau de excelência em suas atividades, sendo um diferencial na escolha pelos utilizadores do serviço prestado

The Xylitol Applicability and its Effects in Health Area Worldwide: A Bibliometric Analysis Based on Randomized Controlled Trials

Objective: To describe and evaluate the xylitol products’ applicability and its effects in the health area worldwide utilizing a bibliometric analysis from randomized controlled trials (RCT) with humans. Material and Methods: Electronic searches were carried out in Medline/PubMed, Scopus, Cochrane Library, Web of Science, and VHL databases. The main data extracted were: year, area of applicability, type of treatment, country, journal, xylitol posology and concentration, presentation form, outcomes, and effects. Results: From 1476 studies, 257 were included. These studies were published between 1973-2021. The majority was carried out in dentistry (73.9%) and under preventive treatment (67.4%). These studies were developed in the USA (15.4%) and published in Caries Research (6.6%). The posology and concentration ranged between 0.004-67 g/day and 0.002-100%, respectively. The xylitol is usually used in the chewing gum form (44.0%), and for antimicrobial activity evaluation (38.5%). A positive effect was observed in 204 studies (79.3%) and was associated with xylitol concentration ≥ 15% (p=0.007). Side effects were reported in 8.2% and were associated with posology ≥ 5 g/day (p=0.03). Conclusion: Most studies with xylitol were conducted to prevent diseases in the dentistry field. The chewing gum form and antimicrobial activity evaluation were more frequent. Most xylitol products have a positive effect, and few studies report side effects

Comportamento da artéria ovárica em éguas sem raça definida (Equus caballus, Linnaeus, 1758)

Atualmente, na medicina veterinária, os estudos envolvendo reprodução de eqüinos e principalmente a qualidade das fêmeas, que na maioria das vezes são consideradas como receptoras, são de extrema valia, devido a ganho de produção e qualidade de plantel dos criadores, sendo assim, teve-se por objetivo estudar o comportamento da artéria ovárica em éguas, ou seja, a sua ramificação e distribuição no parênquima ovariano, para dar subsídios a um melhor entendimento das manobras de melhoramento genético e produção, focando aspectos morfológicos e fisiológicos da vascularização e viabilidade deste órgão na reprodução animal. Foram utilizados 68 ovários (34 pares) de éguas adultas sem raça definida, com diferentes idades, obtidas no Frigorífico Pomar, município de Araguari, MG. Verificou-se que a artéria ovárica apresenta um trajeto longo, flexuoso e espiralado, alcançando a glândula por meio da margem mesovárica, próximo à extremidade uterina. Esta artéria mantém o sentido ora dorsal ora ventral, segue em direção à extremidade tubárica, contorna-a até atingir a fossa ovárica, e penetra na glândula somente após ter percorrido toda a sua superfície. A artéria ovárica apresentou dois arranjos vasculares: um com emissão de 2 a 62 ramos dorsais e 4 a 46 ramos ventrais, durante seu percurso na margem mesovárica em 51 preparações (75%) e no outro arranjo a artéria ovárica, na extremidade uterina, dividiu-se em um ramo dorsal e outro ventral em 17 preparações (25%). Em relação às faces dos ovários, a face lateral apresentou um número maior de ramos que a face medial. Nos ovários direitos, os quadrantes mais irrigados foram, por ordem: o dorsocranial, o ventrocranial, o dorsocaudal e o ventrocaudal. Nos ovários esquerdos, foram: o ventrocranial, o dorsocranial, o ventrocaudal e o dorsocaudal

práticas artísticas no ensino básico e secundário

info:eu-repo/semantics/publishedVersio

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Expansão urbana desordenada e aumento dos riscos ambientais à saúde humana : o caso brasileiro

Monografia (graduação)—Universidade de Brasília, Faculdade de Planaltina, 2012.O crescimento urbano desordenado originou-se a partir da década de 1950 derivados dos avanços tecnológicos na agricultura e os incentivos a modernização da mesma, quando em conseqüência disso ocorreu o êxodo rural. Nessa fase tumultuada de realocação da população do campo para a cidade surgiu um novo problema, pois não havia espaço suficiente para acomodar toda essa população, fazendo com que as grandes cidades chegassem ao ponto de selecionar quem poderia acomodar supervalorizando os terrenos e originando assim as periferias que não continham infra-estrutura básica nem serviços médicos, educacionais ou qualquer outros serviços oferecidos pelo Estado. A aglomeração de muitas pessoas em pequenos locais e um dos fatores de risco aos quais a população pode estar exposta, juntamente com agentes patológicos microbianos ou químicos dispersos pela água, ar e/ou alimentos contaminados pelo solo ou substância química aplicada nos mesmos. Além disso, têm-se ainda os fatores físicos tais como desastres naturais e mudanças climáticas, e socioeconômicos como a má distribuição de verbas. Todos esses problemas deveriam ser resolvidos por intervenções legais do Estado através de políticas públicas de desenvolvimento preferencialmente sustentável, de meio ambiente e de saúde de forma integrada e uma correta destinação das verbas, assim como uma posição da população nos processos participativos a fim de viabilizara aplicação de tais políticas. _________________________________________________________________________________ ABSTRACTThe uncontrolled urban growth originated in the 1950s, derived from technological advances in agriculture and incentives to modernize it, caused strong rural exodus. In this challenging phase of relocation of the population leaving the countryside and heading to the urban areas, a new problem arose since there was not enough space to accommodate this crowd, so that big cities reached the point of selecting who could accommodate, overvaluing land and originating poor suburbs, which contained no basic infrastructure in terms of medical, educational or any other services offered by the State. The clustering of many people in small places constitutes a serious disease risk factor to which people are exposed, along with pathogens, microbial or chemicals that are dispersed by water, air and food, or soil contaminated by chemicals, and even physical factors such as natural disasters and climate change, or still socio-economic factors like poor allocation of funds. All these problems should be solved or at least alleviated by legal interventions of the state through integrated public policies into sustainable development, environment and health, in addition to proper allocation of funds, well as the position of the population in participatory processes in order to facilitate the implementation of such policies

UMA PSICANÁLISE POSSÍVEL: ENTRELAÇAMENTOS DE UMA PRÁTICA PSICANALÍTICA EM UMA CLÍNICA-ESCOLA NO SERTÃO CENTRAL DO CEARÁ

A psicanálise postula recomendações e técnicas para aqueles que desejem realizar atendimentos clínicos de cunho psicanalítico. Muitas destas recomendações, inclusive de autores mais contemporâneos, dissertam sobre a prática e posturas do analista que atua em consultórios particulares. Partindo da literatura e juntamente com o relato de experiência do que foi vivenciado durante as disciplinas de Estágio Profissionalizante I e II, este trabalho objetiva traçar considerações sobre a prática psicanalítica realizada no SPA, uma clínica-escola que possui regras específicas e está inserida em uma instituição maior: a Universidade. Como então as recomendações e ética da psicanálise conseguem dialogar com os discursos institucionais? Quais seriam os limites e possibilidades para a realização dos atendimentos? Serão discutidas, ainda, questões relacionadas com o tempo – do inconsciente, das sessões e do estágio, sobre a transferência e o pagamento das sessões. A partir da experiência vivenciada, pôde-se perceber que é possível se praticar a psicanálise no contexto institucional, utilizando-se do desejo particular do estagiário de construir a sua clínica a partir da experiência aliada aos postulados da teoria, como a associação livre, transferência, realidade psíquica do sujeito. A forma como se dá o manejo de alguns dos pressupostos básicos da psicanálise podem ocorrer de um modo distinto quando se opera em uma clínica-escola, entretanto, isso não significa dizer que estes não aconteçam, pois é através do diálogo com as regras da instituição que a psicanálise se faz acontecer