Medical teleconsultation in the care of children with suspected rare diseases: a pilot study in Brazil during the COVID-19 pandemic

Objective: To evaluate teleinterconsultation in medical genetics for cases of children with suspected rare diseases. Methods: Prospective study of qualitative and quantitative survey that evaluated the use and satisfaction with asynchronous teleinterconsultation for physicians from public hospitals in a city in the northern macro-region of the state of Minas Gerais. Results: A total of 21 teleinterconsultations were performed from September 29, 2020, to January 07, 2021. Eleven (52.4%) of them were able to establish the probable diagnosis in the first evaluation, and the others were within the protocols of rare disease investigation. Of the 12 requesting physicians, 11 (91.6%) were female, seven (58.2%) were paediatric residents, and five (41.7%) were paediatricians. Seven of the requesting physicians had never used telemedicine before. There was 100% satisfaction with the teleinterconsultation with the specialist geneticist. Conclusion: Teleinterconsultation in medical genetics for children with rare diseases met expectations, modified the conduct of non-specialist physicians in a city lacking a geneticist, and guided diagnosis and conduct in all cases

Neoliberalismo em tempos de coronavírus ou coronavírus em tempos de neoliberalismo?

Resenha de: DAVIS, Mike, et al. Coronavírus e a luta de classes. Terra sem Amos: Brasil, 2020. Disponível em: https://terrasemamos.files.wordpress.com/2020/03/coronavc3adrus-e-a-luta-de-classes-tsa.pdf. Em meio ao colapso da saúde global uma reflexão sobre a hierarquia social decorrente do sistema econômico vigente é necessária, visto que, apesar do contágio da COVID-19 ser democrático, as ações para superá-lo não são; muito menos a intensidade que irá atingir cada país e indivíduo. O modelo..

Reactional changes in short-term levonorgestrel-releasing intrauterine system (lng-ius) use

Objective: To evaluate endocervical and vaginal environment changes in women using a levonorgestrel-releasing intrauterine system (LNG-IUS). Methods: A quasi-experimental study included sixty women who had an LNG-IUS inserted in the Family Planning Clinic of UNICAMP between April and November of 2016. Women in reproductive age, non-pregnant, without the use of antibiotics and contraceptives seeking for LNG-IUS insertion were selected for this study. All women were evaluated with regard to vaginal and endocervical pH, vaginal and endocervical Gram-stained bacterioscopy, and Pap-smear before and two months after LNG-IUS insertion. Clinical aspects such as cervical mucus, vaginal discharge, and cervical ectopy were also observed. Results: After LNG-IUS insertion, there was an increase in the following parameters: endocervical pH>4.5 (p=0.02), endocervical neutrophil amount (p<0.0001), vaginal cytolysis (p=0.04). There was a decrease in vaginal discharge (p=0.01). No statistically significant changes were found in vaginal pH, neutrophils amount in the vaginal mucosa, vaginal discharge appearance, vaginal candidiasis, bacterial vaginosis, vaginal coccobacillary microbiota, cervical mucus appearance, or cervical ectopy size. Conclusions: Short-term LNG-IUS use did not increase vulvovaginal candidiasis or bacterial vaginosis, and led to diminished vaginal discharge. Notwithstanding, this device promoted reactional changes in the vaginal and endocervical environment, without modification on cervical ectopy size.65685786

Análise Técnico-Econômica dos Métodos Construtivos de Paredes Diafragmas Moldadas In Loco, Estacas-Prancha e Estacas Secantes

Neste trabalho é apresentado um estudo técnico e, sobretudo, econômico, sobre os métodos de contenção de parede diafragma moldada in loco, estaca-prancha e estaca secante em obras de infraestrutura urbana e turísticas localizadas no município de Fortaleza, capital do Ceará. O estudo de caso analisou os custos relacionados à construção e às suas manutenções preventivas periódicas além de aspectos técnicos e executivos dos métodos utilizados nas obras do Túnel da Avenida Santos Dumont com Via Expressa, do Acquário Ceará e do Túnel da Rotatória da Arena Castelão. Apesar de possuir maiores vantagens técnicas, a estaca secante ainda é um processo de execução com custo significativamente superior ao da parede diafragma moldada in loco. Sendo assim, por razões de viabilidade econômica e, ainda sendo um ótimo método de contenção, a parede diafragma moldada in loco se torna o método mais vantajoso

On an accidental degeneracy in the 31P{¹H} NMR chemical shifts in ruthenium diphosphine complexes

The [RuCl(bipy)(dppb)(4-pic)]PF6 complex was prepared and fully characterized. The X-ray crystal structure of this complex was determined in order to make an unambiguous distinction between the two possible positions of the 4-methylpyridine ligand (4-pic) in the compound: trans to phosphorus atom or trans to nitrogen atom. The [RuCl(bipy)(dppb)(4-pic)]PF6 complex exhibits an unusual temperature-dependent accidental degeneracy of the 31P chemical shifts in its solution NMR spectrum

Propriedade intelectual: a proteção jurídica do conhecimento no setor produtivo tecnológico

-Como se verifica da literatura jurídica atual, o estudo da propriedade intelectual vem sendo realizado do ponto de vista estritamente dogmático. A ausência de um referencial teórico nas pesquisas jurídicas acaba por empobrecer a possibilidade de construção e criação interpretativas em um campo específico do Direito. Nesse sentido, esta pesquisa procura desenvolver um marco teórico de sustentação para a solução de questões práticas envolvendo propriedade intelectual. Em virtude disso, indaga-se qual é a mais adequada estrutura jurídico-econômica para a proteção do conhecimento no setor tecnológico. Como hipótese inicial, afirma-se que, considerando a teoria da argumentação jurídica, informada pela racionalidade comunicativa, a análise das leis de propriedade industrial e de inovação tecnológica forma uma estrutura bipartite de proteção ao conhecimento veiculado no setor tecnológico, cabendo, pois, no momento da aplicação do direito, construir normas adequadas à complexidade das relações empresariais e sociais. Ao longo dessa investigação, percebe-se a relevância da teoria do direito como integridade de Ronald Dworkin, a qual passa a assumir um status de referencial teórico mais apropriado do que a teoria da racionalidade comunicativa de Jürgen Habermas. Decerto, a teoria do direito como integridade mostra-se mais adequada à construção de uma estrutura interpretativa fundada na prática do direito de propriedade intelectual. Levando em conta a teoria do direito como integridade, pode-se elaborar uma hermenêutica dos direitos de propriedade intelectual capaz de lidar com a complexidade social em que ocorrem as criações e os inventos passíveis de registro. Metodologicamente, a pesquisa se estrutura a partir de um procedimento analítico de conceitos no qual são reinseridos os dados bibliográficos e legislativos referentes à propriedade intelectual. Esse sistema analítico de conceitos foi concebido a partir dos elementos teóricos fornecidos pela teoria do direito como integridade. Desse modo, como resultado final, torna-se possível desenvolver um padrão de racionalidade própria do direito a ser aplicado nos casos difíceis envolvendo situações de propriedade intelectual. Enfim, no momento de aplicação e criação do direito de propriedade intelectual, pode-se valer de uma racionalidade hermenêutica não colonizada pelo sistema econômico. Embora diagnosticando e lidando com situações de mercado, não se pode erigir como fundamento racional da decisão jurídica a lógica econômica. Afinal, cabe à ciência do Direito se constituir como estrutura racional própria e não simplesmente absorver teorias econômicas, matemáticas como razões de decidir

Neonatal Sepsis and Inflammatory Mediators

Neonatal sepsis is a major cause of morbidity and mortality and its signs and symptoms are nonspecific, which makes the diagnosis difficult. The routinely used laboratory tests are not effective methods of analysis, as they are extremely nonspecific and often cause inappropriate use of antibiotics. Sepsis is the result of an infection associated with a systemic inflammatory response with production and release of a wide range of inflammatory mediators. Cytokines are potent inflammatory mediators and their serum levels are increased during infections, so changes from other inflammatory effector molecules may occur. Although proinflammatory and anti-inflammatory cytokines have been identified as probable markers of neonatal infection, in order to characterize the inflammatory response during sepsis, it is necessary to analyze a panel of cytokines and not only the measurement of individual cytokines. Measurements of inflammatory mediators bring new options for diagnosing and following up neonatal sepsis, thus enabling early treatment and, as a result, increased neonatal survival. By taking into account the magnitude of neonatal sepsis, the aim of this review is to address the role of cytokines in the pathogenesis of neonatal sepsis and its value as a diagnostic criterion

Behavioral, Neurochemical and Histological Changes in the Use of Low Doses of Naltrexone and Donepezil in the Treatment in Experimental Model of Alzheimer’s Disease by Induction of β-Amyloid1-42 in Rats

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that promotes the involvement of memory-related functions, characterized by the presence of amyloid plaques formed by the β-amyloid peptide (Aβ), and hyperphosphorylated Tau protein neurofibrillary tangles. Evidence suggests that the use of low doses of Naltrexone, an opioid antagonist, possibly promotes a modulation of the immune system and consequent neuroprotective effect. The present study uses the animal model of induction with β-amyloid1-42 (Aβ1-42) to verify the behavioral, neurochemical and histological effects of the use of low doses of Naltrexone. Male wistar rats (250-300g) divided into five groups (N = 8) were used: Control, Sham, Aβ1-42 subdivided into three groups: treated with water, 05 mg Donepezil and 4.5 mg Naltrexone, orally during the 30-day period. Behavioral tests demonstrated the efficacy of induction to the experimental model with reduced memory of Aβ1-42-treated animals as well as reversal of damage in animals treated with Naltrexone. In the structural analysis, observed that the animals induced by Aβ1-42 treated with water alone presented alterations in the pyramidal forms of the hippocampal cells and that the animals treated with Naltrexone presented possibly a reversal of the neuronal damages. In conclusion, treatment with Naltrexone promoted a reversal in the memory impairment of rodents induced to the Alzheimer's model with Aβ1-42 in the behavioral and histological response

Malignant lung PEComa (clear cell tumor): rare case report and literature review

Clear cell tumors of the lung (CCTL), or “sugar tumors” of lung, are very uncommon lesions and are mostly benign perivascular epithelioid cell (PEC) tumors with no specific morphologic features. Fewer than 100 cases have been reported; the aggressive nature demonstrated in sporadic reports has rarely been described in the literature. Although the course is generally described as benign, eight reported cases showed malignant behavior. We report a case of a PEC with a malignant presentation in a young man, correlating the main characteristics of the tumor with other cases reported in the literature to better elucidate this rare presentation. We also performed a literature review of reports on benign and malignant CCTL cases, with a focus on clinical, imaging, and immunohistochemical differentiation. CCTLs are rare tumors that require histopathological and immunohistochemical confirmation; to date, criteria that can predict malignant evolution are lacking