Capacitação e intervenções de técnicos de farmácia na dispensação de medicamentos em Atenção Primária à Saúde

Resumo São escassos artigos científicos brasileiros que discutam a importância do trabalho do técnico em farmácia em assistência direta ao paciente. Este trabalho descreve uma experiência de capacitação de técnicos de farmácia para dispensação de medicamentos. Trata-se de estudo descritivo, transversal, realizado na atenção primária à saúde. Os técnicos foram capacitados pelo farmacêutico a orientar os pacientes no momento da dispensação e para triar casos que necessitavam atendimento farmacêutico. A identificação dos problemas foi feita por meio da observação da prescrição, data de retorno para dispensação ou do questionamento direto ao paciente. Foram elaborados fluxos de identificação de problemas e de intervenção, após os quais os técnicos identificaram 3.944 problemas, sendo os mais comuns: uso de medicamento em quantidade inferior à prescrita (26%) e não adesão ao tratamento farmacológico (25%). Os resultados demonstram a importância da capacitação dos técnicos na dispensação de medicamentos, fazendo deles um aliado do farmacêutico no processo de identificação e resolução de problemas relacionados a medicamentos, além de torná-los membros ativos do processo de cuidado no sistema de saúde pública

Amicus curiae on the request for an advisory opinion concerning the figure of the political judgment or impeachment presented by the Inter-American Commission on Human Rights

O presente trabalho diz respeito à solicitação de Opinião Consultiva feita pela Comissão Interamericana de Direitos Humanos (CIDH) acerca dos julgamentos políticos e impeachment, de modo a fomentar e ampliar o debate sobre o tema. Nesse sentido, o Núcleo Constitucionalismo e Democracia, que integra o Centro de Estudos da Constituição (CCONS), do Programa de Pós-Graduação em Direito da Universidade Federal do Paraná (UFPR), e o Departamento de Direito Constitucional da Universidade Externado da Colômbia, ingressaram, em conjunto, como amicus curiae, e apresentaram esta opinião diante da Comissão Interamericana com o propósito de colaborar, teórica e praticamente, com o Sistema Interamericano de Direitos Humanos (SIDH). Na primeira parte do trabalho faz-se uma série de observações sobre a consulta formulada pela CIDH, inclusive quanto às próprias regras e estrutura do procedimento da função consultiva. Na segunda parte, faz-se referência ao papel e legitimidade dos tribunais internacionais e, concretamente, da Corte Interamericana de Direitos Humanos (Corte IDH), na proteção da democracia e dos direitos políticos. Na terceira parte, responde-se ao objeto central da consulta, sobre as garantias judiciais e a legalidade nos processos de impeachment e julgamentos políticos contra presidentes democraticamente eleitos. Finalmente, na quarta parte, alerta-se a Corte IDH sobre a importância de se especificar o alcance do artigo 23 da Convenção Americana de Direitos Humanos (CADH) em relação aos diferentes fenômenos que ocorrem nos Estados Partes da CADH. O objetivo do trabalho é oferecer à Corte IDH uma visão completa do conteúdo e de problemas concretos que surgem da solicitação de uma opinião consultiva tal como essa, formulada pela CIDH, como também um pronunciamento sobre o contexto jurídico e fático que rodeia este procedimento.This work concerns the request for an Advisory Opinion made by the Inter-American Commission on Human Rights (IACHR) on political judgments and impeachment, in order to encourage and broaden the debate on the subject. In this sense, the Núcleo Constitucionalismo e Democracia (Constitutionalism and Democracy Nucleus), which integrates the Centro de Estudos da Constituição (Center for Constitutional Studies – CCONS) of the Federal University of Paraná (UFPR) Law’s LL.M and Ph.D Program, and the Constitutional Law Department of the Externado University of Colombia, have joined together as amicus curiae and presented their view before the Inter-American Commission, aiming to collaborate, theoretically and practically, with the Inter-American System of Human Rights (IASHR). The first part of this report presents comments on the consultation formulated by the IACHR, including the rules and structure of the advisory procedure itself. The second part deals with the role and legitimacy of international courts and tribunals – specifically, the Inter-American Court of Human Rights (IACHR) – for the protection of democracy and political rights. The third part refers to the core object of the consultation – on judicial guarantees and legality in impeachment proceedings and political trials against democratically elected presidents. Finally, in the fourth part, the Inter-American Court is warned about the importance of specifying the scope of Article 23 of the American Convention on Human Rights (ACHR) in relation to the different phenomena occurring in the States that have ratified it. The objective of this work is to provide the Inter-American Court with a complete view of the content and concrete problems that arise from the request for an advisory opinion such as that formulated by the IACHR, as well as with a statement on the legal and factual context surrounding this procedure

Panoramic snapshot of serum soluble mediator interplay in pregnant women with convalescent COVID-19: an exploratory study

IntroductionSARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators.MethodsA sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array.ResultsIn the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and <5 in HC) observed at the 3rd pregnancy trimester.Discussion and conclusionFrom an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women

Conversas com refugiados : interações de um campo social heterotópico

Orientadora: Prof.ª Dr.ª Melina Girardi FachinDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências Jurídicas, Programa de Pós-Graduação em Direito. Defesa : Curitiba, 13/03/2019Inclui referências: p. 151-161Resumo: O presente estudo pretende lançar sobre o fenômeno do refúgio um olhar holístico que compreenda a relação das vidas concretas com as normas abstratas. Para tanto, são analisados, do modo transversal, o aporte teórico, os elementos normativos e as experiências concretas de refugiados, atribuindo a estas o ponto central da pesquisa desenvolvida, que se baseia precisamente na diversidade de vivências no refúgio. Tal perspectiva não intenta trazer respostas, mas levantar reflexões que possam superar uma perspectiva virtual e homogeneizante desse fenômeno. O enfoque é direcionado a três domínios: o primeiro deles define o fenômeno como um campo social; o segundo traz os elementos normativos que circunscrevem esse campo, definindo quem o integra e quais as relações que podem ser travadas com o meio que lhe é exógeno; e, por fim, são analisadas as formas de interação desse campo com o meio social que atravessa e é atravessado pelo refúgio, relações que podem ser mediadas por pressupostos de alteridade ou de hostilidade. A partir da pesquisa empírica, matrizes teóricas e aporte normativo, é examinada a multidimensionalidade das experiências de refugiados e solicitantes de refúgio de provenientes de Guiné-Bissau, República Democrática do Congo, El Salvador, Venezuela e Síria, no que concerne ao alcance de algumas categorias de direitos fundamentais, tais como: acesso à documentação, moradia, colocação profissional e integração social, tendo como enfoque central a vivência dos sujeitos. Com a realização de entrevistas, investigou-se como fatores subjetivos de origem, condição socioeconômica e raça podem interferir na concretização de direitos e no grau de acolhimento experimentados por refugiados e solicitantes de refúgio. Não há um padrão homogêneo que rege a experiência do refúgio em virtude da complexidade imanente a esse campo social, aqui retratada pela alegoria da heterotopia, que representa as múltiplas e distintas formas de atravessar o refúgio e por ele ser atravessado. Os relatos expostos evidenciam a ampla gama de experiências vivenciadas, caracterizando o refúgio como um campo social heterotópico em virtude da justaposição de lugares opostos e de posições distintas que este fenômeno engendra. Palavras-chave: Direitos Humanos. Direitos dos Refugiados. Campo Social. Heterotopia. Hospitalidade.Abstract: This essay intends to look at refugees' movements through a transversal point of view, combining theory, law and concrete experiences of those who immigrate because of persecution, conflicts and violence. The narratives of twenty refugees and refuge seekers are the central aspect of this thesis, which grounds itself on the diversity of the refuge experience, including those who already are acknowledged as refugees and those who are still waiting for the recognition of this condition. These movements are evaluated from a holistic perspective, which comprehends both real and concrete lives and abstract legislation. This outlook doesn't intend to bring any answers, but to propound reflections that may overcome a homogeneous perspective of refuge. This analysis is directed to three refuge's angles: the first of them defines these movements as a social field; the second one brings the normative elements which circumscribes this field, defining the conditions of admission; and the third one evaluates how the refuge social field interacts with the outer environment, as well as the relations that can be based on hostility or hospitality. It is examined the multidimensionality of experiences of refugees from different origins, race and economic conditions, and how these conditions affect the access to fundamental rights such as documentation, habitation, professional collocation and social integration. Through the interviews, it was analyzed how these subjective conditions weighs on the fundamental rights' concretization, and how refugees are welcomed or not. Thus, this social field contains as many living possibilities as it contains subjects; there isn't a uniform standard in refugees' experiences due to the immanent complexity of this field, which can be represented by the heterotopia allegory, depicting the multiple ways of going through the refuge experience and being affected by it. The stories that were disclosed in this essay point to the multiple means of living the diaspore, distinguishing refuge as a heterotopic social field, due to approximations of opposed and varied positions that it entails. Keywords: Human Rights. Refugees Rights. Social Field. Heterotopia. Hospitalit

Improved Performance of ELISA and Immunochromatographic Tests Using a New Chimeric A2-Based Protein for Human Visceral Leishmaniasis Diagnosis

Summary. Human visceral leishmaniasis (VL) is a major public health problem worldwide, leading to significant mortality rates if not properly treated and controlled. Precise identification of infected patients is essential to establish treatment and control measures. Although several VL serological diagnosis advances have been accomplished lately, mainly using recombinant antigens and immunochromatographic tests (ICTs), improvements may still be achieved using multiepitope chimeric proteins in different test platforms. Here, we reported on the evaluation of ELISA and an ICT developed with a new chimeric protein, named DTL-4, based on repetitive antigenic sequences, including those present in the A2 protein. Methods. A total of 1028 sera samples were used for the development and validation of ELISA (321 samples from L. infantum-infected patients, 62 samples from VL/AIDS coinfected patients, 236 samples from patients infected with other diseases, and 409 samples from healthy donors). A total of 520 sera samples were used to develop and validate ICT (249 samples from L. infantum-infected patients, 46 samples from VL/AIDS coinfected patients, 40 samples from patients infected with other diseases, and 185 samples from healthy donors). Findings. Using the validation sera panels, DTL-4-based ELISA displayed an overall sensitivity of 94.61% (95% CI: 89.94-97.28), a specificity of 99.41% (95% CI: 96.39-99.99), and an accuracy of 97.02% (95% CI: 94.61-98.38), while for ICT, sensitivity, specificity, and accuracy values corresponded to 91.98% (95% CI: 86.65-95.39), 100.00% (95% CI: 96.30-100.00), and 95.14% (95% CI: 91.62-97.15), respectively. When testing sera samples from VL/AIDS coinfected patients, DTL-4-ELISA displayed a sensitivity of 77.42% (95% CI: 65.48-86.16), a specificity of 99.41% (95% CI: 96.39-99.99), and an accuracy of 93.51% (95% CI: 89.49%-96.10%), while for DTL-4-ICT, sensitivity was 73.91% (95% CI: 59.74-84.40), specificity was 90.63% (95% CI: 81.02-95.63), and accuracy was 82.00% (95% CI: 73.63-90.91). Conclusion. DTL-4 is a promising candidate antigen for serodiagnosis of VL patients, including those with VL/AIDS coinfection, when incorporated into ELISA or ICT test formats

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

Resumos concluídos - Neurociências

Resumos concluídos - Neurociência

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data