Investigação de fatores que limitam a autonomia de pacientes do SUS no processo de decisão de sua integridade bucal

The principle of autonomy foresees that patients can accept or refuse any proposal of treatment for its health problems, since they enjoy its intellectual capacity and the informed consent is contemplated. According to the principle of Justice, every patient has access to public health services and this is an important statement for they exert their full autonomy. The dental clinics of the Single Health System that offers dental extraction has great patient demand and frequently they insistently desire to submit themselves to a tooth extraction when there is no biological indication of this procedure. This work aimed to evaluate through a qualitative methodology, the process of informed consent that these patients were submitted and still analyzed, by this way, if they were enjoying their autonomy with the fullness that is foreseen by Bioethics when they make such decision. It was observed that the principle of autonomy is deeply compromised by a previous compromising of the principle of justice. The patients did not have option for treatment choice because there is no other alternative supply than extraction, and thus they decided for a more radical option considering, not that this was most correct, but the one that was available. In such a way, the necessity of reformatting the spirit of respect to the patient on its fullness was evidenced at SUS net of attendance, according the basic assumptions of the Principle-Based Ethics.O principio da autonomia prevê que os pacientes tenham direito de aceitar ou recusar qualquer proposta de tratamento para seus problemas de saúde, desde que gozem de sua capacidade intelectual e que o consentimento informado esteja contemplado. Pelo principio da justiça, todos os pacientes têm acesso aos serviços públicos de saúde, e isso é uma suposição importante para que eles exerçam sua autonomia com plenitude. Nas clínicas de assistência odontológica do Sistema Único de Saúde que oferecem serviços de exodontia, a demanda de atendimento é grande, e não raro incidem pacientes que desejam se submeter insistentemente a uma extração sem que haja indicação biológica desse procedimento. Este trabalho objetivou avaliar, através de metodologia qualitativa, o processo de consentimento informado a que esses pacientes foram submetidos e ainda analisou, dessa forma, se eles estavam gozando de sua autonomia com a plenitude que está prevista pela Bioética durante esse processo de decisão. Observou-se que o principio da autonomia está profundamente prejudicado por um comprometimento prévio do principio da justiça. Os pacientes não tiveram opção na escolha de tratamentos, porque não existe oferta além da exodontia. Assim, eles optaram por uma solução mais radical, considerando, não que ela seja a mais correta, mas sim a que está disponível. Constatou-se, dessa forma, a necessidade de se reformatar o espírito de respeito ao paciente na sua plenitude na rede de atendimento do SUS, seguindo pressupostos fundamentais do Principialismo

Produção de álcool em gel 70% com diferentes precursores poliméricos / Production of alcohol in gel 70% with different polymeric precursors

O presente estudo propõe a utilização de polímeros alternativos para a obtenção de álcool em gel 70% como ferramenta de higiene no combate ao Covid-19. Além da carboximetilcelulose, foram utilizados polímeros comerciais, descritos como derivados da celulose, Carbomex e Maxcarb, os quais apresentam propriedades gelificantes em potencial em diversas áreas. As formulações foram obtidas utilizando diferentes concentrações dos agentes gelificantes com água, glicerina e etanol. Os materiais iniciais, bem como as formulações obtidas, foram caracterizados por diferentes técnicas, incluindo Difração de Raios X, Relaxometria, Análise termogravimétrica.Os resultados das análises de Raios X indicaram uma maior cristalinidade do material obtido com Maxcarb e Carbomex quando comparados à Carboximetilcelulose. A análise termogravimétrica dos materiais indicou que o Maxcarb possui o maior valor de temperatura de degradação. Com as análises de relaxometria foi possível obter os tempos de relaxação dos materiais em solução e nos estado sólido. A Carboximetilcelulose apresentou menor valor de relaxação spin-rede quando comparado ao Maxcarb e Carbomex que apresentaram menores valores

The DNA methyltransferase inhibitor zebularine exerts antitumor effects and reveals BATF2 as a poor prognostic marker for childhood medulloblastoma

Medulloblastoma (MB) is the most common solid tumor among pediatric patients and corresponds to 20% of all pediatric intracranial tumors in this age group. Its treatment currently involves significant side effects. Epigenetic changes such as DNA methylation may contribute to its development and progression. DNA methyltransferase (DNMT) inhibitors have shown promising anticancer effects. The agent Zebularine acts as an inhibitor ofDNAmethylation and shows low toxicity and high efficacy, being a promising adjuvant agent for anti-cancer chemotherapy. Several studies have reported its effects on different types of tumors; however, there are no studies reporting its effects on MB. We analyzed its potential anticancer effects in four pediatric MB cell lines. The treatment inhibited proliferation and clonogenicity, increased the apoptosis rate and the number of cells in the S phase (p < 0.05), as well as the expression of p53, p21, and Bax, and decreased cyclin A, Survivin and Bcl-2 proteins. In addition, the combination of zebularine with the chemotherapeutic agents vincristine and cisplatin resulted in synergism and antagonism, respectively. Zebularine also modulated the activation of the SHH pathway, reducing SMO and GLI1 levels and one of its targets, PTCH1, without changing SUFU levels. A microarray analysis revealed different pathways modulated by the drug, including the Toll-Like Receptor pathway and high levels of the BATF2 gene. The low expression of this gene was associated with a worse prognosis in MB. Taken together, these data suggest that Zebularine may be a potential drug for further in vivo studies of MB treatment3512636CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP478974/2013-22011/22440-

Floristic survey of vascular plants of a poorly known area in the Brazilian Atlantic Forest (Flona do Rio Preto, Espírito Santo)

The Atlantic Forest is one of the most threatened biomes in the world. Despite that, this biome still includes many areas that are poorly known floristically, including several protected areas, such as the "Floresta Nacional do Rio Preto" ("Flona do Rio Preto"), located in the Brazilian State of Espírito Santo. This study used a published vascular plant species list for this protected area from the "Catálogo de Plantas das Unidades de Conservação do Brasil" as the basis to synthesise the species richness, endemism, conservation and new species occurrences found in the "Flona do Rio Preto".The published list of vascular plants was based on field expeditions conducted between 2018 and 2020 and data obtained from herbarium collections available in online databases. Overall, 722 species were documented for the "Flona do Rio Preto", 711 of which are native to Brazil and 349 are endemic to the Atlantic Forest. In addition, 60 species are geographically disjunct between the Atlantic and the Amazon Forests. Most of the documented species are woody and more than 50% of these are trees. Twenty-three species are threatened (CR, EN and VU), while five are Data Deficient (DD). Thirty-two species are new records for the State of Espírito Santo. Our results expand the knowledge of the flora of the Atlantic Forest and provide support for the development of new conservation policies for this protected area