A CONSTITUCIONALIZAÇÃO DO DIREITO PENAL E A LIMITAÇÃO TEMPORAL DAS MEDIDAS DE SEGURANÇA

A medida de segurança não possui prazo legal máximo para sua duração, o qual depende da emissão de laudo psiquiátrico de cessação de periculosidade. As internações dos inimputáveis muitas vezes ultrapassavam trinta anos e adquiriam caráter perpétuo. Nesse cenário, os tribunais superiores começaram a decidir a favor da limitação temporal do instituto. Parte-se da hipótese, em método de revisão bibliográfica e coleta de dados jurisprudenciais, de que o movimento de constitucionalização do Direito Penal e a reinterpretação da legislação ordinária à luz dos direitos fundamentais foram os fundamentos teóricos para esse giro jurisprudencial. Hipótese confirmada nas conclusões do presente artigo

Estudo de caso como uma estratégia de ensino na graduação: percepção dos graduandos em enfermagem

Introdução: Nas últimas décadas do século XX, o processo ensino/aprendizagem na enfermagem caracterizou-se por uma prática pedagógica tradicional e conservadora, contudo, já é possível em vias do século XXI, perceber novo cenário de mudanças que geram um processo de modernização científica e tecnológica na construção do conhecimento. Este estudo teve como objetivo compreender a percepção dos graduandos de enfermagem sobre a estratégia do estudo de caso. Materiais e Métodos: Trata-se de uma pesquisa de campo, exploratória, descritiva e analítica, com abordagem qualitativa, na qual participaram quinze acadêmicos de enfermagem. Os dados foram analisados segundo a técnica de Análise de Conteúdo de Bardin. Resultados e Discussão: Da análise emergiram duas categorias temáticas: Estudo de caso como possibilidade de interdisciplinaridade e, Estudo de caso como estratégia de ensino que favorece a aproximação entre a teoria e a prática. A estratégia do estudo de caso é uma possibilidade para relacionar o conhecimento entre as diversas disciplinas do curso de graduação em Enfermagem. Conclusões: Pode-se concluir que os graduandos de enfermagem consideram que o método do estudo de caso permite a interdisciplinaridade, sendo possível relacionar e utilizar o conhecimento entre as disciplinas da graduação, de tal modo que essa metodologia tem estimulado a busca, com liberdade, por novos saberes, tendo o professor como o facilitador desse processo, compartilhando a responsabilidade na construção do conhecimento.Palavras chave: Educação em Enfermagem, Estudos de Casos, Materiais de Ensino. (Fonte: DeCS BIREME).Cómo citar este artículo: Souza da Silva R, do Nascimento Paixão GP, Batista Lins D, Amorim de Jesus R, Pereira Á. Estudo de caso como uma estratégia de ensino na graduação: percepção dos graduandos em enfermagem. Rev Cuid. 2014; 5(1): 606-12

Occurrence of antibodies to Toxoplasma gondii in opossums caught in urban areas of Bauru, state of São Paulo, Brazil

Toxoplasmosis is one of the most common zoonoses worldwide. It was initially described in rodents and rabbits. There are few data on the morbidity and mortality of this disease among Brazilian marsupial fauna, such as opossums. These animals are of great importance regarding the epidemiology of this disease, given that they are prey for felids and other carnivores. With the aim of ascertaining the serological response to Toxoplasma gondii among marsupials (Didelphis spp.), 38 animals that had been caught in 14 districts of the urban area of the municipality of Bauru, state of São Paulo, were evaluated. The modified agglutination test (MAT) showed that 26.3% (10/38) of the samples analyzed were seropositive. It can be suggested that the opossums’ behavior and persistent proximity to human housing results in contact with cats and T. gondii infection, based on the frequency found in this study. This was the first study on the seroprevalence of T. gondii in opossums caught in the urban area of the municipality of Bauru, SP, and it highlights the need for environmental and health authorities of the municipality to monitor this zoonosis. A toxoplasmose é uma das zoonoses mais comuns no mundo, tendo sido descrita inicialmente em roedores e em coelhos. Todavia, poucos são os dados sobre morbidade e mortalidade da toxoplasmose nos marsupiais da fauna brasileira, como os gambás, sendo de grande importância na epidemiologia da doença, como presas para felídeos e outros carnívoros. Com o objetivo de verificar a resposta sorológica para Toxoplasma gondii em marsupiais (Didelphis spp.), foram avaliados 38 animais capturados em 14 regiões da área urbana do município de Bauru-SP. Foi encontrada uma frequência, de acordo com o teste de aglutinação modificada (MAT), de 26,3% (10/38) nas amostras analisadas. Pode-se sugerir que o comportamento dos gambás e sua permanência próxima a habitações humanas resultam em contato com gatos e infecção por T. gondii, tendo em vista a frequência encontrada neste estudo. Este é o primeiro estudo de soroprevalência de T. gondii em gambás capturados na área urbana do município de Bauru-SP, alertando-se para a necessidade do monitoramento desta zoonose pelas autoridades de vigilância ambiental e sanitária do município

Conditional cash transfer program and child mortality: A cross-sectional analysis nested within the 100 Million Brazilian Cohort.

BACKGROUND: Brazil has made great progress in reducing child mortality over the past decades, and a parcel of this achievement has been credited to the Bolsa Família program (BFP). We examined the association between being a BFP beneficiary and child mortality (1-4 years of age), also examining how this association differs by maternal race/skin color, gestational age at birth (term versus preterm), municipality income level, and index of quality of BFP management. METHODS AND FINDINGS: This is a cross-sectional analysis nested within the 100 Million Brazilian Cohort, a population-based cohort primarily built from Brazil's Unified Registry for Social Programs (Cadastro Único). We analyzed data from 6,309,366 children under 5 years of age whose families enrolled between 2006 and 2015. Through deterministic linkage with the BFP payroll datasets, and similarity linkage with the Brazilian Mortality Information System, 4,858,253 children were identified as beneficiaries (77%) and 1,451,113 (23%) were not. Our analysis consisted of a combination of kernel matching and weighted logistic regressions. After kernel matching, 5,308,989 (84.1%) children were included in the final weighted logistic analysis, with 4,107,920 (77.4%) of those being beneficiaries and 1,201,069 (22.6%) not, with a total of 14,897 linked deaths. Overall, BFP participation was associated with a reduction in child mortality (weighted odds ratio [OR] = 0.83; 95% CI: 0.79 to 0.88; p < 0.001). This association was stronger for preterm children (weighted OR = 0.78; 95% CI: 0.68 to 0.90; p < 0.001), children of Black mothers (weighted OR = 0.74; 95% CI: 0.57 to 0.97; p < 0.001), children living in municipalities in the lowest income quintile (first quintile of municipal income: weighted OR = 0.72; 95% CI: 0.62 to 0.82; p < 0.001), and municipalities with better index of BFP management (5th quintile of the Decentralized Management Index: weighted OR = 0.76; 95% CI: 0.66 to 0.88; p < 0.001). The main limitation of our methodology is that our propensity score approach does not account for possible unmeasured confounders. Furthermore, sensitivity analysis showed that loss of nameless death records before linkage may have resulted in overestimation of the associations between BFP participation and mortality, with loss of statistical significance in municipalities with greater losses of data and change in the direction of the association in municipalities with no losses. CONCLUSIONS: In this study, we observed a significant association between BFP participation and child mortality in children aged 1-4 years and found that this association was stronger for children living in municipalities in the lowest quintile of wealth, in municipalities with better index of program management, and also in preterm children and children of Black mothers. These findings reinforce the evidence that programs like BFP, already proven effective in poverty reduction, have a great potential to improve child health and survival. Subgroup analysis revealed heterogeneous results, useful for policy improvement and better targeting of BFP

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Occurrence of triatomines in public spaces: An atypical case in the Southwestern Brazilian Amazon

ABSTRACT Background: Triatomines infest atypical public spaces in the Western Amazon. Methods: Frequent visitors to these spaces captured the insects in the state of Acre, Brazil (Rio Branco and Cruzeiro do Sul). Results: Six insects were found in a penitentiary, a church, a school, a university, a hospital, and a health center. Five of the insects were adults (three positive for Trypanosoma cruzi) and one was a nymph. Conclusions: This is the first report of triatomine occurrence in schools or churches. These data are important for implementing surveillance strategies and alerting individuals about possible changes in Chagas disease transmission dynamics

Image-guided percutaneous intralesional administration of mesenchymal stromal cells in subjects with chronic complete spinal cord injury: a pilot study

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-08-16T13:31:50Z No. of bitstreams: 1 Larocca TF Image-guided....pdf: 387218 bytes, checksum: 3e5d59f868cf7e153f1aa904be8b2251 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-08-16T13:45:57Z (GMT) No. of bitstreams: 1 Larocca TF Image-guided....pdf: 387218 bytes, checksum: 3e5d59f868cf7e153f1aa904be8b2251 (MD5)Made available in DSpace on 2017-08-16T13:45:57Z (GMT). No. of bitstreams: 1 Larocca TF Image-guided....pdf: 387218 bytes, checksum: 3e5d59f868cf7e153f1aa904be8b2251 (MD5) Previous issue date: 2017Brazilian Development Bank (BNDES).Hospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / Hospital São Rafael. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / Hospital São Rafael. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / National Institute of Science andTechnology for Regenerative Medicine. Rio de Janeiro, RJ, BrazilHospital São Rafael. Salvador, BA, BrasilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / University of Bahia. Faculty of Pharmacy. Salvador, BA, BrazilHospital São Rafael. Salvador, BA, BrasilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / Hospital São Rafael. Salvador, BA, BrasilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, BrazilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, BrazilHospital São Rafael. Salvador, BA, BrasilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / National Institute of Science andTechnology for Regenerative Medicine. Rio de Janeiro, RJ, BrazilHospital São Rafael. Center for Biotechnology and Cell Therapy. Salvador, BA, Brazil / National Institute of Science andTechnology for Regenerative Medicine. Rio de Janeiro, RJ, BrazilThe potential of cell therapies to improve neurological function in subjects with spinal cord injury (SCI) is currently under investigation. In this context, the choice of cell type, dose, route and administration regimen are key factors. Mesenchymal stromal cells (MSCs) can be easily obtained, expanded and are suitable for autologous transplantation. Here we conducted a pilot study that evaluated safety, feasibility and potential efficacy of intralesional MSCs transplantation performed through image-guided percutaneous injection, in subjects with chronic complete SCI. Methods. Five subjects with chronic traumatic SCI (>6 months), at thoracic level, classified as American Spinal Cord Injury Association impairment scale (AIS) grade A, complete injury, were included. Somatosensory evoked potentials (SSEP), spinal magnetic resonance imaging (MRI) and urodynamics were assessed before and after treatment. Autologous MSCs were injected directly into the lesion site through percutaneous injection guided by computerized tomography (CT). Results. Tomography-guided percutaneous cell transplantation was a safe procedure without adverse effects. All subjects displayed improvements in spinal cord independence measure (SCIM) scores and functional independence measure (FIM), mainly due to improvements in bowel movements and regularity. Three subjects showed improved sensitivity to tactile stimulation.Two subjects improved AIS grade to B, incomplete injury, although this was sustained in only one of them during the study follow-up. Conclusion. Autologous bone marrow MSC transplantation, performed through CT-guided percutaneous injection, was shown to be safe and feasible. Further studies are required to demonstrate efficacy of this therapeutic scheme

Avaliação da saturação tecidual de oxigênio durante o sintoma claudicante em pacientes com doença arterial periférica

Resumo Contexto O relato de sintoma claudicante em pacientes com doença arterial periférica é utilizado como modulador da intensidade de exercício físico para o tratamento clínico, entretanto os valores de oxigenação tecidual nesse momento são desconhecidos. Objetivo Descrever o suprimento tecidual de oxigênio por meio da espectroscopia de luz próxima ao infravermelho ou Near-Infrared Spectroscopy (NIRS) nos momentos em que o paciente relata sintoma claudicante inicial e máximo em testes de exercício. Métodos Nove pacientes, oito homens com 65,63 ± 6,02 anos de idade, previamente diagnosticados com doença arterial periférica, realizaram teste de exercício de carga constante e de carga incremental com monitorização do nível de oxigenação tecidual através da NIRS. As saturações de oxigênio obtidas no momento em que o paciente relata sintoma claudicante inicial e no momento em que relata sintoma claudicante máximo foram comparadas com os valores de saturação da manobra de oclusão arterial por meio do intervalo de confiança de 95% da diferença. Resultados Verificou-se que os valores de saturação nos momentos de sintoma claudicante inicial e máximo são estatisticamente distintos quando comparados àqueles obtidos na manobra de oclusão arterial, entretanto, através da análise percentual do quão distante esses valores encontram-se é possível observar que, do ponto de vista clínico, eles estão próximos. Conclusões A saturação no momento em que o paciente relata sintomas claudicantes inicial e máximo é bastante próxima do valor de saturação no momento de oclusão e do ponto de vista clínico o relato subjetivo de sintoma do paciente é adequado como parâmetro para a prescrição do exercício físico