Paisagens bordadas: pintando com memórias de vó

Utilizando a paisagem como pano de fundo, através da pintura, a artista se volta para sua ancestralidade. Ao longo deste trabalho, buscou-se mostrar os lugares íntimos e emocionais por onde pode percorrer a pintura e ainda assim fazer dela não só um discurso, mas quem sabe uma ação relevante no cenário artístico brasileiro. A pintura do gênero expressionismo abstrato, por exemplo, foi por vezes afirmada como uma subversão aos moldes clássicos da arte e propôs uma grande transformação no modo de enxergar a pintura, embora não haja uma mudança de fato se você transforma o assunto, porém não muda quem faz o discurso. Ou seja, no movimento do expressionismo abstrato – e ao longo de toda história da arte – temos constantes descobertas e modificações na forma de fazer arte, mas em geral as mesmas figuras representando e liderando: homens (brancos). Serão apresentados os caminhos percorridos pela artista para responder uma série de questionamentos gerados ao longo da graduação: Por que a abstração como linguagem? Por que a paisagem como objeto visual? Como pode uma mulher se graduando pintora no Brasil ter tão poucos exemplos femininos e não-brancos dentro de uma instituição renomada em 2021? Estas questões se encontraram respondidas em tantos outros trabalhos de colegas de formação e profissão, em tantos nomes relevantes da arte até o momento e ressurgem neste trabalho como uma tentativa de reafirmar e escancarar as portas para que passemos com nossas histórias, nossas origens, nossas vozes que não mais serão silenciadas

O uso de omalizumabe no tratamento da asma em pacientes com COVID-19

RESUMO: Tem-se falado com frequência sobre pacientes asmáticos como grupo derisco para o novo COVID-19. Até então, sabe-se que tais pacientes, caso adquiram ainfecção, devem permanecer em seu tratamento habitual para a asma, considerandoos efeitos protetores da terapêutica e o aumento do risco de infecções nosocomiaiscom a ocorrência de exacerbações. Nos últimos anos, produtos biológicos, comoomalizumabe, vêm sendo utilizados como tratamento complementar para pacientescom asma grave e têm se mostrado eficazes no controle das exacerbações,corroborando, ainda, a diminuição do uso de esteróides sistêmicos. Apresentaravaliações de estudos recentes em relação ao uso de omalizumabe em pacientesasmáticos e relacionar com uma possível infecção por COVID-19. Revisão de literatura;artigos pesquisados a partir das bases de dados PubMed, SciELO, ScienceDirect. Osdescritores Ciências da Saúde (DeCS) foram: asma, COVID. Foram incluídos apenastrabalhos posteriores a 2017 e relevantes de acordo com o tema abordado. Estarevisão é composta por três artigos. O omalizumabe, assim como os outros produtosbiológicos utilizados no manejo da asma, visam o controle das vias inflamatórias dotipo 2, uma vez que se trata de um anticorpo monoclonal contra IgE humana. Umestudo investigou a administração de omalizumabe em pacientes asmáticosinoculados com rinovírus, tendo em vista descobrir se diminuiria o efeito de controledo produto biológico sobre a doença. Os resultados mostraram que o efeito do antiIgE foi mais forte na redução dos sintomas do trato respiratório inferior e houve umamelhora na função pulmonar durante os quatro primeiros dias da infecção. Mostrouse, então, que o tratamento com omalizumabe foi capaz de reduzir a duração dasinfecções por rinovírus, a disseminação viral e o risco de doenças por rinovírus. Logo,sugere-se um efeito potencial do omalizumabe nas respostas antivirais. Como não foirelatado risco de aumento da suscetibilidade à infecção ou efeito imunossupressorcom uso de produtos biológicos, não precisamos interromper esses tratamentosdurante a atual pandemia. No caso do omalizumabe, com a possibilidade de umefeito anti-infeccioso, seria interessante explorar se seu uso tem efeitos positivoscontra a infecção por COVID-19. Além disso, sabe-se que a interrupção de qualquertratamento pode levar a um maior risco de exacerbações da asma e, portanto, maiorprobabilidade de visitas ao pronto-socorro e hospitalização, que representam fatoresde risco para exposição e infecção

Guidelines’ recommendations for the treatment-resistant depression: A systematic review of their quality

Copyright: © 2023 Gabriel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: Depression is a serious and widespread mental health disorder. A significant proportion of patients with depression fail to remit after two antidepressant treatment trials, a condition named treatment-resistant depression (TRD). Clinical practice guidelines (CPGs) are instruments aimed to improve diagnosis and treatment. This study objective is to systematically appraise the quality and elaborate a comparison of high-quality CPGs with high-quality recommendations aimed at TRD. Methods and analysis: We searched several specialized databases and organizations that develop CPGs. Independent researchers assessed the quality of the CPGs and their recommendations using AGREE II and AGREE-REX instruments, respectively. We selected only high-quality CPGs that included definition and recommendations for TRD. We investigated their divergencies and convergencies as well as weak and strong points. Results: Among seven high-quality CPGs with high-quality recommendations only two (Germany's Nationale Versorgungs Leitlinie-NVL and US Department of Veterans Affairs and Department of Defense-VA/DoD) included specific TRD definition and were selected. We found no convergent therapeutic strategy among these two CPGs. Electroconvulsive therapy is recommended by the NVL but not by the VA/DoD, while repetitive transcranial magnetic stimulation is recommended by the VA/DoD but not by the NVL. While the NVL recommends the use of lithium, and a non-routine use of thyroid or other hormones, psychostimulants, and dopaminergic agents the VA/DoD does not even include these drugs among augmentation strategies. Instead, the VA/DoD recommends ketamine or esketamine as augmentation strategies, while the NVL does not mention these drugs. Other differences between these CPGs include antidepressant combination, psychotherapy as a therapeutic augmentation, and evaluation of the need for hospitalization all of which are only recommended by the NVL. Conclusions: High-quality CPGs for the treatment of depression diverge regarding the definition and use of the term TRD. There is also no convergent approach to TRD from currently high-quality CPGs.F.C.G. is a fellow of the Conselho Nacional de Pesquisa e Tecnologia (CNPq, grant number 141811/2020-0).info:eu-repo/semantics/publishedVersio

Effect of combined therapy of virtual reality and transcranial direct current stimulation in children and adolescents with cerebral palsy: A study protocol for a triple-blinded randomized controlled crossover trial

Background: Transcranial direct current stimulation (tDCS) and therapy-based virtual reality (VR) have been investigated separately. They have shown promise as efficient and engaging new tools in the neurological rehabilitation of individuals with cerebral palsy (CP). However, the recent literature encourages investigation of the combination of therapy tools in order to potentiate clinic effects and its mechanisms. Methods: A triple-blinded randomised sham-controlled crossover trial will be performed. Thirty-six individuals with gross motor function of levels I to IV (aged 4–14 years old) will be recruited. Individuals will be randomly assigned to Group A (active first) or S (sham first): Group A will start with ten sessions of active tDSC combined with VR tasks. After a 1-month washout, this group will be reallocated to another ten sessions with sham tDCS combined with VR tasks. In contrast, Group S will carry out the opposite protocol, starting with sham tDCS. For the active tDCS the protocol will use low frequency tDCS [intensity of 1 milliampere (mA)] over the primary cortex (M1) area on the dominant side of the brain. Clinical evaluations (reaction times and coincident timing through VR, functional scales: Abilhand-Kids, ACTIVLIM-CP, Paediatric Evaluation of Disability Inventory-PEDI- and heart rate variability-HRV) will be performed at baseline, during, and after active and sham tDCS. Conclusion: tDCS has produced positive results in treating individuals with CP; thus, its combination with new technologies shows promise as a potential mechanism for improving neurological functioning. The results of this study may provide new insights into motor rehabilitation, thereby contributing to the better use of combined tDCS and VR in people with CP

Factors associated with higher quality of clinical practice guidelines and their recommendations for the pharmacological treatment of depression: a systematic review

Objective The objective of this study was to assess the quality of clinical practice guidelines (CPGs) for the pharmacological treatment of depression along with their recommendations and factors associated with higher quality.Design We conducted a systematic review that included CPGs for the pharmacological treatment of depression in adults.Data sources We searched for publications from 1 January 2011 to 31 December 2021, in MEDLINE, Cochrane Library, Embase, PsycINFO, BVS and 12 other databases and guideline repositories.Eligibility criteria for selecting studies We included CPGs containing recommendations for the pharmacological treatment of depression in adults at outpatient care setting, regardless of whether it met the U.S. National Academy of Medicine criteria, or not. If a CPG included recommendations for both children and adults, they were considered. No language restriction was applied.Data extraction and synthesis Data extraction was also conducted independently and in duplicate, a process that was validated in a previous project. The quality of the CPGs and their recommendations were assessed by three independent reviewers using Appraisal of Guidelines for Research and Evaluation (AGREE II) and Appraisal of Guidelines for Research and Evaluation-Recommendations Excellence (AGREE-REX). A CPG was considered to be of high quality if AGREE II Domain 3 was ≥60%; while their recommendations were considered high if AGREE-REX Domain 1 was ≥60%.Results Seventeen out of 63 (27%) CPGs were classified as high quality, while 7 (11.1%) had high-quality recommendations. The factors associated with higher-scoring CPGs and recommendations in the multiple linear regression analyses were ‘Handling of conflicts of interest’, ‘Multiprofessional team’ and ‘Type of institution’. ‘Inclusion of patient representative in the team’ was also associated with higher-quality recommendations.Conclusions The involvement of professionals from diverse backgrounds, the handling of conflicts of interest, and the inclusion of patients’ perspectives should be prioritised by developers aiming for high-quality CPGs for the treatment of depression