Infecções sexualmente transmissíveis na gestação: educação em saúde como estratégia de prevenção na atenção básica / Sexually transmitted infections during pregnancy: health education as a prevention strategy in primary care

Objetivo:relatara experiência de acadêmicas da Universidade Federal de Mato Grosso do Sul (UFMS) durante ação desenvolvida com o grupo de gestantes de uma Unidade de Básica de Saúde em Campo Grande-MS (UBS). Metodologia: previamente foram confeccionados convites e distribuídos pelosagentes comunitários a todas as gestantes de sua área. A ação ocorreu na sala de reuniões da UBS.Utilizaram-se como estratégias metodológicas dinâmicas lúdicas. Inicialmente com a técnica quebra gelo, em seguida através da roda de conversa e do uso de imagens representando as IST, foram discutidos os sinais e sintomas, tratamento e prevenção a partir do conhecimento prévio das participantes. Foram abordados os mitos e as verdades a respeito das consequências das IST na gestação através de afirmações escritas em papéis e inseridas dentro de balões de ar coloridos que eram estourados pelas gestantes, também foram também oferecidas placas em formato de mãos nas cores verde representando “verdade”, amarela representando “dúvida” e vermelha representando “mito” para que cada participante desse sua opinião em cada afirmação. No último momento foi desenvolvida a “dinâmica do desafio” com o objetivo de transmitir a mensagem que,por mais difícil que parecesse o desafio ao final pode-se ter uma surpresa positiva. A avaliação da ação se deu por meio da escala de faces distribuídas no final da ação. Resultados:compareceram seis gestantes e alguns profissionais ligados à unidade. Em todas as etapas da ação houve participação ativa das gestantes e dos profissionais presentes; utilizar as indicações de “verdadeiro, falso ou em dúvida”, referentes às imagens e mitos apresentados,possibilitoudescontração e leveza. O conhecimento prévio das gestantes sobre as IST era satisfatório e foi valorizado. As gestantes mencionaram o uso de preservativo e ainda o entendimento sobre o caráter não protetivo da gestação, objetivos da ação. Reforçou-sea importância do pré-natal, comparecer ao grupo de gestantes, ressaltando-se a troca de informações, esclarecimento de possíveis dúvidas e resolutividade da equipe de saúde.Conclusão: realização da educação em saúde sobre as IST na gestação mostrou-se efetiva ao se proporcionar o diálogo, interação, a troca de experiências, saberes e vivências, e a construção conjunta do conhecimento, sendo então, tais elementos evidenciados como importantes para a promoção da saúde e a prevenção de doenças, e para o desenvolvimento de uma consciência crítica e reflexiva das gestantes acerca de seu processo saúde-doença, ao torná-las ativas no processo de aprendizagem

Effects of a multidisciplinary program on autonomic modulation in overweight or obese children and adolescents

Purpose: this study evaluated the effects of a multidisciplinary program on autonomic modulation in overweight or obese children and adolescents. Methods: fi fteen individuals with 10,93±2,28 years were submitted to autonomic evaluation using heart rate variability before and after a program based on physical exercises for three months, three times a week, 60 minutes per session and psychological and nutritional counseling. Data was analyzed using the paired t-test or Wilcoxon test and the level of signifi cance was set at P < 0.05. Results: multidisciplinary program was able to promote benefi ts in autonomic modulation observed thought temporal (SDNN: 39,96 ± 10,33 x 49,44 ± 12,31; p = 0,019; rMSSD: 28,97 ± 11,50 x 37,26 ± 11,17; p = 0,018), spectral (LFnu: 64,49 ± 12,21 x 56,74 ± 11,18; p = 0,014; HFnu: 35,50 ± 12,21 x 43,25 ± 11,18; p = 0,014) and geometrical (SD1: 20,51 ± 8,13 x 26,36 ± 7,90; p = 0,018 SD2: 52,31 ± 13,04 x 64,58 ± 16,33; p = 0,031) indices in overweigh and obese children and adolescents. Also, after the intervention there was a reduction on resting heart rate (88,53 ± 9,24 x 83,09 ± 7,93; p = 0,023) and there were changes in the classifi cation of overweigh 26,67% x 46,66% and obesity 73,33% x 53,33%, although not significant changes in body mass index. Conclusions: exercise program together with nutritional and psychological counseling is able to promote benefi ts in autonomic modulation in children and adolescents who are overweight or obese

Campomanesia adamantium (Cambess.) O. Berg e Campomanesia sessiliflora (o.berg) mattos: estudo fitoquímico e toxicidade frente à Artemia salina l. (Crustacea) como indicadores preliminares na elaboração de produtos biotecnológicos: Campomanesia adamantium (Cambess.) O. Berg and Campomanesia sessiliflora (o.berg) mattos: phytochemical study and toxicity against Artemia salina l. (Crustacea) as preliminary indicators in the preparation of biotechnological products

A Campomanesia adamantium (Cambess.) O. Berg e a Campomanesia sessiliflora (O.Berg) Mattos (guaviras) são utilizadas para atividades terapêuticas na medicina popular, porém é necessária a extração dos metabólitos da planta com vistas ao desenvolvimento de produtos terapêuticos e o uso de bioindicadores para avaliar a sua  toxicidade. Foram realizadas as etapas de coleta e preparação do extrato botânico, obtidas soluções etanólicas a 20% e submetidas à análise. Os extratos etanólicos das folhas de C. adamantium e C. sessiliflora demonstraram perfis químicos semelhantes para flavonoides e taninos, negativos para esteroides, terpenos e saponinas, e pouco conclusivo para alcalóides, porém com presença de precipitado indicativo de compostos azotados. Os testes foram realizados em diversas concentrações. Ao revisitar os resultados prévios de citotoxicidade sobre Artemia salina Leach., foi verificado que os espécimes apresentaram resultados estabelecidos dentro da faixa de toxicidade elevada, onde o extrato da C. sessiliflora apresentou valor para CL50 de 65,78 μg mL-1  e com perfil de toxicidade variando entre 11,20 e 120,38 μg mL-1, compatível faixa de elevada toxicidade para todas as correlações dos testes, definidas para mortalidade de 10% e 90% da população exposta, respectivamente. Igualmente a C. adamantium também mostrou valores médios da CL50  em 52,03 μg mL-1 dentro da faixa de toxicidade elevada e suas concentrações atribuídas para as dosagens mínimas e máximas entre 8,45 e 95,44 μg mL-1, recaíram na faixa de elevado risco de toxicidade, revelando a necessidade de cuidado no uso do extrato. Desta forma fica evidente o potencial de toxicidade dos extratos de C. adamantium  e C. sessiliflora sobre Artemia salina L. mostrando que este pode ser promissor na inibição do crescimento in vitro de tumores sólidos humano em estudos. O bioensaio serve como uma ferramenta de pré-triagem para estudo de drogas antitumorais e para o desenvolvimento de novos medicamentos

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Nasal colonization with Staphylococcus aureus in individuals with HIV/ AIDS attended in a Brazilian Teaching Hospital

OBJECTIVE: to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of S&#227;o Paulo (Brazil). METHOD: a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. RESULT: of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2%) of the individuals, resistance to oxacillin being evidenced in 10 (21.8%) participants. CONCLUSION: the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population

Staphylococcus aureus Small Colony Variants (SCVs): News From a Chronic Prosthetic Joint Infection

International audienceSmall colony variants (SCV) of Staphylococcus aureus have been reported as implicated in chronic infections. Here, we investigated the genomic and transcriptomic changes involved in the evolution from a wild-type to a SCV from in a patient with prosthetic joint infection relapse. The SCV presented a stable phenotype with no classical auxotrophy and the emergence of rifampicin resistance. Whole Genome Sequencing (WGS) analysis showed only the loss of a 42.5 kb phage and 3 deletions, among which one targeting the rpoB gene, known to be the target of rifampicin and to be associated to SCV formation in the context of a constitutively active stringent response. Transcriptomic analysis highlighted a specific signature in the SCV strain including a complex, multi-level strategy of survival and adaptation to chronicity within the host including a protection from the inflammatory response, an evasion of the immune response, a constitutively activated stringent response and a scavenging of iron sources

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted