Escola de obstetrícia da Universidade de São Paulo: a história contada no livro de atas (1912-1970)

Throughout the 20th Century, Obstetrics education has undergone innumerous changes which have accompanied changes in the maternal and newborn health care model and conceptions concerning professional nursing education and practice. This qualitative and documentary study aimed to describe and analyze the minutes of the meetings of the São Paulo Obstetrics School. The School was founded in 1912 and was adjacent to the University of São Paulo Medical School until 1970, when it was incorporated into the School of Nursing. The minutes have recorded aspects of the School’s operation such as student selection and performance, examinations, teaching programs, curriculum changes, faculty, school calendar, revalidation of foreign diplomas, financial turnover, and other disciplinary, administrative, and legal matters concerning the course. One can infer that the original purpose of creating the School was “in tune” with the broader project of the medical and social elite of the time

CENTRO DE PARTO NORMAL COMO ESTRATÉGIA DE INCENTIVO AO PARTO NORMAL: ESTUDO DESCRITIVO

Recientemente se verificó un esfuerzo gubernamental para reducir las tasas de cesariana en el sector público y cualificar la asistencia al parto normal. Así, se crearon los Centros de Parto Normal (CPN) destinados al acompañamiento de nacimientos fisiológicos, a cargo de enfermeras obstétricas. Este estudio descriptivo tuvo como objetivo caracterizar a las parturientas en cuanto a la edad materna, historia obstétrica, condiciones del parto y del recién-nacido en un CPN, en la ciudad de São Paulo. Se utilizaron datos secundarios de registros de nacimientos atendidos por enfermeras obstétricas y se analizaron 1.860 registros de partos ocurridos en julio y agosto de 2001. Los resultados indican: edad media de 23,7 años; 44,4% de nulíparas; 79,0% de partos normales; peso medio de los recién-nacidos de 3.174g; Apgar ≥7 en el primer y quinto minutos en 93,7% y 99,1% de los recién nacidos, respectivamente. Se concluyó que la atención al parto hecha por enfermeras obstétricas es importante para valorar la fisiología del parto y nacimiento, con indicadores obstétricos y neonatales de calidad.Tem-se verificado um esforço governamental para reduzir as taxas de cesariana no setor público e qualificar a assistência ao parto normal. Assim, foram criados Centros de Parto Normal (CPN) destinados ao acompanhamento de nascimentos fisiológicos, a cargo de enfermeiras obstétricas. Este estudo descritivo teve como objetivo caracterizar as parturientes quanto à idade materna, história obstétrica, condições do parto e do recémnascido em um CPN, na cidade de São Paulo. Utilizaram-se dados secundários de registros de nascimentos assistidos por enfermeiras obstétricas. Foram analisados 1.860 registros de partos ocorridos em julho e agosto de 2001. Os resultados indicam: idade média de 23,7 anos; 44,4% de nulíparas; 79,0% de partos normais; peso médio dos recém-nascidos de 3.174 g; índice de Apgar ≥7 no primeiro e quinto minutos em 93,7% e 99,1% dos recémnascidos, respectivamente. Concluiu-se que a assistência prestada por enfermeiras obstétricas em CPN vai ir ao encontro da valorização da fisiologia do parto e nascimento, com indicadores neonatais e obstétricos de qualidade

Childbirth care: the oral history of women who gave birth from the 1940s to 1980s

This study's objective was to gain a greater understanding of the changes that took place in the childbirth care model from the experience of women who gave birth in the State of Sao Paulo, Brazil from the 1940s to the 1980s. This is a descriptive study conducted with 20 women using the Thematic Oral History method. Data were collected through unstructured interviews. The theme extracted from the interviews was "The experience of childbirth". The results indicate a time and generational demarcation in the 1970s. Childbirths from 1940 to 1960 occurred in a context of transition from home to hospital births. The 1980s represents a turning point in the elements that compose the childbirth care model, such as the type and place of birth and the professional assisting women, with an increased use of technology and obstetric interventions

Rate and duration of hospitalisation for acute pulmonary embolism in the real-world clinical practice of different countries : Analysis from the RIETE registry

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MicroRNA-146b promotes PI3K/AKT pathway hyperactivation and thyroid cancer progression by targeting PTEN

Recent studies have shown that miR-146b is the most upregulated microRNA in thyroid cancer and has a central role in cancer progression through mechanisms that remain largely unidentified. As phosphoinositide 3-kinase/protein kinase-B (PI3K/AKT) signaling is a fundamental oncogenic driver in many thyroid cancers, we explored a potential role for miR-146b and its target genes in PI3K/AKT activation. Among the predicted target genes of miR-146b, we found the tumor-suppressor phosphatase and tensin homolog (PTEN). Constitutive overexpression of miR-146b in thyroid epithelial cell lines significantly decreased PTEN mRNA and protein levels by direct binding to its 3'-UTR. This was accompanied by PI3K/AKT hyperactivation, leading to the exclusion of FOXO1 and p27 from the nucleus and a corresponding increase in cellular proliferation. Moreover, miR-146b overexpression led to protection from apoptosis and an increased migration and invasion potential, regulating genes involved in epithelial-mesenchymal transition. Notably, with the single exception of E-cadherin expression, all of these outcomes could be reversed by PTEN coexpression. Further analysis showed that miR-146b directly inhibits E-cadherin expression through binding to its 3'-UTR. Interestingly, miR-146b inhibition in human thyroid tumor xenografts, using a synthetic and clinically amenable molecule, blocked tumor growth when delivered intratumorally. Importantly, this inhibition increased PTEN protein levels. In conclusion, our data define a novel mechanism of PI3K/AKT hyperactivation and outline a regulatory role for miR-146b in suppressing PTEN expression, a frequent observation in thyroid cancer. Both events are related to a more aggressive tumoral phenotype. Targeting miR-146b therefore represents a promising therapeutic strategy for the treatment of this disease.This work was supported by grants SAF2013-44709-R and SAF2016-75531-R from the Ministerio de Economía y Competitividad (MINECO) of Spain, RD12/0036/0030 from Instituto de Salud Carlos III (ISCIII), Fondo Europeo de Desarrollo Regional (FEDER), and GCB14142311CRES from Fundación Española contra el Cancer. JR-M holds a FPU fellowship from Ministerio de Educación Cultura y Deporte. LW-L was funded by an FPI fellowship from MEC and is currently an investigator of the project PI14/01980 from ISCIII (Spain).Peer reviewe