ITINERÁRIOS TERAPÊUTICOS EM BUSCA DO DIAGNÓSTICO E TRATAMENTO DA HANSENÍASE

Objetivo: analisar o itinerário terapêutico de usuários em busca do diagnóstico e tratamento da hanseníase e identificar as dificuldades e as percepções dos usuários acerca da doença. Método: estudo qualitativo e descritivo. Participaram 20 usuários com hanseníase em registro ativo até março de 2016 em um Centro de Saúde Escola no município de Belém-Pará, Brasil. Foi realizada entrevista semiestruturada e a técnica de análise de conteúdo temática. Resultado: Emergiram duas categorias temáticas “Percepção sobre a doença” e “Percalços da suspeição ao diagnóstico e tratamento”. Ainda existe percepções negativas sobre a patologia e muitos percalços a percorrer até o diagnóstico da hanseníase. Conclusão: A busca pelo diagnóstico da hanseníase apontou uma sucessão de erros diagnósticos da rede privada à rede básica de saúde, delineando um percurso tortuoso. As percepções dos usuários atrelam-se ao preconceito, seja este dos outros para consigo ou ao auto preconceito. Descritores: Saúde Coletiva; Hanseníase; Vigilância em Saúde

Representações sociais sobre agricultura familiar para alunos de licenciatura em educação do campo residentes da zona rural

O objetivo deste trabalho foi identificar representações sociais de moradores do campo licenciandos em Educação do Campo sobre agricultura familiar. Estudo transversal, exploratório, descritivo, com abordagem qualitativa e embasamento teórico na Teoria das Representações Sociais.  Aplicou-se questionário para caracterização sociodemográfica e prática da agricultura familiar. Foram coletados dados cartográficos e textuais. Participaram do estudo 20 estudantes com idade média de 27 anos (10,28). Dos 20 estudantes, 80% (16) cultivavam hortas em casa e 85% (17) cultivavam pomares, cuja principal finalidade era autoconsumo. A agricultura familiar é representada como prática sustentável, cultural, praticada pelo núcleo familiar, produtora de alimentos saudáveis, sem agrotóxicos e promotora de qualidade de vida, geradora de renda e voltada para autoconsumo. As concepções sobre agricultura familiar estão relacionadas ao tipo de agricultura praticada pelo grupo, às informações recebidas da comunidade, meios midiáticos e familiares, não ao conceito técnico sobre esse tema

Nanostructured system based on hydroxyapatite and curcumin: A promising candidate for osteosarcoma therapy:A promising candidate for osteosarcoma therapy

Osteosarcoma is the most common type of bone cancer. Despite therapeutic progress, survival rates for metastatic cases or that do not respond well to chemotherapy remain in the 30% range. In this sense, the use of nanotechnology to develop targeted and more effective therapies is a promising tool in the fight against cancer. Nanostructured hydroxyapatite, due to its biocompatibility and the wide possibility of functionalization, is an interesting material to design nanoplatforms for targeted drug delivery. These platforms have the potential to enable the use of natural substances in the fight against cancer, such as curcumin. Curcumin is a polyphenol with promising properties in treating various types of cancer, including osteosarcoma. In this work, hydroxyapatite (n-HA) nanorods synthesized by the hydrothermal method were investigated as a carrier for curcumin. For this, first-principle calculations based on the Density Functional Theory (DFT) were performed, in which the modification of curcumin (CM) with the coupling agent (3-aminopropyl) triethoxysilane (APTES) was theoretically evaluated. Curcumin was incorporated in n-HA and the drug loading stability was evaluated by leaching test. Samples were characterized by a multi-techniques approach, including Fourier transform infrared spectroscopy (FTIR), UV–visible spectroscopy (UV–Vis), X-ray diffraction (XRD), X-ray fluorescence spectrometry (FRX), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), zeta potential analysis (ζ), X-ray photoelectron spectroscopy (XPS) and transmission electron microscopy (TEM). The results show that n-HAs with a 90 nm average size were obtained and successful incorporation of curcumin in the nanostructure was achieved. Cell viability and the number of osteosarcoma cells were decreased by CMAP-HA treatment. Furthermore, the stability test suggests that hydroxyapatite nanoparticles present great potential for the transportation of curcumin in the bloodstream, crediting this system for biological performance evaluations aiming at the treatment of osteosarcomas. Keywords: nanostructures, curcumin, hydroxyapatite, osteosarcoma

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Perceptions of the appropriate response to norm violation in 57 societies

An Author Correction to this article: DOI: 10.1038/s41467-021-22955-x.Norm enforcement may be important for resolving conflicts and promoting cooperation. However, little is known about how preferred responses to norm violations vary across cultures and across domains. In a preregistered study of 57 countries (using convenience samples of 22,863 students and non-students), we measured perceptions of the appropriateness of various responses to a violation of a cooperative norm and to atypical social behaviors. Our findings highlight both cultural universals and cultural variation. We find a universal negative relation between appropriateness ratings of norm violations and appropriateness ratings of responses in the form of confrontation, social ostracism and gossip. Moreover, we find the country variation in the appropriateness of sanctions to be consistent across different norm violations but not across different sanctions. Specifically, in those countries where use of physical confrontation and social ostracism is rated as less appropriate, gossip is rated as more appropriate.Peer reviewe

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Conhecimentos sobre prevenção da SIDA entre profissionais e acadêmicos da área de saúde

Este estudo exploratório foi realizado pelas alunas e alunos da Disciplina de Enfermagem nas Doenças Transmissíveis. Foram analisadas as respostas de 52 questionários distribuídos entre acadêmicos de enfermagem, de medicina, médicos, dentistas, enfermeiros e auxiliares de enfermagem que assistem pacientes com SIDA e enfermeiros que não assistem pacientes com SIDA. Estes questionários versaram sobre medidas de prevenção da transmissão sexual, normal de biossegurança, testes diagnósticos, direitos do paciente e do trabalhador e alterações no atendimento aos portadores desta patologia.This work is a exploratory research based on the analysis of the answers to the questionaires of 52 students and health care professionals knowledge about AIDS sexual prevention, biossecurity, diagnosis tests, patients and workers rights and the modifications of nursing and medica/ care to this kind of diseaseTrata se de un estudio exploratório acerca del conocimiento de la prevención de la SIDA, normas de seguridad biológica, pruebas diagnósticas, derechos de /os enfermos y trabajadores con SIDA y de esa mfermedad. Fueron analizados las respuestas de 52 cuestionários de estudientes de enfermería, nédicos, odontólogos, enfermeras y ajudantes de enfermería

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223