Gravidez na adolescência em Boa Vista - Roraima (Brasil) no ano de 2011: fatores predisponentes e medidas de prevenção

Gravidez na Adolescência em Boa Vista - Roraima (Brasil) no ano de 2011: Fatores Predisponentes e Medidas de Prevenção. O número elevado de gravidez na adolescência tem motivado estudos, em caráter mundial, pois repercute em todos os setores da vida das adolescentes, principalmente em seu processo educacional, na construção de sua independência econômica e em seus relacionamentos sociais, especialmente o familiar. O estudo teve o objetivo de identificar comportamentos e fatores familiares e socioculturais que contribuíram para a gravidez entre as adolescentes inscritas na Estratégia de Saúde da Família (ESF) no Município de Boa Vista/Roraima (Brasil) no ano de 2011. Foi desenvolvido nos termos de pesquisa exploratória com abordagem qualitativa. Para a coleta de dados foi usado um roteiro de entrevista contendo 53 questões (abertas e fechadas), aplicado junto às adolescentes grávidas inscritas nas Unidades Básicas de Saúde da Família, no período de 01 a 30 de junho de 2011. A amostra incluiu 110 adolescentes com idades compreendidas entre os 13 e os 19 anos, sendo a média de 16,5 anos. Os resultados mostram que: 98% das jovens sobrevivem com baixa renda; 90,91% possuem baixa escolaridade, apresentando uma evasão escolar de 55% dos casos motivada, principalmente, pela gravidez; 33,64% tiveram que abandonar o emprego; 30,91% já possuíam outros filhos; para 85,50% suas mães também foram adolescentes grávidas; a religião predominante é a evangélica com 47,27%; 72% não tinham aula de educação sexual; 56% conversavam sobre sexo, essencialmente com os amigos, representando 59,68%; 44% não tinham atividade educativa na Unidade de Saúde da Família e 48% não frequentavam a Unidade antes da gravidez; 55% referiram não ter tido orientação sexual; 85% informaram que a mídia influenciou o sexo/gravidez; 82% não planejaram a gravidez; houve predominância de reação negativa por parte da adolescente, de seus familiares, do pai da criança e dos familiares do pai da criança; a média de idade para início de relação sexual foi de 14,6 anos; 36,36% tiveram seus parceiros também adolescentes; 9% foi obrigada a casar; 71% prevenia a gravidez, sendo 69% pelo uso do preservativo masculino; havia presença de DST em 9% das entrevistadas; 23% pensaram realizar o aborto; 27% foi estimulada a realizar o aborto; 11% sofreram violência; 38% relataram que o motivo que mais influenciou a ocorrência da gravidez foi a falta de informação; 43,63% faziam uso de álcool antes da gravidez; 38,18% deixaram de fazer uso de álcool após a descoberta da gravidez; 31% referiram que o álcool influenciou a ocorrência do sexo/gravidez. Espera-se que os resultados alcançados com o presente estudo possam contribuir para a elaboração, implantação e implementação de políticas públicas no sentido de elaborar propostas de projetos assistenciais e de educação em saúde relacionada ao tema, estimulando a multi e interdisciplinaridade, embasados no contexto sócio-cultural das adolescentes, com o objetivo de reduzir a problemática abordada; 6 ABSTRACT Teenage Pregnancy in Boa Vista - Roraima (Brazil) in 2011: Predisposing Factors and Prevention Measures. The high number of teenage pregnancies has motivated studies around the world, since its influence on many aspects in adolescents’ life, including their education, economic independence achievement and social relationships, especially family. Based on this context, this study aimed to identify behaviors related to family and a combination of social and cultural factors that may contribute to pregnancy among adolescents enrolled in Family Health Strategy (FHS) in Boa Vista / Roraima (Brazil), 2011. The sample included 110 adolescents aged 13 to 19 years, on average of 16.5 years. The results show that: 98% of young people living on low income;90.91% had low education, with a dropout of 55% of the cases motivated mainly by pregnancy; 33.64% had to quit her job; 30, 91% already had other children; 85.50% for their mothers were also pregnant adolescents; the predominant religion is evangelical 47.27%; 72% had no sex education class; 56% talked about sex, primarily with friends representing 59.68%; 44% had no educational activity in the Family Health Unit and 48% were not attending the Unity before pregnancy; 55% reported not having sexual orientation, 85% reported that the media influenced the sex / pregnancy , 82% did not plan the pregnancy, there was a predominance of negative reaction on the part of adolescents, their families, the father of the child and family members of the child's parent, the average age of onset of sexual intercourse was 14.6 years; 36.36% had partners also adolescents, 9% was forced to marry, 71% prevented pregnancy, 69% by the use of male condoms, STD was present in 9% of the respondents, 23% thought the abortion; 27 % was encouraged to have an abortion, 11% experienced violence, 38% reported that the reason that most influenced the occurrence of pregnancy was the lack of information; 43.63% drank alcohol before pregnancy; 38.18% stopped use alcohol after the discovery of the pregnancy, 31% reported that alcohol influenced the occurrence of sex / pregnancy. It was conducted as an exploratory research with a qualitative approach. An interview guide containing 53 objective and subjective questions was used for data collection. It was applied to pregnant teenagers enrolled in the Basic Family Health units, from June 1st to 30th, 2011. We hope that the research results may contribute to development, deployment and implementation of public policies, such as care and health education proposals related to the theme. Also, to encourage multi and interdisciplinary work on teenagers’ social and cultural factors, in order to reduce the addressed problem

Atheromas that cause fatal thrombosis are usually large and frequently accompanied by vessel enlargement

Several lines of clinical evidence show that AMI frequently occurs at sites with mild to moderate degree of coronary stenosis. The degree of luminal stenosis depends on plaque deposition and degree of vessel remodeling, features poorly assessed by coronary angiography. This postmortem study tested the hypothesis that the size of coronary atheroma and the type of remodeling distinguish culprit lesion responsible for fatal AMI from equi-stenotic nonculprit lesion in the same coronary tree. The main coronary branches from 36 consecutive patients with fatal AMI were studied. The culprit lesion (Group 1) and an equi-stenotic nonculprit segment (Group 2) obtained in measurements of another coronary branch from the same patient were compared. Morphometry and plaque composition was assessed in both groups. Compared to Group 2, Group 1 had larger areas of: plaque $9.6 vs. 4.7 mm^2$, vessel $12.7 vs. 7.4 mm^2$ and lumen $1.7 vs. 1.2 mm^2$; (P<.01). Positive remodeling was more frequent in Group 1 than Group 2: 21/30 (70%) vs. 8/26 (31%). Plaque area correlated positively with lipid core and macrophages and negatively with fibrosis and smooth muscle cells. Atherosclerotic plaques that cause fatal thrombosis are more frequently positively remodeled and tend to be larger than nonculprit plaques with the same degree of cross-sectional stenosis. We tested whether arterial remodeling and plaque size vary between segments containing a fatal thrombosed plaque versus an equi-stenotic nonculprit plaque. Culprit vessel segments had higher cross-sectional areas of intimal plaque and of vessel wall than equi-stenotic nonculprit plaques. The cross-sectional area of the vessel correlated positively with both the lipid core area and $CD68^+$ macrophage content, and negatively with fibrosis area and smooth muscle cell content. These results add elements explaining limitations of angiography in identifying plaques and provide new insights into the role of remodeling in plaque instability.Other Research Uni

Influência da religiosidade/espiritualidade do profissional de saúde no cuidado ao paciente crítico

Introdução: Estudos comprovam que práticas espirituais melhoram a saúde mental, qualidade de vida e relação interpessoal das pessoas. Para os profissionais de saúde, isto possibilita melhor enfrentamento do estresse no trabalho com consequente melhoria no bem estar e maior satisfação. Este estudo tem como objetivo verificar se a religiosidade/espiritualidade dos profissionais de saúde influencia no cuidado prestado ao paciente crítico. Materiais e Métodos: Estudo de caráter transversal com abordagem quantitativa, realizado com 53 profissionais que atuam em Unidades de Terapia Intensiva Adulto de uma cidade do interior do Brasil. Foi utilizado um questionário adaptado e a escala Spirituality Self Rating Scale, e realizada análise descritiva dos dados e de associação, utilizando o teste exato de Fisher com nível de significância de 5%. Resultados: Verificou-se que 77,4% da amostra eram do sexo feminino, com idade média de 37 anos, tempo médio de serviço de 11 anos e a maioria era evangélica/protestante. A maior parte dos profissionais apresentou espiritualidade elevada e informou que a sua religiosidade/espiritualidade influencia intensamente no entendimento do processo saúde-doença e na sua relação com o paciente crítico, além de modificar sua maneira de cuidar deste paciente. Discussão: Diversos estudos têm demonstrado que a religiosidade/espiritualidade pode ser capaz de gerar estado de calma e tranquilidade, melhorar a saúde física e mental, promover comportamentos e estilos de vida mais saudáveis, diminuindo o estresse e melhorando o relacionamento interpessoal. Conclusões: A religiosidade/espiritualidade dos profissionais que atuam na Unidade de Terapia Intensiva influencia no cuidado prestado ao paciente crítico.Como citar este artigo: Longuiniere ACF, Yarid SD, Silva ECS. Influência da religiosidade/espiritualidade do profissional de saúde no cuidado ao paciente crítico. Rev Cuid. 2018; 9(1): 1961-72. http://dx.doi.org/10.15649/cuidarte.v9i1.41

Pervasive transition of the Brazilian land-use system

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Evidence for maintenance of sex determinants but not of sexual stages in red yeasts, a group of early diverged basidiomycetes

<p>Abstract</p> <p>Background</p> <p>The red yeasts are an early diverged group of basidiomycetes comprising sexual and asexual species. Sexuality is based on two compatible mating types and sexual identity is determined by <it>MAT </it>loci that encode homeodomain transcription factors, peptide pheromones and their receptors. The objective of the present study was to investigate the presence and integrity of <it>MAT </it>genes throughout the phylogenetic diversity of red yeasts belonging to the order Sporidiobolales.</p> <p>Results</p> <p>We surveyed 18 sexual heterothallic and self-fertile species and 16 asexual species. Functional pheromone receptor homologues (<it>STE3.A1 </it>and <it>STE3.A2</it>) were found in multiple isolates of most of the sexual and asexual species. For each of the two mating types, sequence comparisons with whole-genome data indicated that synteny tended to be conserved along the pheromone receptor region. For the homeodomain transcription factor, likelihood methods suggested that diversifying selection acting on the self/non-self recognition region promotes diversity in sexual species, while rapid evolution seems to be due to relaxed selection in asexual strains.</p> <p>Conclusions</p> <p>The majority of both sexual and asexual species of red yeasts have functional pheromone receptors and homeodomain homologues. This and the frequent existence of asexual strains within sexual species, makes the separation between sexual and asexual species imprecise. Events of loss of sexuality seem to be recent and frequent, but not uniformly distributed within the Sporidiobolales. Loss of sex could promote speciation by fostering the emergence of asexual lineages from an ancestral sexual stock, but does not seem to contribute to the generation of exclusively asexual lineages that persist for a long time.</p

Assessing autophagy in archived tissue or how to capture autophagic flux from a tissue snapshot

Autophagy is a highly conserved degradation mechanism that is essential for maintaining cellular homeostasis. In human disease, autophagy pathways are frequently deregulated and there is immense interest in targeting autophagy for therapeutic approaches. Accordingly, there is a need to determine autophagic activity in human tissues, an endeavor that is hampered by the fact that autophagy is characterized by the flux of substrates whereas histology informs only about amounts and localization of substrates and regulators at a single timepoint. Despite this challenging task, considerable progress in establishing markers of autophagy has been made in recent years. The importance of establishing clear-cut autophagy markers that can be used for tissue analysis cannot be underestimated. In this review, we attempt to summarize known techniques to quantify autophagy in human tissue and their drawbacks. Furthermore, we provide some recommendations that should be taken into consideration to improve the reliability and the interpretation of autophagy biomarkers in human tissue samples.This work was supported by grants from the Bernese Cancer League, “Stiftung für klinisch-experimentelle Tumorforschung”, and the Werner and Hedy Berger-Janser Foundation for Cancer Research (to M.H.); by Institute of Health Carlos III (ISCIII) and FEDER funds from the EU (PI14/01085 and PI17/00093) and supported by Miguel Servet contract by ISCIII and FSE funds (CPII16/00023) (to M.M.); from the Spanish Ministry of Science, Innovation and Universities (RTI2018-096748-B-100 to N.A.); from the University Professor Training Fellowship, Ministry of Science, Innovation and University, Government of Spain (FPU17/00026) (to P.C.O); from the ISCIII (PI16/00090 and PI19/01266) and the Andalusian Government (Consejería de Igualdad, Salud y Políticas Sociales, PI-0198-2016) for their financial support, and from the Biomedical Research Network Center for Liver and Digestive Diseases (CIBERehd) founded by the ISCIII and co-financed by European Development Regional Fund (EDRF) “A way to achieve Europe” for their financial support (to J.M.), from Breakthrough Cancer Research, Ireland funding (to S.L.M); from the PI18/00442 grant integrated into the State Plan for R & D + I2013-2016 and funded by the ISCIII and the ERDF, a way to make Europe (to G.V.); from the Luxembourg National Research Fund (C18/BM/12670304/COMBATIC to B.J.); from the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, by the European Regional Development Fund (FEDER), through the Competitiveness Factors Operational Programme (COMPETE) (NORTE-01-0145-FEDER-000013) and from the projects POCI-01-0145-FEDER-028159 and POCI-01-0145-FEDER-030782 by FEDER, through the COMPETE (to P.L.); from National funds, through the Foundation for Science and Technology (FCT) (to P.L.); from ARRS—the Slovenian research agency, programme P1-0140: Proteolysis and its regulation (led by B. Turk) (to E.Ž.); from the Swiss Cancer Research (KFS-3360-02-2014) (to A.P, and M.P.T.) (KFS-3409-02-2014), and the Swiss National Science Foundation (31003A_173219) (to M.P.T.)

Early leaf removal impact on volatile composition of Tempranillo wines

Early defoliation is a very innovative technique in viticulture used for yield management. The effects of early leaf removal performed manually and mechanically at two different phenological stages, pre-bloom and fruit set, on the volatile composition of Tempranillo (Vitis vinifera L.) wines were studied. Volatiles were identified and quantified by gas chromatography Early leaf removal only modified the total concentrations of C6 compounds and acetates, whereas total alcohols, esters, volatile acids and terpenes remained generally unaffected. Early defoliation induced a significant reduction in C6 compounds and increased the concentrations of acetates in Tempranillo wines. An effect of timing (pre-bloom vs fruit set) alone was observed for all acetates analysed. Regarding the method of defoliation (manual vs mechanical), significant differences in some ethyl ester (ethyl-2-methylbutyrate and ethyl octanoate) and volatile acid concentrations were observed among treatments. Ethyl octanoate, 2-phenylethyl acetate, 3-methylbutyl acetate and hexanoic acid, with OAV (odour activity value) > 1 and mainly fruity and floral odour descriptors, showed higher levels after early defoliation treatments compared with non-defoliated vines. Principal component analysis illustrated the difference in wines from defoliated and non-defoliated treatments based on their volatile composition. It can be concluded that early leaf removal significantly modified the wine aroma compounds, increasing or decreasing several of these compounds.We thank the Agencia de Desarrollo Economico de La Rioja (ADER) and the Ministerio de Ciencia e Innovacion for their financial support (ADER-2006-I-ID-00157 and AGL2007-60378 respectively). We would also like to thank the Agrupacion de Bodegas Centenarias y Tradicionales de Rioja (ABC) and New Holland for their assistance and help. Dr Vilanova is grateful to the 'Isidro Parga Pondal' programme financed by the Xunta de Galicia (Spain)

A Deviation from the Bipolar-Tetrapolar Mating Paradigm in an Early Diverged Basidiomycete

In fungi, sexual identity is determined by specialized genomic regions called MAT loci which are the equivalent to sex chromosomes in some animals and plants. Usually, only two sexes or mating types exist, which are determined by two alternate sets of genes (or alleles) at the MAT locus (bipolar system). However, in the phylum Basidiomycota, a unique tetrapolar system emerged in which four different mating types are generated per meiosis. This occurs because two functionally distinct molecular recognition systems, each encoded by one MAT region, constrain the selection of sexual partners. Heterozygosity at both MAT regions is a pre-requisite for mating in both bipolar and tetrapolar basidiomycetes. Tetrapolar mating behaviour results from the absence of genetic linkage between the two regions bringing forth up to thousands of mating types. The subphylum Pucciniomycotina, an early diverged lineage of basidiomycetes encompassing important plant pathogens such as the rusts and saprobes like Rhodosporidium and Sporidiobolus, has been so far poorly explored concerning the content and organization of MAT loci. Here we show that the red yeast Sporidiobolus salmonicolor has a mating system unlike any previously described because occasional disruptions of the genetic cohesion of the bipolar MAT locus originate new mating types. We confirmed that mating is normally bipolar and that heterozygosity at both MAT regions is required for mating. However, a laboratory cross showed that meiotic recombination may occur within the bipolar MAT locus, explaining tetrapolar features like increased allele number and evolution rates of some MAT genes. This pseudo-bipolar system deviates from the classical bipolar–tetrapolar paradigm and, to our knowledge, has never been observed before. We propose a model for MAT evolution in the Basidiomycota in which the pseudo-bipolar system may represent a hitherto unforeseen gradual form of transition from an ancestral tetrapolar system to bipolarity

Dictamen Técnico-Científico sobre la fluoración del agua de abastecimiento público

Se trata de una solicitud del Consejo Regional de Odontología de São Paulo (CROSP), organismo federal creado por la Ley N.º 4.324/1964, responsable de supervisar el ejercicio de las profesiones odontológicas y garantizar el cumplimiento de las normas éticas, para elaborar un Dictamen Técnico-Científico sobre la fluoración del agua de abastecimiento público, debido a la gran demanda que el organismo ha recibido sobre el tema, según consta en la solicitud realizada al Consejo Directivo de la Facultad de Salud Pública (FSP) de la Universidad de São Paulo (USP ), mediante CARTA PRES.0453/2020, de fecha 12/11/2020. En respuesta a la CROSP, el Director del FSP/USP autorizó, el 8/12/2020, la emisión del Dictamen antes mencionado. La Facultad de Salud Pública (FSP) de la Universidad de Sao Paulo (USP) tiene una larga trayectoria de colaboración con instituciones públicas y, de modo general, con la sosedad brasilera con respecto a la fluoración del agua para consumo humano, como una tecnología de salud pública para la prevención de caries dental. El 26 de noviembre de 2009, el Ministerio de Salud reconoció estos antecedentes, que se habían iniciado a mediados del siglo XX, y formalizó la instalación del Centro Colaborados en Vigilancia de Salud Bucal (CECOL) de la FSP/USP. Es así como entre las actividades de supervisión de salud bucal relacionadas al CECOL/USP se enfatizan los aspectos relacionados con la vigilancia de la fluoración del agua de abastecimiento público y temas asociados, con el objetivo de contribuir para mejorar la calidad de la gestión del sector y dotar al país de un sistema de vigilancia de la fluoración del agua que esté basado en informaciones confiables, buscando mejorar la calidad de los datos disponibles acerca de la cobertura de la fluoración en Brasil