Using simulation as cervical and anal cytology teaching-learning strategy

The current descriptive study is an experience report about the use of gynecological simulators in teaching and research activities developed in the Undergraduate and Postgraduate courses in Health at Cruz Alta University in Southern Brazil. The aim of the present study is to describe the use of gynecological simulator as cervical and anal cytological sample collection teaching-learning strategy, as well as to describe the protocol adopted in such procedure. The gynecological simulator is a useful instrument applied to the sample collection practice for cervical and anal cytological examination purposes, since it is a static dummy anatomically similar to the female body. Simulating the procedure allows students to train and improve skills required to the technique; however, the theoretical contextualization must precede the practice in the simulator in order to stimulate students to reflect on all aspects involved in the exam. The use of gynecological simulator is recommended as complementary tool in cytologic examination teaching-learning scenarios

Comorbidades em Idosos Vivendo com HIV/Aids

Objective: To identify the clinical and epidemiological profile of older people living with HIV/Aids.Materials and methods: This was an observational, documentary, cross-sectional, prospective, descriptive and analytical study, conducted from clinical records of the Specialized Attention Service.Results: The study included 64 elderly, of which 53% (34) were men and 47% (30) were women, 81% (52) had completed or less than complete elementary school, 67,18% (43) had TCD4 lymphocytes ≥ 350 cells/mm³, 81% (52) had viral load ≤ 40 copies/mL, 97% (62) were infected by heterosexual relationship and 84,5% (54) had at least one comorbidity. Cachexia (48%), anemia (35%), smoking (31,5%) and systemic arterial hypertension (18,5%) were the most common noncommunicable diseases. Oral candidiasis (55,55%) was the opportunistic diseases with higher incidence in the elderly participants of the study. Conclusion: The presence of comorbidities and opportunistic infections should be investigated among elderly with HIV to ensure support and better care for these individuals.Objetivo: Identificar o perfil clínico e epidemiológico de idosos que vivem com HIV/Aids.Materiais e Métodos: Estudo observacional, documental, transversal, prospectivo, descritivo e analítico, realizado a partir de prontuários clínicos de um Serviço de Atenção Especializada.Resultados: O estudo incluiu 64 idosos, dos quais, 53% (34) eram homens e 47% (30) eram mulheres, 81% (52) possuíam escolaridade igual ou inferior a ensino fundamental completo, 67% (43) apresentaram linfócitos TCD4 ≥ 350 células/mm³, 81% (52) tinham carga viral ≤ 40 cópias/mL, 974% (62) foram infectados por relação heterossexual e 84,5% (54) apresentaram pelo menos uma comorbidade. As comorbidades mais incidentes foram caquexia (48%), anemia (35%), tabagismo (31,5%) e hipertensão arterial sistêmica (18,5%) foram as doenças não transmissíveis mais incidentes. A candidíase oral (55,5%) foi a infecção oportunistas com maior incidência nos idosos participantes do estudo.Conclusão: A presença de comorbidades e infecções oportunistas deve ser investigada entre idosos com HIV para garantir suporte e melhores cuidados a estes indivíduos.

Relação entre os achados da inspeção visual e o exame citológico do colo do útero*

Introduction: The main strategy for the control and screening of cervical cancer (CCU) is cytopathological examination. Objective: To describe the cytological result, relating it to the information of the visual inspection of the cervix. Methodology: Cytological samples collected from women attended at the Primary Health Care were analyzed by the Papanicolaou method. Results: 34 women, aged 19-67 years, participated in the study. Of these, 8.28% were representative of JEC cells; 7.14% presented pathogenic agents and reactive inflammatory changes. One woman, whose cervix was identified as “altered” in the exam requisition, presented a suggestive result of ASC-US. For another woman, with a LSIL cytologic result, the cervix was identified as “normal” in the examination request. Conclusion: This study demonstrates that observation of the visual aspects of the cervix during visual inspection of the pap smear is an important tool for screening the CCU.Introdução: A principal estratégia para o controle e rastreamento do câncer do colo do útero (CCU) é o exame citopatológico. Objetivo: Descrever o resultado citológico, relacionando-o com as informações da inspeção visual do colo do útero. Metodologia: Amostras citológicas coletadas de mulheres atendidas na Atenção Básica de Saúde foram analisadas pelo método de Papanicolaou. Resultados: Participaram do estudo 34 mulheres, com idade entre 19 e 67 anos. Destas, 8,28% tiveram representatividade de células da JEC; 7,14% apresentaram agentes patogênicos e alterações reativas inflamatórias. Uma mulher, cujo colo foi identificado como “alterado” na requisição do exame, apresentou resultado sugestivo de ASC-US. Para outra mulher, com resultado citológico de LSIL, o colo foi identificado como “normal” na requisição do exame. Conclusão: Este estudo demonstra que a observação dos aspectos visuais do colo do útero durante inspeção visual do exame de Papanicolaou é uma importante ferramenta para o rastreamento do CCU

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Macrophages and glial cells: Innate immune drivers of inflammatory arthritic pain perception from peripheral joints to the central nervous system.

Millions of people suffer from arthritis worldwide, consistently struggling with daily activities due to debilitating pain evoked by this disease. Perhaps the most intensively investigated type of inflammatory arthritis is rheumatoid arthritis (RA), where, despite considerable advances in research and clinical management, gaps regarding the neuroimmune interactions that guide inflammation and chronic pain in this disease remain to be clarified. The pain and inflammation associated with arthritis are not isolated to the joints, and inflammatory mechanisms induced by different immune and glial cells in other tissues may affect the development of chronic pain that results from the disease. This review aims to provide an overview of the state-of-the-art research on the roles that innate immune, and glial cells play in the onset and maintenance of arthritis-associated pain, reviewing nociceptive pathways from the joint through the dorsal root ganglion, spinal circuits, and different structures in the brain. We will focus on the cellular mechanisms related to neuroinflammation and pain, and treatments targeting these mechanisms from the periphery and the CNS. A comprehensive understanding of the role these cells play in peripheral inflammation and initiation of pain and the central pathways in the spinal cord and brain will facilitate identifying new targets and pathways to aide in developing therapeutic strategies to treat joint pain associated with RA

Os Efeitos Do Exercício No Desempenho Físico Em Idosos Residentes De Instituições De Longa Permanência: Uma Revisão Integrativa.

Introdução: Com o crescimento no número de idosos na população, cada vez mais surgem indivíduos incapacitados e dependentes de uma rede de cuidados. O treinamento físico pode ser uma intervenção efetiva para atenuar o declínio ou melhorar o desempenho físico relacionado com a idade.  Objetivo: sumarizar os efeitos dos exercícios no desempenho físico em idosos residentes de Instituições de Longa Permanência através da bateria de testes Short Physical Performance Battery, teste Levantar e caminhar, Teste de Sentar e levantar de 30 segundos. Materiais e Métodos: Foi realizada uma revisão integrativa da literatura empregando as bases de dados PubMed/ Medline, Scielo e Lilacs. Foram utilizadas as pesquisas que atendam os critérios de inclusão, sendo eles: pesquisa publicadas nos últimos 10 anos, de ensaios clínicos em adultos com mais de 60 anos residentes em Instituições de Longa Permanência e artigos com textos completos publicados em inglês ou português. Resultados: Considerando os critérios de inclusão, foram selecionados 32 estudos. O treinamento multicomponente foi utilizado em 11 estudos e os exercícios resistidos apareceu em 8, sendo as modalidades mais utilizadas. Conclusões: A revisão apontou que ambas as modalidades melhoram significativamente os parâmetros de desempenho físico relevantes para a capacidade funcional do idoso institucionalizado

AIBP regulates TRPV1 activation in chemotherapy-induced peripheral neuropathy by controlling lipid raft dynamics and proximity to TLR4 in dorsal root ganglion neurons.

Nociceptive afferent signaling evoked by inflammation and nerve injury is mediated by the opening of ligand-gated and voltage-gated receptors or channels localized to cholesterol-rich lipid raft membrane domains. Dorsal root ganglion (DRG) nociceptors express high levels of toll-like receptor 4 (TLR4), which also localize to lipid rafts. Genetic deletion or pharmacologic blocking of TLR4 diminishes pain associated with chemotherapy-induced peripheral neuropathy (CIPN). In DRGs of mice with paclitaxel-induced CIPN, we analyzed DRG neuronal lipid rafts, expression of TLR4, activation of transient receptor potential cation channel subfamily V member 1 (TRPV1), and TLR4-TRPV1 interaction. Using proximity ligation assay, flow cytometry, and whole-mount DRG microscopy, we found that CIPN increased DRG neuronal lipid rafts and TLR4 expression. These effects were reversed by intrathecal injection of apolipoprotein A-I binding protein (AIBP), a protein that binds to TLR4 and specifically targets cholesterol depletion from TLR4-expressing cells. Chemotherapy-induced peripheral neuropathy increased TRPV1 phosphorylation, localization to neuronal lipid rafts, and proximity to TLR4. These effects were also reversed by AIBP treatment. Regulation of TRPV1-TLR4 interactions and their associated lipid rafts by AIBP covaried with the enduring reversal of mechanical allodynia otherwise observed in CIPN. In addition, AIBP reduced intracellular calcium in response to the TRPV1 agonist capsaicin, which was increased in DRG neurons from paclitaxel-treated mice and in the naïve mouse DRG neurons incubated in vitro with paclitaxel. Together, these results suggest that the assembly of nociceptive and inflammatory receptors in the environment of lipid rafts regulates nociceptive signaling in DRG neurons and that AIBP can control lipid raft-associated nociceptive processing