LA VIDA DESPUÉS DEL TRANSPLANTE DE MÉDULA ÓSEA: IMPLICACIONES PARA EL COTIDIANO

Estudio cualitativo cuyo objetivo fue comprender las vivencias de adultos sometidos al transplante de médula ósea autólogo e identificar las implicaciones en el cotidiano de los sujetos que pasaron por ese proceso. Fueron realizadas entrevistas orientadas por guión semi estructurado, con siete adultos trasplantados que viven en un municipio del interior de Minas Gerais y que tuvieron alta entre octubre de 2004 y septiembre de 2010. Se evidenciaron cuestiones referentes a las implicaciones en el cotidiano de las personas con cambios en la vida después del transplante de médula ósea. Después del análisis de contenido temático surgieron tres categorías empíricas: Alejamiento del trabajo; Estado de vigilia: preocupación constante con recidivas después de alta y Restructuración de la vida después del transplante de médula ósea – resignificaciones del existir. Se concluye que es necesaria la adopción de conductas profesionales permeadas de adaptación, utilizándose diferentes estrategias, como creatividad, emoción y, sobretodo, saber científico.Estudo qualitativo buscou compreender as vivências de adultos submetidos ao transplante de medula óssea autólogo e identificar as implicações no cotidiano dos sujeitos que o vivenciam. Foram realizadas entrevistas orientadas por roteiro semiestruturado, com sete adultos transplantados residentes em um município do interior de Minas Gerais e que tiveram alta entre de outubro de 2004 e setembro de 2010. Evidenciaram-se questões relativas às implicações no cotidiano das pessoas com mudanças na vida após o transplante de medula óssea. Após a análise de conteúdo temática surgiram três categorias empíricas: Afastamento do trabalho; Estado de vigília: preocupação constante com recidivas após a alta e Reestruturação da vida após o transplante de medula óssea – ressignificações do existir. Conclui-se que é necessária a incorporação de condutas profissionais permeadas de adaptação, utilizando-se diferentes estratégias, como criatividade, emoção e, sobretudo, saber científico.This qualitative study sought to understand the experiences of adults who had submitted to autologous bone marrow transplant and to identify the implications for daily routines in the individuals who had gone through it. Interviews were undertaken, guided by a semi-structured script, with seven adult inpatients who had undergone the transplant, in a country town in the state of Minas Gerais, and who had been discharged between October 2004 and September 2010. Evidence was found for questions relevant to implications for daily routines of the people, with changes in life after the bone marrow transplant. After thematic content analysis, three empirical categories emerged: Withdrawal from work; Sleeplessness: Constant worry about relapses after discharge and Restructuring of one’s life after bone marrow transplant – redefining existing. It is concluded that it is necessary to incorporate thoroughly adaptive professional conduct, using different strategies such as creativity, emotion and, above all, scientific knowledge

Women: Discrimination, violence and struggles in contemporary Brazil

The present paper delimited as a general objective to analyze the theme of women in relation to discrimination, violence and struggles in contemporary Brazil. This is a qualitative work, with a bibliographic nature, in which we revisit studies that deal with women and their struggles for insertion in the labor market, as well as the current conditions for the insertion of women in the commercial field. The relevance of our study lies in the current condition of women, who, according to the Brazilian Federal Constitution (1988), have the same rights as men, and it is necessary to discuss the subject. Given the degree of vulnerability of women in the context of domestic and family violence, it is of paramount importance that studies be developed that focus on ways to protect women against all forms of violence, bringing in their scope a range of possibilities for reflection. Our results pointed to a great scarcity that still exists in work opportunities for women, but despite the great discrimination, violence and struggles, in the twelfth century they have been gaining insertion and representation

The management and effectiveness of professionalization: An educational-based Epistemical study

This academic paper was developed with the aim of analyzing the management challenges for the effectiveness of professionalization. Managers of companies and educational units must contain all their demands in a unit in the administrative sector, so that there are no gaps or divisions in the separation of problems, such as lack of communication and difficulty in working as a team. Therefore, thinking about the actions of managers is immensely important for a good forwarding of professionalization. This is a bibliographical and documentary research, with a qualitative interpretive nature. With regard to the conditions for the effectiveness of the management process in the Brazilian business and educational fields, it became effective for us to carry out a bibliographic survey of existing studies on the subject since the turn of the 21st century. It is argued, therefore, that it is necessary to adopt a more professional and qualified management for the development and concreteness of the professional subject, as well as all those involved in the administrative system

The challenges in the application of educational strategies for doctors in the Programa Mais Médicos do Brasil (PMMB): An analytical-descriptive study

This article analyzes the challenges faced for the application of educational strategies for physicians in the Programa Mais Médicos of Brasil (“More Physicians”) and the contributions of these professionals to the work processes of Family Health teams with a focus on achieving comprehensiveness of health care and the expansion of health care. access to hard-to-reach regions. It is a documentary analysis of a descriptive nature, which includes from laws and regulations, norms, opinions, letters, memo, personal diaries, autobiographies, newspapers, magazines, speeches, radio and television program scripts to books, statistics and files schoolchildren. The results indicate that there is a need for dynamic flexibility in educational actions, focusing on the needs of the population and regions that host the program to reduce care inequities and favor the strengthening of bonds between staff and users in order to provide comprehensive care . Among the challenges, we can highlight the program\u27s contribution to the reduction of practices segmented by professional categories, subordinated to the (bio)medical figure and knowledge, with limited interprofessional and team-community interaction in the construction of common care and interconstitutive knowledge. However, it could be concluded that the contribution of the doctors of the “Mais Médicos” Program in Brazil, in addition to reducing inequities and expanding access to healthcare for the population, also contributes to the deconstruction of the hegemonic medical model, taking into account the importance of interdisciplinary knowledge for the success of comprehensive health care. In addition, it reiterates the importance of dynamic actions focusing on local and territorial reality for educational strategies, as territories have peculiar characteristics, developing the critical-reflective process of professionals and capable of solving demands in different regions

MAIN CLINICAL CHANGES RESPONSIBLE FOR THE SUBSTITUTION OF POLYCHEMOTHERAPY FOR LEPROSY: AN 11-YEAR SURVEY IN A MICRO-REGION OF SOUTHERN TOCANTINS

Objetivo: Avaliar as principais alterações clínicas responsáveis pela troca do esquema padrão anti-hansênico e traçar o perfil epidemiológico destes pacientes, em caráter regional. Métodos: Estudo transversal, retrospectivo utilizando prontuários dos pacientes com hanseníase de Janeiro de 2006 a Dezembro de 2016, na unidade de saúde Policlínica Luiz Santos Filho, Gurupi-Tocantins, com enfoque para os casos em uso de esquema alternativo. Resultados: Registrou-se 1.240 casos de hanseníase no município, destes, 86 (6,93%) foram intolerantes à poliquimioterapia inicial. A Dapsona foi a droga mais substituída, 88,37% dos casos. A síndrome anêmica foi a principal alteração encontrada (56,97%). Não houve correlação significativa entre o número de notificações e substituições (ρ = - 0,229) (α=0,05).  Conclusões: Apesar da baixa taxa de substituições, é fundamental a capacitação das equipes de saúde no reconhecimento da intolerância medicamentosa no tratamento da hanseníase, fortalecendo adesão terapêutica e o combate a hanseníase enquanto problema de saúde pública. Palavras-chave: Hanseníase; Toxicidade de drogas; Quimioterapia combinada; Sintomas clínicos. ABSTRACT Objective: To evaluate the main clinical changes responsible for the substitution of the standard anti-leprosy treatment and identify the epidemiological profile of patients with leprosy on a regional basis. Methods: A cross-sectional retrospective study was conducted using records of patients with leprosy from January 2006 to December 2016 at the Luiz Santos Filho Polyclinic health unit, Gurupi-Tocantins, focusing on cases using an alternative treatment. Results: A total of 1,240 patients with leprosy were registered in the city, of which 86 (6.93%) were intolerant to initial polychemotherapy. Dapsone was the most commonly substituted drug in 88.37% of the cases. Anemic syndrome was the main change identified (56.97%). There was no significant correlation between the number of notifications and substitutions (ρ=-0.229) (α=.05).  Conclusion: Despite the low substitution rates found, it is essential to train healthcare teams to recognize drug intolerance in the treatment of leprosy, improving therapeutic adherence and treating leprosy as a public health problem. Keywords: Leprosy; Drug toxicity; Drug combinations; Clinical symptoms.  Objective: To evaluate the main clinical changes responsible for the substitution of the standard anti-leprosy treatment and identify the epidemiological profile of patients with leprosy on a regional basis. Methods: A cross-sectional retrospective study was conducted using records of patients with leprosy from January 2006 to December 2016 at the Luiz Santos Filho Polyclinic health unit, Gurupi-Tocantins, focusing on cases using an alternative treatment. Results: A total of 1,240 patients with leprosy were registered in the city, of which 86 (6.93%) were intolerant to initial polychemotherapy. Dapsone was the most commonly substituted drug in 88.37% of the cases. Anemic syndrome was the main change identified (56.97%). There was no significant correlation between the number of notifications and substitutions (ρ=-0.229) (α=.05).  Conclusion: Despite the low substitution rates found, it is essential to train healthcare teams to recognize drug intolerance in the treatment of leprosy, improving therapeutic adherence and treating leprosy as a public health problem

Carcinoma adenóide cístico do pulmão : Adenoid cystic carcinoma of the lung

Introdução: O carcinoma adenóide cístico primário de pulmão é uma neoplasia torácica de crescimento lento e com malignidade de baixo grau. Representa 0,04 a 0,2% de todos os tumores pulmonares, sendo considerada uma neoplasia rara. Apresentação do caso: Paciente, sexo masculino, 49 anos de idade, foi admitido no Hospital Santa Casa de Misericórdia de Goiania, apresentando tosse persistente, dispneia, hemoptise e cerca de 4 episódios previos de pneumonia; negou comorbidades, etilismo e tabagismo, uso de medicamentos e alergias conhecidas. Discussão: O adenocarcinoma pulmonar possui como subtipo o carcinoma adenóide cístico. Anteriormente conhecido como cilindroma. Têm baixo grau de malignidade principalmente pelo seu lento crescimento e curso clínico estendido. Conclusão: Por se tratar de uma baixa malignidade, a sobrevida a longo prazo é satisfatoriamente prevista

Cisto cavum interpositum: Cavum interpositum cyst

Introdução: O velum interpositum (VI) é uma membrana no subaracnóideo formado por uma invaginação da pia-máter preenchido por líquido cefalorraquidiano (LCR). Sua formação ocorre durante o período embrionário e regridem posteriormente. A persistência dessa estrutura primitiva pode acarretar em sua dilatação, sendo denominado cavum veli interpositum (CVI) e, se maior que 10 mm em medida transversal axial, cisto cavum veli interpositum. Sua prevalência é maior em recém nascidos e prematuros. Apresentação do caso: paciente do sexo masculino, recém-nascido de 10 dias, foi admitido no Hospital Materno Infantil (HMI), por quadro de vômitos intermitentes, associado a febre de 39.5ºC. A mãe relata prematuridade de 31 semanas, trabalho de parto prolongado, cesariana e apresentação pélvica. RN teve um episódio convulsivo minutos antes da chegada à unidade. Nega outras queixas. A ressonância magnética destaca-se como exame padrão ouro, seguido da tomografia computadorizada de crânio. Discussão: Os cistos de CVI não apontam fisiopatologia e quadro clínico bem definidos, mas os conhecimentos acerca de sua localização são importantes para correlacionar sinais e sintomas neurológicos que condizem com efeito de massa, sendo um diagnóstico diferencial de lesões císticas intracranianas da linha média. A terapêutica ainda é restrita, mas há muitos relatos de casos em que a técnica de fenestração endoscópica minimamente invasiva foi preconizada para o tratamento dos cistos de CVI. Conclusão: Quanto ao prognóstico, em âmbito radiológico, estudos demonstram redução do cisto e do efeito de massa em imagem de ressonância magnética pós-operatória. E, apesar da resposta clínica ser dependente se os sintomas são decorrentes direta ou indiretamente do cisto, também demonstraram melhora nessa esfera

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