Projeto de Extensão “Criar para Informar”: a utilização da arte para a comunicação e divulgação de temas em neurociências–relato de experiência / Extension Project "Create to Inform": the use of art for communication and dissemination of topics in neurosciences-experience report

Com base na carência de conhecimento da população sobre os distúrbios que afetam o sistema nervoso central (SNC) e o sucesso da utilização de estratégias lúdicas como recurso pedagógico, o projeto “Criar para Informar” foi idealizado pelos professores do Grupo de Estudos em Neuroinflamação e Neurotoxicologia (GENIT), do curso de Medicina da Universidade Estadual do Ceará (UECE), com a participação de acadêmicos do curso, visando levar informações à população acerca dessa temática, de forma criativa, lúdica, acessível e interativa. O objetivo do presente relato de experiência é apresentar o projeto “Criar para Informar” edescrever suas produções de educação em saúde relacionadas a distúrbios do sistema nervoso central e ao uso de substâncias que psicoativas. As ações foram planejadas com base na criação de paródias, canções autorais, vídeos e animações, com foco em uma temática por vez, de interesse da população, procurando esclarecer sobre as principais características dos temas abordados. Foram elaborados três produtos ao longo do primeiro ano do projeto (2018): o primeiro consistiu em um vídeo dublado abordando a temática do uso indiscriminado de benzodiazepínicos (BZDs); o segundo teve o formato de uma paródia problematizando o uso abusivo de psicoestimulantes; e o terceiroproduto consistiu em uma música autoral que focou em demonstrar a visão de mundo dos indivíduos com transtorno do espectro autista (TEA – autismo), estimulando compreensão e empatia. As peças artísticas foram amplamente trabalhadas em eventos, nas redes sociais e site, eficientes meios de divulgação e disseminação de informações através da criatividade, interatividade e ludicidade, permitindo um grande alcance do projeto. Ademais, participar da confecção de obras artísticas que abordam importantes temáticas da saúde, mostrou-se como uma oportunidade ímpar aos discentes e docentes envolvidos com o projeto.

Total reconstruction of the skin coverage of the penis with myocutaneous flap: case report

Introduction: The penis is an important structure of the male body, and its reconstruction is a challenge. Several diseases and deformities affect this organ, being necessary, in certain cases, for the total reconstruction of the cutaneous coverage of the penis, having already been described in the literature several techniques, such as the use of total grafts, scrotal flap, myocutaneous flaps of the fasciae latae and others. Case Report: In this report, a reconstruction of the total coverage of the penis is presented using a myocutaneous flap of the cremaster muscle with skin from the scrotum, achieving good vascularization and maintaining urethral permeability. Conclusion: This technique was not found in any of the databases researched in this study, only similar ones, and it proved to be a good option for the total reconstruction of penile skin coverage

Schinus terebinthifolius leaf extract causes midgut damage, interfering with survival and development of Aedes aegypti larvae

In this study, a leaf extract from Schinus terebinthifolius was evaluated for effects on survival, development, and midgut of A. aegypti fourth instar larvae (L4), as well as for toxic effect on Artemia salina. Leaf extract was obtained using 0.15 M NaCl and evaluated for phytochemical composition and lectin activity. Early L4 larvae were incubated with the extract (0.3–1.35%, w/v) for 8 days, in presence or absence of food. Polymeric proanthocyanidins, hydrolysable tannins, heterosid and aglycone flavonoids, cinnamic acid derivatives, traces of steroids, and lectin activity were detected in the extract, which killed the larvae at an LC50 of 0.62% (unfed larvae) and 1.03% (fed larvae). Further, the larvae incubated with the extract reacted by eliminating the gut content. No larvae reached the pupal stage in treatments at concentrations between 0.5% and 1.35%, while in the control (fed larvae), 61.7% of individuals emerged as adults. The extract (1.0%) promoted intense disorganization of larval midgut epithelium, including deformation and hypertrophy of cells, disruption of microvilli, and vacuolization of cytoplasms, affecting digestive, enteroendocrine, regenerative, and proliferating cells. In addition, cells with fragmented DNA were observed. Separation of extract components by solid phase extraction revealed that cinnamic acid derivatives and flavonoids are involved in larvicidal effect of the extract, being the first most efficient in a short time after larvae treatment. The lectin present in the extract was isolated, but did not show deleterious effects on larvae. The extract and cinnamic acid derivatives were toxic to A. salina nauplii, while the flavonoids showed low toxicity. S. terebinthifolius leaf extract caused damage to the midgut of A. aegypti larvae, interfering with survival and development. The larvicidal effect of the extract can be attributed to cinnamic acid derivatives and flavonoids. The data obtained using A. salina indicates that caution should be used when employing this extract as a larvicidal agent

Caderno de pós-graduação em direito: direito societário e globalização

A industrialização dos meios de produção possibilitou o surgimento da produção em escala, mecanizada, em maior volume e, consequentemente, intensificando a circulação de riquezas. Esse tipo de produção em massa foi possibilitado por uma nova instituição social, a empresa, capaz de empregar técnicas de produção que otimizam a criação de produtos, aumentando a eficiência de toda a cadeia produtiva. A partir de meados do século XVIII a empresa passou a ser protagonista do sistema capitalista, e se tornou a célula social responsável pela dinamização do direito privado, provocando a superação do direito comercial, transformando-o no atual direito empresarial. No Brasil, a absorção da teoria da empresa somente ocorreu apenas com o advento do Código Civil de 2002, mantendo, em seu artigo 966, a ideia de que as sociedades empresárias foram criadas para reduzir os riscos de mercado, minimizar custos de transação e proteger o patrimônio do empreendedor. Portanto, nossa legislação absorveu, recentemente, a noção de que sem as atividades empresariais, a produção em massa de bens e serviços seria insuficiente para atender às necessidades dos membros da sociedade. A eficiência das trocas econômicas depende diretamente do crescimento empresarial, uma vez que, gera inclusão no mercado e avanço tecnológico, criando novos empregos e aumentando arrecadação do Estado. Os investimentos privados são a base do processo de desenvolvimento econômico. Esse raciocínio é o ponto de partida fundamental das disciplinas que ministramos na Pós Graduação Latu Sensu do UniCEUB – Direito Societário e Globalização e Litígios Contratuais. Em ambas, nossos alunos são estimulados a estudar princípios e fundamentos do Direito Empresarial sem as “decorebas” passadas em cursinhos, a fim de que sejam capazes de possuir senso crítico e interpretativo a respeito das constantes alterações legislativas que afetam o instituto da empresa. Seguindo a tradição do UniCEUB, nossos alunos chegam ao final do curso com plana capacidade de se posicionar criticamente frente a jurisprudência de nossos tribunais, vista como fonte de aplicação do Direito Societário inserido em um contexto de competição empresarial por mercados internacionais. Os cursos utilizam o método do estudo de caso em sala de aula, mesclado com aulas expositivas e apresentação de seminários por parte dos alunos. O método do caso, na tradição norte-americana, é um instrumento didático que objetiva o ensino de habilidades voltadas para o desenvolvimento e a prática do raciocínio jurídico por meio da análise de decisões judiciais. Dessa forma, o aluno UniCEUB conhece o direito praticado, e não apenas o direito “doutrinário”. Os trabalhos expostos por esta coletânea demonstram esse grau de amadurecimento intelectual e profissional de nossos discentes, que enfrentaram com naturalidade temas tortuosos com problemáticas pouco discutidas pelo Direito Empresarial. Alguns artigos são produtos de monografias de conclusão de curso que atingiram nível de excelência acadêmica, outros são frutos das profícuas discussões em sala de aula, pesquisas extraclasse e extenso material de leitura,que se transformaram em artigos de leitura recomendada a outras discentes. Os artigos abordam a mais variada temática de Direito Empresarial. Temas como desconsideração da personalidade jurídica, responsabilidade civil das sociedades empresárias por atos de prepostos, governança corporativa, liquidação extrajudicial de instituições financeiras, contratação de seguro de Responsabilidade Civil por instituições integrantes do sistema “S”, Sociedades Anônimas, Cooperativas e contratos empresariais são amplamente debatidos nos artigos que tenho a honra de apresentar. Em comum, todos trazem uma análise crítica a respeito do entendimento jurisprudencial dos tribunais pátrios a respeito desses institutos, enriquecendo e tornando prazerosa a leitura do Ebook. Com essa linha de pensamento, concluo minha breve introdução com votos de que nossos leitores se interessem pela leitura adiante, que os trabalhos sejam fonte de inspiração para pesquisas e discussões. Com muito orgulho, me despeço de vocês, já ressaltando que, se o nosso corpo discente mantiver a excelente produção, em breve teremos uma nova edição deste ebook

Avaliação do potencial de morbimortalidade por COVID-19 em comunidades quilombolas rurais de Goiás, Brasil

Objetivo: analisar o potencial de morbimortalidade por COVID-19 em comunidades quilombolas rurais. Métodos: estudo transversal, com 26 comunidades do Estado de Goiás. Utilizou-se o método Analytic Hierarchy Process (AHP) que hierarquiza critérios para estimar o índice de prioridade de morbimortalidade por COVID-19, sendo eles: sexo masculino, idade ≥ 60 anos, diabetes, câncer, hipertensão, tabagismo, dislipidemia e obesidade. Resultados: de 1.672 entrevistados, 52,0% eram homens, 19,0% ≥ 60 anos, 5,5% autor referiram diabetes, 19,6% hipertensão, 9,2% dislipidemia, 1,3% obesidade, 0,4% câncer e 13,9% tabagismo. Houve menor índice de prioridade na Comunidade Engenho 2, e maior em Buracão; sendo: idade ≥ 60 anos em Quilombo do Magalhães; sexo masculino em Kalunga dos Morros; diabetes e hipertensão em Tomás Cardoso; dislipidemia em Almeidas; obesidade em Buracão; câncer em Água Limpa; tabagismo em José de Coleto. Conclusão: houve diferentes potenciais de morbimortalidade por COVID-19, demonstrando qual comunidade apresenta maior/menor prioridade para ações estratégicas para enfrentamento da pandemia

The legacy of ZikaPLAN: a transnational research consortium addressing Zika

Global health research partnerships with institutions from high-income countries and low- and middle-income countries are one of the European Commission's flagship programmes. Here, we report on the ZikaPLAN research consortium funded by the European Commission with the primary goal of addressing the urgent knowledge gaps related to the Zika epidemic and the secondary goal of building up research capacity and establishing a Latin American-European research network for emerging vector-borne diseases. Five years of collaborative research effort have led to a better understanding of the full clinical spectrum of congenital Zika syndrome in children and the neurological complications of Zika virus infections in adults and helped explore the origins and trajectory of Zika virus transmission. Individual-level data from ZikaPLAN`s cohort studies were shared for joint analyses as part of the Zika Brazilian Cohorts Consortium, the European Commission-funded Zika Cohorts Vertical Transmission Study Group, and the World Health Organization-led Zika Virus Individual Participant Data Consortium. Furthermore, the legacy of ZikaPLAN includes new tools for birth defect surveillance and a Latin American birth defect surveillance network, an enhanced Guillain-Barre Syndrome research collaboration, a de-centralized evaluation platform for diagnostic assays, a global vector control hub, and the REDe network with freely available training resources to enhance global research capacity in vector-borne diseases

ZikaPLAN: addressing the knowledge gaps and working towards a research preparedness network in the Americas.

Zika Preparedness Latin American Network (ZikaPLAN) is a research consortium funded by the European Commission to address the research gaps in combating Zika and to establish a sustainable network with research capacity building in the Americas. Here we present a report on ZikaPLAN`s mid-term achievements since its initiation in October 2016 to June 2019, illustrating the research objectives of the 15 work packages ranging from virology, diagnostics, entomology and vector control, modelling to clinical cohort studies in pregnant women and neonates, as well as studies on the neurological complications of Zika infections in adolescents and adults. For example, the Neuroviruses Emerging in the Americas Study (NEAS) has set up more than 10 clinical sites in Colombia. Through the Butantan Phase 3 dengue vaccine trial, we have access to samples of 17,000 subjects in 14 different geographic locations in Brazil. To address the lack of access to clinical samples for diagnostic evaluation, ZikaPLAN set up a network of quality sites with access to well-characterized clinical specimens and capacity for independent evaluations. The International Committee for Congenital Anomaly Surveillance Tools was formed with global representation from regional networks conducting birth defects surveillance. We have collated a comprehensive inventory of resources and tools for birth defects surveillance, and developed an App for low resource regions facilitating the coding and description of all major externally visible congenital anomalies including congenital Zika syndrome. Research Capacity Network (REDe) is a shared and open resource centre where researchers and health workers can access tools, resources and support, enabling better and more research in the region. Addressing the gap in research capacity in LMICs is pivotal in ensuring broad-based systems to be prepared for the next outbreak. Our shared and open research space through REDe will be used to maximize the transfer of research into practice by summarizing the research output and by hosting the tools, resources, guidance and recommendations generated by these studies. Leveraging on the research from this consortium, we are working towards a research preparedness network

Neurological disease in adults with Zika and chikungunya virus infection in Northeast Brazil: a prospective observational study

Background: Since 2015, the arthropod-borne viruses (arboviruses) Zika and chikungunya have spread across the Americas causing outbreaks, accompanied by increases in immune-mediated and infectious neurological disease. The spectrum of neurological manifestations linked to these viruses, and the importance of dual infection, are not known fully. We aimed to investigate whether neurological presentations differed according to the infecting arbovirus, and whether patients with dual infection had a different disease spectrum or severity. Methods: We report a prospective observational study done during epidemics of Zika and chikungunya viruses in Recife, Pernambuco, a dengue-endemic area of Brazil. We recruited adults aged 18 years or older referred to Hospital da Restauração, a secondary-level and tertiary-level hospital, with suspected acute neurological disease and a history of suspected arboviral infection. We looked for evidence of Zika, chikungunya, or dengue infection by viral RNA or specific IgM antibodies in serum or CSF. We grouped patients according to their arbovirus laboratory diagnosis and then compared demographic and clinical characteristics. Findings: Between Dec 4, 2014, and Dec 4, 2016, 1410 patients were admitted to the hospital neurology service; 201 (14%) had symptoms consistent with arbovirus infection and sufficient samples for diagnostic testing and were included in the study. The median age was 48 years (IQR 34–60), and 106 (53%) were women. 148 (74%) of 201 patients had laboratory evidence of arboviral infection. 98 (49%) of them had a single viral infection (41 [20%] had Zika, 55 [27%] had chikungunya, and two [1%] had dengue infection), whereas 50 (25%) had evidence of dual infection, mostly with Zika and chikungunya viruses (46 [23%] patients). Patients positive for arbovirus infection presented with a broad range of CNS and peripheral nervous system (PNS) disease. Chikungunya infection was more often associated with CNS disease (26 [47%] of 55 patients with chikungunya infection vs six [15%] of 41 with Zika infection; p=0·0008), especially myelitis (12 [22%] patients). Zika infection was more often associated with PNS disease (26 [63%] of 41 patients with Zika infection vs nine [16%] of 55 with chikungunya infection; p≤0·0001), particularly Guillain-Barré syndrome (25 [61%] patients). Patients with Guillain-Barré syndrome who had Zika and chikungunya dual infection had more aggressive disease, requiring intensive care support and longer hospital stays, than those with mono-infection (median 24 days [IQR 20–30] vs 17 days [10–20]; p=0·0028). Eight (17%) of 46 patients with Zika and chikungunya dual infection had a stroke or transient ischaemic attack, compared with five (6%) of 96 patients with Zika or chikungunya mono-infection (p=0·047). Interpretation: There is a wide and overlapping spectrum of neurological manifestations caused by Zika or chikungunya mono-infection and by dual infections. The possible increased risk of acute cerebrovascular disease in patients with dual infection merits further investigation. Funding: Fundação do Amparo a Ciência e Tecnologia de Pernambuco (FACEPE), EU's Horizon 2020 research and innovation programme, National Institute for Health Research. Translations: For the Portuguese and Spanish translations of the abstract see Supplementary Materials section

[Covid-19 in the Northeast of Brazil: from lockdown to the relaxation of social distancing measures].

Even in the period when the Covid-19 pandemic was on the rise in the Northeast of Brazil, the relaxation of social distancing measures was introduced. The scope of the study is to assess, in the light of the epidemiological-sanitary situation in the region, the suitability of relaxation of social distancing measures. Based on the WHO guidelines for relaxation of social distancing, operational indicators were created and analyzed for each guideline in the context of the Northeast. To analyze the behavior of the epidemic, according to selected indicators, Joinpoint trend analysis techniques, heat maps, rate ratios and time trends between capitals and the state interior were compared. The weekly growth peak of the epidemic occurred in May-July 2020 (epidemiological weeks 19 to 31). In most capitals, there was no simultaneous downward trend in the number of cases and deaths in the 14 days prior to flexibilization. In all states the number of tests performed was insufficient. In epidemiological week 24, the state percentages of ICU/Covid-19 bed occupancy were close to or above 70%. The epidemiological situation of the nine Northeastern state capitals analyzed here did not meet criteria and parameters recommended by the World Health Organization for the relaxation of social distancing measures