Atypical manifestation of Ichthyosis vulgaris in children: case report

Introduction: Ichthyosis vulgaris is a common disorder characterized clinically by xerosis, excessive scaling, hyperkeratosis, keratosis pilaris, palmar and plantar hyperlinearity. It is an autosomal dominant genetic disorder with a strong association to atopic disorders. Clinical manifestations typically begin in the first year of life, with a slight thickening of the skins surface and fine scaling, mainly on extensor areas of the extremities, scalp, central part of the face and buttocks. Flexion surfaces are not compromised, and the abdomen, neck, and face are rarely affected. Most cases are not severe, and their clinical manifestations may improve or even disappear with age. Objective: This study aims to discuss the abnormal clinical manifestations of the patient in relation to the characteristics of the disease. Case Report: Male patient, two years old, from São João da Boa Vista - SP, is the first gestation of a non-consanguineous couple without intercurrences in relation to the gestational antecedents; has no siblings. He had prenatal care, born cesarean delivery, at term, newborn suitable for gestational age weighed 3,140kg, 50th percentile, measured 49cm, cephalic perimeter 35cm, thoracic perimeter 33cm, Apgar 9/10. At birth, extremely dry skin was seen with fine, diffuse scaling. At fifteen days of life there was worsening of skin dryness along with widespread erythema of diffuse on his body, including the scalp, face and folds, uncommon manifestations in this pathology. With dermatological guidance, he started treatment with a 10% urea-based moisturizer with partial improvement of the cutaneous condition. At 6 months of age, when breastfeeding stopped, and milk formula was introduced, there was a significant worsening of the skin peeling, being laminar in the upper extremities, lower extremities, scalp, buttocks, abdomen and face. Along with this, he presented pruritus and severe cutaneous hyperemia. This initiated the use of highly hydrolyzed dairy formula, second generation antihistamine and maintenance of cutaneous hydration. Research was conducted for food allergies using RAST to test for major food antigens, the results were negative. Biopsy results were compatible with ichthyosis vulgar. The oral challenge test results were positive for proteins in cows milk. In a follow-up with allergist and dermatologist, the child began to maintain a diet that excludes cow’s milk and derivatives, along with industrialized products with dyes and preservatives that also worsen the cutaneous condition. At two years of age, he reports improvement in the appearance of the skin with less flaking and less pruritus present in exposed areas such as face, scalp and limbs. Also, he shows ephemeral episodes of skin whitening. Mother relates clinical cutaneous improvement with less sun exposure. His neuropsychomotor development is normal. He is currently using an antihistamine, 10% urea-based moisturizing liquid petroleum jelly and sunscreen. At his physical examination: weight and height z score 0. Fine scaling was seen in the abdomen and in plaques in the upper limbs and scalp. This is causing large, square, brown, adherent scales in the center, with loose edges and areas of scaling with erythematous fundus. There is slight alopecia in areas on the scalp

Cultura, Mídia e Direitos Humanos

Este trabalho é o resultado do Projeto de Pesquisa e Extensão Cultura, Mídia e Direitos Humanos, que visa contribuir com o estímulo de ações educativas na temática direitos humanos, bem como assessorar e estimular ações políticas coletivas no âmbito da pressão pelo acesso a direitos.  Intentou-se descortinar sobre e desenvolver processos de potencialização da consciência crítica e emancipatórios, visando o acesso a direitos e a educação em direitos humanos através de estímulos culturais

A importância de cotas raciais universitárias no contexto brasileiro

The objective of this study was to analyze educational policies for blacks, brown and indigenous people in the University, and the advances and setbacks to Brazilian literature have been presented throughout history. For this, through a bibliographical and documentary research, we analyze together the history of racial quotas in Brazil, arranging their assumptions and characteristics. The date makes an analysis of legislation, which deals with public policy issues as educational public policies. The evaluation of educations of racial quotas is important for young people who have a social disadvantage in the University. Submissão: 2018/09/30. Aceito em: 2019/05/20.  O trabalho tem por objetivo analisar as políticas públicas educacionais para os negros, pardos e indígenas na Universidade, apontando os avanços e retrocessos que a legislação brasileira tem presentado ao longo da história. Para isso, por meio de uma pesquisa bibliográfica e documental, analisamos inicialmente o histórico da cotas raciais no Brasil, apontando seus pressupostos e características. Na sequência realiza-se uma análise da legislação, que trata das questões das cotas que permeiam as políticas públicas educacionais. Concluímos que as políticas públicas educacionais de cotas raciais são relevantes, pois integram jovens que tem uma desvantagem social na Universidade.

Comparative study of oral health indicators in primary care of a São Paulo State's city

To compare four oral health indicators (Income, Attrition, Modified Prevention Emphasis, Restoration/Extraction) and the 1st Consultation/Urgency Relationship in 15 Family Health Units and 11 Basic Health Units, in an interior city of São Paulo State, 2008-2011. The data were collected from SIA-SUS and the indicators compared through historical series using the non-parametric test (Mann Whitney) and descriptive statistics. Although there is a strengthening process of the Family Health Strategy, the care model represented by the Basic Health Units still proves more effective in some aspects of oral health in public service.Comparar indicadores de saúde bucal (Rendimento, Atrição, Ênfase em Prevenção Modificado, Relação Restauração/Extração) e Relação 1ª Consulta/Urgência entre 15 Unidades de Saúde da Família e 11 Unidades Básicas de Saúde de município do interior paulista, de 2008 a 2011. Os dados foram coletados a partir do Sistema de Informações Ambulatoriais do SUS (SIA-SUS) e comparados os modelos de atenção por meio de série histórica, teste não paramétrico (Mann-Whitney) e estatística descritiva. Embora haja o processo de fortalecimento da Estratégia Saúde da Família o modelo assistencial representado pelas Unidades Básica de Saúde se mostra mais efetivo em alguns aspectos da saúde bucal no serviço público.4010814415

Can functional exercise capacity discriminate older individuals with poor postural control?

Postural instability can be related to functional limitations as a result of the aging process. This study aimed to compare functional exercise capacity and postural control in older adults. Participants were allocated into three groups according to their functional exercise capacity based on the six minute walking test (6MWT): 1) Low performance group (LP: distance walked ≤ 80% of the predicted value n = 19), 2) Normal performance group (NP: distance walked 81-100% of the predicted value n = 21) and, 3) High performance group (HP: distance walked >100% of the predicted value n = 23). All groups performed three trials of a one-leg stance for 30s on a force platform. LP showed worse postural control in comparison to NP and HP, and significant differences (p < .05) were found between groups for area, velocity antero-posterior of center of pressure and time limit variables during the one-leg stance task. These results have implications for rehabilitation management with regard to exercise, balance assessment and intervention in older adults. Instabilidade postural pode estar relacionada com as limitações funcionais, como um resultado do processo de envelhecimento. Este estudo teve como objetivo comparar a capacidade funcional de exercício e o controle postural em indivíduos idosos. Os participantes foram separados em três grupos de acordo com sua capacidade funcional de exercício baseada no teste de caminhada de seis minutos (TC6min): 1) grupo baixo desempenho (BD: distância caminhada ≤ 80% do valor predito n = 19), 2) grupo normal desempenho (ND : distância caminhada 81-100% do valor predito n = 21) e, 3) grupo alto desempenho (AD: distância caminhada >100% do valor predito n = 23). Todos os grupos realizaram três testes com apoio unipodal permanecendo por 30s sobre a plataforma de força. BD apresentou pior equilíbrio postural em comparação com ND e AD; com diferenças significativas (p < 0,05) encontradas entre os grupos para os parâmetros de área e velocidade antero-posterior do centro de pressão e a variável tempo-limite durante a posição unipodal. Estes resultados têm implicações para estratégias de reabilitação no que diz respeito ao exercício, avaliação do equilíbrio e intervenção em idosos. Inestabilidad postural puede estar relacionada con las limitaciones funcionales como resultado del proceso de envejecimiento. Este estudio tuvo como objetivo evaluar la comparación entre la capacidad funcional del ejercicio en el control postural de las personas de edad avanzada. Los participantes fueron divididos en tres grupos de acuerdo a su capacidad de ejercicio funcional basado en la Prueba de Caminada de seis minutos (PC6M): 1) grupo Bajo Rendimiento (BR: distancia recorrida ≤ 80% del valor predijo, n = 19), 2) grupo Normal Rendimiento (NR: distancia recorrida 81-100% del valor predijo, n = 21) y 3) grupo Alto Rendimiento (AR: distancia recorrida >100% del valor predijo, n = 23). Todos los grupos realizaron tres pruebas sobre un solo pie por 30s en la plataforma de fuerza. BR presentó un mal equilibrio postural en comparación con NR y AR; con diferencias significativas (p < 0,05) encontrado entre los grupos de los parámetros área y velocidad antero-posterior del centro de presión y el límite de tiempo para la postura de una sola pierna. Estos resultados tienen implicaciones para las estrategias de rehabilitación en relación con el ejercicio, la evaluación del equilibrio y la intervención en los ancianos

Obstructive Urethrolithiasis in a Mule

Background: Obstructive urolithiasis is a rare but potentially serious condition in equids. In the reviewed literature, there are several case reports of urolithiasis in horses and donkeys, but the only mention of this condition in mules occurred as incidental findings at a slaughterhouse. Therefore, this work aims to describe the first report and successful treatment of obstructive urethrolithiasis in a mule (Equus asinus x Equus caballus). Case: A 10-year-old castrated male mule weighing 380 kg was referred for hospital care. Tachycardia (64 beats per min), mild dehydration (7%), increased capillary filling time (3 s), slightly congested mucous membranes, and dysuria were observed. During its attempts to urinate, the mule was able to expose the penis, resulting in only dribbling of urine with reddish coloration. Urethral catheterization failed to reach the urinary bladder and revealed an obstruction at the ischial arch (7 x 4 cm), as confirmed by palpation and ultrasonography. Additionally, rectal ultrasound examination showed urine sedimentation and a single 2.36 mm vesical calculus. After sedation, local anesthesia, and surgical preparation, urethrotomy in the standing position was performed over the urethral obstruction at the ischial arch, reaching the urethrolith that fragmented during removal. Urethral catheterization from the urethrotomy site to flush the urinary bladder and urethra were performed, but the remaining vesical calculus was not retrieved. Considering the presence of a vesical calculus, severe urethral damage caused by the spiculated calculus and catheterization attempts, permanent perineal urethrostomy was performed. Laboratory tests revealed unremarkable hematological parameters, while serum biochemistry showed increased creatinine level. Urinalysis revealed cloudiness, amber appearance, countless red blood cells and bacteria, and calcium carbonate crystals. The urethrolith composition included ammonia, carbonate, and oxalate. Twelve months after surgery, the mule was healthy, the urethrostomy was viable, and no complications were recorded during this period.Discussion: Although uncommon, there are reports describing calculi of different sizes and weighing up to 803 g, causing mild to severe clinical signs according to the degree of obstruction in horses and donkeys. In the mule described here, the urethrolith did not completely obstruct the urethra, but the spiculated calculus caused dysuria and hematuria. In fact, most animals are usually referred for acute abdominal signs or hematuria and pollakiuria, but other unusual signs, such as rectal prolapse, may also be present. In the present report, the diagnosis of obstructive urethrolithiasis was established based on clinical signs and transcutaneous ultrasound of the subischial area, allowing visualization of the urethrolith. To the best of our knowledge, this is the first report of obstructive urethrolithiasis affecting a mule in Brazil. We reiterate that this condition must be included in the differential diagnosis of mules and hinnies with hematuria and dysuria, especially when associated with abdominal pain. Additionally, urethrostomy associated with urethrotomy performed on this mule in the standing position was a low-cost procedure with good results. Due to the lack of specificity regarding the food management of the mule on the previous farm, an assessment cannot be made regarding the effects of its food on urolith composition

Equidade de gênero nas organizações: o trabalho e os desafios da mulher na construção civil

O presente trabalho tem como objetivo investigar, à luz da diversidade de gênero, a percepção de profissionais do gênero feminino acerca de sua participação em empresas da construção civil, a fim de perceber quais barreiras esse grupo tem enfrentado no cotidiano do ambiente de trabalho. O estudo se valeu de uma pesquisa descritiva e exploratória, com abordagem qualitativa, utilizando um roteiro de entrevista semiestruturada aplicado a seis profissionais da área operacional de seis empresas da construção civil de uma cidade de médio porte do Nordeste brasileiro, sendo posteriormente submetida à análise de conteúdo. Os resultados mostraram que o gênero feminino ainda enfrenta grandes desafios na captação, seleção, promoção, igualdade salarial e retenção nas empresas da construção civil. Constatou-se que, dentre as mulheres, as jovens, as menos experientes e as mães são as que mais atravessam obstáculos no mercado de trabalho. Fatores como preconceito, discriminação, locomoção, viagens a serviço da empresa, estado civil, o fato de ter filhos, o medo da reação dos demais empregados com a contratação foram apontados como os grandes desafios para a entrada desse grupo no mercado de trabalho da construção civil. O presente estudo trouxe implicações importantes para a academia, organizações e para a sociedade