Pessoas com deficiência visual e o uso da tutela coletiva para remoção de barreiras

O presente artigo estuda a possibilidade de uso de mecanismos de tutela coletiva de direitos para a remoção de barreiras impostas à pessoa com deficiência visual. Para isso, analisa conceitualmente as expressões “pessoa com deficiência” e “deficiência visual”, bem como as chamadas “barreiras”, considerando sua existência e a necessidade de sua remoção como elemento essencial para a inclusão deste grupo. O texto analisa, também, o cabimento e as características da tutela coletiva, concluindo pela adequação de seu uso no caso. Isso porque o artigo destaca que a remoção das barreiras impostas a este grupo revela-se um interesse que ultrapassa o indivíduo, suscitando o cabimento mais eficaz da tutela coletiva. O intuito é, considerando as previsões da LBI, demonstrar como garantir, de forma eficaz, a acessibilidade, quando considerado o enfoque processual. A pesquisa adotou a metodologia de pesquisa jurídico-dogmática por meio de pesquisa bibliográfica

Caseous Stomatitis Caused by Pseudomonas aeruginosa in Boa constrictor amarali

Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be an opportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganism may present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reports of infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agents involved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amaral's boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspect in the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination, and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of the isolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolated and showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaning of the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine. Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5 mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole (20 mg/kg) with intervals of 48 h, both during 21 days. Daily subcutaneous fluid therapy was performed as support treatment, using Lactated Ringer's solution (25 mg/kg) and Vitamin C (10 mg/kg) with intervals of 24 h, being the cure observed at the end of treatment.Discussion: This paper presents the pathological findings of the Pseudomonas aeruginosa oral infection in a B. constrictor amarali. This bacterium is an opportunistic pathogen that is commonly found  in snakes, thus, humans in contact with these animals may be contaminated with this pathogen. However, oral cavity lesions associated with P. aeruginosa had not yet been related to Boa constrictor amarali, which is a non-venomous species. Few bacteria associated with reptile diseases are primary causative agents. Clinical bacterial infections generally tend to be secondary to viral infections. Predisposing factors for the development of bacterial diseases in these reptiles include immunodepression, malnutrition, poor adaptation to captivity, and the maintenance of these animals at temperatures and humidities outside their thermal comfort range. In the present study, the P. aeruginosa behaved as an opportunistic pathogen, resulting in clinical manifestations with caseous lesions in the oral cavity, probably due to an imbalance of the microbiota caused by stress or immunodepression. The antibiogram allowed the adoption of a correct therapeutic protocol based on the susceptibility of the pathogen, resulting in remission of lesions and clinical signs after 21 days of treatment

The barriers dentists face to communicate cancer diagnosis:self-assessment based on SPIKES protocol

This study aimed to characterize the barriers faced by Brazilian dentists to deliver bad news (DBN) about oral and oropharyngeal cancer diagnoses to patients by using a questionnaire based on the guidelines of the SPIKES protocol. This was an observational cross-sectional study. The questionnaire contained 27 questions based on the SPIKES protocol, which were answered in the SurveyMonkey platform. A total of 186/249 dentists answered the questionnaire. The main specialties reported were 36.02% oral medicine, 21.5% oral pathology, and 9.13% oral and maxillofacial surgery. A total of 44.6% expressed concern about the patient?s emotional reactions, and 46.24% of respondents had never participated in any specific training to communicate bad news. The lack of training and low confidence in dealing with patients? emotional reactions dentists were considered the greatest barriers to DBNs. Moreover, most dentists who participated in the survey believe that a protocol to guide the communication of bad news would be useful for clinical practice. For those protocols to be used by dentists, training is critical for these protocols to be incorporated by professionals

Open-source tool for real-time and automated analysis of droplet-based microfluidic

Publisher Copyright: © 2023 The Royal Society of Chemistry.Droplet-based microfluidic technology is a powerful tool for generating large numbers of monodispersed nanoliter-sized droplets for ultra-high throughput screening of molecules or single cells. Yet further progress in the development of methods for the real-time detection and measurement of passing droplets is needed for achieving fully automated systems and ultimately scalability. Existing droplet monitoring technologies are either difficult to implement by non-experts or require complex experimentation setups. Moreover, commercially available monitoring equipment is expensive and therefore limited to a few laboratories worldwide. In this work, we validated for the first time an easy-to-use, open-source Bonsai visual programming language to accurately measure in real-time droplets generated in a microfluidic device. With this method, droplets are found and characterized from bright-field images with high processing speed. We used off-the-shelf components to achieve an optical system that allows sensitive image-based, label-free, and cost-effective monitoring. As a test of its use we present the results, in terms of droplet radius, circulation speed and production frequency, of our method and compared its performance with that of the widely-used ImageJ software. Moreover, we show that similar results are obtained regardless of the degree of expertise. Finally, our goal is to provide a robust, simple to integrate, and user-friendly tool for monitoring droplets, capable of helping researchers to get started in the laboratory immediately, even without programming experience, enabling analysis and reporting of droplet data in real-time and closed-loop experiments.publishersversionepub_ahead_of_prin

SPECIALIZED NURSING TERMINOLOGY FOR PEOPLE WITH VISCERAL LEISHMANIASIS

Objective: to create specialized Nursing terminology for the care of people with Visceral Leishmaniasis.Method: a methodological study carried out in two stages: identification of the relevant concepts in medical records of patients with chosen health priority admitted between 2017 and 2019 to a public and teaching hospital in the north of Minas Gerais, BR; cross-mapping of the concepts identified with the ICNP®.Results: a total of 57,797 simple and compound (with repetitions) concepts, were extracted, of which 624 were useful single concepts for the Nursing care to be provided to people with Visceral Leishmaniasis. 281 (45%) primitive concepts were identified as included in ICNP® 2019-2020, as well as 343 (55%) not included in the classification. The concepts related to Focus and Location stood out in the axes.Conclusions: a specialized ICNP® terminology was created for the care of people with Visceral Leishmaniasis, with potential impacts on the standardization of actions and on generation of indicators sensitive to the Nursing practice

TERMINOLOGÍA ESPECIALIZADA DE ENFERMERÍA PARA LA ATENCIÓN DE PERSONAS COM LEISHMANIASIS VISCERAL

Objetivo: desarrollar terminología especializada de Enfermería para la atención de personas con Leishmaniasis Visceral.Método: estudio metodológico realizado en dos etapas: identificación de los conceptos relevantes en historias clínicas de pacientes con la prioridad de salud elegida internados entre 2017 y 2019 en un hospital público y de enseñanza del norte de Minas Gerais, Brasil; mapeo cruzado de los conceptos identificados con los de la CIPE®.Resultados: se extrajeron 57 797 conceptos simples y compuestos (con repeticiones), de los cuales 624 eran conceptos únicos útiles para la atención de Enfermería provista a personas con Leishmaniasis Visceral. Se identificaron 281 (45%) conceptos primitivos incluidos en la CIPE® 2019-2020 y 343 (55%) no incluidos en la clasificación. En los ejes se destacaron los conceptos relacionados con Foco y Lugar.Conclusiones: se elaboró una terminología especializada de la CIPE® para la atención de personas con Leishmaniasis Visceral, con potenciales efectos sobre la estandarización de acciones y la, generación de indicadores sensibles a la práctica de Enfermería

TERMINOLOGIA ESPECIALIZADA DE ENFERMAGEM PARA O CUIDADO DE PESSOAS COM LEISHMANIOSE VISCERAL

Objetivo: construir uma terminologia especializada de enfermagem para o cuidado de pessoas com Leishmaniose Visceral.Método: estudo metodológico, realizado em duas etapas: identificação dos conceitos relevantes em prontuários de pacientes com a prioridade de saúde eleita internados em hospital público e de ensino do norte de Minas Gerais, BR, entre 2017 e 2019; e mapeamento cruzado dos conceitos identificados com a CIPE®.Resultados: extraíram- se 57.797 conceitos simples e compostos (com repetições), dos quais, 624 foram considerados conceitos únicos úteis no cuidado de enfermagem à pessoa com Leishmaniose Visceral. Foram identificados 281 (45%) conceitos primitivos como constantes na CIPE® 2019-2020 e 343 (55%) não constantes na classificação. Nos eixos, destacaram-se os conceitos relacionados ao Foco e Localização.Conclusões: construiu-se uma terminologia especializada da CIPE® para o cuidado de pessoas com Leishmaniose Visceral com potenciais impactos na padronização de ações e geração de indicadores sensíveis à prática de enfermagem

Evaluation of response to anti-leptospira bacterin vaccination in pregnant ewes and the passive transfer of antibodies to their offspring

Leptospirosis in sheep is often underestimated, and leads to great economic losses for the sheep farming industry. The aim of this study was to evaluate the humoral immune response in pregnant ewes, after the injection of a commercial polyvalent vaccine for leptospirosis, and to observe the transmission of anti-Leptospira antibodies through the colostrum to the offspring. For this, 24 pregnant ewes were vaccinated for leptospirosis.  Blood samples were collected prior to vaccination and then 7, 14, 21, 28, 35, 42 and 49 days after vaccination. In order to evaluate passive immunity transfer, blood samples of 32 lambs were collected during the first 48 hours after birth, and another collection was performed 10 to 21 days after birth. The lambs were placed into 2 groups: Group A (n=16): singleton lambs; and group B (n=16): twins. The sera samples were submitted to the Microscopic Agglutination Test (MAT), in which 21 Leptospira serovars were tested. The results were analyzed in a descriptive form. The number of sheep reactive to MAT gradually increased until 21 days after vaccination, and decreased right after. Of all the serovars contained in the vaccine, the largest proportion of animals were seroconverted to Hardjoprajtino serovar, Serjoe serogroup. Anti-Leptospira antibodies transferred through colostrum to lambs were detected by MAT in the serum collected 24-48 hours after birth.  It was observed that 65.6% (21 out of 32) of the lambs were reactive. In the subsequent collections that occurred from 10 to 21 days after birth, a decrease in the number of animals reactive to the MAT was detected. There was no significant statistical difference for the passive transfer of antibodies between single or twin lambs

THYROID CANCER: CLINICAL EVALUATION, ENDOCRINOLOGICAL MANIFESTATIONS AND SURGICAL MANAGEMENT

Thyroid cancer is more common in women and people over 40, but it can affect anyone. There are different types of thyroid cancer, the most common being differentiated carcinomas (papillary and follicular), which have a good prognosis and respond well to treatment. The clinical evaluation of thyroid cancer involves taking anamnesis, physical examination, measuring thyroid hormones and performing imaging tests and biopsy. The main symptom of thyroid cancer is the appearance of a nodule in the cervical region, which may be palpable or visible. The main surgical modalities are total thyroidectomy, which consists of complete removal of the thyroid gland; partial thyroidectomy or lobectomy, which consists of removing only part of the gland; and lymphadenectomy, which consists of removing lymph nodes affected by cancer. Objective: to synthesize the scientific evidence available on clinical assessment, endocrinological manifestations and surgical management in thyroid cancer. Methodology: based on the PRISMA checklist, the PubMed, Scielo and Web of Science databases were consulted to identify relevant studies published in the last 10 years. The descriptors used were: “thyroid cancer”, “thyroid neoplasm”, “clinical evaluation”, “surgical management” and “endocrinological manifestations”. Original studies in English or Portuguese that addressed the clinical, endocrinological or surgical aspects of thyroid cancer in humans were included. Studies that did not meet the inclusion criteria, were duplicates, had low methodological quality or did not have access to the full text were excluded. Results: 18 studies were selected, which revealed that thyroid cancer is a disease that presents different clinical, endocrinological and surgical aspects, depending on the type, stage and response to treatment. The studies analyzed provided evidence on diagnostic methods, indications and surgical techniques, the efficacy and safety of radioactive iodine therapy, and the role of suppressive hormone therapy in differentiated thyroid cancer. Conclusion: Thyroid cancer is a heterogeneous disease that requires a multidisciplinary approach for its diagnosis and treatment. The systematic review showed that there is consistent evidence on diagnostic methods, surgical modalities and radioactive iodine therapy in differentiated thyroid cancer. However, there are gaps in knowledge about the endocrinological manifestations of thyroid cancer and therapeutic alternatives for more complex or aggressive cases. Therefore, more studies are needed to clarify these aspects and improve the clinical management of patients with thyroid cancer.Thyroid cancer is more common in women and people over 40, but it can affect anyone. There are different types of thyroid cancer, the most common being differentiated carcinomas (papillary and follicular), which have a good prognosis and respond well to treatment. The clinical evaluation of thyroid cancer involves taking anamnesis, physical examination, measuring thyroid hormones and performing imaging tests and biopsy. The main symptom of thyroid cancer is the appearance of a nodule in the cervical region, which may be palpable or visible. The main surgical modalities are total thyroidectomy, which consists of complete removal of the thyroid gland; partial thyroidectomy or lobectomy, which consists of removing only part of the gland; and lymphadenectomy, which consists of removing lymph nodes affected by cancer. Objective: to synthesize the scientific evidence available on clinical assessment, endocrinological manifestations and surgical management in thyroid cancer. Methodology: based on the PRISMA checklist, the PubMed, Scielo and Web of Science databases were consulted to identify relevant studies published in the last 10 years. The descriptors used were: “thyroid cancer”, “thyroid neoplasm”, “clinical evaluation”, “surgical management” and “endocrinological manifestations”. Original studies in English or Portuguese that addressed the clinical, endocrinological or surgical aspects of thyroid cancer in humans were included. Studies that did not meet the inclusion criteria, were duplicates, had low methodological quality or did not have access to the full text were excluded. Results: 18 studies were selected, which revealed that thyroid cancer is a disease that presents different clinical, endocrinological and surgical aspects, depending on the type, stage and response to treatment. The studies analyzed provided evidence on diagnostic methods, indications and surgical techniques, the efficacy and safety of radioactive iodine therapy, and the role of suppressive hormone therapy in differentiated thyroid cancer. Conclusion: Thyroid cancer is a heterogeneous disease that requires a multidisciplinary approach for its diagnosis and treatment. The systematic review showed that there is consistent evidence on diagnostic methods, surgical modalities and radioactive iodine therapy in differentiated thyroid cancer. However, there are gaps in knowledge about the endocrinological manifestations of thyroid cancer and therapeutic alternatives for more complex or aggressive cases. Therefore, more studies are needed to clarify these aspects and improve the clinical management of patients with thyroid cancer

Formar bem as mães para criar e educar boas crianças: as revistas portuguesas de educação familiar e a difusão da maternidade científica (1945-1958)

Este artigo tem como principal objetivo contribuir para a compreensão do processo de construção da maternidade científica em Portugal. Neste sentido, foi analisado um conjunto de artigos (n=628), publicados em revistas de educação familiar, entre 1945 e 1958. A análise realizada permitiu compreender que as revistas analisadas contribuem para a difusão da maternidade científica, ou seja, da ideia de que a aquisição de conhecimento científico sobre a criação e educação das crianças é elemento indispensável ao adequado exercício da função maternal. Observou-se, ainda, a existência de diferentes estratégias de educação para a maternidade, às quais está subjacente um elemento de classe, assim como diferentes níveis de adesão, por parte das mulheres, à concepção de maternidade científica