Pesquisa | SciELO

El Movimiento Internacional de Oidores de Voces, surgido en la década de 1980, entiende el fenómeno de oír voces no solo como un síntoma, sino que auxilia en el desarrollo de estrategias para enfrentarlas. El objetivo de este estudio fue comprender cómo personas que participaron en grupos de oidores de voces en el SUS enfrentaron tales experiencias. Se trata de una investigación cualitativa, realizada en 2020, con colecta de datos, a partir de entrevistas en profundidad y diario de campo, analizadas utilizándose análisis de contenido. Los participantes adultos (4) frecuentaron el grupo durante más de un mes. Fue posible explorar las estrategias de enfrentamiento individuales desarrolladas a partir de las vivencias de cada uno con sus voces. El grupo también fue un instrumento de socialización y, a partir de la normalización de la experiencia, de mayor autoaceptación y reducción del estigma.

O Movimento Internacional de Ouvidores de Vozes, surgido nos anos 1980, entende o fenômeno de ouvir vozes não apenas como um sintoma, mas auxilia o desenvolvimento de estratégias para lidar com essas vozes. O objetivo deste estudo foi compreender como pessoas que participaram de grupos de ouvidores de vozes no SUS lidaram com tais experiências. Trata-se de uma pesquisa qualitativa, realizada em 2020, coletando dados de entrevistas em profundidade e diário de campo, examinados utilizando-se análise de conteúdo. Os participantes adultos (4) frequentaram o grupo por mais de um mês. Foi possível explorar as estratégias de enfrentamento individuais desenvolvidas pelas vivências de cada um com as suas vozes. O grupo também foi instrumento de socialização, por meio da normalização da experiência, de maior autoaceitação e de redução do estigma.

Abstract The international Hearing Voices Movement, which emerged in the 1980s, understands the phenomenon of hearing voices not just as a symptom, but helps in the development of strategies to deal with these voices. The objective of this study was to understand how people who participated in groups of voice hearers in the Brazilian health system dealt with such experiences. This was a qualitative research study, carried out in 2020, with data collection from in-depth interviews and field diary, analyzed using content analysis. Adult participants (4) attended the group for more than a month. It was possible to explore the individual coping strategies developed from the experiences of each one with their voices. The group was also an instrument of socialization and, from the normalization of the experience, of greater self-acceptance and reduction of stigma.

https://doi.org/10.1590/interface.220275

Immunopathological evaluation of oral squamous cell carcinomas: a case series
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Souza, Vinícius G. de

; Santos, Damilys J.

; Araújo, Tatiana S.

; Silva, Ana G.

; Ribeiro, Rosy I.

; Loyola, Adriano M.

; Cardoso, Sérgio V.

; Siqueira-Miranda, Carla S.

; Cardoso, Ludimila P.

Gaceta mexicana de oncología

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2023, Volume 22 Supl. 1 Páginas 100 - 104

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen La evaluación de la expresión del ligando 1 de muerte programada (PD-L1) es un criterio de elegibilidad para la inmunoterapia anti-PD-L1 en el carcinoma oral de células escamosas (COCE). También deben evaluarse otros componentes del microambiente tisular. Aquí se informaron cuatro casos de carcinoma de células escamosas orales. Se realizaron análisis histopatológicos del grado tumoral y TIL (infiltrado inflamatorio asociado a tumor) e inmunohistoquímica para CD4, CD8 y PD-L1. Los casos se clasificaron según el microambiente tisular en resistencia inmunitaria adaptativa, ignorancia inmunológica, tolerancia o inducción intrínseca. Este análisis destaca la importancia de comprender el microambiente inmunológico que puede presentar el COCE para la identificación de dianas terapéuticas más eficaces contra la enfermedad.

Abstract The evaluation of the expression of programmed cell death protein (PD-L1) is an eligibility criterion for anti-PD-L1 immunotherapy in oral squamous cell carcinoma (OSCC). Other components of tissue microenvironment should also be evaluated. Here, four cases of oral squamous cells carcinoma were reported. Histopathological analysis of tumor grade and TILs and immunohistochemistry for CD4, CD8, and PD-L1 was done. The cases were classified according to the tissue microenvironment in adaptive immune resistance, immunological ignorance, tolerance, or intrinsic induction. This analysis highlights the importance of understanding the immunological microenvironment that the OSCC can present for the identification of more effective therapeutic targets against the disease.

https://doi.org/10.24875/j.gamo.22000145

How many species of Mollusca are there in Brazil? A collective taxonomic effort to reveal this still unknown diversity
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Machado, Fabrizio M.

; Miranda, Marcel S.

; Salvador, Rodrigo B.

; Pimenta, Alexandre D.

; Côrtes, Mariana O.

; Gomes, Jaime A.J.

; Miyahira, Igor C.

; Agudo-Padrón, Ignacio

; Oliveira, Cléo D.C.

; Caetano, Carlos H.S.

; Coelho, Paulo R.S.

; D’Ávila, Sthefane

; Arruda, Eliane P. de

; Almeida, Sérgio M. de

; Gomes, Suzete R.

; Alvim, Juliana

; Galvão-Filho, Hilton

; L. Ferreira-Júnior, Augusto

; Marques, Rodrigo C.

; Martins, Inês

; Souza, Leonardo S. de

; Arruda, Janine O.

; Cavallari, Daniel C.

; Santos, Sonia B. dos

; Pedro, Natan C.

; Salles, Anna C. de A.

; Dornellas, Ana P.S.

; Lima, Tarcilla C. de

; Amaral, Vanessa S. do

; Silva, Fernanda S.

; Passos, Flávio D.

; Thiengo, Silvana S.

; Leite, Tatiana S.

; Simone, Luiz R.L.

Zoologia (Curitiba)

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2023, Volume 40 elocation e23026

Resumo: En | Texto: En | PDF: En

ABSTRACT The expression ‘you need to know to conserve’ is a well-known cliche among biologists. Documenting the richness of a group of organisms is the first step towards understanding biodiversity and preparing efficient conservation plans. In this context, many efforts have been made to quantify the number of species on Earth and estimate the number of species still unknown to science. A few countries have complete and integrated databases estimating the approximate number of species recorded for their territory, particularly in the Global South. In Brazil, a country of continental dimensions, revealing the richness of the second most diverse clade of invertebrates (=Mollusca) has been a goal of taxonomists. Recently, in an unprecedented, collective, and integrated effort among Brazilian malacologists, it was possible to estimate how many valid species of molluscs are there in Brazil. In this effort, more than 30 mollusc experts joined together to update the Taxonomic Catalogue of the Brazilian Fauna (TCBF), a governmental website that allows a quick and real-time updating of all Metazoan. So far, more than 5,000 updates have been made in TCBF, indicating the presence of 3,552 valid species of molluscs in Brazil, distributed among the main clades as follows: Caudofoveata (10 spp.), Solenogastres (6 spp.), Polyplacophora (35 spp.), Scaphopoda (43 spp.), Cephalopoda (92 spp.), Bivalvia (629 spp.) and Gastropoda (2,737 spp.). The present study, in addition to demonstrating for the first time the richness of Brazilian molluscs, also presents the state of the art of this important phylum of invertebrates highlighting its most representative and neglected groups.

https://doi.org/10.1590/s1984-4689.v40.e23026

As vozes são muito mais que um sintoma
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Oliveira, Loraine Oltmann de

; Stefanello, Sabrina

; Santos, Deivisson Vianna Dantas dos

; Miranda, Giovana Ferreira de Freitas

; Motter, Arlete Ana

Interface - Comunicação, Saúde, Educação

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2023, Volume 27 elocation e220275

Resumo: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

https://doi.org/10.1590/interface.220275

Zinc deficiency disrupts pain signaling promoting nociceptive but not inflammatory pain in mice
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LIMA, CLEVERTON KLEITON F.

; SISNANDE, THÁYNA

; SILVA, RAFAELA V. DA

; SILVA, VANESSA DOMITILLA C.S. DA

; AMARAL, JULIO J. DO

; OCHS, SORAYA M.

; SANTOS, BRUNA L.R. DOS

; MIRANDA, ANA LUÍSA P. DE

; LIMA, LUÍS MAURÍCIO T.R.

Anais da Academia Brasileira de Ciências

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2023, Volume 95 Supl. 1 elocation e20220914

Resumo: En | Texto: En | PDF: En

Abstract Zinc (Zn) is an essential micronutrient involved in the physiology of nervous system and pain modulation. There is little evidence for the role of nutritional Zn alternations to the onset and progression of neuropathic (NP) and inflammatory pain. The study investigated the effects of a zinc restricted diet on the development of pain. Weaned mice were submitted to a regular (38 mg/kg of Zn) or Zn deficient (11 mg/kg of Zn) diets for four weeks, pain responses evaluated (mechanical, cold and heat allodynia; formalin- and carrageenan-induced inflammatory hypernociception), plasma and tissues collected for biochemical and metabolomic analysis. Zn deficient diet inhibited animal growth (37%) and changed mice sensitivity pattern, inducing an intense allodynia evoked by mechanical, cold and heat stimulus for four weeks. The inflammatory pain behavior of formalin test was drastically reduced or absent when challenged by an inflammatory stimulus. Zn restriction also reduce plasma TNF, increase neuronal activation, oxidative stress, indicating a disruption of the immune response. Liver metabolomic analyses suggest a downregulation of lipid metabolism of arachidonic acid. Zn restriction since weaned disrupts pain signaling considerably and reduce inflammatory pain. Zn could be considered a predisposing factor for the onset of chronic pain such as painful neuropathies.

https://doi.org/10.1590/0001-3765202320220914

Esfuerzos realizados en Puerto Rico hacia la consolidación de políticas públicas para la prevención de cánceres asociados al VPH
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Medina-Laabes, Diana T

; Colón-López, Vivian

; Rivera-Figueroa, Vilnery

; Vázquez-Otero, Coralia

; Arroyo-Morales, Glizette O

; Arce-Cintrón, Lara

; Fernández-Rivera, Paola

; Vega, Idamaris

; Soto-Abreu, Roxana

; Díaz-Miranda, Olga L

; Rivera, Ángel

; Cardona, Iris

; Ortiz, Ana P.

; Capó, Lilliam Rodríguez

; Hull, Pamela C.

Revista Panamericana de Salud Pública

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2022, Volume 46 elocation e3

Resumo: En Pt Es | Texto: En Pt Es | PDF: En | PDF: Pt | PDF: Es

ABSTRACT The purpose of this special report is to describe chronologically the events that contributed to the development and approval of legislation and subsequent implementation of a school vaccination mandate in order to prevent HPV and HPV-associated cancers in Puerto Rico (PR). Starting in 2010, PR initiated public-policy approvals aimed at improving cancer registries and HPV vaccine coverage through health insurance for adolescents aged 11 to 18 years. In 2014, scientific and community efforts succeeded in documenting the magnitude of morbidity caused by HPV and jointly developing HPV vaccine prevention and promotion strategies. In August 2018, PR became one of the first four territories of the United States of America to implement the HPV vaccine school entry requirement to decrease the incidence of HPV-associated cancers on the island. In 2019, it was enshrined in law that every immunization provider must submit immunization data to the Puerto Rico Immunization Registry. The case of PR demonstrates that public policy-making alongside collaboration between academic, scientific, and community coalitions can achieve population change and measurable outcomes aimed at HPV prevention. Countries with a similar public health problem could adopt efforts similar to those presented herein and align them with the World Health Organization goal of eradicating cervical cancer by 2030.

RESUMO O propósito deste relatório especial é descrever cronologicamente os eventos que contribuíram para o desenvolvimento e a aprovação de legislação, e a implementação da exigência escolar de vacinação em Porto Rico (PR), a fim de prevenir o HPV e os cânceres associados a ele. A partir de 2010, PR iniciou as aprovações de políticas públicas com o objetivo de aprimorar o registro dos casos de câncer e a cobertura vacinal contra o HPV, por meio de planos de saúde, em adolescentes de 11 a 18 anos. Em 2014, esforços científicos e comunitários permitiram documentar a magnitude das doenças causadas pelo HPV e elaborar conjuntamente estratégias de prevenção e promoção da vacina contra o HPV. Em agosto de 2018, PR foi um dos primeiros quatro territórios dos Estados Unidos da América a implementar a vacina contra o HPV como exigência escolar, a fim de diminuir a incidência de cânceres associados ao HPV na ilha. Em 2019 ficou garantido por lei que todos os vacinadores devem enviar informações ao Registro de Imunização. O caso de PR demonstra que o desenvolvimento de políticas públicas, em conjunto com parcerias entre coalizões acadêmicas, científicas e comunitárias, alcança mudanças populacionais e resultados mensuráveis dirigidos à prevenção do HPV. Países com uma problemática de saúde pública similar poderiam adotar esforços semelhantes aos apresentados e alinhá-los ao objetivo da Organização Mundial da Saúde: a erradicação do câncer cervical até 2030.

RESUMEN El propósito de este informe especial es describir cronológicamente los eventos que contribuyeron al desarrollo y aprobación de la legislación e implementación del requisito escolar de vacunación en Puerto Rico (PR), con el fin de prevenir el VPH y los cánceres asociados a este. A partir del 2010, PR inició las aprobaciones de políticas públicas con el objetivo de mejorar el registro de casos de los cánceres y la cobertura de la vacuna contra el VPH a través de los planes médicos en adolescentes de 11 a 18 años. En el 2014, los esfuerzos científicos y comunitarios lograron documentar la magnitud de las enfermedades causadas por el VPH, y desarrollar en conjunto, estrategias de prevención y promoción de la vacuna contra el VPH. En agosto de 2018, PR logró ser uno de los primeros cuatro territorios de los Estados Unidos de América en implementar la vacuna contra el VPH como requisito escolar con el fin de disminuir la incidencia de cánceres asociados al VPH en la isla. En el 2019 se garantizó por ley que todo proveedor de vacunación debe reportar al Registro de Inmunización. El caso de PR demuestra que el desarrollo de políticas públicas junto con colaboraciones entre coaliciones académicas, científicas y comunitarias, logran cambios poblacionales y resultados medibles dirigidos a la prevención de VPH. Países con una problemática de salud pública similar podrían adoptar esfuerzos similares a los presentados, y alinearlos al objetivo de la Organización Mundial de la Salud: erradicación del cáncer cervical para 2030.

https://doi.org/10.26633/rpsp.2022.3

Budd-Chiari Syndrome and Acute Liver Failure: An Uncommon Presentation of Acute Myeloid Leukaemia
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Costa, Ana Rita Gonçalves

; Freitas, Inês

; Raposo, Joana

; Barbosa, Gustavo

; Miranda, Helena P.

; Nery, Filipe

GE-Portuguese Journal of Gastroenterology

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Fev 2021, Volume 28 Nº 1 Páginas 62 - 66

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo: A falência hepática aguda (FHA) é uma entidade rara, particularmente no contexto da Síndrome de Budd-Chiari (SBC). A SBC é uma doença incomum com múltiplos fatores de risco, principalmente as doenças mieloproliferativas. Na SBC, a procura ativa e exclusão de malignidade subjacente é obrigatória, particularmente no contexto de FHA, já que pode contraindicar o transplante hepático (TH). Apresentamos o caso de um homem de 29 anos saudável, sem fatores de risco conhecidos para doença hepática que se apresentou no serviço de urgência com dor abdominal, ascite e icterícia. A SBC associada a lesão hepática severa com rápida progressão para FHA foi diagnosticada e o doente colocado em lista para TH. O estudo do sangue periférico finalmente revelou a presença de blastos mieloides e a citometria de fluxo a presença de uma população de blastos com perfil imunofenotípico anormal (CD33 + e mieloperoxidase (MPO) +). A biópsia da medula óssea mostrou aspetos morfológicos e imunofenotípicos de leucemia mieloide aguda (LMA) FAB M1. Este diagnóstico foi considerado uma contraindicação formal para o TH, pelo que o doente foi retirado de lista. Pela FHA a quimioterapia de resgate estava também contraindicada. O doente faleceu 48 horas após a admissão na UCI. O despiste de neoplasia subjacente é obrigatório no contexto de SBC, ainda mais com FHA, pois pode limitar o tratamento lifesaving a cuidados de suporte e paliativos.

Abstract: Acute liver failure (ALF) is a rare entity, particularly in the context of Budd-Chiari syndrome (BCS). BCS is an uncommon disorder with multiple risk factors, most commonly myeloproliferative disorders. In BCS, active search and exclusion of underlying malignancy is mandatory, particularly in the context of ALF, as it may contraindicate liver transplantation (LT). We present the case of a healthy 29-year-old male, without known risk factors for liver disease, who presented to the emergency department with abdominal pain, ascites, and jaundice. BCS with consequent severe acute liver injury with rapid progression to ALF was diagnosed. The patient was listed for LT. The study of peripheral blood finally revealed myeloid blasts, and flow cytometry showed a population of blast cells with abnormal immunophenotypic profile (CD33+ and myeloperoxidase, MPO+). The bone marrow biopsy showed morphological and immunophenotypic aspects of acute myeloid leukaemia (AML) FAB M1. This diagnosis was considered a formal contraindication to LT, so the patient was delisted. ALF contraindicated rescue chemotherapy and AML contraindicated LT. The patient died 48 h after ICU admission. The search for underlying neoplasia is mandatory in the context of BCS, moreover with associated ALF, as it may limit lifesaving treatments and interventions to supportive and palliative care.

https://doi.org/10.1159/000507335 38 downloads

Consenso de hemofilia en México
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López-Arroyo, José L.

; Pérez-Zúñiga, Juan M.

; Merino-Pasaye, Laura E.

; Saavedra-González, Azucena

; Alcivar-Cedeño, Luisa María

; Álvarez-Vera, José Luis

; Anaya-Cuellar, Irene

; Arana-Luna, Luara L.

; Ávila-Castro, David

; Bates-Martín, Ramón A.

; Cesarman-Maus, Gabriela

; Chávez-Aguilar, Lénica A.

; Peña-Celaya, José A. de la

; Espitia-Ríos, María E.

; Estrada-Domínguez, Patricia

; Fermín-Caminero, Denisse

; Flores-Patricio, Willy

; García Chávez, Jaime

; García-Lee, María T.

; González-Pérez, María del Carmen

; González-Rubio, María del Carmen

; González-Villareal, María Guadalupe

; Ramírez-Moreno, Fabiola

; Hernández-Colin, Ana K.

; Hernández-Ruiz, Eleazar

; Herrera-Olivares, Wilfrido

; Leyto-Cruz, Faustino

; Loera-Fragoso, Sergio

; Martínez-Ríos, Annel

; Miranda-Madrazo, María R.

; Morales-Hernández, Alba

; Nava-Villegas, Lorena

; Orellana-Garibay, Juan J.

; Palma-Moreno, Orlando G.

; Paredes-Lozano, Eugenia P.

; Peña-Alcántara, Paula

; Pérez-Lozano, Uendy

; Pichardo-Cepín, Yayra M.

; Reynoso-Pérez, Ana Carolina

; Rodríguez-Serna, Mishel

; Rojas-Castillejos, Flavio

; Romero-Rodelo, Hilda

; Ruíz-Contreras, Josué I.

; Segura-García, Adela

; Silva-Vera, Karina

; Soto-Cisneros, Paulina M.

; Tapia-Enríquez, Ana L.

; Tavera-Rodríguez, Martha G.

; Teomitzi-Sánchez, Óscar

; Tepepa-Flores, Fredy

; Valencia-Rivas, María D.

; Valle-Cárdenas, Teresa

; Varela-Constantino, Ana

; Javier-Morales, Adrián

; Martínez-Ramírez, Mario A.

; Tena-Cano, Sergio

; Terrazas-Marín, Ricardo

; Vilchis-González, Shendel P.

; Villela-Peña, Atenas

; Mena-Zepeda, Verónica

; Alvarado Ibarra, Martha

Gaceta médica de México

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2021, Volume 157 Supl. 1 Páginas S1 - S37

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Hemophilia is a hemorrhagic disorder with a sex-linked inherited pattern, characterized by an inability to amplify coagulation due to a deficiency in coagulation factor VIII (hemophilia A or classic) or factor IX (hemophilia B). Sequencing of the genes involved in hemophilia has provided a description and record of the main mutations, as well as a correlation with the various degrees of severity. Hemorrhagic manifestations are related to levels of circulating factor, mainly affecting the musculoskeletal system and specifically the large joints (knees, ankles and elbows). This document is a review and consensus of the main genetic aspects of hemophilia, from the inheritance pattern to the concept of women carriers, physiopathology and classification of the disorder, the basic and confirmation studies when hemophilia is suspected, the various treatment regimens based on infusion of the deficient coagulation factor as well as innovative factor-free therapies and recommendations for the management of complications associated with treatment (development of inhibitors and/or transfusion transmitted infections) or secondary to articular hemorrhagic events (hemophilic arthropathy). Finally, relevant reviews of clinical and treatment aspects of hemorrhagic pathology charachterized by acquired deficiency of FVIII secondary to neutralized antibodies named acquired hemophilia.

resumen está disponible en el texto completo

https://doi.org/10.24875/gmm.m20000451 305 downloads

A sobredotação na Região Autónoma da Madeira: Desenvolvimento de políticas e práticas educativas
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Antunes, Ana P.

; Almeida, Leandro S.

; Miranda, Lúcia C.

; Xavier, Joana O.

; Ramos, Conceição

; Raffan, Johanna M.

Revista Portuguesa de Educação

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Jun 2020, Volume 33 Nº 1 Páginas 121 - 136

Resumo: Es Pt En | Texto: Es Pt En | PDF: Es | PDF: Pt | PDF: En

La atención a los estudiantes superdotados y con altas capacidades en la Región Autónoma de Madeira (RAM) se ha mencionado como pionera en el contexto portugués. En este estudio se pretende trazar la evolución de los mecanismos de atención de los niños y adolescentes con altas capacidades en la RAM, con su respectivo marco legal, de lo que viene sucediendo desde los años 90. Los datos fueron recogidos a partir de entrevistas a algunos de los participantes en este proceso y a través de la consulta de documentos disponibles. Así, fue posible organizar el recorrido histórico de la superdotación en Madeira, presentando un breve encuadre del surgimiento del apoyo a la sobredotación y describiendo tres fases secuenciales del mismo: (a) implementación de servicios de atención; (b) consolidación de la prestación de servicios; y (c) servicios prestados en la actualidad. En general, a pesar de la evolución y la modificación de los servicios, la inversión se ha centrado en el proceso de identificación y de intervención, en la formación y en la práctica basada en evidencia, buscando hacer converger las actuaciones con las orientaciones internacionales en el área. Se apuntan algunas reflexiones sobre las políticas públicas en el área de la superdotación, teniendo como premisa la escuela inclusiva y una posible mejora de servicios que pueda facilitar la igualdad de oportunidades y la diferenciación de las prácticas educativas en función de las características y necesidades de cada alumno.

A atenção à sobredotação e a alunos com altas capacidades, na Região Autónoma da Madeira (RAM), tem sido referenciada pelo seu pioneirismo no contexto português. Neste artigo descreve-se a evolução, desde os anos 90, dos mecanismos de atendimento das crianças e adolescentes com elevadas capacidades, e respetivo enquadramento legal. Os dados foram recolhidos a partir de entrevistas a alguns dos intervenientes neste processo e através da consulta de documentos disponíveis. Assim, foi possível organizar o percurso histórico da sobredotação na Madeira, apresentando um breve enquadramento da emergência do apoio à sobredotação e descrevendo três fases sequenciais do mesmo: (a) implementação de serviços de atendimento; (b) consolidação da prestação de serviços; e (c) serviços prestados na atualidade. De uma forma geral, apesar da evolução e modificação dos serviços, o investimento tem-se centrado no processo de identificação e de intervenção, na formação e na prática baseada em evidência, procurando fazer convergir as atuações com as orientações internacionais na área. Apontam-se algumas reflexões sobre as políticas públicas na área da sobredotação, tendo como premissa a escola inclusiva e uma melhoria de serviços que promovam a igualdade de oportunidades e a diferenciação das práticas educativas, em função das características e necessidades de cada aluno.

Attention to giftedness and high ability students, in the Autonomous Region of Madeira (RAM), has been acknowledged for being pioneer in Portugal. The main purpose of this paper is to outline the evolution of practices for high abilities students, and their legal framework, since the 90s, in RAM. Data were collected from interviews with some of the actors in this process and through analysis of available documents. Thus, it was possible to organise the historical path of giftedness in Madeira. So, it is presented a brief framework of the emergence of giftedness educational support and three sequential phases are also described: (a) implementation of support services; (b) consolidation of the provision of services; and (c) current services provided. In general, despite the evolution and modification of the organisation of the services, the investment has been centered on the identification and intervention process, on training and on evidence-based practice, seeking convergence of intervention with international guidelines. Some reflections on public policies about giftedness are pointed out, based on the premise of an inclusive school and a possible improvement of practices that might facilitate equal opportunities and differentiation of educational practices, according to the characteristics and needs of each student.

https://doi.org/10.21814/rpe.18654 86 downloads

10.

Impact of Vacuum-Assisted Venous Drainage on Forward Flow in Simulated Pediatric Cardiopulmonary Bypass Circuits Utilizing a Centrifugal Arterial Pump Head
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Guimarães, Daniel Peres

; Caneo, Luiz Fernando

; Matte, Gregory

; Carletto, Luciana P.

; Policarpo, Valéria Camargo

; Castro, Ana Vitória C. X.

; Miranda, Matheus H. C.

; Costa, Priscila S.

; Jatene, Marcelo B.

; Cestari, Idagene

; Jatene, Fabio B.

Brazilian Journal of Cardiovascular Surgery

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Abr 2020, Volume 35 Nº 2 Páginas 134 - 140

Resumo: En | Texto: En | PDF: En

Abstract Objective: To analyze the impact of vacuum-assisted venous drainage (VAVD) on arterial pump flow in a simulated pediatric cardiopulmonary bypass circuit utilizing a centrifugal pump (CP) with an external arterial filter. Methods: The simulation circuit consisted of a Quadrox-I Pediatric oxygenator, a Rotaflow CP (Maquet Cardiopulmonary AG, Rastatt, Germany), and a custom pediatric tubing set primed with Lactated Ringer's solution and packed red blood cells. Venous line pressure, reservoir pressure, and arterial flow were measured with VAVD turned off to record baseline values. Four other conditions were tested with progressively higher vacuum pressures (-20, -40, -60, and -80 mmHg) applied to the baseline cardiotomy pressure. An arterial filter was placed into the circuit and arterial flow was measured with the purge line in both open and closed positions. These trials were repeated at set arterial flow rates of 1500, 2000, and 2500 mL/min. Results: The use of progressively higher vacuum caused a reduction in effective arterial flow from 1490±0.00 to 590±0.00, from 2020±0.01 to 1220±0.00, and from 2490±0.0 to 1830±0.01 mL/min. Effective forward flow decreased with increased levels of VAVD. Conclusion: The use of VAVD reduces arterial flow when a CP is used as the main arterial pump. The reduction in the forward arterial flow increases as the vacuum level increases. The loss of forward flow is further reduced when the arterial filter purge line is kept in the recommended open position. An independent flow probe is essential to monitor pump flow during cardiopulmonary bypass.

https://doi.org/10.21470/1678-9741-2019-0311 402 downloads

11.

Recomendaciones para el uso racional de la prueba 25-hidroxivitamina D Resumen de política
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Herrera-Molina, Emilio

; González, Nancy Yomayusa

; Low-Padilla, Eduardo

; Oliveros-Velásquez, Juan David

; Mendivelso-Duarte, Fredy

; Gómez-Gómez, Olga Victoria

; Castillo, Ana María

; Barrero-Garzón, Liliana Isabel

; Álvarez-Moreno, Carlos Arturo

; Moscoso-Martínez, Ernesto Augusto

; Ruíz-Blanco, Pilar Cristin

; Luna-Ríos, Joaquín Gustavo

; Ortiz, Natasha

; Herrera, Emiliano Mauricio

; Guevara-Santamaría, Fabián

; Moreno-Gómez, Jairo Enrique

; Cárdenas-Ramírez, Héctor Mauricio

; González-González, Camilo Alberto

; Jannauth, María José

; Patiño-Pérez, Adulkarin

; Pinto, Diego Alejandro

; Acevedo, Juan Ramon

; Torres, Rodolfo Eduardo

; Montero, Jairo Camilo

; Acevedo, Andrés David

; Caceres, Ximena Adriana

; Acuña-Olmos, Jairo

; Arias, Carlos Andrés

; Medardo-Rozo, José

; Castellanos-Parada, Jeffrey

; López-Miranda, Ángelo Mauricio

; Pinzón-Serrano, Estefanía

; Rincón-Sierra, Oswaldo

; Isaza-Ruget, Mario

; Suárez-Ramos, María del Pilar

; Vargas-Rodríguez, Johanna

; Mejia-Gaviria, Natalia

; Moreno-Marín, Sandra Yadira

; García-Guarín, Bibiana María

; Cárdenas, Martha Lucía

; Chavarro, Luis Fernando

; Ronderos-Bernal, Camila

; Rico-Landazabal, Arturo

; Coronado-Daza, Jorge Antonio

; Alfaro-Tejeda, Mercedes Teresa

; Yama-Mosquera, Erica

; Hernández-Sierra, Astrid Patricia

; Restrepo-Valencia, César Augusto

; Arango-Álvarez, Javier

; Rosero-Olarte, Francisco Oscar Fernando

; Medina-Orjuela, Adriana

; Robayo-García, Adriana

; Carballo-Zarate, Virgil

; Rodríguez-Sánchez, Martha Patricia

; Bernal, Dora P.

; Jaramillo, Laura

; Baquero-Rodríguez, Richard

; Mejía-Gaviria, Natalia

; Aroca, Gustavo

Revista Colombiana de Nefrología

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Dez 2019, Volume 6 Nº 2 Páginas 179 - 192

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract The exponential increase in the request for laboratory tests of 25-Hydroxyvitamin D or [25 (OH) D has ignited the alarms and generated a strong call for attention, since it may reflect deficiencies in the standardization of clinical practice and in the use non-systematic scientific evidence for decision-making in real life, which allows to analyze the indications of the test, its frequency, interpretation and even to assess the impact for health systems, especially when contrasted with the minimum or almost. No effects of the strategy of screening or supplying indiscriminately to the general population, without considering a comprehensive clinical assessment of risks and needs of people. From a purely public health impact point of view, the consequence of massive and unspecified requests is affecting most of the health systems and institutions at the global level. The primary studies that determined average population intake values have been widely used in the formulation of recommendations in Clinical Practice Guidelines, but unfortunately misinterpreted as cut points to diagnose disease and allow the exaggerated prescription of nutritional substitution. The coefficient of variation in routine tests to measure blood levels of 25 (OH) D is high (28%), decreasing the overall accuracy of the test and simultaneously, increasing both the falsely high and falsely low values. The most recent scientific evidence analyzes and seriously questions the usefulness and the real effect of the massive and indiscriminate practice of prescribing vitamin D without an exhaustive risk analysis. The available evidence is insufficient to recommend a general substitution of vitamin D to prevent fractures, falls, changes in bone mineral density, incidence of cardiovascular diseases, cerebrovascular disease, neoplasms and also to modify the growth curve of mothers' children. They received vitamin D as a substitute during pregnancy. The recommendations presented in the document are based on the critical analysis of current evidence and the principles of good clinical practice and invite to consider a rational use of 25 (OH) D tests in the context of a clinical practice focused on people and a comprehensive assessment of needs and risks. The principles of good practice suggest that clinicians may be able to justify that the results of the 25 (OH) D test strongly influence and define clinical practice and modify the outcomes that interest people and impact their health and wellness. Currently there is no clarity on how to interpret the results, and the relationship between symptoms and 25 (OH) D levels, which may not be consistent with the high prevalence of vitamin D deficiency reported. For this reason, it is suggested to review the rationale of the request for tests for systematic monitoring of levels of 25 (OH) D or in all cases where substitution is performed. Consider the use of 25 (OH) D tests within the comprehensive evaluation of people with suspicion or confirmation of the following conditions: rickets, osteomalacia, osteoporosis, hyper or hypoparathyroidism, malabsorption syndromes, sarcopenia, metabolic bone disease.

597 downloads

12.

Effects of Light Quality and Chemical Elicitors on the Growth Parameters and Rosmarinic Acid Content of in vitro Cultures of Hyptis pectinata (L.) Poit.
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Pedroso, Rita C. N.

; Pimenta, Leticia P.

; Tozatti, Marcos G.

; Branquinho, Núbia A. A.

; Hara, Alessandra C. B. A. M.

; Silva, Fernando H. L.

; Costa, Alan C.

; Silva, Fabiano G.

; Miranda, Carlos E. S.

; Silva, Marcio L. A.

; Cunha, Wilson R.

; Pauletti, Patricia M.

; Januario, Ana H.

Journal of the Brazilian Chemical Society

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Nov 2019, Volume 30 Nº 11 Páginas 2430 - 2437

Resumo: En | Texto: En | PDF: En

Hyptis pectinata (L.) Poit is a folk medicinal species in Northeast Brazil. In this work, seedlings of H. pectinata were cultured in vitro under diverse light quality spectra and under the influence of two distinct chemical elicitors, salicylic acid and silver nitrate (SN), at concentrations of 30 and 60 μM. Growth parameters, biomass and rosmarinic acid (RA) content were evaluated. RA may be associated with the functional properties of this plant. In the light quality experiments, the highest level of rosmarinic acid was found under red light (161.65 ± 8.64 μg g-1 DW (dry weight)) at 20 days (4.26-fold higher than the control white light). Among the evaluated elicitors, elicitation with 60 μM SN at 3 days and 30 μM SN at 6 days favored the highest rosmarinic acid content (6361.70 ± 216.96 and 4542.98 ± 92.53 μg g-1 DW, respectively), with relatively high biomass yield and a similar number of leaves and height as those of control seedlings. This approach is new for H. pectinata.

https://doi.org/10.21577/0103-5053.20190159 385 downloads

13.

Aqueous extract of Baccharis trimera improves redox status and decreases the severity of alcoholic hepatotoxicity
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Rabelo, Ana Carolina S.

; Araújo, Glaucy R. de

; Lúcio, Karine de P.

; Araújo, Carolina M.

; Miranda, Pedro H. de A.

; Silva, Breno de M.

; Carneiro, Ana Claudia A.

; Ribeiro, Érica M. de C.

; Lima, Wanderson G. de

; Souza, Gustavo H. B. de

; Brandão, Geraldo C.

; Costa, Daniela C.

Revista Brasileira de Farmacognosia

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Dez 2017, Volume 27 Nº 6 Páginas 729 - 738

Resumo: En | Texto: En | PDF: En

ABSTRACT The metabolism of ethanol occurs mainly in the liver, promoting increase of reactive oxygen species and nitrogen, leading to redox imbalance. Therefore, antioxidants can be seen as an alternative to reestablish the oxidizing/reducing equilibrium. The aim of this study was to evaluate the antioxidant and hepatoprotective effect of aqueous extract of Baccharis trimera (Less.) DC., Asteraceae, in a model of hepatotoxicity induced by ethanol. The extract was characterized and in vitro tests were conducted in HepG2 cells. It was evaluated the cells viability exposed to aqueous extract for 24 h, ability to scavenging the radical DPPH, besides the production of reactive oxygen species and nitric oxide, and the influence on the transcriptional activity of transcription factor Nrf2 (12 and 24 h) after exposure to 200 mM ethanol. The results showed that aqueous extract was non-cytotoxic in any concentration tested; moreover, it was observed a decrease in ROS and NO production, also promoting the transcriptional activity of Nrf2. In vivo, we pretreatment male rats Fisher with 600 mg/kg of aqueous extract and 1 h later 5 ml/kg of absolute ethanol was administrated. After two days of treatment, the animals were euthanized and lipid profile, hepatic and renal functions, antioxidant status and oxidative damage were evaluated. The treatment with extract improved liver function and lipid profile, reflecting the reduction of lipid microvesicules in the liver. It also promoted an increase of glutathione peroxidase activity, decrease of oxidative damage and MMP-2 activity. These results, analyzed together, suggest the hepatoprotective effect of B. trimera aqueous extract.

https://doi.org/10.1016/j.bjp.2017.09.003 698 downloads

14.

Detection of antimicrobial resistance genes in beta-lactamase- and carbapenemase-producing Klebsiella pneumoniae by patient surveillance cultures at an intensive care unit in Rio de Janeiro, Brazil
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Flores, Claudia

; Romão, Célia Maria C. P. A.

; Bianco, Kayo

; Miranda, Catia Chaia de

; Breves, Angela

; Souza, Ana Paula S.

; Santos, Rosana Maria R.

; Fonseca, Bianca O.

; Filippis, Ivano de

; Clementino, Maysa M.

Jornal Brasileiro de Patologia e Medicina Laboratorial

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Out 2016, Volume 52 Nº 5 Páginas 284 - 292

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: O aumento da incidência de microrganismos multirresistentes é considerado um dos principais problemas de saúde pública. Uma das rotinas incluídas na prática hospitalar é a busca de pacientes colonizados e/ou infectados. Objetivo: Avaliar a variabilidade genética e as relações clonais de K. pneumoniae produtoras de betalactamases de espectro estendido (ESBL) em culturas de vigilância de unidade de terapia intensiva (UTI) no Rio de Janeiro, Brasil. Materiais e métodos: Setenta isolados obtidos a partir de swab retal, (março/2013 a março/2014). O perfil de suscetibilidade a antibióticos foi avaliado pelo sistema VITEK 2. Foram pesquisados os genes de resistência: blaSHV, blaTEM, blaOXA-1, blaKPC, blaOXA-48, blaCTX-M-15, blaVIM, blaIMP e blaNDM pela reação em cadeia da polimerase (PCR). A diversidade genética foi avaliada por Enterobacterial Repetitive Intergenic Consensus-PCR (ERIC-PCR). Resultados: Foram detectados altos percentuais de resistência a cefepime (94%), ceftazidima (96%), ertapenem (61%), imipenem (54%) meropenem (43%) e ciprofloxacino (69%). Os genes prevalentes foram: blaSHV (69%), blaTEM (63%), blaOXA-1 (60%), blaKPC (57%), blaCTX-M-15 (47%), blaOXA-48 (16%). Os genes blaVIM, blaIMP e blaNDM não foram detectados. Foram observados 29 perfis em relação aos genes de resistência, com 23% apresentando pelo menos cinco genes. Uma grande diversidade genética (68 perfis) foi observada entre as cepas. Conclusão: Embora não tenha sido observada relação clonal entre os isolados, este estudo revelou dados alarmantes quanto à resistência microbiana em monitoramento preventivo, abordagem ainda pouco adotada no Brasil. Nossos dados permitem concluir que a inclusão de culturas de vigilância nas unidades de saúde é uma estratégia recomendada, visando principalmente à prevenção da disseminação dos genes de resistência no ambiente hospitalar e, consequentemente, redução da morbimortalidade.

ABSTRACT Introduction: The increasing incidence of multi-resistant microorganisms has been considered a public health problem. One of the routines included in hospital practice is the screening of colonized and/or infected patients. Objective: The aim of this study was to evaluate the genetic variability and clonal relationships of extended-spectrum beta-lactamase (ESBL)-producing K. pneumoniae, from surveillance cultures, at an intensive care unit, in Rio de Janeiro, Brazil. Material and methods: Seventy K. pneumoniae isolates were obtained from rectal swabs (March 2013 to March 2014). Antimicrobial susceptibility was assessed by VITEK 2 System. Resistant genes blaSHV, blaTEM, blaOXA-1, blaKPC, blaOXA-48, blaCTX-M-15, blaVIM, blaIMP and blaNDM were investigated by polymerase chain reaction (PCR); genetic diversity, by Enterobacterial Repetitive Intergenic Consensus-PCR (ERIC-PCR). Results: Strains showed high resistance rates to cefepime (94%), ceftazidime (96%), ertapenem (61%), imipenem (54%) meropenem (43%) and ciprofloxacin (69%). The most prevalent genes were blaSHV (69%), blaTEM (63%), blaOXA-1 (60%), blaKPC (57%), blaCTX-M-15 (47%), blaOXA-48 (16%). Genes blaVIM, blaIMP and blaNDM were not detected. Twenty nine profiles of resistance genes were observed, with 23% carrying at least five genes. A great genetic diversity (68 ERIC profiles) was also observed among the strains. Conclusion: Although no clonal relationship was observed within the isolates, this study revealed alarming data on the antimicrobial resistance deficiently monitored for preventive purposes in Brazil. Our data allow us to conclude that the inclusion of surveillance cultures in health facilities is a recommended strategy aiming particularly at preventing the spread of resistance genes in the hospital environment and, consequently, reducing morbidity and mortality.

https://doi.org/10.5935/1676-2444.20160049 4183 downloads

15.

Antinociceptive and anti-inflammatory effects of a Geissospermum vellosii stem bark fraction
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LIMA, JOSÉLIA A.

; COSTA, THIAGO W.R.

; SILVA, LEANDRO L.

; MIRANDA, ANA LUÍSA P.

; PINTO, ANGELO C.

Anais da Academia Brasileira de Ciências

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Mar 2016, Volume 88 Nº 1 Páginas 237 - 248

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO O Geissospermum vellosii (Pau pereira) é uma árvore brasileira, cujas cascas do caule são ricas em alcalóides indólicos que apresentam intensa atividade anticolinesterásica. Este estudo avaliou os efeitos de uma fração da casca (fração PPAC) e do extrato etanólico (EE) do Pau pereira em modelos clássicos de inflamação e dor em murinos. O EE e a fração PPAC, ambos na dose de 30 mg/kg, reduziram significativamente a constrição abdominal induzida por ácido acético em camundongos em 34,8% e 47,5% respectivamente. No teste da formalina, o EE (30 mg/kg) e a fração PPAC (30 e 60 mg/kg) inibiram somente a segunda fase em 82,8%; 84,9% e 100%, respectivamente. Comparado com a indometacina, doses similares do EE ou da fração PPAC foram cerca de duas vezes mais eficazes em causar antinocicepção. A fração PPAC não foi eficaz no teste da placa quente, enquanto reduziu a resposta inflamatória na segunda (50,6%) e na terceira (57,8%) horas do edema de pata de rato induzido por carragenina. A atividade anti-hiperalgésica foi observada depois de 30 min com um pico em 2 h (60,1%). Esses resultados mostrararam que os compostos presentes na fração PPAC têm atividade anti-inflamatória e antinociceptiva por um mecanismo aparentemente não relacionado ao sistema opióide. A despeito das respostas similares às observadas para a indometacina, os efeitos da fração PPAC são atribuídos principalmente às ações da acetilcolina.

ABSTRACT Geissospermum vellosii (Pao pereira) is a Brazilian tree whose stem barks are rich in indole alkaloids that present intense anticholinesterase activity. The present study evaluated the effects of a stem bark fraction (PPAC fraction) and ethanolic extract (EE) of Pao pereira in classic murine models of inflammation and pain. The EE and PPAC fraction, both at a dose of 30 mg/kg, significantly reduced mice abdominal constriction induced by acetic acid by 34.8% and 47.5%, respectively. In the formalin test, EE (30 mg/kg) and PPAC fraction (30 and 60 mg/kg) inhibited only the second phase, by 82.8%, 84.9% and 100%, respectively. Compared with indomethacin, similar doses of EE or PPAC fraction were approximately twice as effective in causing antinociception. PPAC fraction was not effective in the hot plate test but reduced the inflammatory response at the second (50.6%) and third (57.8%) hours of rat paw edema induced by carrageenan. Antihyperalgesic activity was observed within 30 min with a peak at 2 h (60.1%). These results demonstrate that compounds in PPAC fraction have anti-inflammatory and antinociceptive activity by a mechanism apparently unrelated to the opioid system. Regardless of similar responses to indomethacin, the effects of PPAC fraction are mainly attributed to acetylcholine actions.

https://doi.org/10.1590/0001-3765201520140374 2114 downloads

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