Pesquisa | SciELO

ABSTRACT Introduction: Survival of patients living with HIV has increased and low bone mineral density and fractures are reported in this population. Chronic kidney disease causes bone disorder, which also contributes to low bone mineral density, fractures, and vascular calcification. This study aimed to assess the osteometabolic profile in HIV patients undergoing hemodialysis. Methods: Data of 21 patients were assessed. Laboratory: calcium, phosphorus, albumin, intact parathyroid hormone, total alkaline phosphatase, 25OH-vitamin D, CD4 count and HIV viral load. Bone mineral density was assessed by bone densitometry, and x-rays were taken to determine vascular calcification scores. Results: The median age of patients was 48 years (81% male) and the median times of HIV infection and hemodialysis were 132 and 120 months, respectively. Median serum calcium and phosphorus levels were normal and the median intact parathyroid hormone was 360 pg/mL. Osteopenia was diagnosed in 33% of patients and osteoporosis in 33%; 24% of patients had previously suffered fractures. The Kauppila score was higher in patients with fractures (p=0.040). Vascular calcification was identified in 12 (57%) patients. Inverse correlations were demonstrated between the Kauppila score and the T-score of the femoral neck (p<0.001) and the T-score of the lumbar spine (p<0.001); and between the Adragão score and T-score of the femoral neck (p=0.001) and the T-score of the lumbar spine (p=0.001). Conclusion: A high prevalence was observed of low bone mineral density, fractures and vascular calcification in HIV patients on hemodialysis. It is necessary to confirm these results with larger studies and with a control group of non-HIV patients.

https://doi.org/10.32932/pjnh.2023.11.264

Soil organic carbon fractions in agroforestry system in Brazil: seasonality and short-term dynamic assessment
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Matos, Priscila Silva

; Pinto, Luiz Alberto da Silva Rodrigues

; Lima, Sandra Santana de

; Alves, Thassiany de Castro

; Cerri, Eduardo Pellegrino

; Pereira, Marcos Gervasio

; Zonta, Everaldo

Revista Brasileira de Ciência do Solo

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2023, Volume 47 Nº spe elocation e0220095

Resumo: En | Texto: En | PDF: En

ABSTRACT Adopting land-uses that contribute with a considerable litter input can affect the accumulation, protection, and bioavailability of organic carbon in the edaphic environment, compromising the different compartments of soil organic matter (SOM) and the associated benefits. Moreover, changes in seasons can influence the dynamic of SOM. Notably, the mechanisms involved in SOM stabilization and storage, particularly in agroforestry production areas, are still poorly explored. This study aimed to verify if the contents of soil organic carbon (SOC) and the physical fractions of the SOM are modified as a function of agroforestry systems implemented in the short term, and verify if seasonality can affect the compartmentalization of SOM in agrifood systems. Also, we tested if the carbon management index (CMI) is sensitive to detecting management practices quality across the unmanaged pasture, different agroforestry systems, and a reference area (forest). We measured soil physical properties, SOC content in bulk soil, particular organic carbon (POC), and mineral-associated organic carbon (MAOC) fractions at three different depths (0.00-0.05, 0.05-0.10, and 0.10-0.20 m) in response to the adoption of agroforestry systems. Our results show that after a short period of implementation of agroforestry systems, significant changes were observed in SOC contents and the physical fractions of SOM in the most superficial layers (0.00-0.05 and 0.05-0.10 m), with emphasis on the particulate fraction of SOM. We verified that the seasonality affected the SOC, POC, and MAOC contents. We also found that the CMI index was more sensitive and efficient in detecting changes arising from seasonality and the management practices involved. According to this index, it was possible to verify that the agroforestry system with the highest density of species for biomass production (AS3) has been accumulating more carbon in the soil. Therefore, this study provides relevant information regarding soil carbon management in agroforestry systems.

https://doi.org/10.36783/18069657rbcs20220095

Safety, Effectiveness, and Hemodynamic Performance of the Bovine Pericardium Organic Valvular Bioprosthesis
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Rösler, Álvaro Machado

; Lucchese, Fernando Antonio

; Pomerantzeff, Pablo Maria Alberto

; Passos, Luiz Carlos Santana

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 Nº 6 elocation e20230015

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: To assess actual data on the safety, effectiveness, and hemodynamic performance of Bovine Pericardium Organic Valvular Bioprosthesis (BVP). Methods: The BIOPRO Trial is an observational, retrospective, non-comparative, non-randomized, and multicenter study. We collected data from 903 patients with symptomatic, moderate, or severe valve disease who underwent BVP implants in the timeframe from 2013 to 2020 at three Brazilian institutions. Death, valve-related adverse events (AEs), functional recovery, and hemodynamic performance were evaluated at the hospital, at discharge, and six months and one year later. Primary analysis compared late (> 30 days after implant) linearized rates of valve-related AEs, such as thromboembolism, valve thrombosis, major hemorrhage, major paravalvular leak, and endocarditis, following objective performance criteria (OPC). Analysis was performed to include at least 400 valve-years for each valve position (aortic and mitral) for complete comparisons to OPC. Kaplan-Meier survival and major adverse cardiovascular and cerebrovascular event analyses were also performed. Results: This retrospective study analyzed follow-up data collected from 903 patients (834.2 late patient-years) who have undergone surgery for 455 isolated aortic valve replacement (50.4%), 382 isolated mitral valve replacement (42.3%), and 66 combined valve replacement or other intervention (7.3%). The linearized rates of valve-related AEs were < 2 × OPC. One-year survival rates were 95.1% and 92.7% for aortic and mitral valve replacement, respectively. This study demonstrated an improvement in the New York Heart Association classification from baseline and hemodynamic performance within an expected range. Conclusion: According to this analysis, BVP meets world standards for safety and clinical efficacy.

https://doi.org/10.21470/1678-9741-2023-0015

New records of predation of Harpactorinae (Hemiptera: Reduviidae) over Euglossini and Xylocopini bees (Hymenoptera: Apidae) in Brazil
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Marsaro Júnior, Alberto Luiz

; Storck-Tonon, Danielle

; Halinski, Rosana

; Silva Monte, Gersonval Leandro

; Gil-Santana, Hélcio Reinaldo

Revista chilena de entomología

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Mar 2022, Volume 48 Nº 1 Páginas 93 - 97

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

Abstract The predatory activities of Apiomerus duckei Costa Lima, Seabra & Hathaway, 1951, Apiomerus pilipes (Fabricius, 1787) and Apiomerus luctuosus Costa Lima, Seabra & Hathaway, 1951 (Hemiptera: Reduviidae: Harpactorinae: Apiomerini) on orchid bees (Hymenoptera: Apidae: Apinae: Euglossini) in odoriferous traps in the influence area of Santo Antonio Hydroelectric Power Plant, Rondonia State, Brazil, and of Cosmoclopius annulosus Stal, 1872 (Hemiptera: Reduviidae: Harpactorinae: Harpactorini) on the bee Ceratina rupestris Holmberg, 1884 (Hymenoptera: Apidae: Apinae: Xylocopini: Ceratinina), in an experimental area cultivated with canola in Passo Fundo, Rio Grande do Sul State, Brazil, are recorded by the first time.

Resumen Se registran por primera vez las actividades depredadoras de Apiomerus duckei Costa Lima, Seabra y Hathaway, 1951, Apiomerus pilipes (Fabricius, 1787) y Apiomerus luctuosus Costa Lima, Seabra y Hathaway, 1951 (Hemiptera: Reduviidae: Harpactorinae: Apiomerini) sobre abejas orquídeas (Hymenoptera: Apidae: Apinae: Euglossini) en trampas odoríferas ubicadas en el área de influencia de la Central Hidroeléctrica Santo Antonio (HEP), Estado de Rondonia, Brasil, y de Cosmoclopius annulosus Stal, 1872 (Hemiptera: Reduviidae: Harpactorinae: Harpactorini) sobre la abeja Ceratina rupestris Holmberg, 1884 (Hymenoptera: Apidae: Apinae: Xylocopini: Ceratinina), en un área experimental cultivada con canola en Passo Fundo, Rio Grande do Sul State, Brasil.

https://doi.org/10.35249/rche.48.1.22.08 6 downloads

13C ss-NMR Singular value decomposition and fitting for sorghum proteins conformation elucidation
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Ribeiro, Tatiana Santana

; Scramin, Juliana Aparecida

; Rodrigues, José Avelino Santos

; Bernardes Filho, Rubens

; Colnago, Luiz Alberto

; Forato, Lucimara Aparecida

Polímeros

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2022, Volume 32 Nº 1 elocation e2022009

Resumo: En | Texto: En | PDF: En

Abstract Kafirins, water-insoluble proteins from Sweet Sorghum BR501 grains, have been an alternative to prepare edible coatings for food due to their hydrophobic character. In this work, the secondary structures (SS) content of reduced (SSr) and unreduced (SSu) kafirins were determined by 13C solid-state-NMR spectroscopy using areas of carbonyl peak. The SS elucidate by fitting the signal with the Lorentzian function shows 56% and 59% of α-helix and 40% and 12% of β-sheet structures for SSr and SSu, respectively. The SS also were elucidated by a Singular value decomposition- SVD method shows 55% and 49% of α-helix and 12% and 8% of β-sheet structure for SSr and SSu, respectively. Since SVD does not depend on the operator and has higher correlation coefficients for α-helix (0.96%) and β-sheet (0.91%), it is a reliable method to quantify the SS of insoluble proteins using the 13C NMR signal.

https://doi.org/10.1590/0104-1428.20210082

Extracorporeal Membrane Oxygenation in COVID-19 Treatment: a Systematic Literature Review
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Oliveira, Tatiana Farias de

; Rocha, Carlos Alberto de Oliveira

; Santos, Aisla Graciele Galdino dos

; Silva Junior, Luiz Carlos Francelino

; Aquino, Saulo Henrique Salgueiro de

; Cunha, Euclides José Oliveira da

; Alcântara, Rafaela Campos

; Mesquita, Rodrigo da Rosa

; Arnozo, Gabriel Monteiro

; Santana, Fernanda Mayara Santos

; Silva Filho, Etvaldo Rodrigues da

; Souza, Carlos Dornels Freire de

Brazilian Journal of Cardiovascular Surgery

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Jun 2021, Volume 36 Nº 3 Páginas 388 - 396

Resumo: En | Texto: En | PDF: En

Abstract Introduction: The present study intends to systematically review the literature on the use of extracorporeal membrane oxygenation (ECMO) in patients with coronavirus disease 2019 (COVID-19). Methods: The research was carried out according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). Studies were selected from PubMed/MEDLINE and LILACS databases between December 2019 and May 17 2020, using the descriptors "ECMO AND COVID-19", "Extracorporeal Membrane Oxygenation AND COVID-19", "ECLS AND COVID-19", and "Extracorporeal Life Support AND COVID-19". Exclusion criteria were government epidemiological bulletins, comments, literature reviews, and articles without full access to content. Results: Two hundred and thirty-three scientific productions were found, however only 18 did not met the exclusion criteria and could be included in this study, amouting to a total of 911 patients - 624 (68.5%) men, 261 (28.6%) women, and 26 (2.8%) without sex information. The mean age of the patients was 53.7 years. ECMO was necessary in 274 (30.1%) people (200 [73%] submitted to veno-venous ECMO, nine [3.3%] to veno-arterial ECMO, and seven [2.5%] moved between these two types or needed a more specific ECMO according to the disease prognosis). Five studies did not specify the type of ECMO used, amounting 57 (20.8%) patients. Five patients (1.8%) were discharged, 77 (28.1%) died, 125 (45.6%) remained hospitalized until publication time of their respective studies, and 67 patients (24.4%) had no outcome information. Conclusion: It is evident that more research, covering larger populations, must be carried out in order to clearly elucidate the role of ECMO in the treatment of COVID-19.

https://doi.org/10.21470/1678-9741-2020-0397 4 downloads

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Resumo: En | Texto: En | PDF: En

ABSTRACT OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9–11.8%) to 25.0% (95%CI: 21.7–28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

https://doi.org/10.11606/s1518-8787.2021055003970

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Resumo: En | Texto: En | PDF: En

https://doi.org/10.11606/s1518-8787.2021055003970 43 downloads

Physicogenic and biogenic aggregates under different management systems in the Cerrado region, Brazil
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Pinto, Luiz Alberto da Silva Rodrigues

; Torres, José Luiz Rodrigues

; Morais, Igor de Sousa

; Ferreira, Robert

; Silva Júnior, Wanderson Farias da

; Lima, Sandra de Santana

; Beutler, Sidinei Júlio

; Pereira, Marcos Gervasio

Revista Brasileira de Ciência do Solo

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2021, Volume 45 elocation e0200114

Resumo: En | Texto: En | PDF: En

ABSTRACT An important strategy for the sustainable management of Cerrado soils is no-till (NT) systems, which may improve soil properties, particularly aggregation. Soil aggregates can be categorized according to their formation pathways into physicogenic (Phy) and biogenic (Bio). This study aimed (i) to quantify the relative proportion of physicogenic and biogenic aggregates and (ii) evaluate the levels of total organic carbon and their respective humic and physical fractions in the aggregates’ formation pathways. The following managed and unmanaged sites were evaluated: a 6-year no-till site (6NT), an 18-year no-till site (18NT), a conventional tillage site (CT), and a reference Cerrado site (RS). Retained aggregates were analyzed morphologically, separated into Phy and Bio, and quantified. Subsequently, aggregates were subjected to total organic carbon (TOC) determination, fulvic acid carbon, humic acid carbon, humin carbon, particulate organic carbon (POC), mineral-associated organic carbon, and free light fraction carbon (FLFC). The proportion of Bio aggregates increased with decreasing management intensity. When TOC and humic acid carbon levels were compared between sites, it was found that Bio aggregates from 18NT and 6NT contained higher carbon content than Bio aggregates from CT. Particulate organic carbon and FLFC differed between aggregate types, with higher POC values observed in Bio aggregates from CT and 18NT and higher FLFC values in Bio aggregates from CT, 6NT, and 18NT. The practices adopted in the conservation management system favored biogenic aggregation in the Cerrado region, which can be proven through the study of the fractions of soil organic matter contained in these aggregates. The biogenic aggregation changed the SOM dynamics. Principal component analysis showed a clear distinction between conventional and conservationist management systems.

https://doi.org/10.36783/18069657rbcs20200114 413 downloads

10.

Formação Médica na UFSB: III. Aprendizagem Orientada por Problemas e Competências
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Almeida Filho, Naomar

; Lopes, Antonio Alberto

; Coutinho, Denise Maria

; Cardoso, Antonio José

; Santana, Luciana Alaíde

; Santos, Vanessa Prado

; Guimarães, Luiz Henrique

; Oliveira-Lima, José Antonio

Revista Brasileira de Educação Médica

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Jan 2018, Volume 42 Nº 1 Páginas 129 - 141

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

RESUMO O tema das reformas curriculares na educação médica brasileira tem sido bastante debatido na literatura especializada. Algumas reformas buscaram introduzir estratégias de aprendizagem ativas, porém com poucas mudanças efetivas. Em artigos anteriores, apresentamos o modelo geral de um curso médico baseado em regime de ciclos, proposto pela Universidade Federal do Sul da Bahia. Neste artigo, submetemos ao debate o conjunto de estratégias pedagógicas estruturantes desse projeto. Primeiro, discutimos o conceito de “competência” articulado às demandas de uma formação ampliada, cidadã e profissional, incorporando tecnologias resolutivas ao cuidado humanizado e aos processos de trabalho em saúde. Em seguida, apresentamos instrumentos e metodologias ativas de aprendizagem que conformam a matriz de estratégias pedagógicas adotada pelo curso, baseada em quatro dispositivos centrais: Compromissos de Aprendizagem Significativa; Equipes de Aprendizagem Ativa; Sistema Integrado de Aprendizagem Compartilhada; Aprendizagem Orientada por Problemas e Competências. Tais dispositivos (e estratégias correlatas) promovem a aplicação de princípios e modelos de aprendizagem ativa e solidária em todas as etapas da formação, com uso intensivo de tecnologias digitais e mídias sociais. Discutimos fundamentos e perspectivas desse formato de organização pedagógico no que se refere à consistência com o modelo curricular da UFSB, enfatizando a estratégia de Aprendizagem Orientada por Problemas Concretos como eixo central de formação orientada pela prática de cuidados em saúde. Como ferramenta padronizada e dinâmica para acompanhamento de pacientes, adota-se o Prontuário Orientado por Problemas e Evidências (POPE), numa versão informatizada, mais adequada e eficiente que o modelo tradicional de prontuário, adaptada para uso nos diferentes contextos de prática clínica onde atua a UFSB. Esta proposta insere-se no esforço de construção de uma nova cultura pedagógica pautada numa perspectiva sociocrítica (intercultural, interepistêmica, interprofissional e interdisciplinar) da educação médica, capaz de articular, de forma indissociável, o sistema de formação em saúde aos de ciência, tecnologia e inovação, visando promover integralidade, humanização e resolutividade nas práticas de atenção à saúde. 310 palavras

ABSTRACT Curricular reforms in medical education has been much debated in the specialized Brazilian literature. Some reforms have sought to introduce active learning strategies, but with few effective changes. In previous articles, we have introduced the general model of a medical course based on cycles, proposed by the Federal University of Southern Bahia. In this article, we submit to debate the set of pedagogical strategies structuring this project. First, we discuss the concept of “competence” articulated to the demands of a broad professional citizen formation, incorporating effective technologies to humanized care and to labor processes in health. Then, we present learning tools and methodologies that conform a matrix of active pedagogical strategies adopted by the course, based on four central devices: Significant Learning Commitments; Active Learning Teams; Integrated Shared Learning System; Competency and Problem-Based Learning. Such devices (and related strategies) promote the application of strategies and instruments of active and solidary learning in all stages of training, with intensive use of digital technologies and social media. We discuss the fundamentals and perspectives of this pedagogical organization format, which refers to the consistency with the curricular model, emphasizing the strategy of learning oriented by concrete problems as the central axis of training guided by health care practices. As a standardized and dynamic tool for patient follow-up, the patient's record oriented by problems and evidence (POPE) is used, in a computerized version, more adequate and efficient than the traditional template, adapted for use in the different contexts of UFSB clinical practice. This proposal is part of the effort to build a new pedagogical culture based on a sociocritical (inter-cultural, inter-personal, interprofessional and interdisciplinary) perspective of medical education, capable of articulating, in an integrated way, the education system in health to those of science, technology and innovation, aiming to promote integrality, humanization and resolution in health care practices. 300 words

https://doi.org/10.1590/1981-52712015v41n3rb20170026 2461 downloads

11.

Brazilian guidelines for the diagnosis and treatment of cystic fibrosis
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Athanazio, Rodrigo Abensur

; Silva Filho, Luiz Vicente Ribeiro Ferreira da

; Vergara, Alberto Andrade

; Ribeiro, Antônio Fernando

; Riedi, Carlos Antônio

; Procianoy, Elenara da Fonseca Andrade

; Adde, Fabíola Villac

; Reis, Francisco José Caldeira

; Ribeiro, José Dirceu

; Torres, Lídia Alice

; Fuccio, Marcelo Bicalho de

; Epifanio, Matias

; Firmida, Mônica de Cássia

; Damaceno, Neiva

; Ludwig-Neto, Norberto

; Maróstica, Paulo José Cauduro

; Rached, Samia Zahi

; Melo, Suzana Fonseca de Oliveira

; Pinto, Leonardo Araújo

; Monte, Luciana Freitas Velloso

; Higa, Laurinda Yoko Shinzato

; Folescu, Tania Wrobel

; Marson, Fernando Augusto de Lima

; Sad, Isabela

; Servidoni, Maria de Fátima Correa Pimenta

; Kussek, Paulo

; Raskin, Salmo

; Zuana, Adriana Della

; Augustin, Albin

; Hoffmann, Anneliese

; Barbisan, Beatriz

; Hochhegger, Bruno

; Levy, Carlos Emilio

; Veiga, Claudine Sarmento da

; Ricachinevsky, Claudio

; Esposito, Concetta

; Escuissato, Dante

; Brandemburgo, Diego

; Marques, Elisabeth

; Aquino, Evanirso de

; Fischer, Gilberto Bueno

; Rodrigues, Joaquim Carlos

; Machado, Leticia

; Muramato, Lucia

; Costa, Lusmaia Damasceno Camargo

; Donadio, Marcio

; Castro, Marcos César Santos de

; Ribeiro, Maria Angela

; Santana, Maria Angélica

; Canan, Mariane

; Almeida, Marina Buarque de

; Britto, Murilo

; Dalcin, Paulo Roth Tarso

; Ramos, Regina Terse Trindade

; Chiba, Sonia

; Martins, Valéria de Carvalho

; Lacerda, Claudine

; Barbosa, Eliana

; Guimarães, Elizabet Vilar

; Hessel, Gabriel

; Gurmini, Jocemara

; Neri, Lenycia

; Nogueira, Marcelo Coelho

; Wayhs, Mônica Chang

; Simon, Miriam Isabel Santos

; Fernandes, Arlene Gonçalves dos Santos

; Silva, Claudia de Castro de

; Albuquerque, Cristiano Túlio Maciel

; Souza, Edna Lúcia

; Silva, Fernando Antonio de Abreu e

; Dalcin, Paulo de Tarso

; Noronha, Renata Maria de

; Teixeira, Ricardo

; Machado, Sandra Helena

; Camargo, Spencer Marcantonio

; Rozov, Tatiana

; Rodrigues, Ticiana da Costa

Jornal Brasileiro de Pneumologia

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Jun 2017, Volume 43 Nº 3 Páginas 219 - 245

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

RESUMO A fibrose cística (FC) é uma doença genética autossômica recessiva caracterizada pela disfunção do gene CFTR. Trata-se de uma doença multissistêmica que ocorre mais frequentemente em populações descendentes de caucasianos. Nas últimas décadas, diversos avanços no diagnóstico e tratamento da FC mudaram drasticamente o cenário dessa doença, com aumento expressivo da sobrevida e qualidade de vida. Atualmente, o Brasil dispõe de um programa de ampla cobertura para a triagem neonatal de FC e centros de referência distribuídos na maior parte desses estados para seguimento dos indivíduos. Antigamente confinada à faixa etária pediátrica, tem-se observado um aumento de pacientes adultos com FC tanto pelo maior número de diagnósticos de formas atípicas, de expressão fenotípica mais leve, assim como pelo aumento da expectativa de vida com os novos tratamentos. Entretanto, ainda se observa uma grande heterogeneidade no acesso aos métodos diagnósticos e terapêuticos para FC entre as diferentes regiões brasileiras. O objetivo dessas diretrizes foi reunir as principais evidências científicas que norteiam o manejo desses pacientes. Um grupo de 18 especialistas em FC elaborou 82 perguntas clínicas relevantes que foram divididas em cinco categorias: características de um centro de referência; diagnóstico; tratamento da doença respiratória; tratamento gastrointestinal e nutricional; e outros aspectos. Diversos profissionais brasileiros atuantes na área da FC foram convidados a responder as perguntas formuladas pelos coordenadores. A literatura disponível foi pesquisada na base de dados PubMed com palavras-chave, buscando-se as melhores respostas às perguntas dos autores.

ABSTRACT Cystic fibrosis (CF) is an autosomal recessive genetic disorder characterized by dysfunction of the CFTR gene. It is a multisystem disease that most often affects White individuals. In recent decades, various advances in the diagnosis and treatment of CF have drastically changed the scenario, resulting in a significant increase in survival and quality of life. In Brazil, the current neonatal screening program for CF has broad coverage, and most of the Brazilian states have referral centers for the follow-up of individuals with the disease. Previously, CF was limited to the pediatric age group. However, an increase in the number of adult CF patients has been observed, because of the greater number of individuals being diagnosed with atypical forms (with milder phenotypic expression) and because of the increase in life expectancy provided by the new treatments. However, there is still great heterogeneity among the different regions of Brazil in terms of the access of CF patients to diagnostic and therapeutic methods. The objective of these guidelines was to aggregate the main scientific evidence to guide the management of these patients. A group of 18 CF specialists devised 82 relevant clinical questions, divided into five categories: characteristics of a referral center; diagnosis; treatment of respiratory disease; gastrointestinal and nutritional treatment; and other aspects. Various professionals working in the area of CF in Brazil were invited to answer the questions devised by the coordinators. We used the PubMed database to search the available literature based on keywords, in order to find the best answers to these questions.

https://doi.org/10.1590/s1806-37562017000000065 75529 downloads

12.

Análise e avaliação da qualidade de serviços internos com foco na manutenção de utilidades em uma empresa de manufatura
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Calarge, Felipe Araújo

; Fujii, Carlos Alberto Mitsuo

; Santana, José Carlos Curvelo

; Silva, Ivan Luiz Laranjeiras

; Miguel, Paulo Augusto Cauchick

Production

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Dez 2016, Volume 26 Nº 4 Páginas 724 - 741

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

Resumo A gestão da qualidade em serviços tem sido um tema frequentemente abordado como fator de diferenciação para as organizações nos dias atuais. Aliado a esse fato, os serviços de manutenção de utilidades são fundamentais para o funcionamento e desempenho adequado da infraestrutura das empresas. Nesse contexto, este artigo tem como objetivo caracterizar, mensurar e analisar a percepção da qualidade dos usuários de serviços internos de manutenção de utilidades em uma empresa de manufatura, líder em seu mercado de atuação. Por meio da elaboração de um questionário estruturado considerando o método SERVQUAL, foram coletados dados de forma não probabilística junto aos usuários. Para os dados coletados foi utilizada a análise com base no alfa de Cronbach, bem como o teste-t, buscando-se verificar a consistência e confiabilidade do instrumento. Os resultados indicaram diferenças entre expectativa e percepção dos usuários na maioria dos fatores analisados, sendo tais gaps discutidos no presente trabalho.

Abstract Service quality management is currently a subject that companies frequently consider as a differentiated factor. Maintenance services are essential to the suitable operation and performance of the internal services maintenance of a manufacturing company that is a market leader. Non-probabilistic data were collected from service users with an instrument based on the SERVQUAL scale. Cronbach alpha and t-test were used to verify the consistency and reliability of the instrument. The results highlighted differences between the performance and expectations of users regarding the most analyzed factors; discrepancies are subsequently discussed in the paper.

https://doi.org/10.1590/0103-6513.118013 6732 downloads

13.

Anatomical and histochemical analysis of Dysphania ambrosioides supported by light and electron microscopy
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Sá, Rafaela D.

; Santana, Asaph S.C.O.

; Silva, Flávia C.L.

; Soares, Luiz Alberto L.

; Randau, Karina P.

Revista Brasileira de Farmacognosia

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Out 2016, Volume 26 Nº 5 Páginas 533 - 543

Resumo: En | Texto: En | PDF: En

ABSTRACT Dysphania ambrosioides (L.) Mosyakin & Clemants (syn: Chenopodium ambrosoides L.), Amaranthaceae, popularly known as “mastruz”, is an herb widely used in Brazil as anthelmintic. To contribute to the knowledge about medicinal plants, a microscopic analysis was accomplished to describe the main anatomical characters of root, stem, petiole and leaf blade of D. ambrosioides and histochemical tests were performed on the leaf blade. Cross-sections were obtained, by hand, for microscopic analysis of root, stem, petiole and leaf blade; to the leaf blade were still made paradermal sections, scanning electron microscopy analysis, maceration and histochemical tests. The main characters useful in the identification of the plant were: anomalous secondary thickening in the root and stem; presence of idioblasts containing crystal sand in the root, stem, petiole and leaf blade; in these there are also idioblasts with druses; presence of non-glandular and glandular trichomes in the stem, petiole and leaf blade; stomata on the stem, petiole and leaf blade, identified in these as anomocytic and anisocytic; dorsiventral mesophyll and collateral vascular bundles. Maceration revealed that the vessel elements are helical type. Through the histochemical tests, it was evidenced the presence of lipophilic substances, essential oils, oleoresins, phenolic compounds, starch, lignin and calcium oxalate crystals. This work provides support to the quality control of the species.

https://doi.org/10.1016/j.bjp.2016.05.010 2384 downloads

14.

SEGURANÇA E REPRODUTIBILIDADE DO TESTE TIMED UP AND GO EM IDOSOS HOSPITALIZADOS
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Martinez, Bruno Prata

; Santos, Marilúcia Reis dos

; Simões, Leonardo Pamponet

; Ramos, Isis Resende

; Oliveira, Carolina Santana de

; Forgiarini Júnior, Luiz Alberto

; Camelier, Fernanda Warken Rosa

; Camelier, Aquiles Assunção

Revista Brasileira de Medicina do Esporte

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Out 2016, Volume 22 Nº 5 Páginas 408 - 411

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

RESUMO Introdução: Testes físicos seguros e confiáveis são importantes para rastrear risco de queda em idosos, entretanto, não existem estudos que tenham avaliado a segurança e a confiabilidade do teste Timed Up and Go (TUG) em idosos hospitalizados. Objetivos: Avaliar a segurança e reprodutibilidade do TUG em idosos hospitalizados. Métodos: Trata-se de um estudo transversal no qual foram coletadas três aferições do TUG para cada idoso, sendo considerado o melhor desempenho em segundos (s). Outras variáveis coletadas foram função cognitiva (MEEM), índice de comorbidades de Charlson, perfil admissional (clínico ou cirúrgico), relato de quedas no último ano e IMC. Para avaliar a confiabilidade relativa utilizou-se o coeficiente de correlação intraclasse (CCI) e para a confiabilidade absoluta, a análise de Bland-Altman. Resultados: Foram incluídos 68 idosos com média de idade de 70,4 ± 7,7 anos, índice de Charlson 5,4 ± 2,0 e predomínio do perfil clínico (64,7%). Nenhum dos 204 testes foi interrompido pelos critérios estabelecidos. Houve redução gradativa entre a primeira e a terceira aferição (1a = 11,6 ± 6,54; 2a = 10,7 ± 6,22 e 3a = 10,3 ± 5,54; p = 0,001) e elevado CCI (1a e 2a: CCI = 0,98; 1a e 3a: CCI = 0,98; 2a e 3a: CCI = 0,98; p = 0,001), sendo que a maior correlação com o melhor desempenho foi associada a 3a aferição (CCI = 0,99; p = 0,001). Identificou-se que os menores viés (0,29 s) e limites de concordância (-1,1 a 1,68 s) ocorreram também entre a terceira aferição e a de melhor desempenho. A medida de erro do método para avaliação da variabilidade foi 0,5 s e a alteração clinicamente significante 3,4 s. Conclusão: O TUG foi um instrumento seguro e com boa reprodutibilidade para mensuração do desempenho físico em idosos hospitalizados.

ABSTRACT Introduction: Safe and reliable physical tests are important to identify risk of falling in the elderly. However, there are no studies that have evaluated the safety and reliability of the test Timed Up and Go (TUG) in hospitalized elderly. Objectives: To evaluate the safety and reproducibility of the TUG in hospitalized elderly. Methods: This is a cross-sectional study where three measurements of the TUG were collected for each elderly, being considered the best performance in seconds (sec). Other variables collected were cognitive function (MMSE), Charlson comorbidity index, admission profile (clinical or surgical), history of falls in the last year and BMI. To assess the relative reliability we used the intraclass correlation coefficient (ICC), and for the absolute reliability we used the Bland-Altman analysis. Results: The study included 68 elderly with a mean age 70.4 ± 7.7 years, Charlson index 5.4 ± 2.0 and prevalence of clinical profile (64.7%). None of the 204 tests was interrupted by the established criteria. There was a gradual reduction between the first and third measurement (1st = 11.6 ± 6.54; 2nd = 10.7 ± 6.22 and 3rd = 10.3 ± 5.54; p = 0.001) and high ICC (1st and 2nd: ICC = 0.98; 1st and 3rd: ICC = 0.98; 2nd and 3rd: ICC = 0.98; p = 0.001), and the highest correlation with the best performance was associated with third measurement (ICC = 0.99; p = 0.001). We identified that the smallest bias (0.29 sec) and limits of concordance (-1.1 to 1.68 sec) also occurred between the third measurement and the best performance. The measure of the method error to evaluate the variability was 0.5 sec, and the clinically significant change was 3.4 sec. Conclusion: The TUG was a safe instrument with good reproducibility for measuring physical performance in hospitalized elderly.

RESUMEN Introducción: Pruebas físicas seguras y fiables son importantes para el rastreo del riesgo de caídas en los ancianos; sin embargo, no existen estudios que evaluaron la seguridad y la fiabilidad de la prueba Timed Up and Go (TUG) en ancianos hospitalizados. Objetivos: Evaluar la seguridad y fiabilidad del TUG en ancianos hospitalizados. Métodos: Se trata de un estudio transversal en el que se recogieron tres mediciones del TUG para cada anciano y se considera el mejor rendimiento en segundos (s). Otras variables recogidas fueron la función cognitiva (MMSE), el índice de comorbilidad de Charlson, perfil de ingreso hospitalario (clínico o quirúrgico), antecedentes de caídas en el último año y el IMC. Para evaluar la fiabilidad relativa se utilizó el coeficiente de correlación intraclase (CCI) y para la fiabilidad absoluta, el análisis de Bland-Altman. Resultados: Se incluyeron 68 ancianos con una edad media de 70,4 ± 7,7 años, índice de Charlson 5,4 ± 2,0 y prevalencia del perfil clínico (64,7%). Ninguna de las 204 pruebas fue interrumpida por los criterios establecidos. Hubo una reducción gradual entre la primera y tercera medición (1a = 11,6 ± 6,54, 2a = 10,7 ± 6,22 y 3a = 10,3 ± 5,54, p = 0,001) y CCI alto (1a y 2a: CCI = 0,98; 1a y 3a: CCI = 0,98; 2a y 3a: CCI = 0,98; p = 0,001), y la más alta correlación con el mejor rendimiento se asoció con la tercera medición (ICC = 0,99; p = 0,001). Se identificó que el sesgo más pequeño (0,29 s) y límites de concordancia (-1,1 a 1,68 s) también se produjo entre la tercera medición y el mejor rendimiento. La medición del error del método para la evaluación de la variabilidad fue de 0,5 s y el cambio clínicamente significativo fue 3,4 s. Conclusión: El TUG fue un instrumento seguro y reproducible para medir el rendimiento físico en ancianos hospitalizados.

https://doi.org/10.1590/1517-869220162205145497 16129 downloads

15.

Case 1/2016 - 56-Year-Old Male with Atrial Septal Defect, Pulmonary Arterial Hypertension, Hospitalized Due to Eisenmenger Syndrome
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Santana, Carolina

; Lopes, Antonio Augusto B.

; Paiva, Antonio Fernando Lins de

; Benvenuti, Luiz Alberto

Arquivos Brasileiros de Cardiologia

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Mar 2016, Volume 106 Nº 3 Páginas 250 - 258

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

https://doi.org/10.5935/abc.20160035 5208 downloads

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