bluuebunny/crossref_metadata_2025 huggingface dataset:
Truncated TrkB.T1-Mediated Astrocyte Dysfunction Contributes to Impaired Motor Function and Neuropathic Pain after Spinal Cord Injury
Authors: Matyas Jessica J. , O'Driscoll Cliona M. , Yu Laina , Coll-Miro Marina , Daugherty Sean , Renn Cynthia L. , Faden Alan I. , Dorsey Susan G. , Wu Junfang
Published: March 2017

Following spinal cord injury (SCI), astrocytes demonstrate long-lasting reactive changes, which are associated with the persistence of neuropathic pain and motor dysfunction. We previously demonstrated that upregulation of trkB.T1, a truncated isoform of the brain-derived neurotrophic factor receptor (BDNF), contributes to gliosis after SCI, but little is known about the effects of trkB.T1 on the function of astrocytes. As trkB.T1 is the sole isoform of trkB receptors expressed on astrocytes, we examined the function of trkB.T1-driven astrocytesin vitroandin vivo. Immunohistochemistry showed that trkB.T1+cells were significantly upregulated 7 d after injury, with sustained elevation in white matter through 8 weeks. The latter increase was predominantly found in astrocytes. TrkB.T1 was also highly expressed by neurons and microglia/macrophages at 7 d after injury and declined by 8 weeks. RNA sequencing of cultured astrocytes derived fromtrkB.T1+/+(WT) andtrkB.T1−/−(KO) mice revealed downregulation of migration and proliferation pathways in KO astrocytes. KO astrocytes also exhibited slower migration/proliferationin vitroin response to FBS or BDNF compared with WT astrocytes. Reduced proliferation of astrocytes was also confirmed after SCI in astrocyte-specifictrkB.T1KO mice; using mechanical allodynia and pain-related measurements on the CatWalk, these animals also showed reduced hyperpathic responses, along with improved motor coordination. Together, our data indicate that trkB.T1 in astrocytes contributes to neuropathic pain and neurological dysfunction following SCI, suggesting that trkB.T1 may provide a novel therapeutic target for SCI.

SIGNIFICANCE STATEMENTNeuropathic pain after spinal cord injury (SCI) may in part be caused by upregulation of the brain-derived neurotrophic factor (BDNF) receptor trkB.T1, a truncated isoform of BDNF. TrkB.T1 is the only isoform of tropomyosin-related receptor kinase type B (trkB) receptors expressed on astrocytes. Here, we showed that trkB.T1 is significantly increased in the injured mouse spinal cord, where it is predominantly found in astrocytes. RNA sequencing of cultured astrocytes demonstrated downregulation of migration and proliferation pathways intrkB.T1KO astrocytes. This was validatedin vivo, where deletion oftrkB.T1in astrocytes reduced cell proliferation and migration. After SCI, astrocyte-specifictrkB.T1KO mice showed reduced hyperpathic responses and improved motor coordination. Therefore, the trkB.T1 receptor plays a significant pathophysiological role after SCI, and may provide a novel therapeutic target for SCI.
Mild Cognitive Impairment Is Characterized by Deficient Brainstem and Cortical Representations of Speech
Authors: Bidelman Gavin M. , Lowther Jill E. , Tak Sunghee H. , Alain Claude
Published: March 2017

Mild cognitive impairment (MCI) is recognized as a transitional phase in the progression toward more severe forms of dementia and is an early precursor to Alzheimer's disease. Previous neuroimaging studies reveal that MCI is associated with aberrant sensory–perceptual processing in cortical brain regions subserving auditory and language function. However, whether the pathophysiology of MCI extends to speech processing before conscious awareness (brainstem) is unknown. Using a novel electrophysiological approach, we recorded both brainstem and cortical speech-evoked brain event-related potentials (ERPs) in older, hearing-matched human listeners who did and did not present with subtle cognitive impairment revealed through behavioral neuropsychological testing. We found that MCI was associated with changes in neural speech processing characterized as hypersensitivity (larger) brainstem and cortical speech encoding in MCI compared with controls in the absence of any perceptual speech deficits. Group differences also interacted with age differentially across the auditory pathway; brainstem responses became larger and cortical ERPs smaller with advancing age. Multivariate classification revealed that dual brainstem–cortical speech activity correctly identified MCI listeners with 80% accuracy, suggesting its application as a biomarker of early cognitive decline. Brainstem responses were also a more robust predictor of individuals' MCI severity than cortical activity. Our findings suggest that MCI is associated with poorer encoding and transfer of speech signals between functional levels of the auditory system and advance the pathophysiological understanding of cognitive aging by identifying subcortical deficits in auditory sensory processing mere milliseconds (<10 ms) after sound onset and before the emergence of perceptual speech deficits.

SIGNIFICANCE STATEMENTMild cognitive impairment (MCI) is a precursor to dementia marked by declines in communication skills. Whether MCI pathophysiology extends below cerebral cortex to affect speech processing before conscious awareness (brainstem) is unknown. By recording neuroelectric brain activity to speech from brainstem and cortex, we show that MCI hypersensitizes the normal encoding of speech information across the hearing brain. Deficient neural responses to speech (particularly those generated from the brainstem) predicted the presence of MCI with high accuracy and before behavioral deficits. Our findings advance the neurological understanding of MCI by identifying a subcortical biomarker in auditory–sensory processing before conscious awareness, which may be a precursor to declines in speech understanding.
TT‐seq captures enhancer landscapes immediately after T‐cell stimulation
Authors: Michel Margaux , Demel Carina , Zacher Benedikt , Schwalb Björn , Krebs Stefan , Blum Helmut , Gagneur Julien , Cramer Patrick
Published: March 2017

To monitor transcriptional regulation in human cells, rapid changes in enhancer and promoter activity must be captured with high sensitivity and temporal resolution. Here, we show that the recently established protocol TT‐seq (“transient transcriptome sequencing”) can monitor rapid changes in transcription from enhancers and promoters during the immediate response of T cells to ionomycin and phorbol 12‐myristate 13‐acetate (PMA). TT‐seq maps eRNAs and mRNAs every 5 min after T‐cell stimulation with high sensitivity and identifies many new primary response genes. TT‐seq reveals that the synthesis of 1,601 eRNAs and 650 mRNAs changes significantly within only 15 min after stimulation, when standard RNA‐seq does not detect differentially expressed genes. Transcription of enhancers that are primed for activation by nucleosome depletion can occur immediately and simultaneously with transcription of target gene promoters. Our results indicate that enhancer transcription is a good proxy for enhancer regulatory activity in target gene activation, and establish TT‐seq as a tool for monitoring the dynamics of enhancer landscapes and transcription programs during cellular responses and differentiation.
Efficacy of pasireotide in controlling severe hypercortisolism until cardiac transplantation
Authors: Attanasio Roberto , Cortesi Liana , Gianola Daniela , Vettori Claudia , Sileo Fulvio , Trevisan Roberto
Published: March 2017

Cushing’s syndrome is associated with increased morbidity and mortality. Although surgery is the first-line treatment, drugs can still play a role as an ancillary treatment to be employed while waiting for surgery, after unsuccessful operation or in patients unsuitable for surgery. We were asked to evaluate a 32-year-old male waiting for cardiac transplantation. Idiopathic hypokinetic cardiomyopathy had been diagnosed since 6 years. He was on treatment with multiple drugs, had a pacemaker, an implantable cardioverter and an external device for the support of systolic function. Physical examination showed severely impaired general status, signs of hypercortisolism and multiple vertebral compression fractures. We administered teriparatide, and the few evaluable parameters supported the diagnosis of ACTH-dependent hypercortisolism: serum cortisol was 24.2 µg/dL in the morning and 20.3 µg/dL after overnight 1 mg dexamethasone, urinary free cortisol (UFC) was 258 µg/24 h and ACTH 125 pg/mL. Pituitary CT was negative. Pasireotide 300 µg bid was administered and uptitrated to 600 µg bid. Treatment was well tolerated, achieving dramatic improvement of clinical picture with progressive normalization of serum cortisol and ACTH levels as well as UFC. After 4 months, the patient underwent successful heart transplantation. Many complications ensued and were overcome. Pituitary MRI was negative. On pasireotide 300 µg bid and prednisone 2.5 mg/day (as part of immunosuppressive therapy), morning serum cortisol and ACTH were 15.6 µg/dL and 54 pg/mL respectively, UFC was 37 µg/24 h, fasting glucose: 107 mg/dL and HbA1c: 6.5%. In conclusion, primary treatment with pasireotide achieved remission of hypercortisolism, thus allowing the patient to undergo heart transplantation.

Learning points:

Untreated Cushing’s syndrome is associated with ominous prognosis.

First-line treatment is surgery (at pituitary or adrenal, according to disease localization).

A few drugs are available to treat hypercortisolism.

Pasireotide is a multi-ligand somatostatin analog approved for treatment of hypercortisolism.

Primary treatment with pasireotide was effective in a patient with severe Cushing’s syndrome, allowing him to undergo heart transplantation.
Impact of a National Guideline on Antibiotic Selection for Hospitalized Pneumonia
Authors: Williams Derek J. , Hall Matthew , Gerber Jeffrey S. , Neuman Mark I. , Hersh Adam L. , Brogan Thomas V. , Parikh Kavita , Mahant Sanjay , Blaschke Anne J. , Shah Samir S. , Grijalva Carlos G. ,   Pediatric Research in Inpatient Settings Network
Published: March 2017

BACKGROUND:

We evaluated the impact of the 2011 Pediatric Infectious Diseases Society/Infectious Diseases Society of America pneumonia guideline and hospital-level implementation efforts on antibiotic prescribing for children hospitalized with pneumonia.

METHODS:

We assessed inpatient antibiotic prescribing for pneumonia at 28 children’s hospitals between August 2009 and March 2015. Each hospital was also surveyed regarding local implementation efforts targeting antibiotic prescribing and organizational readiness to adopt guideline recommendations. To estimate guideline impact, we used segmented linear regression to compare the proportion of children receiving penicillins in March 2015 with the expected proportion at this same time point had the guideline not been published based on a projection of a preguideline trend. A similar approach was used to estimate the short-term (6-month) impact of local implementation efforts. The correlations between organizational readiness and the impact of the guideline were estimated by using Pearson’s correlation coefficient.

RESULTS:

Before guideline publication, penicillin prescribing was rare (<10%). After publication, an absolute increase in penicillin use was observed (27.6% [95% confidence interval: 23.7%–31.5%]) by March 2015. Among hospitals with local implementation efforts (n = 20, 71%), the median increase was 29.5% (interquartile range: 19.6%–39.1%) compared with 20.1% (interquartile rage: 9.5%–44.5%) among hospitals without such activities (P = .51). The independent, short-term impact of local implementation efforts was similar in magnitude to that of the national guideline. Organizational readiness was not correlated with prescribing changes.

CONCLUSIONS:

The publication of the Pediatric Infectious Diseases Society/Infectious Diseases Society of America guideline was associated with sustained increases in the use of penicillins for children hospitalized with pneumonia. Local implementation efforts may have enhanced guideline adoption and appeared more relevant than hospitals’ organizational readiness to change.
The behavior of ß-lactoglobulin protein in plate heat exchanger’s channel during milk heat treatment
Authors: Aouanouk S.A. , Mouheb A. , Absi R. , Zazoun R.
Published: March 2017

A major problem related to heat treatment of milk is formation of deposits. This is due to the chemical alteration of β-lactoglobulin protein that leads to formation of coatings on the walls of the equipment. These deposits induce losses in the thermal performance of the heat exchanger. In order to provide an adequate prediction of these deposits, we present a two-dimensional (2D) modelling study of the channel of a plate heat exchanger. Compared with the former studies, where the domain is related to a single plate, our work is related to the area between the two plates. This approach will allow a better understanding and description of the evolution and behaviour of β-lactoglobulin protein. Equations for fluid flow, energy, and fouling were resolved. Special boundary conditions had been implemented to link the amount of deposits with thermal transfer. Predicted results for the amount of fouling deposit on the wall were validated by comparisons with experimental data available in literature. The behaviour of β-lactoglobulin protein was studied by analyzing its distribution in the channel.
Development of an innovative gas chromatography-mass spectrometry method for assessment of formaldehyde in the workplace atmosphere
Authors: Dugheri Stefano , Bonari Alessandro , Pompilio Ilenia , Colpo Marco , Mucci Nicola , Montalti Manfredi , Arcangeli Giulio
Published: March 2017

World consumption of formaldehyde (FA) is forecast to grow at an average annual rate of about 4% from 2015 to 2020 with world production to exceed 52 million tons in 2017. From the first day of January 2016, the Commission Regulation No. 91/2015 established the FA classification through an indication from European Chemical Agency as category 2 mutagenic and category 1B carcinogen. A novel method for the determination of gaseous FA in air is presented herewith. The sampling was carried out using a miniaturized cartridge by means of a medium-flow pumping system (1.0 L min-1, 5–60 min) and absorption of FA vapors on 2,4-dinitrophenylhydrazine. Cartridge desorption removing the excess derivatizing agent based upon solid-phase extraction was performed by an innovative xyz robotic system on-line with fast gas chromatography (GC)—mass spectrometry (MS). Through the generation of standard atmospheres of known concentration of FA, we evaluated the precision (relative standard deviation for n = 10, 8.8%), lower limit of quantification (0.072 µg/cartridge), and linearity (from 0.125—64 µg/cartridge with correlation coefficient of 0.99) of the method. The described procedure combines the efficiency of fast GC—MS systems with both the high throughput of autosampler and the quantitative accuracy of FA-dinitrophenylhydrazone for measuring American Conference of Governmental Industrial Hygienists TLV Ceiling.
È possibile risolvere la questione dell’incardinazione anomala di cui al can. 701 del CIC/83?
Authors: Michowicz Przemysław
Published: March 2017

The main goal of this article is to find a constructive legal solution after incardinatio abnormis arose as a result of a legal dismissal of the member of the clerical religious Institute. By virtue of a legal dismissal decree, the punished religious-cleric looses a proper canonical status of being consecrated. The author discusses the meaning of the legal dismissal in the Code of Canon Law of 1983. Emphasis is placed on the consequences and circumstances of this act; especially in order to address the problem of incardination of a religious-cleric who was punished with a dismissal. Dimissio modo iure praescripto automatically excardinates from the religious Institute, however without any guarantee or a subjective right or faculty given to the punished cleric in order to be eligible to be incardinated to another ecclesial community according to the can. 265 CIC/83.
Hysteria to conversion disorders: Babinski's contributions
Authors: Gomes Marleide da Mota , Engelhardt Eliasz
Published: March 2017

The main objective of this paper is to present the importance of hysteria on Babinski's oeuvre, and the conceptions of pithiatism from Babinski until the one of conversion disorder. Babinski gave a mental basis for hysteria in the place of Charcot's encephalopatic one, and several important semiotic tools to differentiate organic from hysterical manifestations based on studies from 1893-1917/8. His teachings were spread worldwide, and in Brazil they were also appreciated in the work on hysteria by Antonio Austregesilo, the first Brazilian neurology chairman. The neurobiological basis of hysteria conceived by Charcot is nowadays reappraised, and Babinski's neurosemiological contribution is everlasting. The patients believed to be hysterical, and the two outstanding neurologists, Charcot and Babinski, gave support for the development of the modern neurology.
Delayed latencies of auditory evoked potential P300 are associated with the severity of Parkinson's disease in older patients
Authors: Lopes Marcia da Silva , Melo Ailton de Souza , Nóbrega Ana Caline
Published: March 2017

Electrophysiological methods could provide important information about the neurophysiological status in Parkinson's disease (PD). Objective: To investigate the prolonged auditory P300 latency in PD and its association with the disease clinical stage. Method: Clinical profiles of 44 patients were evaluated and those in initial and advanced stages of PD were identified. The frequency of altered latencies, median of latencies in each stage, and correlation between latencies and motor and non-motor clinical features were analyzed. Latencies were considered altered when they were more than two standard deviations from the mean of controls, per age group. Results: It was verified 10% of alterations in initial stages and 31% in advanced. There was correlation between latencies and non-motor clinical features. Subjects older than 65, in advanced stages, presented a significant increase of latencies. Conclusion: There was an association between PD severity and P300 prolonged latencies among subjects 65 years old or older.
Electrophysiologic characteristics of tremor in Parkinson?s disease and essential tremor
Authors: Cichaczewski Ederson , Munhoz Renato P. , Maia Joaquim M. , Nohama Percy , Nóvak Edison M. , Teive Helio A.
Published: March 2017

Tremor in essential tremor (ET) and Parkinson’s disease (PD) usually present specific electrophysiologic profiles, however amplitude and frequency may have wide variations. Objective: To present the electrophysiologic findings in PD and ET. Method: Patients were assessed at rest, with posture and action. Seventeen patients with ET and 62 with PD were included. PD cases were clustered into three groups: predominant rest tremor; tremor with similar intensity at rest, posture and during kinetic task; and predominant kinetic tremor. Results: Patients with PD presented tremors with average frequency of 5.29±1.18 Hz at rest, 5.79±1.39 Hz with posture and 6.48±1.34 Hz with the kinetic task. Tremor in ET presented with an average frequency of 5.97±1.1 Hz at rest, 6.18±1 Hz with posture and 6.53±1.2 Hz with kinetic task. Seven (41.2%) also showed rest tremor. Conclusion: The tremor analysis alone using the methodology described here, is not sufficient to differentiate tremor in ET and PD.
Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications
Authors: Carvalho Fernanda O. de , Bellas Antonio R. , Guimarães Luciano , Salomão José Francisco
Published: March 2017

Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus. Objective: To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a “non reliable” peritoneum. Method: From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy. Results: After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far. Conclusion: Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.
Transtornos mentais comuns em educadores sociais
Authors: Romero Daniel Luiz ,   Universidade Metodista de São Paulo,  Brasil, Akiba Henrique Teruo , Dias Álvaro Machado , Serafim Antonio de Pádua ,   Universidade de São Paulo,  Brasil,   Universidade Federal de São Paulo,  Brasil,   USP,  Brasil
Published: March 2017

RESUMO Objetivo Investigar a presença de transtornos mentais comuns (TMC) em Educadores Sociais de albergues e abrigos do município de São Paulo. Métodos A amostra foi composta por 104 orientadores socioeducativos, entre 18 e 60 anos (masculino e feminino), que prestam serviço para a Secretaria Municipal de Assistência e Desenvolvimento Social (SMADS). Utilizou-se um Questionário Sociodemográfico, além do Self Report Questionnaire (SRQ-20). Resultados Os dados demonstraram que há maior prevalência de mulheres nessa função, a maioria dos profissionais já passou por situações de risco no trabalho, 68,3% (71 sujeitos) apresentaram índices que caracterizam a presença de TMC, e 40,4% das mulheres apresentam sintomas de TMC, enquanto o índice de TMC nos homens foi de 27,9%. Conclusões Neste cenário, observou-se que o público feminino é mais vulnerável à presença de TMC em relação ao público masculino.
RECONSTRUÇÃO RACIONAL, ARGUMENTO TRANSCENDENTAL, FUNDAMENTAÇÃO ÚLTIMA: SOBRE O DEBATE ENTRE HABERMAS E APEL
Authors: Repa Luiz ,   Universidade de São Paulo, Brazil
Published: March 2017

RESUMO O artigo pretende mostrar o sentido da noção de transcendental no interior do método reconstrutivo de Jürgen Habermas. Para isso, ele procura apresentar em primeiro lugar a diferença entre a argumentação transcendental como argumentação anticética e a prova transcendental em Kant e, em seguida, a diferença entre Habermas e Apel sobre a possibilidade de uma fundamentação última da racionalidade comunicativa. Segundo minha interpretação, há razões de ordem lógica para a recusa da fundamentação última em Habermas, mas também razões ligados à historicidade da compreensão da razão.
Um Barquinho para navegar: devoção e habitus religioso na constituição da Capelinha de São Francisco
Authors: Magalhães Eloi dos Santos
Published: March 2017

Resumo O objetivo deste estudo é explorar uma compreensão histórica da constituição do Centro Espírita e Culto de Oração Casa de Jesus – Fonte de Luz, localizado na cidade amazônica de Rio Branco, estado do Acre. O processo de institucionalização dessa associação religiosa é investigado à medida que se apresentam as relações associativas desenvolvidas ao longo da formação de uma religiosidade de devoção. Assim, trata-se de mostrar a expressão de uma comunalização religiosa em seu processo histórico de organização como uma forma de interação social. Este artigo baseia-se em material etnográfico reunido entre os anos de 2009 e 2012.
Evidências de validade da Escala de Avaliação do Relacionamento
Authors: Hernandez José Augusto Evangelho
Published: March 2017

Este estudo, de caráter exploratório e confirmatório, buscou evidências de validade para a Escala de Avaliação do Relacionamento de Hendrick. No primeiro estudo, participaram 201 pessoas de ambos os sexos que coabitavam com seus parceiros na cidade de João Pessoa, Paraíba. A análise fatorial exploratória para componentes principais dos escores da escala extraiu solução inicial com um fator responsável pela explicação de 61% da variância total e com coeficiente alfa de 0,89. No segundo estudo, participaram 538 pessoas envolvidas em diversos tipos de relacionamentos amorosos da cidade de Porto Alegre, Rio Grande do Sul. Uma análise fatorial confirmatória (GFI = 0,97, razão CMIN/DF = 3,62) indicou a adequação do modelo. Análises das relações dessa escala com outras medidas de satisfação no relacionamento revelaram correlações estatísticas significativas que variaram de moderadas altas a fortes. Esses resultados evidenciaram a validade fatorial, convergente e consistência interna para escores oriundos de diferentes culturas.
Rorschach e sofrimento psíquico grave: funcionamento psíquico nas primeiras crises psicóticas
Authors: Silva Hayanna Carvalho Santos Ribeiro , Costa Ileno Izídio da
Published: March 2017

Trata-se de um estudo sobre a estrutura e a dinâmica de personalidade de pessoas em primeira crise do tipo psicótica, questionando criticamente as práticas tradicionais da intervenção precoce. Dez clientes atendidos na esfera individual e familiar pelo Grupo de Intervenção Precoce nas Primeiras Crises do Tipo Psicótico foram submetidos ao método de Rorschach no Sistema Compreensivo. Dados foram comparados com estatísticas descritivas de pacientes esquizofrênicos e adultos não pacientes; a análise enfocou os índices de transtorno do pensamento, traços depressivos, inabilidade social e um grupo de variáveis de relevância específica da população estudada. Resultados indicam que pessoas em primeiras crises do tipo psicótico não possuem traços significativos de transtorno de pensamento. Têm percepções acuradas e incomuns da realidade, sobrecarga afetiva e diminuídas habilidades sociais e dispõem de recursos cognitivos e afetivos para enfrentamento a serem aprimorados. A intervenção precoce nas psicoses pode embasar suas práticas nas características específicas dessa população.
DRIS standard and normal ranges of foliar nutrients for the culture of ‘Thompson’ atemoya
Authors: Santos Eduardo Maciel Haitzmann dos , Rozane Danilo Eduardo
Published: March 2017

ABSTRACT: Atemoya, an interspecific hybrid belonging to Annonaceae family, is the outcome of a cross between cherimoya (Annona cherimola Mill.) and Custard apple (Annona squamosa L.). In light of the current shortage of scientific data on the nutritional management techniques for this fruit, the need to develop and apply a specific methodology becomes crucial. From the variety of plant diagnostic tools available, the DRIS method was selected, for use in the commercial cultivation of the ‘Thompson’ cultivar of atemoya located in the São Paulo State, municipalities of Itapetininga, Piedade, Pilar do Sul and Salto de Pirapora. Normal nutrient ranges were determined to interpret the levels of N, P, K, Ca, Mg, S, B, Cu, Fe, Mn and Zn in the culture through statistical regression analysis and samples of leaf dry matter, with their respective DRIS indices. Although the general index of the nutritional balance of DRIS disallowed establishing a link with productivity, this study achieved it based on the standard of determining normal ranges for cognate macronutrients to the ones cited in the literature.
USER EMBRACEMENT WITH RISK CLASSIFICATION: PERCEPTIONS OF THE SERVICE USERS OF AN EMERGENCY CARE UNIT
Authors: Oliveira João Lucas Campos de ,   Universidade Estadual de Maringá, Brazil, Gatti Ana Paula , Barreto Mayckel da Silva , Bellucci Junior José Aparecido , Góes Herbert Leopoldo de Freitas , Matsuda Laura Misue ,   Universidade Estadual de Maringá, Brazil,   UEM, Brazil,   Universidade Estadual do Norte do Paraná, Brazil,   UEM, Brazil,   UEM, Brazil
Published: March 2017

ABSTRACT Objective: to investigate the perception of service users of an emergency unit, regarding attendance based in User Embracement with Risk Classification. Method: his descriptive-exploratory study, with a qualitative approach. The data were collected from 20 service users through an audio-recorded interview, guided by the following question: Tell me about your initial attendance, the user embracement with risk classification, which you received in this unit. Results: content analysis was undertaken with the data in thematic modality, from which two categories resulted: Risk classification as an advantage in attending emergencies; and Disagreement with the risk classification established by the professionals. Although the service users perceived User Embracement with Risk Classification as a measure which optimizes attendance in emergencies, some users disagreed with the classification made by the professionals. Conclusion: the objectives of User Embracement with Risk Classification need to be better publicized, with a view to the better acceptance of its results by society, as when classified as being of lower priority, the service users mention feeling unsafe and dissatisfied.
Fatores de risco associados ao agravamento de sepse em pacientes em Unidade de Terapia Intensiva
Authors: Barros Lea Lima dos Santos , Maia Cristiane do Socorro Ferraz , Monteiro Marta Chagas
Published: March 2017

Resumo Introdução a sepse é um grave problema de saúde pública e uma das principais causas de morte em Unidade de Terapia Intensiva (UTI). Objetivo este trabalho avaliou o agravamento e a mortalidade de pacientes sepse em UTI, relacionando aos fatores de risco, diferentes etiologias e terapêuticas. Metodologia O estudo foi observacional descritivo, e avaliou os casos de sepse (sepse, sepse severa e choque séptico) no período de janeiro de 2009 a dezembro de 2010. Resultados dos 212 pacientes internados em UTI, 181 apresentaram sepse nas diferentes gravidades, cuja mortalidade por sepse na UTI foi de 63%, principalmente nos pacientes com choque séptico (53%), seguida da sepse grave (8,3%). Além disso, os fatores de risco associados ao agravamento da sepse foram: idade superior que 65 anos, maior tempo médio de internação na UTI, elevada frequência de comorbidades e a utilização de procedimentos invasivos. O maior consumo de antibióticos foi de carbapenêmicos, e as principais cepas multirresistentes isoladas foram MRSA, VRE, P. aeruginosa e A. baumannii resistente a carbapenêmicos. Conclusão este estudo mostrou uma elevada mortalidade por sepse na UTI, principalmente em pacientes com choque séptico com comorbidades, que foram submetidos aos procedimentos invasivos e com maior tempo de internação.
Fatores de risco para doenças crônicas não transmissíveis em quilombolas do norte de Minas Gerais
Authors: Oliveira Stéphany Ketllin Mendes , Caldeira Antônio Prates
Published: March 2017

Resumo Introdução O comportamento das Doenças Crônicas Não Transmissíveis (DCNT) ainda é pouco conhecido para determinados grupos. Este estudo objetivou conhecer a prevalência de fatores de risco para as DCNT em uma amostra de comunidades quilombolas. Métodos Trata-se de pesquisa transversal, conduzida por inquérito domiciliar em comunidades quilombolas no norte de Minas Gerais, com coleta de dados sociodemográficos, hábitos alimentares e comportamentais, índice de massa corporal e morbidade autorreferida. Resultados Foram entrevistadas 756 pessoas, a maioria do sexo feminino (64,2%) e com baixa ou nenhuma escolaridade (60,1%). As prevalências dos principais fatores de risco foram: 23,5% para elevado consumo de refrigerante, 41,8% para consumo de carne com gordura, 40,7% para consumo de frango com pele, 66,1% para baixo consumo de frutas, 26,9% para uso de sal diretamente no prato, 24,1% para tabagismo, 31,6% para uso excessivo de bebidas alcoólicas, 63,9% para sedentarismo e 47,9% para excesso de peso. Os homens e as pessoas com menor escolaridade apresentaram mais fatores de risco. A morbidade autorreferida foi mais prevalente para pessoas acima de 40 anos. Conclusão Os resultados destacam elevada prevalência de fatores de risco para DCNT nas comunidades avaliadas. Há a necessidade de intervenções educativas e assistenciais para amenizar a situação observada.
Análise das intervenções e dos fatores socioambientais associados à ocorrência de tracoma em Pernambuco a partir de dois inquéritos em escolares realizados em 2006 e 2012
Authors: Alves Fabia Alexandra Pottes , Souza Wayner Vieira de , Luna Carlos Feitosa , Gouveia Giselle Campozana
Published: March 2017

Resumo O tracoma é a principal causa de cegueira prevenível nos países em desenvolvimento. O objetivo foi descrever o panorama do tracoma entre escolares no Estado de Pernambuco, identificando as estratégias norteadoras do programa de controle e analisando a existência de associação entre variáveis socioeconômicas, demográficas e de saúde, em âmbito ecológico, com as taxas de prevalência da doença obtidas nos inquéritos realizados em 2006 e 2012. Realizou-se um estudo ecológico descritivo, com dados secundários de inquéritos realizados em escolas públicas de 79 municípios de Pernambuco, em 2006, e de 22 municípios, em 2012. O pequeno número de examinados em 2006 resultou em estimativas imprecisas de prevalência, fragilizando metodologicamente a escolha dos 22 municípios considerados prioritários pelo Programa SANAR em 2012. Só foi possível comprovar a diminuição da prevalência do tracoma apenas em 5 dos 22 prioritários investigados. Investigações de base populacional deverão ser executadas no Estado e as ações de controle deverão ser repensadas, pois o formato das investigações ainda é baseado em campanhas com ações pontuais, sem o desenvolvimento de outras contínuas e efetivas que reduzam as formas ativas da doença, alcançando, assim, a meta de eliminação do tracoma com causa de cegueira no Brasil.
Aplicação do questionário SCORED para rastreamento da doença renal crônica entre pacientes hipertensos e diabéticos
Authors: Santos Paulo Roberto , Monte Neto Vicente Lopes
Published: March 2017

Resumo Introdução O questionário SCORED foi desenvolvido para predizer a probabilidade de um indivíduo apresentar doença renal crônica (DRC). O estudo teve por objetivo avaliar o desempenho do SCORED entre hipertensos e diabéticos cadastrados na unidade-sede da Estratégia Saúde da Família (ESF), na cidade de Meruoca, no Estado do Ceará. Métodos A amostra foi formada por 221 participantes. A taxa de filtração glomerular de <60 mL/min foi utilizada como padrão-ouro para o diagnóstico da DRC. Foram calculadas as propriedades de acurácia, sensibilidade, especificidade e likelihood ratios positivo e negativo do instrumento SCORED para o diagnóstico da DRC. Resultados Os resultados do desempenho do SCORED foram os seguintes: a pontuação gerada pelo SCORED foi preditora independente da presença de DRC (OR=1,261; IC95%=1,108-1,597; p=0,049); o questionário apresentou sensibilidade de 97% e especificidade de 23% em diagnosticar DRC, com likelihood ratio positivo de 1,25 e negativo de 0,13, além de acurácia de 47%. Alta sensibilidade e baixo likelihood ratio negativo habilitam o SCORED como instrumento de rastreamento de DRC entre hipertensos e diabéticos. Conclusão A utilização desse questionário tem o potencial de incrementar o diagnóstico precoce da DRC entre pacientes cadastrados na ESF, além de sua aplicabilidade na população geral e em campanhas educacionais.
Efeitos terapêuticos da produção artística para a reabilitação psicossocial de pessoas com transtornos mentais: uma revisão sistemática da literatura
Authors: Correia Pedro Rocha , Torrenté Mônica de Oliveira Nunes de
Published: March 2017

Resumo Atividades criativas vêm sendo utilizadas como recurso terapêutico para portadores de transtornos psíquicos no Brasil e no mundo. Há a necessidade de se consolidar a base teórica sobre o tema, levando-se em consideração dados qualitativos e o modelo conceitual do recovery. Neste trabalho, foi realizada uma revisão sistemática sobre os efeitos da produção de arte como recurso terapêutico no campo da saúde mental. Foram pesquisadas as bases de dados PubMed, LILACS e SciELO, com a seleção de estudos de metodologia qualitativa sobre o tema, publicados em inglês ou português, entre 2000 e 2013. Vinte e oito artigos foram revisados por meio de análise de conteúdo. Foram demonstrados benefícios para aspectos importantes do processo de reabilitação dos sujeitos, como o alívio de sentimentos negativos, o empoderamento e a reinserção social, fundamentais ao modelo do recovery. Conclui-se que a arte possui um potencial terapêutico significativo para a reabilitação psicossocial de pessoas com transtornos psíquicos, podendo funcionar como um recurso valioso no cenário atual de desafios para o cuidado na saúde mental.
Dependência funcional e fatores associados em idosos corresidentes
Authors: Pinto Junior Elzo Pereira , Silva Isnanda Tarciara da , Vilela Alba Benemérita Alves , Casotti Cezar Augusto , Pinto Francisco José Maia , Silva Marcelo Gurgel Carlos da
Published: March 2017

Resumo Introdução O envelhecimento populacional traz inúmeros desafios, incluindo o suporte familiar aos idosos com incapacidade funcional. Métodos Foi realizado um estudo transversal, com abordagem analítica, que objetivou estimar a prevalência e os fatores associados à dependência funcional dos idosos corresidentes. O estudo foi do tipo censo, realizado com 191 idosos que moravam com a família e eram assistidos pela Estratégia Saúde da Família. Realizaram-se entrevistas domiciliares, e a avaliação funcional foi feita com o uso do índice de Katz e do índice de Barthel. Resultados Observou-se que 94,2% dos idosos eram independentes para as atividades básicas, e 51,3%, para as atividades instrumentais da vida diária. Em uma avaliação conjunta, 52,3% dos idosos se mostraram independentes em ambas. Na análise bivariada, a dependência funcional se associou a: sexo feminino, ter mais de 80 anos, hospitalizações, doença do coração e depressão. Conclusão Conclui-se que a avaliação da saúde do idoso deve levar em conta diversos fatores, incluindo aqueles ligados aos aspectos familiares e status funcional.
Inadequate food intake among adults living with HIV
Authors: Giudici Kelly Virecoulon , Duran Ana Clara Fonseca Leitao , Jaime Patricia Constante
Published: March 2017

CONTEXT AND OBJECTIVE The number of people living with HIV (PLHIV) in Brazil is between 600,000 and 890,000. Assessing the diet is important in planning healthcare actions and improving PLHIV's quality of life. This study aimed to estimate the prevalence of inappropriate protein, total fat, saturated fat, carbohydrate, fiber, sodium, calcium and cholesterol intake among PVHIV on highly-active antiretroviral therapy (HAART). DESIGN AND SETTING Cross-sectional study in nine Specialized STD/AIDS Healthcare Centers in São Paulo. METHODS Men and women aged 20 to 59 years, on HAART for at least three months, were included. Nutrient intake was assessed using 24-hour food recall applied in person and repeated among 30% of the population by telephone. The between and within-person variances were corrected. RESULTS 507 individuals were evaluated: 58% male, mean age 41.7 years (standard deviation, SD = 7.8). The mean time since HIV diagnosis was 6.6 years (SD = 4.1), and since HAART onset, 5.1 years (SD = 3.3). More than 20% of the population presented intake above the recommendations for saturated fat, cholesterol and/or sodium, and below the recommendations for fiber. The recommended maximum tolerable sodium level was exceeded by 99% of the sample, and 86% of men and 94% of women did not reach the daily recommendations for calcium. Protein, carbohydrate and total fat intakes were adequate for the majority of the population. CONCLUSIONS A significant portion of the population presented inappropriate intake of saturated fat, sodium, fiber and calcium. Interventions aimed at improving PLHIV's dietary quality are needed.
Collaborative multicenter trials in Latin America: challenges and opportunities in orthopedic and trauma surgery
Authors: Moraes Vinicius Ynoe de , Belloti Joao Carlos , Faloppa Flavio , Bhandari Mohit
Published: March 2017

CONTEXT AND OBJECTIVE Orthopedic research agendas should be considered from a worldwide perspective. Efforts should be planned as the means for obtaining evidence that is valid for health promotion with global outreach. DESIGN AND SETTING Exploratory study conducted at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil, and McMaster University, Hamilton, Canada. METHODS We identified and analyzed collaborative and multicenter research in Latin America, taking into account American and Canadian efforts as the reference points. We explored aspects of the data available from official sources and used data from traffic accidents as a model for discussing collaborative research in these countries. RESULTS The evaluation showed that the proportion of collaborative and multicenter studies in our setting is small. A brief analysis showed that the death rate due to traffic accidents is very high. Thus, it seems clear to us that initiatives involving collaborative studies are important for defining and better understanding the patterns of injuries resulting from orthopedic trauma and the forms of treatment. Orthopedic research may be an important tool for bringing together orthopedic surgeons, researchers and medical societies for joint action. CONCLUSIONS We have indicated some practical guidelines for initiatives in collaborative research and have proposed some solutions with a summarized plan of action for conducting evidence-based research involving orthopedic trauma.
Evidence on acne therapy
Authors: Costa Caroline Sousa , Bagatin Edileia
Published: March 2017

Among the current treatments available for acne vulgaris, many widely practiced options lack support from studies at the best level of scientific evidence. The aim of this narrative review was to present the very latest information on topical and systemic treatments for acne vulgaris. Information from systematic reviews and well-designed clinical trials, obtained through a systematic search of the major medical databases, is emphasized. There are important issues regarding the clinical management of acne that still lack consistent grounding in scientific evidence. Among these are the optimum dose and duration of treatment with oral antibiotics that can be given without inducing bacterial resistance, and the safety of oral isotretinoin.
Diferenciando grados de sofisticación epistémica durante la resolución de un problema de electrostática
Authors: Perea Andrea , Buteler Laura , Coleoni Enrique
Published: March 2017

Resumen: El presente es un estudio en el cual se analizan las producciones de tres estudiantes de un curso universitario introductorio mientras resuelven un problema de electrostática. El objeto de estudio son las epistemologías personales, las cuales sirven a los estudiantes, y a los sujetos en general, para gestionar el propio conocimiento y posicionarse de maneras particulares frente a éste durante tareas cognitivas como la resolución de problemas. Se presenta un aporte de carácter teórico en relación al constructo de sofisticación epistémica. Se proveen elementos que permiten graduarla y tomarla como un indicador de la experticia de los sujetos en el plano epistémico. La importancia de los resultados radica en la posibilidad de visibilizar más la dimensión epistémica en el aprendizaje de la física.
Confirmatory factor analysis of the Appraisal of Self-Care Agency Scale - Revised
Authors: Stacciarini Thaís Santos Guerra , Pace Ana Emilia
Published: March 2017

ABSTRACT Objective: to analyze the factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R), adapted for Brazil. Method: methodological study conducted with 150 individuals with diabetes mellitus cared for by the Family Health Strategy, most of whom are elderly with low educational levels. The test of the hypothesis concerning the confirmatory factor composition of the ASAS-R was performed using latent variables structural equations. Results: the model’s goodness-of-fit indexes were satisfactory (χ2 = 259.19; χ2/g.l = 2.97, p < 0.001; GFI = 0.85; RMR = 0.07; RMSEA = 0.09); the factor loads were greater than 0.40; and most item-to-factor-correlations presented moderate to strong magnitude (0.34 to 0.58); total alpha value was 0.74, while the alpha of the three factors were 0.69, 0.38 and 0.69, respectively. Conclusion: the scale’s factor structure presented satisfactory validity and reliability results, with the exception of one factor. Application of this scale to samples of the general population is desirable in order to strengthen analyses of internal consistency and the dimensionality of the factor structure. This study is expected to contribute to further studies addressing the self-care agency construct and the development of the ASAS-R.
Nacionalismo, Educação Física e a missão francesa na Força Pública de São Paulo: uma comunidade imaginada (1906-1913)
Authors: GÓIS JUNIOR Edivaldo ,   Universidade Estadual de Campinas,  Brasil
Published: March 2017

Resumo O objetivo deste estudo foi analisar os interesses que levaram o Estado de São Paulo a reformar sua polícia, e organizar uma escola de educação física, tendo como objetivo central observar e analisar suas prerrogativas em relação à construção de uma identidade nacional. Para isso foi realizada uma pesquisa histórica que teve como fontes, documentos governamentais e o jornal “Correio Paulistano” entre os anos de 1906 e 1913. Concluímos que a militarização paulista objetivava colocar São Paulo em posição estratégica para liderar e influenciar a construção de um Brasil disciplinado, enfim, uma comunidade imaginada na ordem e no progresso.
Motivos de abandono na prática de ginástica artística no contexto extracurricular
Authors: LOPES Priscila ,   Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brasil, OLIVEIRA Maurício Santos , FÁTIMA Cíntia Regina de , NUNOMURA Myrian ,   Universidade Federal do Espírito Santo, Brasil,   Pontifícia Universidade Católica de São Paulo, Brasil,   Universidade de São Paulo, Brasil
Published: March 2017

Resumo O Esporte consiste na principal opção para a prática de atividades físicas entre as crianças e os jovens. Apesar do grande interesse desse público às práticas esportivas, a literatura aponta alto índice de abandono. Motivados por essa conjuntura, o objetivo desse estudo foi verificar o motivo de abandono, mais especificamente, na prática de Ginástica Artística (GA) no contexto das atividades extracurriculares. Entrevistamos praticantes meninas de GA que apresentavam histórico de abandono dessa prática esportiva por determinado período de tempo. Para o tratamento dos dados, optamos pela Análise de Conteúdo proposta por BARDIN. Constatamos que fatores intrínsecos e extrínsecos estão vinculados ao processo de abandono da prática desse esporte. Entretanto, os fatores extrínsecos sobrepuseram àqueles intrínsecos, o que evidencia que o ambiente e as condições situacionais e interpessoais exercem maior influência sobre o afastamento das ginastas. Assim, ressaltamos a importância da atenção dos profissionais a esses aspectos para garantir que as atividades atendam às necessidades e aos anseios das ginastas.