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Introdução: Com a eclosão da pandemia causada pela COVID-19, o distanciamento físico trouxe à tona a necessidade de novas formas de interação social. Essa nova realidade atinge diversas áreas da vida cotidiana nos âmbitos social, profissional e acadêmico. Sendo assim, a educação remota passou a ser uma nova constante na academia. Um dos efeitos disso foi a organização do PetLive, que inicia em abril de 2020 como uma solução para dar continuidade às ações praticadas pelo Pet Saúde Interprofissionalidade e refletindo sobre o contexto da pandemia. Objetivo: Apresentar o PETLive – Saúde em Pauta enquanto iniciativa que, por meio do preconizado pela educação interprofissional1, fomentou o acesso às informações técnicas de qualidade sobre saúde em tempos de pandemia e distanciamento físico. Metodologia: A plataforma virtual ‘Instagram’ foi utilizada para a realização dos encontros remotos, por meio de “lives” (encontros ao vivo) na internet. Nesses encontros, profissionais da área de saúde foram entrevistados por discentes dos cursos de Saúde Coletiva e Serviço Social, somado a isso foi utilizado o recurso das “caixas de perguntas”, espaço de interação entre os que assistem com os que apresentam, facilitando a interação entre espectador e profissionais por meio de perguntas. Foram convidados profissionais de áreas diversas da saúde para a exposição dos temas, como docentes de Saúde Coletiva e Serviço Social, Fonoaudióloga, Assistentes Sociais e Psiquiatra. Ao total ocorreram cinco “lives” com os temas “História do SUS”, “Distanciamento Físico”, “Atenção Primária em Saúde”, “Serviço Social em tempos de pandemia” e “Saúde Mental”. Os temas foram pré-estabelecidos pelos discentes e divulgadas com antecedência nas redes sociais. Após a transmissão do encontro, os vídeos foram hospedados no ‘Youtube’ e ‘Instagram’ (IGTv) para viabilizar o acesso dos que não conseguiram assistir de forma síncrona. Resultados: As “lives” tiveram um alcance significativo; as transmissões ao vivo, feitas uma vez por semana no Instagram em conjunto com as publicações no Youtube, potencializaram o alcance e a disseminação de informação técnica de qualidade sobre temas atinentes a pandemia. As transmissões duraram 60 minutos e atraíram um público média de 150 pessoas a cada encontro. Considerações Finais: Os discentes são parte essencial para o desenvolvimento dessa iniciativa, portanto, para a continuidade do PetLive será necessário a participação de novos discentes, para uma melhor execução da mesma e pluralidade de ideias e propostas. O projeto inicial, que teve duração de 5 semanas, obteve um resultado positivo, com um bom desempenho nas redes, extrapolando o nicho municipal. Sendo assim, a perspectiva é da organização de novas temporadas para serem abordados outros temas relacionados à Saúde e enfrentamento a COVID-19. Palavras-chave: Coronavírus. Saúde. Educação em Saúde.

This article analyzes the configuration of the active civil servant workforce of the Brazilian government during Fernando Henrique Cardoso - FHC - (1995-2002) and Luiz Inácio Lula da Silva - Lula - (2003-2010) mandates. The article associates the condition of the workforce of the Brazilian government with the changes in the government coalition. The residual participation of the Ministry of Health (MOH) in the direct provision of public services influenced the downward trend of the federal workforce.The implementation of the Unified Health System (SUS) was strongly affected by the structural adjustment of the workforce at the federal level during the decades of 1990 and 2000.

Eighty-eight consecutive patients (48 men and 40 women; mean age, 58.9 years; range, 16–84 years) with clinically localized cutaneous melanoma involving the trunk, extremities or head and neck underwent lymphatic mapping at our institution. The primary melanoma had a mean thickness of 2.74 mm (range, 0.95 to 9 mm). Patients were divided into two groups: group A (39 patients) underwent only vital blue dye (VBD) mapping, while group B (49 patients) underwent lymphatic mapping with VBD and radio-guided surgery (RGS) combined. In all patients 1-1.5 mL of VBD was injected subdermally around the biopsy scar 10–20 min before surgery. In group B 37 MBq in 150 μL of 99mTc-HSA nanocolloid was additionally injected intradermally 18 h before surgery (3–6 aliquots injected perilesionally). In all lymphatic basins where drainage was noted the sentinel lymph nodes (SNs) were identified and marked with a cutaneous marker. Final identification of the SN was then performed externally by a hand-held gamma probe. After the induction of anesthesia 0.5–1-0 mL of patent blue V dye was injected intradermally with a 25-gauge needle around the site of the primary melanoma. SNs were examined by routine hematoxylin and eosin (H&E) staining and immunohistochemistry. Patients with histologically positive SN(s) underwent standard lymph node dissection (SLND) in the involved lymph node basin. The SN was identified in 37/39 patients (94.9%) of group A and in 48/49 patients (98.0%) of group B. Blue dye mapping failed to identify the SN in 5 of the 88 patients (5.8%), while the radioisotope method failed in only 1 of 49 patients (2.0%). Similar results were obtained with the combined use of the two probes. The average number of SNs harvested was 1.9 per basin sampled, which does not differ significantly from the numbers reported by other authors114. The SN was histologically positive in 18 patients (20.5%). None of the 12 patients with a Breslow thickness less than 1.5 mm had positive SNs, whereas 18 of the 77 patients (23.4%) with a Breslow index exceeding 1.5 mm showed metastatic SNs with H&E or immunohistochemistry. The latter all underwent SLND of the affected basin. In 10 patients (55.6%) the SN was the only site of tumor invasion; eight patients (44.4%) with positive SNs had one or more metastatic lymph nodes in the draining basin.

Several studies have been published describing the techniques of identification of the “sentinel lymph node'’ (SN). There are marked differences in the techniques used by different investigators. Although agreement exists about the tracer particle size and the volume of injection, it is unknown what is the best site where to inject the tracer or the vital dye. The aim of the present study was to define the influence of different sites of injection on imaging of the lymphatic ducts and their SNs. We performed a pilot study in 30 consecutive patients with breast cancer who underwent SN biopsy by means of radioguided surgery and vital blue dye mapping. The patients were divided into six groups of five patients each; each patient was given a subdermal (ID) or peritumoral (IP) injection of radiotracer (300 μCi in 150 mL of 99mTc-HSA microcolloids; Albures, Amersham Sorin) above the tumor site in order to localize the SN. After the identification of the SN, a second injection of radiotracer was performed, which was different in each patient subset. In some cases more than one lymph node appeared on the lymphoscintigraphic scans after the second injection of radiotracer. When the peritumoral route was used it took longer to visualize the lymphatic pathways. For the ID route, injection at the exact skin projection over the tumor is optimal. Internal mammary lymph nodes were identified by both IP (2) and ID (1) injection, irrespective of the quadrant in which the tracer was injected. Our findings support the hypothesis of a precise topographic correspondence between the primary tumor and its specific SN. The subdermal route is more accurate than the intraparenchymal route, as it allows faster identification of the lymphatic vessels and SN. We believe these observations should be taken into account for the proper selection of the injection site of either vital dye or radiopharmaceuticals.

Os Centros de Saúde do Rio de Janeiro são analisados enquanto uma organização estruturada para desempenhar, na área da saúde, parte das funções do aparato burocrático do Estado brasileiro. Seu papel institucional vincula-se à emergência de novos problemas sanitários numa sociedade em processo de urbanização e de consolidação de um Estado nacional. Ao longo de usa trajetória histórica passou por situações distintas, no que se refere ao seu papel no Sistema de Saúde, articuladas a determinantes de natureza técnica e política. Enquanto fenômeno burocrático, esta organização sobreviveu às diversas conjunturas históricas interpondo resistências, que se manifestaram, principalmente, pela lentidão com que eram processadas as mudanças internas propostas. The Health Centers in the city of Rio de Janeiro are analyzed as organizations that have been structured to execute parto of the bureaucratic duties petaining to the brazilian State, as far as health care is concerned. Their role, as institutions, is related to the solution of new problems, in their sanitary aspects, that are emerging in a society in processo f increasing urbanization and inside a process of organizing a National State. Along the course of their history, these organization have overcome various distinctive situations, dependind on technical and political determinants. As bureaucratic phenomena, this organization have survived many historical conjuntures, presenting itself as resistant to the proposed changes, mainly by slow ways of implementing these propositions.