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An analysis is presented of the work of three international entities in Brazilian favelas in the 1960s: Brasil-Estados Unidos Movimento, Desenvolvimento e Organização de Comunidade; Ação Comunitária do Brasil; and the United Nations. These entities conveyed the ideal of developmentalism through technical cooperation with countries deemed underdeveloped, drawing on the pure and applied social sciences through community development. Documents from the Anthony Leeds archive at Casa de Oswaldo Cruz were used to analyze these entities' actions in the favelas and their conceptions of development. Their official documents were compared, including newspapers and programs, as well as fieldnotes and letters by social scientists engaged in fieldwork in favelas in the period.

Background: External stimuli can improve gait performance in Parkinsons Disease (PD): auditory stimuli can increase velocity and visual stimuli may act at step length., Objective: To systematize the scientific evidence about the effects of auditory or visual stimuli on gait in patients with PD., Methods: From January 2016 to December 2018, a systematic literature research was conducted in the PubMed/Medline and Web of Science databases. Study designs considered were randomized controlled trials (RCTs) and observational studies, which evaluated the effects of auditory or visual stimuli on gait in PD. The methodological quality was assessed by the Critical Appraisal Skills Program., Results: Five articles were included with 232 participants and a methodological rank of mean of 10.3 on the cohort studies (n = 3), 8 on the case control studies (n = 1), and 6 on the RCTs (n = 1). Although 3 evaluated the effects of auditory stimuli on gait in PD, 2 analyzed those of visual stimuli. Based on these, it was verified a significant improvement of diverse gait parameters., Conclusion: The application of auditory or visual stimuli have beneficial effects on gait parameters. Further investigation is required., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of PBJ-Associação Porto Biomedical/Porto Biomedical Society. All rights reserved.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

The aim of this study was to investigate the effects of pelvic floor muscles training in elite female volleyball athletes and whether it is an effective therapy for stress urinary incontinence. Fourteen athletes, both continent and incontinent, between 18 and 30 years of age, were randomly assigned to an experimental group or a control group. The experimental group received a protocol for pelvic floor muscle training for 4 months. This consisted of three phases: awareness/stabilization, strength training and power. The control group was not subject to any intervention during the same period. Measures were collected at the initial and final phase for both groups. Maximum voluntary contractions were evaluated with a perineometer, involuntary urine loss with a Pad test and quality of life with the King's Health Questionnaire. Baseline sociodemographic and anthropometric characteristics were not significantly different. Comparing the two groups, the experimental group improved maximum voluntary pelvic contractions (p<0.001) and reduced urine loss (p=0.025), indicating the existence of significant differences between groups in the variation from the initial and final phases. The percentage of urine loss decreased in the experimental group, from 71.4-42.9%, suggesting that the protocol intervention for 16 weeks may help athletes with stress urinary incontinence., Competing Interests: The authors declare that they have no conflict of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

Paxillin is a scaffold protein that participates in focal adhesion signaling in mammalian cells. Fission yeast paxillin ortholog, Pxl1, is required for contractile actomyosin ring (CAR) integrity and collaborates with the β-glucan synthase Bgs1 in septum formation. We show here that Pxl1's main function is to recruit calcineurin (CN) phosphatase to the actomyosin ring; and thus the absence of either Pxl1 or calcineurin causes similar cytokinesis defects. In turn, CN participates in the dephosphorylation of the Cdc15 F-BAR protein, which recruits and concentrates Pxl1 at the CAR. Our findings suggest the existence of a positive feedback loop between Pxl1 and CN and establish that Pxl1 is a crucial component of the CN signaling pathway during cytokinesis., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

In the fission yeast Schizosaccharomyces pombe the cell integrity pathway (CIP) orchestrates multiple biological processes like cell wall maintenance and ionic homeostasis by fine tuning activation of MAPK Pmk1 in response to various environmental conditions. The small GTPase Rho2 positively regulates the CIP through protein kinase C ortholog Pck2. However, Pmk1 retains some function in mutants lacking either Rho2 or Pck2, suggesting the existence of additional upstream regulatory elements to modulate its activity depending on the nature of the environmental stimulus. The essential GTPase Rho1 is a candidate to control the activity of the CIP by acting upstream of Pck2, whereas Pck1, a second PKC ortholog, appears to negatively regulate Pmk1 activity. However, the exact regulatory nature of these two proteins within the CIP has remained elusive. By exhaustive characterization of strains expressing a hypomorphic Rho1 allele (rho1-596) in different genetic backgrounds we show that both Rho1 and Pck1 are positive upstream regulatory members of the CIP in addition to Rho2 and Pck2. In this new model Rho1 and Rho2 control Pmk1 basal activity during vegetative growth mainly through Pck2. Notably, whereas Rho2-Pck2 elicit Pmk1 activation in response to most environmental stimuli, Rho1 drives Pmk1 activation through either Pck2 or Pck1 exclusively in response to cell wall damage. Our study reveals the intricate and complex functional architecture of the upstream elements participating in this signaling pathway as compared to similar routes from other simple eukaryotic organisms.

Rho1 GTPase is the main activator of cell wall glucan biosynthesis and regulates actin cytoskeleton in fungi, including Schizosaccharomyces pombe. We have obtained a fission yeast thermosensitive mutant strain carrying the rho1-596 allele, which displays reduced Rho1 GTPase activity. This strain has severe cell wall defects and a thermosensitive growth, which is partially suppressed by osmotic stabilization. In a global screening for rho1-596 multicopy suppresors the pmp1+ gene was identified. Pmp1 is a dual specificity phosphatase that negatively regulates the Pmk1 mitogen-activated protein kinase (MAPK) cell integrity pathway. Accordingly, elimination of Pmk1 MAPK partially rescued rho1-596 thermosensitivity, corroborating the unexpected antagonistic functional relationship of these genes. We found that rho1-596 cells displayed increased basal activation of the cell integrity MAPK pathway and therefore were hypersensitive to MgCl2 and FK506. Moreover, the absence of calcineurin was lethal for rho1-596. We found a higher level of calcineurin activity in rho1-596 than in wild-type cells, and overexpression of constitutively active calcineurin partially rescued rho1-596 thermosensitivity. All together our results suggest that loss of Rho1 function causes an increase in the cell integrity MAPK activity, which is detrimental to the cells and turns calcineurin activity essential.

Alterations in protein expression within the initiation phase of acute pancreatitis (AP) might play an important role in the development of this disease, lysosomes being involved in its pathophysiology. The use of pancreatic subcellular fractions in proteomic analysis, simplifies protein maps and helps in the identification of new protein changes and biomarkers characterizing tissue damage. The present study aims to determine the differentially expressed acidic proteins in the pancreatic soluble and lysosomal+mitochondrial (L+M) fractions from rats during the early phase of the experimental model of cerulein (Cer)-induced AP. Subcellular pancreatic extracts from diseased and control rats were analyzed by 2-DE (3-5.6 pH range) and MALDI-TOF/TOF MS. Comparative analysis afforded the conclusive identification of 13 (soluble fraction) and 7 (L+M fraction) proteins or protein fragments occuring in different amounts between diseased and control pancreas, some of them being newly described in AP. In the soluble fraction, we detected changes related to inflammation and apoptosis (α1-inhibitor-3, α-1 antitrypsin, α-1 macroglobulin, haptoglobin, STRAP), oxidative stress and stress response (peroxiredoxin-2, thioredoxin-like 1, GRP94/TRA1, heat shock cognate 71kDa protein), digestive proteases (elastase 3B), serine protease inhibition (serpins B6 and A3L) and translation processes (EF 1-δ). In the L+M fraction, we detected changes mainly related to energy generation or cellular metabolism (ATP synthase β subunit, chymotrypsinogen B, triacylglycerol lipase), cell redox homeostasis (iodothyronine 5´monodeiodinase) and digestive proteases (carboxypeptidase B1). The data should provide valuable information for unraveling the early pathophysiologic mechanisms of Cer-induced AP., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Objective: Appropriate nutritional support is important to the outcomes of critically ill patients. However, a significant portion of these patients experience intestinal motility problems. Administration of enteral nutrition by means of tubes placed in the post-pyloric position has been suggested to improve the nutrition tolerance. The aim of this study was to compare the rate of successful post-pyloric placement using a real-time electromagnetic positioning device to the success rate using the conventional placement method., Methods: This was a prospective, randomized and controlled study, conducted in a tertiary hospital over a period of three months. The patients were randomized to one of two groups: electromagnetically guided system group, whose patients underwent real-time monitoring of post-pyloric tube placement; or the control group, whose patients underwent tube placment using to the conventional blinded technique. The rates of successful post-pyloric placement and the procedure times were assessed and compared between the groups., Results: Thirty-seven patients were enrolled, 18 in the electromagnetic group and 19 in the control group. The final tube position was evaluated using radiography. The electromagnetic guided group showed better success rates and shorter procedure times when compared to the control group. Additionally, in the electromagnetic guided group, higher pH values were found in the fluids aspirated from the probe, suggesting successful postpyloric placement., Conclusion: The electromagnetically guided method provided better placement accuracy than did the conventional technique.

Objective: Anemia is common in severely ill patients, and blood sampling plays a relevant causative role. Consequently, blood transfusions are frequent an related to several complications. Trying to reduce the transfusion-related risk, minimizing blood loss is mandatory. Thus, this work aimed to evaluate a closed blood sampling system as a strategy to spare unnecessary blood losses and transfusions., Methods: This was a prospective, randomized, controlled, multicenter, 6 months, clinical trial. The patients were assigned to either VAMP (Venous Arterial Blood Management Protection) group, using a closed blood sampling system, or control group. The groups' transfusion rate, as well as hemoglobin (Hb) and Hematocrit (Ht) changes were compared for 14 days., Results: Were included 127 patients, 65 assigned to the control group, and 62 to VAMP. During the intensive care unit stay, both groups experienced both hemoglobin and hematocrit drops. However, when the final Ht and Hb were compared between the groups, a difference was identified with higher values in the VAMP group (p=0.03; p=0.006, respectively). No statistical difference was found for both groups transfusion rates, although the VAMP group had an absolute 12% blood transfusion reduction., Conclusion: The use of a closed blood sampling system was able to minimize blood count values changes, however failed to reduce transfusions rate.

Objective: To describe the relevance of transvulvar ultrasound in the assessment of anatomical differences induced by the lata fascia sling (LFS) and tension-free vaginal tape (TVT) procedures., Materials and Methods: Forty women with stress urinary incontinence (SUI), aged 30 to 60 years, have been treated with either LFS (20 patients) or TVT (20 patients). The transvulvar ultrasound of the urethrovesical junction (UVJ) and proximal urethra (PU) has been used as the main investigational tool both pre- and post-operatively. The studied parameters were the vertical (VUVJD) and horizontal (HUVJD) UVJ distances, the pubourethral distance (PUD) and the PU length., Results: The VUVJD did not vary significantly after the LFS surgery (P=0.10). The PUD became shorter (P=0.001) and the HUVJD became shorter only at rest (P=0.03) after the correction by LFS. The TVT procedure has led to shortening of the VUVJ displacement (P=0.0005) and of the PU length (P=0.02)., Conclusions: The transvulvar ultrasound was of utmost importance in the demonstration that both the LFS and TVT surgical procedures elongate the PU, even though the LFS technique does it more efficiently. The LFS technique focus more on shortening the PUD and the TVT procedure focus more on the correction of the vertical UVJ displacement.

The objective of this review was to evaluate current knowledge regarding terminal illness and palliative care in the intensive care unit, to identify the major challenges involved and propose a research agenda on these issues The Brazilian Critical Care Association organized a specific forum on terminally ill patients, to which were invited experienced and skilled professionals on critical care. These professionals were divided in three groups: communication in the intensive care unit, the decision making process when faced with a terminally ill patient and palliative actions and care in the intensive care unit. Data and bibliographic references were stored in a restricted website. During a twelve hour meeting and following a modified Delphi methodology, the groups prepared the final document. Consensual definition regarding terminality was reached. Good communication was considered the cornerstone to define the best treatment for a terminally ill patient. Accordingly some communication barriers were described that should be avoided as well as some approaches that should be pursued. Criteria for palliative care and palliative action in the intensive care unit were defined. Acceptance of death as a natural event as well as respect for the patient's autonomy and the nonmaleficence principles were stressed. A recommendation was made to withdraw the futile treatment that prolongs the dying process and to elected analgesia and measures that alleviate suffering in terminally ill patients. To deliver palliative care to terminally ill patients and their relatives some principles and guides should be followed, respecting individual necessities and beliefs. The intensive care unit staff involved with the treatment of terminally ill patients is subject to stress and tension. Availability of a continuous education program on palliative care is desirable.

This study attempted to correlate mean pulmonary arterial pressure with four radiological indices of pulmonary hypertension in 159 patients with chronic obstructive pulmonary disease. The mean pulmonary arterial pressure at rest (PAPR) and with exercise (PAPE) and four indices measured from the plain chest radiograph were considered. The measurements were: 1) DIP: the distance between the bifurcation of the right and left main pulmonary arteries, 2) DIP/T X 100 where T is a maximal thoracic diameter, 3) R: the diameter of the right descending pulmonary artery, and 4) R/h x 100 where h is T/2. The mean index values +/- SD obtained from three observers were: DIP = 11.4 +/- 1 cm, DIP/T x 100 = 36.1 +/- 3.5 R = 1.9 +/- 4cm, R/h x 100 = 12 +/- 2.7. An analysis of variation demonstrated that the interobserver error was unacceptable for R and R/h x 100 but small for DIP and DIP/T x 100. Increased PAP does not implicate high index values but high values specify abnormal PAP. The results suggest that DIP greater than 13 cm or DIP/T x 100 greater than 42 are diagnostic. A minority presented such values, but in 20 to 30% of these cases this preceded clinical or electrocardiographic manifestations of cor pulmonale.