Search

Abstract Background Human T-cell lymphotropic virus type 1 (HTLV-1), also denominated Human T-cell leukemia virus-1, induces immune activation and secretion of proinflammatory cytokines, especially in individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Regulatory T lymphocytes (Tregs) may control of inflammation through the production of regulatory cytokines, including IL10 and TGF-β. In this study we determined the frequencies of CD4 + and CD8 + Tregs in a HAM/TSP population, compared to asymptomatic carriers and uninfected individuals, as well as investigated the profiles of regulatory and inflammatory cytokines. Methods Asymptomatic HTLV-1 carriers and HAM/TSP patients were matched by sex and age. The frequencies of IL10- and/or TGF-β-producing Tregs were quantified by flow cytometry. Real-time reverse transcription polymerase chain reaction (RT-PCR) was used to quantify HTLV-1 proviral load and the mRNA expression of cytokines and cellular receptors in peripheral blood mononuclear cells. Results Total frequencies of CD4 + Tregs, as well as the IL10-producing CD4 + and CD8 + Treg subsets, were statistically higher in patients with HAM/TSP compared to asymptomatic HTLV-1-infected individuals. In addition, a positive correlation was found between the frequency of CD4 + IL10 + Tregs and proviral load in the HAM/TSP patients evaluated. A positive correlation was also observed between gene expression of proinflammatory versus regulatory cytokines only in HAM / TSP group. Conclusions A higher frequencies of IL10-producing Tregs were identified in patients with HAM/TSP. Imbalanced production of IL10 in relation to TGF-β may contribute to the increased inflammatory response characteristically seen in HAM/TSP patients.

Este artigo apresenta uma análise diacrônica da trajetória de aun si no espanhol, segundo os pressupostos teóricos de gramaticalização assentados nas bases da Gramática Discursivo-Funcional (Hengeveld 2017 y Hengeveld y Mackenzie 2008). Na tradição gramatical espanhola, aun si é considerada uma locução conjuntiva concessivo-condicional, por atuar em orações tanto concessivas quanto condicionais. A análise de ocorrências dos períodos antigo, médio e moderno do espanhol mostram que, em sincronias mais pretéritas, a conjunção condicional si é escopada por aun, enquanto no período moderno ocorre fixação de aun e de si, conforme atestam os critérios de mobilidade e de modificação aplicados à locução (Keizer 2007 y Giomi 2020). Apesar dessa tendência geral, o cline de gramaticalidade de aun si não comprova totalmente a hipótese inicial de que sua trajetória parte do valor condicional (nos períodos mais pretéritos) e, no processo de gramaticalização, segue em direção ao valor concessivo, uma vez que se constata uma estabilidade sintática, semântica e discursiva de aun si desde o século XIII até o XXI, o que explica a coexistência, no espanhol moderno, de dois tipos de aun si, o condicional e o concessivo-condicional.

Endometriosis is a chronic gynecological disease, primarily associated with pelvic pain and infertility, that affects approximately 10% of the women of reproductive age. Estrogen plays a central role in endometriosis, and there is growing evidence that endocrine disruptors, such as phthalates, may contribute to its development. This review aimed to determine whether there is a causal relationship between phthalate exposure and the development of endometriosis, as well as the possible effects of phthalates on fertility, by analyzing epidemiological data. After a literature search with a combination of specific terms on this topic, we found that although there are limitations to the current studies, there is a clear association between phthalate exposure and endometriosis. Phthalates can interfere with the cellular processes of the endometrium; specifically, they can bind to PPAR and ER-α and activate TGF-β, promoting different signaling cascades that regulate the expression of specific target genes. This may lead to inflammation, invasion, cytokine alteration, increased oxidative stress, and impaired cell viability and proliferation, culminating in endometriosis. Nevertheless, future research is important to curb the progression and development of endometriosis, and strategies for prevention, diagnosis, and treatment are a priority. In this regard, public policies and recommendations to reduce exposure to phthalates and other endocrine disruptors should be promptly implemented.

Abstract Calcifying organisms are considered as threatened by ocean acidification, because of their calcium carbonate skeleton. This study investigated if a calcareous sponge could synthesize its skeleton (i.e. spicules) under ocean-acidification conditions. Sponge cell aggregates that have the potential to develop into a functional sponge, called primmorphs, were submitted to a 5-day experiment, with two treatments: control (pH 8.1) and acidified conditions (pH 7.6). Primmorphs of the calcareous sponge Paraleucilla magna were able to synthesize a skeleton, even under low pH, and to develop into functional sponges. The spicules had the same shape in both conditions, although the spicules synthesized in low pH were slightly thinner than those in the control. These results suggest that P. magna may be able to survive near-future ocean-acidification conditions.

Abstract The aim of this study is to evaluate the preemptive analgesic effects of dexamethasone (DEX) alone or combined with non-steroidal anti-inflammatory drugs (NSAIDs) in third molar surgeries. The subjects were divided into five groups (n = 20 teeth/group); subjects received only 8 mg of dexamethasone 1 h before the surgical procedure (DEX group), or in combination with etodolac (DEX + ETO), ketorolac (DEX + KET), ibuprofen (DEX + IBU), loxoprofen (DEX + LOX). Paracetamol 750 mg was provided as the number of rescue analgesics (NRA). Salivary PGE2 expression was measured preoperatively and at 48 h. Edema and Maximum mouth opening (MMO) were measured postoperatively at 48 h and 7 days. A visual analog scale (VAS) was performed postoperatively at 6, 12, 24, 48, 72 h, and 7 days. Salivary expression of PGE2 showed a decrease only for the DEX group. Edema and MMO and NRA consumption showed no significant differences among the groups (P > 0.05). The VAS showed a significantly lower pain perception at 6 h after the surgery for the DEX + ETO and DEX + KET groups (P

A pecuária brasileira se destaca como a maior exportadora de carne bovina no mundo devido ao grande número de rebanhos criados a pasto, forma mais econômica e prática de oferecer alimento para os animais. No entanto, ainda há muitas pastagens com baixo valor nutricional. Os alimentos sólidos passam por uma cadeia interdependente durante o processo de digestão, iniciando na mastigação onde são quebrados pelos dentes para facilitar o processo. Caso haja alguma deficiência dentária, o animal poderá apresentar problemas na digestibilidade e posteriormente causar um ônus para o organismo. Devido à ausência de estudos que enfatizem a qualidade dos dentes desses animais, torna-se necessário avaliar as alterações dentárias dos bovinos para interceptar as enfermidades incuráveis que reduzem a vida útil e trazem queda na produção, além da possibilidade de acarretarem perdas dos animais. Foram utilizadas 72 mandíbulas de bovinos para a avaliação das alterações dentárias. Após esse processo, os exemplares foram submetidos à maceração e clarificação com hipoclorito de sódio para a preparação de peças anatômicas. Além disso, um questionário sobre a saúde oral dos bovinos também foi elaborado e aplicado com o intuito de conhecer melhor as principais patologias orais dos bovinos das regiões Norte e Noroeste Fluminense. Como o experimento foi realizado a partir das mandíbulas adquiridas após o abate, foi possível identificar as possíveis anomalias mandibulares que acometem os bovinos. As principais alterações encontradas foram: diastema aumentado (20%), fraturas (18%); desgaste irregular (15%) e ausência dentária (11%). Dos 27 proprietários entrevistados, 15 relataram problemas orais nos bovinos, sendo que 11 confirmaram a perda dentária. Ademais, todos os proprietários assumiram que a saúde bucal dos animais nunca foi avaliada por um Médico Veterinário. Através dessa metodologia foi possível ressaltar a necessidade da análise e divulgação das pesquisas relacionadas à odontologia bovina a fim de evitar danos à saúde geral desses animais que podem acarretar diminuição da produção.

The objective of this study was to evaluate the effect of feed restriction on acute-phase response in horses. Twenty horses were deprived of food for 48 h and others 12 animals (control) had free access to water and hay. They were closely monitored and examined, and blood samples were taken at the beginning (0) of the study and 6, 12, 18, 24, 30, 36, 42 and 48 hours afterward. Data were submitted to two-way analysis of variance with repeated measures and statistical significance was P ≤ 0.05. The horses tolerated feed restriction without serious clinical complications. Feed restriction induced an increase in the acute-phase response by elevating serum concentrations of α2-macroglobulin (24-38 h), ceruloplasmin (36-48 h), α1-antitrypsin (30-48 h), α1-acid glycoprotein (42-48 h) and haptoglobin (42-48 h). Nutrient deprivation raised the levels of circulating cortisol, which acts on the innate immune system, which then induces the acute-phase response. In conclusion, food restriction is a physical stressor for horses, capable of inducing an acute-phase protein reaction, characterized by increased production of α2-macroglobulin, ceruloplasmin, α1-antitrypsin, α1-acid glycoprotein and haptoglobin. Keywords: Equine; Feed restriction; Inflammation; Immune response; Proteins; Stress.The objective of this study was to evaluate the effect of feed restriction on acute-phase response in horses. Twenty horses were deprived of food for 48 h and others 12 animals (control) had free access to water and hay. They were closely monitored and examined, and blood samples were taken at the beginning (0) of the study and 6, 12, 18, 24, 30, 36, 42 and 48 hours afterward. Data were submitted to two-way analysis of variance with repeated measures and statistical significance was P ≤ 0.05. The horses tolerated feed restriction without serious clinical complications. Feed restriction induced an increase in the acute-phase response by elevating serum concentrations of α2-macroglobulin (24-38 h), ceruloplasmin (36-48 h), α1-antitrypsin (30-48 h), α1-acid glycoprotein (42-48 h) and haptoglobin (42-48 h). Nutrient deprivation raised the levels of circulating cortisol, which acts on the innate immune system, which then induces the acute-phase response. In conclusion, food restriction is a physical stressor for horses, capable of inducing an acute-phase protein reaction, characterized by increased production of α2-macroglobulin, ceruloplasmin, α1-antitrypsin, α1-acid glycoprotein and haptoglobin. Keywords: Equine; Feed restriction; Inflammation; Immune response; Proteins; Stress.

The production of fuels and other industrial products from renewable sources has intensified the search for new substrates or for the expansion of the use of substrates already in use, as well as the search for microorganisms with different metabolic capacities. In the present work, we isolated and tested a yeast from the soil of sugarcane irrigated with vinasse, that is, with high mineral content and acidic pH. The strain of Meyerozyma caribbica URM 8365 was able to ferment glucose, but the use of xylose occurred when some oxygenation was provided. However, some fermentation of xylose to ethanol in oxygen limitation also occurs if glucose was present. This strain was able to produce ethanol from molasses substrate with 76% efficiency, showing its tolerance to possible inhibitors. High ethanol production efficiencies were also observed in acidic hydrolysates of each bagasse, sorghum, and cactus pear biomass. Mixtures of these substrates were tested and the best composition was found for the use of excess plant biomass in supplementation of primary substrates. It was also possible to verify the production of xylitol from xylose when the acetic acid concentration is reduced. Finally, the proposed metabolic model allowed calculating how much of the xylose carbon can be directed to the production of ethanol and/or xylitol in the presence of glucose. With this, it is possible to design an industrial plant that combines the production of ethanol and/or xylitol using combinations of primary substrates with hydrolysates of their biomass.

Abstract Introduction: Kidney transplant (KT) recipients have a high risk for adverse outcomes from infections, such as COVID-19. Methods: We have retrospectively reviewed all KT recipients with documented COVID-19 between March 1, 2020, and March 15, 2021, and analyzed patients’ characteristics, clinical course, treatment, and outcomes. Results: We identified 123 patients, 72% were male, with a mean age of 54.5±13.0 years. Twenty percent were asymptomatic, 7% had a nosocomial transmission, and 36% of the remainder required hospitalization. Almost all admitted patients received oxygen, 30% required invasive mechanical ventilation (IMV), more than a half had acute kidney injury, with 10% requiring dialysis, and 20% died. Incidence was comparable to that of the Portuguese population, but the mortality rate was almost four times higher (SMR of 3.768 (95% CI:1.723-7.154). Higher body mass index (OR 1.275, P=0.001), lower baseline graft function (OR 0.968, P=0.015), and nosocomial transmission (OR 13.836, P=0.019) were associated with oxygen demand, whereas female gender (OR 3.801, P=0.031) and lower baseline kidney graft function (OR 0.955, P=0.005), but not body mass index, were associated with IMV and/or death. Conclusion: Mortality rate in KT patients was higher than in the general population and lower baseline kidney function was the most consistent marker for adverse outcomes.

Objetivo: identificar o papel da equipe de enfermagem de um centro cirúrgico quanto à aplicação da segurança do paciente. Material e Método: trata-se de um estudo descritivo de caráter exploratório com abordagem quantitativa, realizado com profissionais da equipe de enfermagem atuantes no centro cirúrgico de uma instituição hospitalar privada, localizada na Serra Gaúcha, no estado do Rio Grande do Sul, Brasil. Os dados foram coletados através de questionários formulados por 25 perguntas, que posteriormente foram armazenados em planilhas no Microsoft® Windows® Excel® 2010 em forma de tabelas para análise estatística descritiva. Resultados: considerando os critérios de inclusão e exclusão, a amostra foi composta por 24 questionários válidos. Os dados analisados evidenciaram predomínio de concordância entre os enfermeiros e os técnicos em enfermagem referente à adesão da segurança do paciente em centro cirúrgico. Conclusão: a pesquisa ressaltou as dificuldades que os profissionais relatam durante sua jornada de trabalho. Tornou-se evidente a insatisfação dos mesmos em relação ao quantitativo dos profissionais de enfermagem, que, de acordo com eles, é um número insuficiente em relação à demanda das necessidades de um processo de cuidar e de segurança do paciente.

Este artigo analisa, segundo a perspectiva da Gramática Discursivo-Funcional, a partícula incluso em orações introduzidas por incluso si no espanhol peninsular escrito sob a hipótese de que assinala ênfase, o que permitiria concebê-la como independente da conjunção si. Para König (1985), Flamenco García (1999) e Rodríguez Rosique (2012) as construções introduzidas por incluso si são híbridas, porque misturam características de sentenças condicionais e de concessivas. Neste estudo, no entanto, rejeitamos esse hibridismo porque entendemos que incluso pode enfatizar uma oração condicional. O universo da pesquisa é o banco de dados CREA (Corpus de Referencia del Español Actual), que possui textos de diversas origens, tanto na língua falada quanto na escrita. Os resultados mostram que as orações introduzidas por incluso si se estabelecem em diferentes níveis e camadas, desempenhando função retórica Concessão e função semântica Condição, respectivamente. Nos dois casos, incluso tem estatuto de operador de ênfase e o que muda é o seu escopo, que não necessariamente acompanha a conjunção si.

Objetivo: avaliar o processo de realização do banho no leito e os cuidados realizados pela equipe de enfermagem antes, durante e após o banho no leito. Métodos: estudo transversal e observacional, realizado na Unidade de Terapia Intensiva de um Hospital/Escola, com oito técnicos de enfermagem. Para a coleta de dados foi utilizado instrumento estruturado tipo checklists em 30 momentos de observação de 1080 ações. Resultados: foram observados 10 cuidados antes e 28 durante e após o banho no leito. O banho foi realizado de forma automática sem comunicação prévia, sem considerar a individualidade e privacidade do paciente, principalmente naqueles submetidos a ventilação mecânica. Não houve participação do enfermeiro e a maioria das ações realizadas pela equipe de enfermagem não atendeu às recomendações da literatura. Conclusões: há necessidade de melhoria da qualidade do banho no leito realizado pela enfermagem e adoção de práticas baseadas em evidências no processo de cuidar.

Abstract Background Life in the ocean will increasingly have to contend with a complex matrix of concurrent shifts in environmental properties that impact their physiology and control their life histories. Rhodoliths are coralline red algae (Corallinales, Rhodophyta) that are photosynthesizers, calcifiers, and ecosystem engineers and therefore represent important targets for ocean acidification (OA) research. Here, we exposed live rhodoliths to near-future OA conditions to investigate responses in their photosynthetic capacity, calcium carbonate production, and associated microbiome using carbon uptake, decalcification assays, and whole genome shotgun sequencing metagenomic analysis, respectively. The results from our live rhodolith assays were compared to similar manipulations on dead rhodolith (calcareous skeleton) biofilms and water column microbial communities, thereby enabling the assessment of host-microbiome interaction under climate-driven environmental perturbations. Results Under high pCO2 conditions, live rhodoliths exhibited positive physiological responses, i.e. increased photosynthetic activity, and no calcium carbonate biomass loss over time. Further, whereas the microbiome associated with live rhodoliths remained stable and resembled a healthy holobiont, the microbial community associated with the water column changed after exposure to elevated pCO2. Conclusions Our results suggest that a tightly regulated microbial-host interaction, as evidenced by the stability of the rhodolith microbiome recorded here under OA-like conditions, is important for host resilience to environmental stress. This study extends the scarce comprehension of microbes associated with rhodolith beds and their reaction to increased pCO2, providing a more comprehensive approach to OA studies by assessing the host holobiont.

(1) Background: Hypersensitivity reactions to metals may arise in predisposed patients chronically exposed to metallic materials, including dental implants made of titanium alloys. The purpose of this article was to systematically review titanium allergy manifestations in patients treated with dental implants and report a clinical case; (2) Methods: A systematic electronic search was performed for articles published in the English language until July 2021. The following eligibility criteria were adopted: (1) Population: individuals undergoing titanium and/or titanium alloy implant-supported rehabilitations; (2) Exposure: peri-implant soft tissue reactions attributable to implant insertion; (3) Outcome: evidence of titanium allergy, diagnostic methods, and forms of resolution; (3) Results: The included studies, in summary, presented evidence that titanium should not be considered an inert material, being able to trigger allergic reactions, and may be responsible for implant failure. A 55-year-old male patient received 3 implants in the posterior region of the left mandible and presented an epulis-like lesion developed from the peri-implant mucosa. The immunohistochemical analysis of the biopsy specimen confirmed the initial diagnosis of allergic reaction to titanium; (4) Conclusions: Although the evidence is weak, and titanium allergy has a low incidence, hypersensitivity reactions should not be underestimated. A rapid and conclusive diagnosis is mandatory to prevent further complications.

Lipase is an important group of biocatalysts, which combines versatility and specificity, and can catalyze several reactions when applied in a high amount of industrial processes. In this study, the lipase produced by Aspergillus japonicus under submerged cultivation, was immobilized by physical adsorption, using clay supports, namely, diatomite, vermiculite, montmorillonite KSF (MKSF) and kaolinite. Besides, the immobilized and free enzyme was characterized, regarding pH, temperature and kinetic parameters. The most promising clay support was MKSF that presented 69.47% immobilization yield and hydrolytic activity higher than the other conditions studied (270.7 U g−1). The derivative produced with MKSF showed high stability at pH and temperature, keeping 100% of its activity throughout 12 h of incubation in the pH ranges between 4.0 and 9.0 and at a temperature from 30 to 50 °C. In addition, the immobilized lipase on MKSF support showed an improvement in the catalytic performance. The study shows the potential of using clays as support to immobilized lipolytic enzymes by adsorption method, which is a simple and cost-effective process.

Este trabajo tiene como objetivo discutir las construcciones concesivas introducidas por a pesar de (que) en el español hablado a la luz de la teoría de la Gramática Discursivo-Funcional (Hengeveld y Mackenzie, 2008). El objetivo de este estudio es verificar en qué Nivel y camada de esta teoría las cláusulas concesivas introducidas por ese nexo actúan. Según Bosque y Demonte (2000), a pesar de puede ser utilizada como locución prepositiva e introducir tanto sintagmas nominales como oraciones de infinitivo; a pesar de que, sin embargo, muestra un comportamiento similar a la conjunción aunque en cuanto al uso del tiempo y de los modos verbales. Tenemos la intención de investigar de qué manera se distinguen a pesar de y a pesar de que bajo la hipótesis de que hay diferencias semántico-pragmáticas entre esas dos conjunciones para marcar la relación concesiva y que esta diferencia se relaciona con los Niveles y camadas propuestos por la Gramática Discursivo-Funcional.

Background: After 2006 the cross-border region between the state of Mato Grosso do Sul (Brazil) and the Germán Busch Province (Bolivia) became risk areas for canine rabies antigenic variant 1, previously unknown in the Brazilian territory. Objectives: To perform a descriptive analysis of canine rabies from 2006 to 2014, analyzing the database of the official rabies diagnostic laboratory of the State Agency of Animal and Plant Health Protection of Mato Grosso do Sul. Methods: A descriptive analysis of canine rabies from 2006 to 2014 was performed using the database of the official rabies diagnostic laboratory of the State Agency of Animal and Plant Health Protection of Mato Grosso do Sul. Location, time and residence status of the animals were analyzed. Monthly frequencies were calculated as the ratio of the number of positive samples to the total of sent samples and were then statistically compared. Findings: In the period, 539 samples of nervous system from dogs and cats were sent for rabies diagnosis, of which 37 (6.9%; CI95% 5.0–9.3) canine and no positive feline samples were found positive. Twenty-four (64.9%, CI95% 48.8–78.2) positive samples were from Bolivia and 13 (31.1%, CI95% 21.8–51.2) from Brazil. Most positive animals were owned. The years 2008 and 2009 showed the highest occurrence of canine rabies, with 18 cases recorded in 2008 and 6 in 2009 (17 in Bolivia and 7 in Brazil). Annual samples sent in Brazil presented a decreasing trend (R2 = 0.53) and, over the months, a higher concentration of samples was observed between May and August (R2 = 0.69). No annual or monthly trends were observed for Bolivian samples (R2 < 0.003). Conclusions: AgV1 canine rabies due to antigenic variant 1 is still considered an endemic disease in the Brazil-Bolivia border region, requiring an international One Health Approach to mitigate canine rabies in Latin America.

The handover process must contain all the necessary information for continuing care. Ineffective handover process, with loss of information can be a risk to patient safety. The present study aimed to characterize the handover process from the Surgical Center and the Intensive Care Unit. Descriptive cross-sectional study conducted at an adult Intensive Care Unit of a teaching hospital in the city of de Goiânia – Goiás, from May to August 2014. Data was collected through a checklist divided into four categories containing information related to patient identification, procedure performed, clinical status and postoperative care. A great deal of information of the checklist was not transferred to the Intensive Care Unit staff. We expect that the data provided here contribute to the creation of safe strategies and strengthen the commitment of health professionals with the quality of the information transmitted during the handover process.

INTRODUÇÃO: O objetivo deste estudo foi avaliar a concordância entre os kits de fator antinúcleo (FAN) HEp-2 em relação aos padrões de fluorescência observados. Objetivou-se, ainda, avaliar o desempenho dos kits em relação à intensidade de fluorescência apresentada pelo uso dos conjugados fluorescentes, o número de mitoses por campo presentes no poço de reação e a titulação necessária para se obter o limiar de reatividade mínima (1+) dos soros controle reagentes presentes nos kits. MATERIAIS E MÉTODOS: Setenta e quatro amostras com resultados conhecidos foram testadas em quatro kits comerciais para a pesquisa de FAN HEp-2. O processamento estatístico foi feito pelo programa STATA® 9.2 e a concordância entre os resultados foi aferida pelo teste Kappa. RESULTADOS: O índice de concordância entre os kits, obtido pelo teste Kappa, foi superior a 0,94. Houve grande variabilidade quanto ao número de mitoses por campo presentes por poço de reação e quanto à intensidade de fluorescência dos conjugados, além de ter havido significativa diferença em dois kits em relação à diluição necessária para obtenção do limiar de reatividade mínima (1+). CONCLUSÃO: A taxa de concordância geral obtida pelo teste Kappa foi elevada, atingindo índice superior a 0,94. As maiores diferenças foram devido à presença de amostras com padrão variando entre nuclear pontilhado fino (PF), nuclear pontilhado fino denso (PFD) e nuclear homogêneo (HOMO). É necessária maior padronização dos kits quanto ao soro controle para a obtenção do limiar de reatividade mínima e em relação à intensidade de fluorescência dos conjugados.INTRODUCTION: The objective of this study was to assess the concordance among antinuclear antibody (ANA) HEp-2 kits as to the observed fluorescent patterns. The objective was also to evaluate their performance concerning the following items: fluorescence intensity due to the use of fluorescent conjugates, the number of mitosis per field on the reaction wells, and the required dilution to obtain minimum reactivity (1+) of the reagent control-serum present in the kits. MATERIAL AND METHODS: Seventy-four samples previously known results were tested using four commercial kits ANA HEp-2 kits. The statistical evaluation was carried out with STATA® 9.2 software and the concordance among the results was assessed with Kappa test. RESULTS: The concordance coefficient among the kits obtained with Kappa test was higher than 0.94. There was a great variability as to the number of mitosis per field on the reaction wells and the intensity of fluorescence conjugates. Concerning the required dilution to obtain a minimum reactivity (1+), there was a significant difference in two kits. CONCLUSION: The general concordance level obtained with Kappa test was higher than 0.94. The greatest differences were observed in samples with nuclear fine speckled (FS), nuclear dense fine speckled (DFS) and nuclear homogeneous (HOMO) patterns. As far as serum for minimum reactivity level and intensity of fluorescent conjugates are concerned, a better standardization is yet to be pursued.

Estudio cualitativo con objetivo de analizar el Plan Director de Atención Primaria de la Salud en el proceso de educación permanente y la formación de profesionales para actuar como multiplicadores en tal proceso. Los datos empíricos fueron obtenidos en entrevistas a 11 enfermeros que actuaron como facilitadores del Plan Director en un municipio de la región metropolitana de Belo Horizonte, Brasil. Los resultados indican que la experiencia como facilitador permitió reflexionar sobre el proceso de trabajo y contribuir a la incorporación de nuevas herramientas en la atención básica. Los participantes señalaron las dificultades enfrentadas en la conducción del trabajo y los vacíos en la formación de profesionales para implementar procesos de educación permanente en el cotidiano de los servicios. El Plan Director representa importante estrategia de educación permanente, con potencial para cambiar procesos y prácticas en la atención primaria de la salud.

Este estudo tomou como objeto a articulação teoria-prática da disciplina Fundamentos e Práticas da Enfermagem em Saúde Coletiva, do curso de graduação em enfermagem da EEUSP, e como objetivos: identificar a apreensão dos conceitos da disciplina e verificar sua aplicação nas práticas de enfermagem entre esses estudantes de graduação. Utilizou questionário com questões fechadas e abertas para apreensão empírica do objeto, através de análise de conteúdo. Os resultados indicam que a dimensão teórica apenas em parte possibilitou sínteses capazes de fomentar práticas sociais coerentes com o arcabouço teórico-conceitual da Saúde Coletiva. Para superar essa dificuldade faz-se necessário explicitar as diferentes abordagens teórico-metodológicas que fundamentam as práticas e que o educador direcione o educando para elaboração de sínteses, com a finalidade de formar enfermeiros comprometidos com a interpretação da saúde-doença como processo social e da saúde como direito social e, portanto, com a transformação das práticas reiterativas do modelo hegemônico.Este estudio tuvo como objeto la articulación teoría-práctica del curso Fundamentos y Prácticas de Enfermería en Salud Colectiva, para alumnos de graduación de la Escuela de Enfermería de la Universidad de Sao Paulo. Se buscó identificar la aprehensión de los conceptos del curso y evaluar su aplicación en las prácticas de enfermería. Se utilizó un cuestionario para aprehender empíricamente el objeto. Las informaciones fueron analizadas con análisis de contenido. Resultados: la dimensión teórica, apenas en parte, posibilitó una síntesis capaz de fomentar prácticas sociales coherentes con la estructura teórica-conceptual de Salud Colectiva. Para superar esa dificultad es necesario explicar los diferentes enfoques teórico-metodológicos que fundamentan las prácticas y que el educador conduzca al educando en la elaboración de síntesis. De esta manera, formar enfermeros comprometidos con la interpretación de salud-enfermedad como proceso social, con la salud como derecho social y con la transformación de las prácticas reiterativas del modelo hegemónico.This study focused on the relationship theory-practice of the discipline Fundamentals and Practices of Collective Health Nursing, offered to undergraduate students of the Nursing School, University of São Paulo, Brazil. The objectives were: to identify and understand the concepts studied in the discipline and to identify its application in nursing practices among these students Data were collected using a questionnaire and analyzed by content analysis. Results: theoretical dimension only partly allowed students to make syntheses potent to develop social practices consistent with the conceptual framework of Collective Health. To overcome this difficulty - and prepare nurses committed to the interpretation of health and disease as a social process and health as social right and, therefore, the transformation of reiterative practices of the hegemonic model -, it is necessary to clarify the different theoretical and methodological approaches underpinning the practices, having teachers directing students to articulate theory and practice.

Objetivos: A disfunção sexual feminina (DSF) é altamente prevalente, situando-se entre os 40% e 70% em Portugal, e traduz-se por uma alteração em qualquer uma das fases do ciclo de resposta sexual da mulher (desejo, excitação e orgasmo) ou ainda por perturbações dolorosas associadas ao ato sexual. O presente estudo pretendeu estudar a prevalência da DSF numa amostra de mulheres em idade reprodutiva, a prevalência dos diferentes subtipos de DSF e a existência de fatores associados. Tipo de estudo: Tratou-se de um estudo observacional, transversal e analítico. Local: Unidades de Saúde Familiar (USF) Novo Cuidar, Centro de Saúde de Fafe. População: Mulheres entre os 18 e os 58 anos utentes da USF Novo Cuidar. Métodos:A uma amostra aleatória de 346 utentes foi aplicado um questionário anónimo e confidencial de autorresposta. Usaram-se os testes Qui-Quadrado ou de Fisher para comparar proporções, o Odds Ratio para determinar a força de associação entre variáveis e os testes t-Student e Mann-Whitney para testar a associação entre variáveis qualitativas e quantitativas (adotou-se um nível de significância de 0,05). Resultados: A taxa de resposta foi de 86,4% e a prevalência de DSF foi de 77,2% (IC95% 72,0-82,7), tendo a perturbação do orgasmo sido o subtipo mais prevalente, 55,8% (IC95% 51,0-63,9). Foi encontrada uma associação entre a contraceção hormonal e a perturbação do desejo (p = 0,003). A aversão sexual foi estatisticamente relacionada com experiências sexuais indesejadas prévias (p = 0,001). Conclusões: A DSF em idade reprodutiva é muito prevalente apesar de apenas metade das mulheres a considerarem um problema. Foram encontradas associações com alguns fatores que podem ter importância na vivência de uma sexualidade feliz pela mulher.

This is a qualitative study that aims at analyzing the Primary Health Care Strategic Planning in a continuing education process, as well as the professional’s formation to work as facilitators in it. Data was obtained through interviews with 11 nurses that had acted as the plan’s facilitators in a municipality within Belo Horizonte. The results indicate that the experience as facilitators allowed them to reflect on the work process and this practice contributed to the incorporation of new tools to the primary health care system. The participants reported the difficulties faced when conducting the experience and the gap in the professionals’ formation to act in the PHC and to put into practice the processes of continuing education on a day to day basis. In conclusion, the Planning represents an important continuing education strategy and it is significance to transform processes and practices in the primary health care service.

Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.

ABSTRACT Objective: To verify the comprehension of the education handout and the level of Functional Health Literacy of individuals with cardiac pacemaker (PM) and whether there is correlation between the comprehension and Functional Health Literacy (FHL). Method: Cross-sectional study with 63 individuals with PM who answered to comprehension tests of the handout, literacy assessment (SAHLPA-50) and cognition (MMSE). Measurements of dispersion, Pearson correlation and multiple linear regression were calculated. Results: Most women, study time ≤ 9 years, 66.21 (average age) presented no cognitive changes. An adequate literacy level was evidenced in 50.8% individuals with PM and satisfactory comprehension of the handout. No correlation was identified between FHL, handout comprehension, age, years of study and cognition. Conclusion: The handout comprehension assessed by individuals with appropriate FHL indicated that it can be a printed material suitable for use, aiming to improve care process and knowledge of individuals with PM.