28492 research outputs found
Sort by
Aprendizagem sobre atividade física por estudantes de Medicina: a situação hoje no Brasil
No full textIntrodução: A atividade física é essencial para prevenir e tratar muitas doenças. Embora os médicos sejam os profissionais de saúde que mais influenciam
a orientação de seus pacientes sobre os benefícios da atividade física, a maioria dos programas de graduação em Medicina no Brasil parece não incluir
tópicos sobre atividade física em seus currículos.
Objetivo: Este estudo teve como objetivo investigar a presença de tópicos sobre atividade física nos currículos médicos ativos no Brasil.
Método: A pesquisa foi realizada separadamente em abril de 2015 e fevereiro de 2019, utilizando um recurso governamental, o sistema e-MEC, e
pesquisa em bancos de dados da internet. Os dados foram divididos em categorias, de acordo com a condição de matrícula (obrigatória ou opcional)
dos cursos com disciplinas ou módulos temáticos contendo tópicos sobre atividade física, tipo de atividades (teóricas, práticas ou teórico-práticas) e
ênfase no conteúdo (saúde, desempenho ou saúde e desempenho).
Resultado: Dos 223 currículos médicos compilados em 2015 e 286 em 2019, respectivamente, apenas 24 (10,8%) e 19 (6,7%) apresentaram pelo menos
uma disciplina ou módulo temático contendo tópico sobre atividade física com ênfase em saúde.
Conclusão: No Brasil, o número de currículos de graduação em Medicina contemplando tópicos de atividade física ainda é pequeno e sofreu uma redução
entre 2015 e 2019, o que deve servir de alerta para as instituições de ensino médico quanto à necessidade de inclusão de conteúdos longitudinalmente
distribuídos sobre atividade física, com abordagens teórica e, se possível, prática, e com ênfase na promoção da saúde e no tratamento de doenças, em
unidades curriculares obrigatóriasIntroduction: Physical activity is essential for preventing and treating many diseases. Although physicians are the most influential health
professionals in advising their patients on the benefits of physical activity, most medical degree programs in Brazil do not seem to include physical
activity topics in their curricula.
Objective: This study aimed to investigate physical activity topics on active medical curricula in Brazil.
Method: The research was conducted separately in April 2015 and February 2019 using a governmental resource, the e-MEC system, and search in
internet databases. Data were split into categories according to the type of enrollment (mandatory or optional) of the courses that have subjects
or thematic modules with topics on physical activity, type of activities (theoretical, practical, or theoretical-practical), and emphasis on the content
(health, performance, or health and performance).
Results: Of the 223 medical curricula compiled in 2015 and 286 in 2019, respectively, only 24 (10.8%) and 19 (6.7%) had at least one subject or
thematic module concerning physical activity with emphasis on health.
Conclusion: In Brazil, the number of undergraduate medical curricula covering physical activity topics is still small and suffered a reduction between
2015 and 2019, which should warn medical education institutions about the need to include physical activity longitudinally distributed contents,
with theoretical and - if possible - practical approaches, and emphasis on health promotion and treatment of diseases, in mandatory curricular units
Evaluation of Aedes aegypti, Aedes albopictus, and Culex quinquefasciatus Mosquitoes Competence to Oropouche virus Infection
No full textThe emergence of new human viral pathogens and re-emergence of several diseases are of particular concern in the last decades. Oropouche orthobunyavirus (OROV) is an arbovirus endemic to South and Central America tropical regions, responsible to several epidemic events in the last decades. There is little information regarding the ability of OROV to be transmitted by urban/peri-urban mosquitoes, which has limited the predictability of the emergence of permanent urban transmission cycles. Here, we evaluated the ability of OROV to infect, replicate, and be transmitted by three anthropophilic and urban species of mosquitoes, Aedes aegypti, Aedes albopictus, and Culex quinquefasciatus. We show that OROV is able to infect and efficiently replicate when systemically injected in all three species tested, but not when orally ingested. Moreover, we find that, once OROV replication has occurred in the mosquito body, all three species were able to transmit the virus to immunocompromised mice during blood feeding. These data provide evidence that OROV is restricted by the midgut barrier of three major urban mosquito species, but, if this restriction is overcome, could be efficiently transmitted to vertebrate hosts. This poses a great risk for the emergence of permanent urban cycles and geographic expansion of OROV to other continents
Detection of Common Deletional of α-Thalassemia 3.7 Kb from Metropolitan Region of Manaus, Amazonas, Brazil
No full textFundação de Amparo à Pesquisa do Estado do Amazonas (FAPEAM) – Protocol Number: 1094/2013-FAPEAM.
• Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).Alpha Thalassemia (α-thal) is a heterogeneous group of hereditary alterations caused by deletions that affect alpha regulatory genes, and the 3.7Kb deletion is the most frequent worldwide. The prevalence ranges from 20% and 35% in Brazil, depending mainly on race, predominant in Afro-descendants.
Purpose: The aim was to determine α-thal -α3.7Kb and -α4.2Kb deletions, estimating their frequency in individuals from six regions of Amazonas State.
Methods: Volunteers age between 18-59 years old of both genders participated in the study. Blood was collected from March 2014 to September 2017 at the health centers of each participant city. α-thal3.7Kb was performed by GAP-PCR, while α-thal4.2Kb by Multiplex-PCR. The total samples collected from each city were: Manaus (capital), 356 (19.7%); Iranduba 232 (12.8%); Manacapuru, 287 (15.9%); Presidente Figueiredo, 370 (20.5%); Itacoatiara, 301 (16.6%); and Coari, 263 (14.5%).
Results: The average age among males was 35.3±14.8, while for females, it was 36.7±14.9 years old. Microcytosis (MCV <80fL) was found in 158 individuals (8,46%) and α-thal diagnosed in 143 individuals (7.9%), and all of these individuals carried the 3.7Kb deletion 5.95% in heterozygous and 1.95% in homozygous. α-thal4.2kb was not found in any volunteer. The association analyses to the α-thal3.7kb genotypes were statistically significant for all hematological parameters (p<.001), except serum iron and serum ferritin analyses.
Conclusion: This study highlights α-thal 3.7kb deletion as an important public health problem, especially in a population not yet characterized about this disease. Thus, epidemiological studies using molecular tools become relevant in regions where the disease is underestimated, contributing to a better understanding of thalassemia incidence and iron deficiency anemias incidence of the participating cities. We reinforce that future molecular studies in North Region from Brazil can be utilized to describe other genetic anemias as structural hemoglobinopathies that have already proven to be highly prevalent in Brazil
Differences in the prevalence of prediabetes, undiagnosed diabetes and diagnosed diabetes and associated factors in cohorts of Brazilian and English older adults
No full textObjective: To analyse differences in the prevalence of prediabetes (PD), undiagnosed diabetes (UDD) and diagnosed diabetes (DD) and associated factors between Brazilian and English older adults.
Design: Cross-sectional study.
Setting: England and Brazil.
Participants: 5301 participants of the English Longitudinal Study of Ageing study and 1947 participants of the Brazilian Longitudinal Study of Aging study classified as non-diabetics, PD, UDD and DD.
Results: The prevalence of PD, UDD and DD was 48·6, 3 and 9·6 % in England and 33, 6 and 20 % in Brazil. In England, the increase in age, non-white skin colour, smoking, general obesity and abdominal obesity were associated with PD, UDD and DD, whereas hypertriglyceridaemia, low HDL levels, hypertension and stroke were associated with UDD and DD. In Brazil, the increase in age was associated with DD and UDD, non-white skin colour and smoking were associated with UDD and abdominal obesity and hypertriglyceridaemia were associated with all three conditions. CVD in England and schooling in Brazil were associated with PD and DD. A sedentary lifestyle was associated with DD in both samples.
Conclusions: The prevalence of diabetes was higher in the Brazilian sample. Different associated factors were found in the two samples, which may be related to differences in nutritional transition, access to healthcare services and the use of such services
Extended Communities of Research-Action: a contribution to methodological for an Emancipatory Promotion of Health in urban spaces
No full textA Comunidade Ampliada de Pesquisa-Ação (CAP) desenvolvida pelo Laboratório Territorial de Manguinhos (LTM) como dispositivo metodológico de pesquisa no campo da Saúde Coletiva, é tomada nesta tese como objeto de sistematização e reflexão crítica, na perspectiva proposta por Oscar Jara. Trata-se da sistematização de experiências como caminho metodológico de produção de conhecimentos a partir das práticas em que a própria experiência é o ponto de partida. A reflexão crítica dessa experiência no decorrer dos últimos dezessete anos (2003-2020), a partir de projetos de pesquisa-ação e intervenção em favelas do Rio de Janeiro, particularmente Manguinhos. Dela resultou a sistematização não apenas dos principais referenciais teórico-metodológicos que, ao longo da trajetória, foram sendo consolidados como forma de constituir e compreender nossas práticas com as CAP, mas também da experiência do LTM voltada para a Promoção Emancipatória da Saúde, que culminou na proposição do Método CAP. Como produtos da tese foram elaborados três capítulos, que constituem o núcleo reflexivo acerca do Método CAP e que expressam nosso aprendizado com a pesquisa-ação nos territórios de favelas. Inicialmente, propomos um quadro de referências para uma leitura compreensiva desses territórios e a PES como caminho para a desconstrução dos processos desumanizadores desses espaços da cidade (Capítulo 3). Em seguida, discutimos os referenciais teóricometodológicas que deram base à proposição da CAP e fazemos uma reflexão crítica sobre as diversas conformações de CAP na aproximação com o território (Capítulo 4). E, por fim, elaboramos uma reflexão crítica sobre o trabalho artesanal no cotidiano das CAPs, como contribuição às discussões metodológicas no campo da pesquisa em Saúde Coletiva e às reflexões sobre a pesquisa participante no contexto urbano de favelas e no contexto de um convívio cotidiano com esses territórios. Vislumbramos esse caminho como possibilidade de construção de \201Cinéditos viáveis\201D a partir da produção de conhecimentos sobre os processos de determinação social da saúde nestes espaços da cidade. A metodologia CAP conforma-se como um aporte político-pedagógico para a ressignificação da participação social no SUS, numa perspectiva instituinte. Finalmente, com base em algumas interrogações sobre nosso trabalho, destacamos temas para uma agenda futura de pesquisas, enfatizando as invisibilidades e os processos de determinação socioambiental da saúde, o cotidiano e os desafios do mundo digital na interlocução com o território e quem é o pesquisador em uma CAP.The Extended Community of Action Research (CAP) has been used by the Territorial Laboratory of Manguinhos (LTM) as a methodological research device in the field of Public Health. In this thesis it was used as an object of systematization and critical reflection, as proposed by Oscar Jara. In this context, the experiences were systematized as a methodological way of producing knowledge based on the practices in which the experience itself is the starting point. This work critically reports the reflection of this experience obtained over the past seventeen years (2003-2020), based on action research and intervention projects in Rio de Janeiro's slums, particularly Manguinhos. This resulted in the systematization not only of the main theoretical and methodological references that, throughout the trajectory, were consolidated as a way of constituting and understanding our practices with the PACs, but also of the LTM experience focused on the Emancipatory Promotion of Health, which culminated in the CAP Method proposition. As products of the thesis, three chapters were elaborated, which constitute the reflexive nucleus about the CAP Method and which express our learning with action research in the slum\2019s territories. Initially, we propose a framework of references for a comprehensive reading of these territories and PES as a way to deconstruct the dehumanizing processes of these spaces in the city (Chapter 3). Then, we critically discuss the theoretical and methodological frameworks that supported the CAP's proposition and the different configurations of CAP in the approach to the territory (Chapter 4). And, finally, we elaborate a critical reflection on artisanal work in the daily life of CAPs, as a contribution to methodological discussions in the field of public health research and to reflections on participatory research in the urban context of slums and in the context of a daily living with those territories. We envision this path as the possibility of building \201Cviable innovations\201D based on the production of knowledge about the processes of social determination of health in these spaces of the city. The CAP methodology conforms as a political-pedagogical contribution to the resignification of social participation in SUS, in an instituting perspective. Finally, based on some questions about our work, we highlight themes for a future research agenda, emphasizing the invisibilities and processes of socioenvironmental determination of health, the daily life and the challenges of the digital world in interlocution with the territory and who is the researcher in a CAP
Detección de Enterobacterales Productores de Carbapenemasas en Pacientes Colonizados, Atendidos en un Hospital Universitario
No full textObjetivo: Investigar a produção de carbapenemase entre amostras de Enterobacterales obtidas a partir de
culturas de vigilância, de pacientes internados em um hospital universitário no Rio de Janeiro, bem como a
distribuição das espécies bacterianas e seus perfis de sensibilidade. Métodos: Os swabs retais foram
coletados na admissão dos pacientes e, após, semanalmente, nas unidades: Coronariana, Diálise,
Emergência, Hematológica, Pediatria, e de Terapia Intensiva. As amostras obtidas foram submetidas a
métodos fenotípicos para detecção de produção de carbapenemases. A identificação bacteriana foi realizada
por meio de espectrometria de massas. O perfil de sensibilidade aos antimicrobianos foi determinado por
disco-difusão e a detecção dos determinantes genéticos foi realizada por meio da Reação em Cadeia da
Polimerase. Resultados: A produção de carbapenemases foi observada em 34,9% dos isolados. As espécies
mais frequentes foram Klebsiella pneumoniae (68,4%) e Escherichia coli (15,8%). Uma elevada taxa de
multirresistência (89,5%) foi observada entre as Enterobacterales produtoras de carbapenemases (EPC).
Verificou-se que 81,6% das amostras apresentavam o gene blaKPC e 15,8%, o blaNDM. Duas amostras foram
concomitantemente positivas para os genes blaKPC/blaNDM. Conclusão: Foi observada uma elevada taxa de
colonização por EPC multirresistentes, com predominância de K. pneumoniae carreando blaKPC.Objective: To investigate of the production of carbapenemase among Enterobacterales isolates obtained from
surveillance cultures from patients attended at a university hospital in Rio de Janeiro, as well as the distribution
of bacterial species and their susceptibility patterns. Methods: Rectal swabs were collected at the admission
of patients and, afterwards, weekly, in the units: Coronary, Dialysis, Emergency, Hematological, Pediatrics,
and Intensive Care. The isolates obtained were submitted to phenotypic methods for the detection of
carbapenemase production. Bacterial identification was performed using mass spectrometry. The antimicrobial
susceptibility was determined by disk-diffusion and the detection of the genetic determinants was carried out
through the Polymerase Chain Reaction. Results: The production of carbapenemases was observed in 34.9%
of the isolates. The most frequent bacterial species were Klebsiella pneumoniae (68.4%) and Escherichia coli (15.8%). A high rate of multidrug resistance (89.5%) was observed among the carbapenemase-producing
Enterobacterales (CPE). It was found that 81.6% of the isolates had the blaKPC gene and 15.8%, blaNDM. None
of the isolates presented the blaOXA-48-like gene. Two isolates were concomitantly positive for blaKPC/blaNDM
genes. Conclusion: A high rate of colonization by multidrug-resistant CPE was observed, with a
predominance of K. pneumoniae carrying blaKPC
Bedbug salivation patterns during hematophagy in the skin of a mammalian host
No full textCimex lectularius (Hemiptera:Cimicidae) infestations have increased over the past decades in several parts of the world, constituting a major urban pest with no reversion signs. The impact on human health caused by these insects, commonly known as bedbugs, is associated with their obligatory hematophagous habit. Allergies induced by hematophagous arthropod bites are related to the deposition of salivary molecules in the host tissues. Many reports of humans developing severe allergic reactions due to bedbug bites have been recorded, however, there is limited information on the salivation of bedbugs on the host, which was the objective of this study. C. lectularius females were fed on blood containing acridine orange fluorochrome, which labeled the principal salivary glands content. The salivation pattern of bedbugs was investigated using intravital microscopy during its blood meal on the ear skin of hairless mice. Saliva deposition occurred during all insect blood-feeding phases, beginning as soon as the mouthpart touched the host skin. During the probing phase, saliva was deposited in large quantities in the host dermis. In contrast, during the engorgement phase (which represents the largest blood meal of the insects), saliva was released at a much slower rate. The apparent release of saliva into the cannulated vessel and/or adjacent tissue occurs only sporadically during insect blood ingestion. However, a small area (spot) of fluorescence was detected around the proboscis tip during this feeding phase. An interesting feature of bedbugs is that they release saliva inside and outside the vessels without removing their mouthparts from the vessel lumen. This is an effective feeding strategy because it does not interrupt blood ingestion and decreases the mouthparts movements on the host\'s skin, minimizing the damage to tissues and contact time with the host (feeding time)
Treatment of mycobacteriosis in a patient with compatible symptoms after a cesarean delivery
No full textThis study aims to report the diagnostic course and treatment of a fast-growing mycobacteria infection after cesarean delivery. We report the case of a 37-year-old woman admitted to the Infectious Diseases' Clinic of the Hospital das Clinicas da Universidade Federal de Pernambuco, Pernambuco State, Brazil, four months after a cesarean section, presenting with healing difficulties and located pain outside the surgical site. The first diagnosis was a probable rejection of the sutures that were not absorbed, but based on the clinical signs, reported history, complementary laboratory tests and no response to treatment with the conventional antibiotic therapy (cephalosporins/quinolones) prescribed, the ultimate diagnosis was a mycobacteriosis caused by Micobacterium fortuitum. Since fast-growing mycobacteria do not easily penetrate host tissues, they is mainly related to post-trauma or post-surgical procedures. It is extremely important to call attention to these occurrences in the gynecological-obsthetric field. Treatment for mycobacteriosis is often complicated because of the side effects of antibiotics, especially the ototoxicity of amikacin
Um estudo de caso no Parque das Aves (PR): as placas e a percepção de grupos de adolescentes
No full textOs zoológicos são instituições de pesquisa, conservação e educação ambiental. Nesses locais, uma parte da comunicação é feita por meio das placas distribuídas ao longo das trilhas e percursos expositivos, tendo o potencial de informar e engajar os diferentes públicos visitantes. No presente estudo de caso, de caráter qualitativo, em um primeiro momento, analisamos todas as 287 placas da trilha do Parque das Aves, uma instituição privada situada em Foz do Iguaçu (PR, Brasil) e focada na conservação das aves da Mata Atlântica. As placas do Parque foram fotografadas presencialmente e posteriormente organizadas e categorizadas quanto ao formato e conteúdo. Os resultados indicam que, por meio das placas, existe na trilha uma narrativa em prol da conservação. Em um segundo momento, realizamos cinco grupos focais virtuais com adolescentes, com o objetivo de investigar suas percepções em relação a algumas placas selecionadas, representativas da totalidade analisada. As conversas dos grupos focais foram transcritas e codificadas. As placas selecionadas para estimular as conversas renderam comentários ricos e variados, o que demonstra que elas têm potencial para gerar discussões sobre o meio ambiente e sua conservação, com destaque para o bioma da Mata Atlântica. Somado a isso, provocaram falas dos adolescentes sobre a preocupação com o bem-estar dos animais e com questões ambientais, como o tráfico de animais e o desmatamento. Os participantes também demonstraram, nos grupos focais, outros sentimentos relacionados às lembranças de experiências prévias no Parque das Aves, além de uma variedade de vivências pessoais e opiniões sobre outros zoológicos. Alguns deles, inclusive, fizeram sugestões de como certos elementos poderiam ser aperfeiçoados e abordaram várias considerações em relação ao conteúdo visual e design, demonstrando que as placas são elementos comunicativos que são observados pelos adolescentes, pelo menos quando solicitado.CAPESZoos are institutions of research, conservation and environmental education. In these settings, labels, distributed along trails and exhibits, have the potential to inform and engage different audiences. This qualitative case study analyzed all 287 labels on the trail of Parque das Aves, a private institution located in Foz do Iguaçu (PR, Brazil) that focuses on the conservation of Atlantic Forest birds. The park\2019s labels were photographed on-site and then organized and categorized according to format and content. Results indicate that a narrative in favor of conservation is created on the trail through labels. The second step included five virtual focus groups with adolescents, investigating their perceptions of selected representative labels. Focus groups\2019 conversations were transcribed and coded. Labels selected to stimulate the conversation yielded rich and varied data, demonstrating that labels have the potential to generate discussions about the environment and its conservation, focused on the Atlantic Forest biome. In addition, labels provoked adolescents to talk about their concern for animal well-being and environmental issues such as animal trafficking and deforestation. Focus group participants also demonstrated other feelings related to memories of previous experiences at Parque das Aves in addition to a variety of personal experiences and opinions about other zoos. Some participants made suggestions about how certain label elements could be improved and addressed considerations regarding visual content and design, demonstrating that adolescents do notice communicative elements of labels, at least when prompted
Data quality and arbovirus infection associated factors in pregnant and non-pregnant women of childbearing age in Brazil: A surveillance database analysis
No full textThe dengue surveillance system in Brazil has registered changes in the disease's morbidity and mortality profile over successive epidemics. Vulnerable groups, such as pregnant women, have been particularly hard hit. This study assessed the quality of notifications of dengue cases among pregnant women and non-pregnant women of childbearing age in Brazil, in addition to discussing the factors associated with arbovirus infection in the group of pregnant women. We carried out a retrospective study of cases registered in the national arbovirus surveillance system between 2007 and 2017. The indicator for assessing quality was incompleteness. Logistic regression was used to analyze the association between dengue during pregnancy and sociodemographic, epidemiological, clinical, and laboratory variables. The incompleteness of the data in the notification form for dengue cases in women of childbearing age and pregnant women indicates a significant loss of information. Dengue was shown to be positively associated with Social Determinants of Health in both groups, with more severe effects among pregnant women. The incompleteness of the data can limit the quality of information from the notification system and the national assessment of the situation of the disease in women of childbearing age and pregnant women