Battacin-Inspired Ultrashort Peptides: Nanostructure Analysis and Antimicrobial Activity.

Peptides can serve as versatile therapeutics with a highly modular structure and tunable biophysical properties. In particular, the efficacy of peptide antibiotics against drug-resistant pathogens is of great promise, as few new classes of antibiotics are being developed to overcome the ever-increasing bacterial resistance to contemporary drugs. This work reports biophysical and antimicrobial studies of a designed library of ultrashort peptides that self-assemble into hydrogels at concentrations as low as 0.5% w/v in buffered saline, as confirmed by rheology. The hydrogels are constituted by ß-sheet-rich nanofibril networks, as determined by biophysical techniques including spectroscopy (attenuated total reflectance Fourier transform infrared spectroscopy and Congo red binding assay), short- and wide-angle X-ray scattering, and electron microscopy. Both peptide solutions and self-assembled hydrogels show potent antimicrobial activity against S. aureus and Pseudomonas aeruginosa by membrane lysis. These peptides also displayed selectivity toward bacterial cells over human dermal fibroblasts in vitro, as determined from Live/Dead, scanning electron microscopy, and coculture assays. This work reports an antimicrobial self-assembling motif of only three residues comprising an aromatically acylated cationic d-Dab/Lys amino acid, a second cationic residue, and naphthylalanine that heavily influences the self-assembly of these peptides into hydrogels. The variations in the antimicrobial activity and self-assembly properties between analogues may have implications in future studies on the correlation between self-assembly and biological activity in ultrashort peptides.

Obstetric violence and LGBTQIA+phobia: interlaced oppressions and violations. / Violência obstétrica e LGBTQIA+fobia: o entrelaçamento de opressões e violações.

The cisheteropatriarchal capitalist system has developed by class, racial and sexual oppression and exploitation in establishing unequal, hierarchical power relations. One of these kinds of oppression involves the use of violence against bodies considered wayward and transgressive within this structure. Of the different types of violence, this study focused on obstetric violence, understood as patriarchal gender violence designed to remove the rights, autonomy and agency of trans women and men during the processes of pregnancy, childbirth, postpartum and abortion. This article reflects on obstetric violence and its impacts on homo-parenthood for lesbian women and trans men, on the understanding that the LGBTQIA+ population is one of the most vulnerable and removed from health services, mainly because of the institutional violence suffered by these bodies. Accordingly, the intention is to understand, through social and historical analysis, how these sexist, heteropatriarchal violations, interlacing and reflecting in health care for these people, generate even more forms of oppression against this population.

O sistema capitalista e cisheteropatriarcal se desenvolveu através da opressão e exploração de classe, raça e sexo no estabelecimento de relações desiguais e hierarquizadas de poder, e uma dessas opressões é o uso da violência contra os corpos considerados errantes e transgressores dentro dessa estrutura. Dentre os diversos tipos de violência, o foco deste estudo está na violência obstétrica, compreendida como uma violência patriarcal de gênero que visa a retirada de direitos, autonomia e protagonismo de mulheres e homens trans durante o período gestacional, do parto e puerpério ou em processos de abortamento. Esse artigo tem como objetivo refletir sobre a violência obstétrica e seu impacto nas homoparentalidades de mulheres lésbicas e de homens trans, pois compreende-se que a população LGBTQIA+ é uma das mais vulnerabilizadas e que está mais distante dos serviços de saúde, justamente pela violência institucional que acomete esses corpos. Dessa forma, pretende-se compreender, através de uma análise social e histórica, como os atravessamentos dessas violações sexistas e heteropatriarcais se entrelaçam e refletem na assistência à saúde dessas pessoas, gerando ainda mais formas de opressão contra essa população.

Context-Dependent Ant-Pollinator Mutualism Impacts Fruit Set in a Hummingbird-Pollinated Plant.

Context-dependence in mutualisms is a fundamental aspect of ecological interactions. Within plant-ant mutualisms, particularly in terms of biotic protection and pollination, research has predominantly focused on elucidating the benefits while largely overlooking potential costs. This notable gap underscores the need for investigations into the drawbacks and trade-offs associated with such mutualistic relationships. Here, we evaluated the role of pericarpial nectaries (PNs) in shaping the dynamics of ant-pollinator mutualisms. Specifically, we investigated whether ants visiting the PN of Palicourea rigida (Rubiaceae) could deter hummingbirds and disrupt pollination, ultimately influencing fruit production. Our research involved manipulative experiments and observation of ant-pollinator interactions on P. rigida plants in the Brazilian savannah. We found that visiting ants can deter hummingbirds and/or disrupt pollination in P. rigida, directly influencing fruit set. However, these results are species-specific. The presence of very aggressive, large predatory ants, such as E. tuberculatum, had a negative impact on hummingbird behavior, whereas aggressive mid-sized ants, such as C. crassus, showed no effects. Our study illuminates the multifaceted aspects of ant-plant mutualisms and underscores the importance of evaluating costs and unexpected outcomes within these ecological relationships.

Rational design of potent ultrashort antimicrobial peptides with programmable assembly into nanostructured hydrogels.

Microbial resistance to common antibiotics is threatening to cause the next pandemic crisis. In this context, antimicrobial peptides (AMPs) are receiving increased attention as an alternative approach to the traditional small molecule antibiotics. Here, we report the bi-functional rational design of Fmoc-peptides as both antimicrobial and hydrogelator substances. The tetrapeptide Fmoc-WWRR-NH2-termed Priscilicidin-was rationally designed for antimicrobial activity and molecular self-assembly into nanostructured hydrogels. Molecular dynamics simulations predicted Priscilicidin to assemble in water into small oligomers and nanofibrils, through a balance of aromatic stacking, amphiphilicity and electrostatic repulsion. Antimicrobial activity prediction databases supported a strong antimicrobial motif via sequence analogy. Experimentally, this ultrashort sequence showed a remarkable hydrogel forming capacity, combined to a potent antibacterial and antifungal activity, including against multidrug resistant strains. Using a set of biophysical and microbiology techniques, the peptide was shown to self-assemble into viscoelastic hydrogels, as a result of assembly into nanostructured hexagonal mesophases. To further test the molecular design approach, the Priscilicidin sequence was modified to include a proline turn-Fmoc-WPWRR-NH2, termed P-Priscilicidin-expected to disrupt the supramolecular assembly into nanofibrils, while predicted to retain antimicrobial activity. Experiments showed P-Priscilicidin self-assembly to be effectively hindered by the presence of a proline turn, resulting in liquid samples of low viscosity. However, assembly into small oligomers and nanofibril precursors were evidenced. Our results augur well for fast, adaptable, and cost-efficient antimicrobial peptide design with programmable physicochemical properties.

Molecular engineering of antimicrobial peptides: microbial targets, peptide motifs and translation opportunities.

The global public health threat of antimicrobial resistance has led the scientific community to highly engage into research on alternative strategies to the traditional small molecule therapeutics. Here, we review one of the most popular alternatives amongst basic and applied research scientists, synthetic antimicrobial peptides. The ease of peptide chemical synthesis combined with emerging engineering principles and potent broad-spectrum activity, including against multidrug-resistant strains, has motivated intense scientific focus on these compounds for the past decade. This global effort has resulted in significant advances in our understanding of peptide antimicrobial activity at the molecular scale. Recent evidence of molecular targets other than the microbial lipid membrane, and efforts towards consensus antimicrobial peptide motifs, have supported the rise of molecular engineering approaches and design tools, including machine learning. Beyond molecular concepts, supramolecular chemistry has been lately added to the debate; and helped unravel the impact of peptide self-assembly on activity, including on biofilms and secondary targets, while providing new directions in pharmaceutical formulation through taking advantage of peptide self-assembled nanostructures. We argue that these basic research advances constitute a solid basis for promising industry translation of rationally designed synthetic peptide antimicrobials, not only as novel drugs against multidrug-resistant strains but also as components of emerging antimicrobial biomaterials. This perspective is supported by recent developments of innovative peptide-based and peptide-carrier nanobiomaterials that we also review.

Violência obstétrica e LGBTQIA+fobia: o entrelaçamento de opressões e violações / Obstetric violence and LGBTQIA+phobia: interlaced oppressions and violations

Resumo O sistema capitalista e cisheteropatriarcal se desenvolveu através da opressão e exploração de classe, raça e sexo no estabelecimento de relações desiguais e hierarquizadas de poder, e uma dessas opressões é o uso da violência contra os corpos considerados errantes e transgressores dentro dessa estrutura. Dentre os diversos tipos de violência, o foco deste estudo está na violência obstétrica, compreendida como uma violência patriarcal de gênero que visa a retirada de direitos, autonomia e protagonismo de mulheres e homens trans durante o período gestacional, do parto e puerpério ou em processos de abortamento. Esse artigo tem como objetivo refletir sobre a violência obstétrica e seu impacto nas homoparentalidades de mulheres lésbicas e de homens trans, pois compreende-se que a população LGBTQIA+ é uma das mais vulnerabilizadas e que está mais distante dos serviços de saúde, justamente pela violência institucional que acomete esses corpos. Dessa forma, pretende-se compreender, através de uma análise social e histórica, como os atravessamentos dessas violações sexistas e heteropatriarcais se entrelaçam e refletem na assistência à saúde dessas pessoas, gerando ainda mais formas de opressão contra essa população.

Abstract The cisheteropatriarchal capitalist system has developed by class, racial and sexual oppression and exploitation in establishing unequal, hierarchical power relations. One of these kinds of oppression involves the use of violence against bodies considered wayward and transgressive within this structure. Of the different types of violence, this study focused on obstetric violence, understood as patriarchal gender violence designed to remove the rights, autonomy and agency of trans women and men during the processes of pregnancy, childbirth, postpartum and abortion. This article reflects on obstetric violence and its impacts on homo-parenthood for lesbian women and trans men, on the understanding that the LGBTQIA+ population is one of the most vulnerable and removed from health services, mainly because of the institutional violence suffered by these bodies. Accordingly, the intention is to understand, through social and historical analysis, how these sexist, heteropatriarchal violations, interlacing and reflecting in health care for these people, generate even more forms of oppression against this population.

Pressupostos teórico-metodológicos e didático-pedagógicos da unidade curricular ética profissional na Unifesp / Theoretical-methodological and didactic-pedagogical assumptions of the Professional Ethics curricular unit at Unifesp

Resumo: O objetivo deste artigo é refletir sobre a ética na formação profissional, na particularidade da Unidade Curricular de Ética Profissional na graduação em Serviço Social da Unifesp. Realizou-se pesquisa bibliográfica, documental e sistematização de experiências. Os resultados apontam para a importância do compartilhamento dos pressupostos teórico-filosóficos e das estratégias didático-pedagógicas no desenvolvimento das disciplinas específicas de ética, em coerência com as diretrizes curriculares da Abepss.

Abstract: The article aims to reflect on ethics in professional training, particularly, in the Professional Ethics Curricular Unit in the undergraduate course in Social Work at Unifesp. Bibliographical, documentary research and systematization of experiences were carried out. The results point to the importance of sharing theoretical-philosophical assumptions and didactic-pedagogical strategies in the development of specific ethics disciplines in coherence with Abepss curricular guidelines.

Chirobiotic V Versus Chiralpak ID for the Enantioselective Chromatographic Separation of Chloroquine: Stability and Validation Study.

Chloroquine is a chiral antimalarial drug and demonstrates enantioselective pharmacodynamic and pharmacokinetic properties. However, this drug is administered as racemate. The knowledge of stereoselective aspects of these agents may be useful to better understand their mechanisms of action and to optimize their safety and/or clinical efficacy. In this study, an enantioselective analytical method for the quantification of chloroquine enantiomers was developed using HPLC-UV. The chromatographic conditions were: Chirobiotic V column (100 × 2.1 mm, 5 µm) at 25°C, mobile phase containing methanol:acetic acid:triethylamine (100:0.12:0.12), flow rate 1 mL/min, injection volume 10 µL and detection at 258 nm. The validation parameters evaluated were selectivity, linearity, precision, accuracy, and robustness. In addition, a stability study after forced degradation of chloroquine enantiomers was performed. The enantioseparation of chloroquine using a polysaccharide-based chiral stationary phase (Chiralpak ID) at different mobile phase composition was evaluated and the chromatographic performance of both columns was compared. Thus, a stability-indicating chiral analytical method was developed and fully validated, allowing the separation of chloroquine enantiomers and its degradation products in tablets available in Brazil.

Implementation of a rapid response team in a large nonprofit Brazilian hospital: improving the quality of emergency care through Plan-Do-Study-Act. / Implantação de um time de resposta rápida em um grande hospital filantrópico brasileiro: melhora na qualidade dos cuidados de emergência por meio do ciclo Planejar-Fazer-Estudar-Agir.

OBJECTIVE: To describe the implementation of a rapid response team in a large nonprofit hospital, indicating relevant issues for other initiatives in similar contexts, particularly in Latin America. METHODS: In general terms, the intervention consisted of three major components: (1) a tool to detect aggravation of clinical conditions in general wards; (2) the structuring of a rapid response team to attend to all patients at risk; and (3) the monitoring of indicators regarding the intervention. This work employed four half-year Plan-Do-Study-Act cycles to test and adjust the intervention from January 2013 to December 2014. RESULTS: Between 2013 and 2014, the rapid response team attended to 2,296 patients. This study showed a nonsignificant reduction in mortality from 8.3% in cycle 1 to 5.0% in cycle 4; however, death rates remained stable in cycles 3 and 4, with frequencies of 5.2% and 5.0%, respectively. Regarding patient flow and continuum of critical care, which is a premise of the rapid response system, there was a reduction in waiting time for intensive care unit beds with a decrease from 45.9% to 19.0% in the frequency of inpatients who could not be admitted immediately after indication (p < 0.001), representing improved patient flow in the hospital. In addition, an increase in the recognition of palliative care patients from 2.8% to 10.3% was noted (p = 0.005). CONCLUSION: Implementing a rapid response team in contexts where there are structural restrictions, such as lack of intensive care unit beds, may be very beneficial, but a strategy of adjustment is needed.

OBJETIVO: Descrever a implantação de um time de resposta rápida em um grande hospital filantrópico, indicando as questões relevantes para as iniciativas em contextos similares, particularmente na América Latina. MÉTODOS: Em termos gerais, a intervenção consistiu em três componentes principais: (1) uma ferramenta para detecção de agravamento das condições clínicas nas enfermarias gerais; (2) estruturação de time de resposta rápida capaz de atender a todos os pacientes em risco; e (3) monitoramento dos indicadores relacionados à intervenção. Este trabalho empregou quatro ciclos semestrais (Planejar-Fazer-Estudar-Agir), com a finalidade de testar e ajustar a intervenção, entre janeiro de 2013 e dezembro de 2014. RESULTADOS: Entre 2013 e 2014, o time de resposta rápida atendeu 2.296 pacientes. Houve redução não significante da mortalidade de 8,3% no ciclo 1, para 5,0% no ciclo 4; contudo, o número de óbitos permaneceu estável nos ciclos 3 e 4, com frequência de 5,2% e 5,0%, respectivamente. Com relação ao fluxo de pacientes e cuidados críticos continuados − uma premissa do time de resposta rápida −, houve decréscimo no tempo de espera por um leito na unidade de terapia intensiva, com diminuição de 45,9% para 19,0% na frequência de pacientes hospitalizados que não puderam ser imediatamente admitidos após a indicação (p < 0,001), representando melhora no fluxo de pacientes do hospital; ocorreu também aumento no reconhecimento de pacientes para cuidados paliativos, de 2,8% para 10,3% (p = 0,005). CONCLUSÃO: A implantação de um time de resposta rápida pode trazer benefícios nos contextos em que ocorrem restrições estruturais, como falta de leitos em unidades de terapia intensiva, porém há necessidade de alguns ajustes.

Desigualdade de gênero e escuta psi de mulheres atendidas na atenção básica / Gender inequality and psychological listening of women attended in primary healthcare / Desigualdad de género y escucha de mujeres que procuran atención primaria

Este estudo tem como objetivo investigar o que psicólogos na atenção básica de Porto Alegre identificam como necessidades em saúde mental das mulheres atendidas, buscando verificar se sua escuta profissional permite estabelecer nexos entre o sofrimento psíquico e a desigualdade de gênero vivenciada pelas usuárias. Em 2017, foi realizado grupo focal com nove psicólogas que atuam em unidades de Saúde da Família, em que foi construída coletivamente uma narrativa segundo o método de Grupo Focal Narrativo. Constituem a narrativa final oito núcleos argumentais: "Sofrimento mascarado"; "Os homens também sofrem com isso"; "Várias gerações de mulheres cuidadoras"; "Aquele desejo de constituir uma família a qualquer custo"; "Por que o homem acha que pode usar uma mulher como se fosse um objeto?"; "Maternidade compulsória"; "Novas formas de exercício da sexualidade"; e "O hospital tomou como uma afronta o empoderamento da mulher". Considera-se que o estudo proporcionou às participantes um espaço de reflexão coletiva sobre si mesmas e suas práticas.(AU)

This study aims to investigate the mental health need of female patient as to psychologists working in primary healthcare services in Porto Alegre - Brazil, verifying whether their psychological listening establishes associations between the psychological suffering and gender inequality experienced by the users. Based on a Narrative Focus Group methodology, a focus group with nine psychologists from Family Health services was conducted in 2017. The final narrative consists of eight argumentative nuclei: "masked suffering," "men also suffer from this," "several generations of female caregivers," "that desire to set up a family at any cost," "why do men think they can use a woman as if she were an object?," "compulsory maternity", "new ways of exercising sexuality," and "the hospital took woman's empowerment as an affront." This study provided participants a space for collectively reflecting on themselves and on their practices.(AU)

Este estudio tiene como objetivo conocer lo que los psicólogos en la atención primaria de Porto Alegre (Brasil) identifican como necesidades en salud mental de las mujeres que procuran atención, con el fin de verificar si su escucha profesional posibilita establecer nexos entre el sufrimiento psíquico y la desigualdad de género vivida por las usuarias. En el 2017, se realizó un grupo focal con nueve psicólogas que actúan en Unidades de Salud Familiar y se construyó colectivamente una narrativa conforme al método de grupo focal narrativo. Ocho núcleos argumentales constituyeron la narrativa final: "Sufrimiento enmascarado"; "Los hombres también sufren con eso"; "Varias generaciones de mujeres cuidadoras"; "La intención de constituir una familia sin importar el costo"; "¿Por qué el hombre cree que puede usar a una mujer como un objeto?"; "Maternidad obligatoria"; "Nuevas formas de ejercicio de la sexualidad"; y "El hospital cree ser una afrenta el empoderamiento femenino". Se considera que el grupo focal proporcionó a las participantes un espacio de reflexión colectiva acerca de sí mismas y de sus prácticas.(AU)

Adolescentes autores de atos infracionais: dificuldades de acesso e permanência na escola / Adolescentes autores de infracciones: dificultades de acceso y permanencia en la escuela / Teenagers responsible for infractions: difficulties in accessing and staying in school

RESUMO Este artigo discute parte de uma pesquisa que teve como objetivo compreender a construção da identidade de adolescentes autores de atos infracionais durante suas trajetórias escolares. O enfoque deste artigo trata das dificuldades enfrentadas por esses alunos em acessar e permanecer no sistema educacional e as implicações na constituição das suas identidades. A pesquisa se utilizou de registros dos Livros de Ocorrência Escolares (LOE), de processos judiciais e entrevistas com os adolescentes. A análise foi feita a partir de núcleos de significação apreendidos nos discursos dos adolescentes, em conjunto com a análise documental. Os dados demonstraram que a escola é um lugar, para a maioria desses adolescentes, de reposição de identidade estigmatizada, o que dificulta o acesso e a permanência nesse ambiente. Portanto, o estudo sugere uma urgente discussão no âmbito das políticas públicas de educação que visem o acesso e a permanência desses adolescentes na escola.

RESUMEN Este artículo discute parte de una investigación que tuvo como objetivo comprender la construcción de la identidad de adolescentes autores de infracciones durante su trayectoria escolar. El enfoque de este artículo trata de las dificultades que esos alumnos enfrentan para acceder y permanecer en el sistema educativo y las implicaciones en la constitución de sus identidades. La investigación se basó en el registro de los Libros de Ocurrencia Escolares (LOE), en procesos judiciales y en entrevistas con los adolescentes. El análisis se hizo a partir de núcleos de significación aprehendidos en los discursos de los adolescentes, en conjunto con el análisis documental. Los datos demostraron que la escuela es un lugar, para la mayoría de estos adolescentes, de reposición de identidad estigmatizada, lo que dificulta el acceso y la permanencia en ese ambiente. Por lo tanto, el estudio sugiere una urgente discusión en el ámbito de las políticas públicas de educación que tengan como objetivo el acceso y la permanencia de esos adolescentes en la escuela.

ABSTRACT This article discusses part of a research that had as its aim to understand the construction of the identity of adolescents who committed infractions during their school trajectories. The focus of this article is the difficulties faced by these students to access and remain in the educational system and the implications in the constitution of their identities. The research was based on records of School Occurrences Books (LOE), court proceedings and interviews with adolescents. The analysis was made from nuclei of meaning detected in the discourses of the adolescents, together with the documentary analysis. The data showed that the school is a place, for most of these adolescents, that supports stigmatized identites, which makes it difficult to access and stay in school. Therefore, the study points to an urgent discussion in the scope of the public policies of education that aim at the access and permanence of these adolescents at school.

Implantação de um time de resposta rápida em um grande hospital filantrópico brasileiro: melhora na qualidade dos cuidados de emergência por meio do ciclo Planejar-Fazer-Estudar-Agir / Implementation of a rapid response team in a large nonprofit Brazilian hospital: improving the quality of emergency care through Plan-Do-Study-Act

RESUMO Objetivo: Descrever a implantação de um time de resposta rápida em um grande hospital filantrópico, indicando as questões relevantes para as iniciativas em contextos similares, particularmente na América Latina. Métodos: Em termos gerais, a intervenção consistiu em três componentes principais: (1) uma ferramenta para detecção de agravamento das condições clínicas nas enfermarias gerais; (2) estruturação de time de resposta rápida capaz de atender a todos os pacientes em risco; e (3) monitoramento dos indicadores relacionados à intervenção. Este trabalho empregou quatro ciclos semestrais (Planejar-Fazer-Estudar-Agir), com a finalidade de testar e ajustar a intervenção, entre janeiro de 2013 e dezembro de 2014. Resultados: Entre 2013 e 2014, o time de resposta rápida atendeu 2.296 pacientes. Houve redução não significante da mortalidade de 8,3% no ciclo 1, para 5,0% no ciclo 4; contudo, o número de óbitos permaneceu estável nos ciclos 3 e 4, com frequência de 5,2% e 5,0%, respectivamente. Com relação ao fluxo de pacientes e cuidados críticos continuados − uma premissa do time de resposta rápida −, houve decréscimo no tempo de espera por um leito na unidade de terapia intensiva, com diminuição de 45,9% para 19,0% na frequência de pacientes hospitalizados que não puderam ser imediatamente admitidos após a indicação (p < 0,001), representando melhora no fluxo de pacientes do hospital; ocorreu também aumento no reconhecimento de pacientes para cuidados paliativos, de 2,8% para 10,3% (p = 0,005). Conclusão: A implantação de um time de resposta rápida pode trazer benefícios nos contextos em que ocorrem restrições estruturais, como falta de leitos em unidades de terapia intensiva, porém há necessidade de alguns ajustes.

ABSTRACT Objective: To describe the implementation of a rapid response team in a large nonprofit hospital, indicating relevant issues for other initiatives in similar contexts, particularly in Latin America. Methods: In general terms, the intervention consisted of three major components: (1) a tool to detect aggravation of clinical conditions in general wards; (2) the structuring of a rapid response team to attend to all patients at risk; and (3) the monitoring of indicators regarding the intervention. This work employed four half-year Plan-Do-Study-Act cycles to test and adjust the intervention from January 2013 to December 2014. Results: Between 2013 and 2014, the rapid response team attended to 2,296 patients. This study showed a nonsignificant reduction in mortality from 8.3% in cycle 1 to 5.0% in cycle 4; however, death rates remained stable in cycles 3 and 4, with frequencies of 5.2% and 5.0%, respectively. Regarding patient flow and continuum of critical care, which is a premise of the rapid response system, there was a reduction in waiting time for intensive care unit beds with a decrease from 45.9% to 19.0% in the frequency of inpatients who could not be admitted immediately after indication (p < 0.001), representing improved patient flow in the hospital. In addition, an increase in the recognition of palliative care patients from 2.8% to 10.3% was noted (p = 0.005). Conclusion: Implementing a rapid response team in contexts where there are structural restrictions, such as lack of intensive care unit beds, may be very beneficial, but a strategy of adjustment is needed.

Risk factors in cardiovascular disease in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic and multisystemic autoimmune disorder which predominantly affecting women. The most common cause of death in SLE patients affected by disease for more than 5 years is cardiovascular disease (CVD). Epidemiological observations suggest that, together with classical conventional risk factors, other mechanisms (non-conventional/disease-specific factors) promote accelerated atherosclerosis in inflammatory diseases like SLE. Traditional CVD risk factors included age, hypertension, diabetes mellitus, dyslipidemia, previous vascular event defined as previous history of cerebrovascular accidents or ischemic heart disease, menopause and smoking. The nontraditional factors presents in SLE are disease-specific like renal disease manifestation as Lupus nephritis (LN), presence of pro-inflammatory cytokines, some of inflammatory mediators, antiphospholipid antibodies, anti-oxLDL antibodies, corticosteroid uses and cumulative dose of glucocorticoids. We will review traditional and non-traditional risk factors associated with CVD in SLE patients.

Todo mundo olha, quase ninguém vê: a percepção de trabalhadores operacionais com relação à invisibilidade social de seus trabalhos / Everybody looks, almost no one sees: the perception of operational workers in relation to the social invisibility of their work

Introdução: O trabalho representa uma condição fundamental na existência humana, em que o sujeito cria e transforma o ambiente em que vive e, também, sua subjetividade é transformada por meio deste. Entende-se que a importância dada à significação da atividade laboral pelo sujeito e a percepção de desqualificação ou a invisibilidade decorrente de sua função pode trazer consequências ao aparelho psíquico de quem executa a função desqualificada socialmente. Objetivo: Compreender como trabalhadores operacionais da área de limpeza, de uma empresa de Joinville-SC, percebem a invisibilidade social no âmbito organizacional, bem como a forma que esta interfere em sua subjetividade. Método: Estudo de caráter qualitativo e exploratório, com obtenção de dados por meio de entrevistas semiestruturadas individuais, realizadas com profissionais terceirizados. Resultados: Identificou-se que a maioria dos profissionais se sente desvalorizada com sua profissão; alguns deles foram submetidos a episódios de grande desrespeito e humilhação e não se sentem profissionais. Conclusão: A invisibilidade no trabalho vai além do desrespeito e da desvalorização. Levanta-se a hipótese de que os participantes, possivelmente, já internalizaram a falta de visibilidade, ou se colocam na posição de não serem merecedores desta, uma vez que entendem que seu trabalho é desqualificado.

Introduction: Work represents a fundamental condition in human existence, in which the individual creates and transforms the environment in which he lives and also his subjectivity is transformed through it. It is understood that the importance given to the meaning of the work activity by the individual and the perception of disqualification or invisibility due to its function, can bring consequences to the psychic apparatus of the one performing the socially disqualified function. Objective: To understand how operational workers in the cleaning area of a company in Joinville-SC perceive social invisibility in the organizational context, as well as the way it interferes in their subjectivity. Method: Qualitative and exploratory study, with data collection through individual semi-structured interviews, performed with outsourced professionals. Results: It was identified that most professionals feel devalued by their profession; some of them have been subjected to episodes of great disrespect and humiliation and do not feel professional. Conclusion: Invisibility at work goes beyond disrespect and devaluation. Arises the hypothesis that the participants have possibly internalized the lack of visibility, or put themselves in the position of not deserving it, once they believe that their work is disqualified.

80 anos de formação em Serviço Social: uma trajetória de ruptura com o conservadorismo / 80 years of educacion in Social Work: a break trajectory with conservatism

Resumo: O presente artigo visa realizar análise crítica acerca da formação dos assistentes sociais no Brasil em seus oitenta anos de existência, reconstruindo a trajetória dessa formação desde a primeira Escola de Serviço Social, fundada em 1936. Retoma os currículos que deram base a tal formação desde sua gênese, passando por todos os currículos mínimos aprovados nacionalmente, até as atuais diretrizes curriculares, demonstrando a importante inflexão político-pedagógica realizada na ruptura com o conservadorismo.

Abstract: This article aims to carry out critical analysis of the education of social workers in Brazil in his eighty years of existence, reconstructing the history of this formation since the first School of Social Work founded in 1936. It resumes curricula that based such education since its genesis, through all minimum curricula nationally approved until the current curriculum guidelines, demonstrating the political-pedagogical inflection held in break with conservatism.

[Neonatal and maternal morbidity related to the type of delivery]. / Morbidade neonatal e maternas relacionada ao tipo de parto.

An evaluation of infant morbimortality and mother morbidity was undertaken according to the type of delivery. A prospective study was undertaken on 170 puerperal patients divided into two groups: Group 1 (n = 95), natural or vaginal delivery, Group 2 (n = 75), submitted to caesarean delivery. Complications in mothers were classified in small, moderate and severe. The infant parameters were: period of pregnancy, weight on birth, Apgar score, necessity of intensive care and neurological disorders. Mothers who had not completed elementary school (p=0.0045) had more vaginal delivery. Previous vaginal deliveries were more common in Group 1 than caesarean section in Group 2 (p = < 0.001) (OR = 104.00; 21.11 < OR < 610.99). In Group 1, vaginal delivery was preferred by 78 (82,1%) of mothers comparing to 28 (37.3%) from Group 2, who preferred caesarean section (p = 0.0002) (OR = 4; 1.77 < OR < 9.17). Post-operative was more intense and frequent after caesarean section (8 cases) than patients of Group 1 (2 cases) (p = 0.018) (OR = 0.18; 0.03 < OR < 0.96). Obstetric trauma was found in 14 deliveries of Group 1 and 7 of Group 2 (p = 0.28). Infant hospitalization was greater in Group 2 (3.43 +/- 0.70 days) in comparison with Group 1 (2.71 +/- 0.67 days) (p < 0.0001). The infant morbidity was greater after vaginal deliveries, but maternal morbidity was greater after caesarean deliveries.

[Evaluation of patients submitted to surgical treatment for palmar hyperhidrosis with regard to the quality of life and to the appearance of compensatory hyperhidrosis]. / Avaliação de pacientes submetidos a tratamento cirúrgico de hiperidrose palmar quanto à qualidade de vida e ao surgimento de hiperidrose compensatória.

OBJECTIVES: The purpose of this study was to assess the quality of life and the presence of compensatory hyperhidrosis of patients submitted to sympathectomy as a treatment of hyperhidrosis. METHODS: Fifty consecutive patients submitted to surgical treatment for hand hyperhidrosis at the Santa Casa Hospital of Belo Horizonte were included in this investigation, according to their age, gender and skin color. These patients were studied according to the indication of surgical treatment, previous clinical therapeutics, their complaints related to hyperhydrosis, incidence of compensatory hyperhidrosis and its relation with personality and local of hyperhidrosis. The patients' satisfaction with the treatment was observed as well. Differences were considered as significant when their values were greater than the corresponding to p < 0.05. RESULTS: Personal discomfort with excessive perspiration was the main complaint of 27 (54%) patients; social embarrassment occurred in 23 (46%) of these patients; adversities at school was reported by 22 (44%) patients; discomfort at work occurred in 20 (40%) patients. 33 (66%) of these patients started to feel the effects of the ailment during the childhood; 15 (30%) when they were teenagers (from 12 to 18 years of age) and only 1 (2%) started this problem in the adult life (after 18 years of age). Heat was responsible for bringing on a perspiration crisis in 17 (34%) of the patients and anxiety occurred in 19 (38%). Anger or exasperation provoked crisis in 31 (62%) patients. Compensatory hyperhidrosis occurred in 39 (78%) of patients including 3 (6%) compensatory perspiration on feet, 28 (56%) on dorsum, and 8 (16%) presented either on dorsum and feet. Despite these findings, 46 (92%) patients considered their quality of life improved. CONCLUSION: Surgical treatment for hyperhidrosis improved the quality of life of our patients, and compensatory hyperhidrosis was present in most of them.

Perfil epidemiológico das doenças dermatológicas em Centro de Saúde de Atençao Primária / Epidemiological profile of skin diseases at a Primary Care Health Center

Objetivo: analisar a prevalência das doenças dermatológicas em Centro de Saúde de Atenção Primária. Método: avaliados 46 pacientes atendidos em Centro de Saúde, em consultas de clínica médica, durante os meses de agosto a novembro de 2007. Não houve seleção dessa população por faixa etária, sexo ou cor da pele. Parâmetros avaliados: motivo principal que levou o paciente a procurar atendimento médico, incidência de lesão dermatológica e se esta era o motivo principal da consulta ou se foi identificada durante o exame clínico, necessidade de exames laboratoriais para o diagnóstico das doenças dermatológicas e se houve a resolução do quadro dermatológico nas consultas subsequentes. Os resultados foram comparados pelo teste exato de Fisher e qui-quadrado. Valores de p < 0,05 foram considerados significativos. Resultados: dos 46 pacientes avaliados, 56,52% apresentaram alguma dermatose diagnosticada. Entre esses, 42,3% tiveram a queixa dermatológica como motivo da consulta médica. As demais lesões cutâneas foram identificadas a partir do relatodo paciente durante a anamnese (23,07%) ou do exame físico (34,61%). Conclusão: as afecções dermatológicas apresentaram alta prevalência no grupo estudado. A maioria delas, no entanto, só foi diagnosticada após anamnese detalhada e, principalmente, exame dermatológico minucioso. Esses resultados indicam a necessidade de consultas de qualidade na atenção primária e a importância da capacidade diagnóstica de dermatoses pelo clínico geral.

Objective: To analyze the prevalence of skin diseases at a Primary Care Health Center. Methods: Forty-six patients were studied during medical examinations at the Health Centre from August to November 2007. Patients were not classified by age, sex, or color. Parameters evaluated: Main reason for seeking medical attention, incidence of skin lesions, whether these were the main reason for consultation or if they were identified during clinical examination, laboratory exams eventually requiredto diagnose skin diseases, and if the dermatologic condition was resolved in subsequent consultations. Results were compared by Fisher's exact test and chi-square test. Values of p<0.05 were considered significant. Results: of the 46 patients assessed, 56.52% had some dermatosis diagnosed. Among these, 42.3% had a dermatological complaint as the reason for consultation. In other patients skin lesions were identifiedbased on reported medical history (23.07%) or during physical examinations (34.61%) Conclusion: The incidence of skin diseases was high in the group under study. Most of them, however, were only diagnosed following detailed study of case history, and mainly thorough dermatological examination. These results show the importance of quality examination in Primary Care and the importance of the general practitioner's skill in diagnosing dermatoses.

A intervenção profissional do assistente social no eixo de planejamento e gestão: uma discussão a partir da experiência na coordenação de um serviço de assistência social no âmbito da Proteção Social Básica / The social workers intervention in planning and management axis: a discussion from the experience in the coordination of a social work’s service in the ambit of the Basic Social Protection

O artigo discute, mediante a exposição dos dados de uma pesquisa exploratória, a intervenção profissional dos assistentes sociais no eixo de planejamento e gestão em um dos serviços da Proteção Social Básica da política de assistência social de um município de grande porte do estado de Santa Catarina. O objetivo do estudo foi caracterizar a intervenção profissional do assistente social, no espaço de coordenação dos Centros de Educação Complementar (CEC), que atualmente correspondem aos Serviços de Convivência e Fortalecimento de Vínculos voltados para crianças e adolescentes com idade entre seis e 14 anos de idade. A pesquisa, de natureza qualitativa, teve os dados e informações coletadas através de entrevistas semiestruturadas com assistentes sociais que atuavam na coordenação dos serviços. Metodologicamente, foi respeitado, para a ida a campo, o prazo de aprovação do estudo pelo Comitê de Ética e Pesquisa com Seres Humanos (CEPSH) da Universidade Federal de Santa Catarina (UFSC). Dentre os principais resultados, o estudo apontou a necessidade de fortalecer e qualificar a inserção dos profissionais de Serviço Social no eixo de intervenção de processos de planejamento e gestão das políticas sociais, assim como compreender a intervenção profissional para além da execução das políticas, serviços, programas e projetos sociais.

The article discuss, trough the data exposition of an exploratory research, the professional intervention of social workers in a planning and management axis at one service of the Basic Social Protection of the social’s assistance politic in a large city of Santa Catarina. The study’s objective was to characterize the professional intervention of the social worker, at the coordination’s space of the Complementary Education Centers (CEC), which actually corresponds as Coexistence and Ties Enhance Services directed to the children and adolescents in age between six and fourteen years old. The researches qualitative nature has its data and information collected trough semi-structured interviews with social workers which were acting in coordination of the services. Methodologically were respected, to the field research, the period of approbation of the study by the Human Being’s Ethic and Research Committee (CEPSH) of the Santa Catarina’s Federal University (UFSC). Among the main results the study appointed to the qualifying and enhancing necessity of insert the Social Service’s professionals in the intervention axis of social politics planning and management process and understands the professional intervention beyond the politics execution, services, programs and social projects.

Morbidade neonatal e maternas relacionada ao tipo de parto / Neonatal and maternal morbidity related to the type of delivery

Foi realizada uma análise da morbidade neonatal e materna e a mortalidade neonatal de acordo com o tipo de parto, cesariana ou vaginal. Foram estudadas prospectivamente 170 parturientes sem complicações gestacionais e com nascimento a termo: Grupo 1 (n = 95), puérpera com parto por via vaginal, Grupo 2 (n = 75), puérpera submetida à cesariana. Parâmetros maternos e fetais foram avaliados. Foi observada maior incidência de partos por via vaginal nas pacientes que estudaram até o ensino fundamental incompleto (p = 0,0045). Houve prevalência maior de partos prévios por via vaginal no Grupo 1 e de cesáreas no Grupo 2 (p < 0,001). Observou preferência de 78 (82,1 por cento) das mulheres do Grupo 1 pelo parto vaginal contra apenas 28 (37,3 por cento) das mulheres do Grupo 2, pela cesárea (p = 0,0002). Houve dor intensa no pós-operatório nas pacientes submetidas a parto cesáreo (oito casos) (p = 0,018). Traumas obstétricos foram verificados em catorze recém-nascidos do Grupo 1 e em sete do Grupo 2 (p = 0,28). Concluímos que existe maior morbidade neonatal em recém-natos de parto por via vaginal quando comparada com neonatos de cesárea e maior morbidade materna em puérperas com parto cesariana.

An evaluation of infant morbimortality and mother morbidity was undertaken according to the type of delivery. A prospective study was undertaken on 170 puerperal patients divided into two groups: Group 1 (n = 95), natural or vaginal delivery, Group 2 (n = 75), submitted to caesarean delivery. Complications in mothers were classified in small, moderate and severe. The infant parameters were: period of pregnancy, weight on birth, Apgar score, necessity of intensive care and neurological disorders. Mothers who had not completed elementary school (p=0.0045) had more vaginal delivery. Previous vaginal deliveries were more common in Group 1 than caesarean section in Group 2 (p = < 0.001) (OR = 104.00; 21.11 < OR < 610.99). In Group 1, vaginal delivery was preferred by 78 (82,1 percent) of mothers comparing to 28 (37.3 percent) from Group 2, who preferred caesarean section (p = 0.0002) (OR = 4; 1.77 < OR < 9.17). Post-operative was more intense and frequent after caesarean section (8 cases) than patients of Group 1 (2 cases) (p = 0.018) (OR = 0.18; 0.03 < OR < 0.96). Obstetric trauma was found in 14 deliveries of Group 1 and 7 of Group 2 (p = 0.28). Infant hospitalization was greater in Group 2 (3.43 +/- 0.70 days) in comparison with Group 1 (2.71 +/- 0.67 days) (p < 0.0001). The infant morbidity was greater after vaginal deliveries, but maternal morbidity was greater after caesarean deliveries.