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1.
Artigo em Inglês | MEDLINE | ID: mdl-37947569

RESUMO

The cultivation of critical thinking and decision-making skills promotes student autonomy. Only a few instruments measure nursing students' autonomy, and the PALOP® Scale is one of them. This study aimed to semantically and culturally adapt the PALOP® Scale to European Portuguese and assess the psychometric properties of a short version. A methodological study was conducted with 530 second and fourth-year undergraduate nursing students. Content validity was assessed using exploratory and discriminant factor analysis, and reliability was determined through analyses of internal consistency, temporal stability, and floor and ceiling effects. The analysis of the psychometric properties of a short version of the PALOP®-PT Scale revealed complete agreement (100%) among panel members for content validity. The scale also showed discriminative capacity among second- and fourth-year students (t (528) = -7.907, p < 0.001) with a five-factor structure, with a total explained variance of 57.2%. Reliability analysis showed excellent internal consistency (α = 0.935) and moderate temporal stability (95% ICC (3.1) = 0.520 [0.290-0.693], p < 0.01). The short version of the PALOP®-PT Scale is a promising tool to assess nursing students' perceived autonomy and identify necessary adjustments to their professional identity.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Reprodutibilidade dos Testes , Portugal , Inquéritos e Questionários , Psicometria
2.
IJID Reg ; 8: 164-171, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37694221

RESUMO

Objectives: This study aimed to analyze the relevance of investigation committees in eliminating mother-to-child transmission of syphilis in Brazil. Methods: Questionnaires and interviews were conducted with health managers of 25 Brazilian Federative Units and Brazil's Federal District. Data were analyzed using Bardin's content analysis technique and subsequently compared with the global prescriptions for syphilis response of the Pan American Health Organization, World Health Organization, and recent research publications examining the course of syphilis in Brazil, in Brazilian regions, and globally. Results: While the investigation committees drew on the successful experience of those in reducing maternal mortality, which helped the country achieve the Millennium Development Goals, they are not demonstrated to be sufficient for preventing mother-to-child transmission of syphilis. The committees' systematic and bureaucratic agenda has not been efficient in managing avoidable factors for syphilis, nor do they operate in the scope of the integration of surveillance and care actions, as recommended by the health policy. Conclusion: The committees' model needs to be reviewed in the context of Brazil's National Health System. The research process should be rescaled in order to remain a cornerstone for the induction of health policy that integrates surveillance and healthcare across Brazilian Federative Units. The advancement toward an automated case management model becomes relevant for the country to meet global commitments to eliminate congenital syphilis transmission and achieve the goals outlined in the 2030 Agenda.

3.
Front Immunol ; 14: 1215730, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37457689

RESUMO

Introduction: Dengue virus (DENV), the etiologic agent of dengue fever illness, represents a global public health concern, mainly in tropical and subtropical areas across the globe. It is well known that this acute viral disease can progress to severe hemorrhagic stages in some individuals, however, the immunopathogenic basis of the development of more severe forms by these patients is yet to be fully understood. Objective: In this context, we investigated and characterized the histopathological features as well as the cytokine profile and cell subpopulations present in liver tissues from three fatal cases of DENV in children. Methods: Hematoxylin and Eosin, Periodic Acid Schiff and Picro Sirius Red staining were utilized for the histopathological analysis. Immunohistochemistry assay was performed to characterize the inflammatory response and cell expression patterns. Results: Vascular dysfunctions such as hemorrhage, vascular congestion and edema associated with a mononuclear infiltrate were observedin all three cases. Liver tissues exhibited increased presence of CD68+ and TCD8+ cells as well as high expression of MMP-9, TNF-a, RANTES, VEGFR-2 mediators. Viral replication was confirmed by the detection of NS3 protein. Conclusion: Taken together, these results evidenced key factors that may be involved in the development of severe alterations in liver tissues of children in response to DENV infection.


Assuntos
Vírus da Dengue , Dengue , Humanos , Criança , Mediadores da Inflamação/metabolismo , Antígenos Virais/metabolismo , Fígado/patologia
6.
Cad. Ibero Am. Direito Sanit. (Impr.) ; 11(1): 10-31, jan.-mar.2022.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1361446

RESUMO

Objetivo: discutir se replicar o Projeto "Sífilis Não", naquilo que se refere ao tratamento de vastas quantidades de dados pessoais relativos à saúde sem o consentimento dos titulares, seria possível em solo português. Metodologia: análise da legislação referente à proteção de dados pessoais brasileira, portuguesa e europeia, tendo o Projeto "Sífilis Não" como o caso em estudo. Resultados: o tratamento de dados pessoais sensíveis sem o consentimento do titular é, em regra, proibido pelo Regulamento Geral de Proteção de Dados, entretanto, o tratamento por motivo de interesse público na área da saúde e para fins de pesquisa científica é autorizado, desde que sejam garantidas as liberdades fundamentais dos titulares. Conclusão: tendo em vista que o Projeto "Sífilis Não" é um projeto de pesquisa que envolve o enfrentamento e erradicação da sífilis em todas as suas formas, hipóteses específicas da legislação portuguesa e europeia autorizam o tratamento de dados pessoais sensíveis mesmo sem o consentimento dos titulares, notadamente o tratamento de dados pessoais por motivos de interesse público no domínio da saúde pública e para fins de investigação científica.


Objective: to discuss whether the reproduction of the "No Syphilis" Project regarding the processing of large scale of personal data related to health without the consent of the holders would be possible in Portugal. Methods: analysis of the Brazilian, Portuguese, and European legislation on personal data protection, with the "No Syphilis" Project as a case study. Results: the processing of sensitive personal data without the consent of the owner is, as a rule, prohibited by the General Data Protection Regulation, however the processing for reasons of public interest in the field of health and scientific research purposes is authorized, provided that the fundamental freedoms of the holders are guaranteed. Conclusion: considering that the "No Syphilis" Project is a research project that involves addressing and eradicating syphilis in all its forms, specific hypotheses of Portuguese and European legislation authorize the processing of sensitive personal data even without the consent of the holders, specifically, the processing of personal data for reasons of public interest in the field of public health and scientific research purposes.


Objetivo: discutir si la reproducción del Proyecto "Sífilis No", con respecto al procesamiento de grandes cantidades de datos personales relacionados con la salud sin el consentimiento de los titulares, sería posible en el terreno portugués. Metodología: análisis de la legislación sobre protección de datos personales brasileños, portugueses y europeos, con el Proyecto "Sífilis No" como caso en estudio. Resultados: el tratamiento de datos personales sensibles sin el consentimiento del titular está, por regla general, prohibido por el Reglamento General de Protección de Datos, sin embargo, el tratamiento por razones de interés público en el ámbito de la salud y con fines de investigación científica está autorizado, siempre que se garanticen las libertades fundamentales de los titulares. Conclusión: considerando que el Proyecto "Sífilis No" es un proyecto de investigación que implica hacer frente y erradicar la sífilis en todas sus formas, hipótesis específicas de la legislación portuguesa y europea autorizan el procesamiento de datos personales sensibles incluso sin el consentimiento de los titulares, en concreto, el tratamiento de datos personales por razones de interés público en el ámbito de la salud pública y con fines de investigación científica.

7.
PLoS One ; 17(1): e0262785, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35041718

RESUMO

Dengue viral (DENV) infections can lead to acute pancreatitis and associated tissue damage. This study examined the pancreas from two fatal cases of DENV for histopathological changes as well as for the detection of cytokines, and other inflammatory mediators. Tissue sections were prepared for examination by ultrastructural and histopathological techniques. Sections from the pancreas of non-infected individuals were prepared in parallel as a control. The presence of viral replication in macrophages was detected by co-staining for the proteins NS3 and CD68 by immunofluorescence. Immunohistochemistry was used to detect cells that expressed cytokines and inflammatory mediators to characterize the inflammatory response. Edema, acinar necrosis and fibrosis areas associated with a mononuclear infiltrate were found in infected tissues. The major site of virus replication appeared to be macrophages based on their exclusive presentation of the viral protein NS3. Pancreatic tissues from the infected individuals also displayed increased levels of high mobility group box-1, caspase-3, gelatinase B and tumor necrosis factor alpha compared to controls. The presence of virus replicating macrophages in the pancreas was associated with multiple changes in tissue structure that included elevated levels of cytokines and inflammatory markers that may differentiate acute pancreatitis due to DENV infections from other causes.


Assuntos
Biomarcadores/metabolismo , Citocinas/metabolismo , Vírus da Dengue/isolamento & purificação , Dengue/complicações , Mediadores da Inflamação/metabolismo , Pancreatite/patologia , Adulto , Apoptose , Dengue/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/metabolismo , Pancreatite/virologia , Adulto Jovem
8.
Lancet Reg Health Am ; 7: 100163, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36777651

RESUMO

Background: To fight against the rising incidence of syphilis, the Brazilian Ministry of Health (MoH) launched the "Syphilis No!" Project (SNP), with specific resources funded by a parliamentary amendment. Then, in 2018, a national rapid response started to be implemented on the Brazilian Unified Health System (SUS, Sistema Único de Saúde) in two strategic lines (1) to reinforce SUS's universal actions and (2) to implement specific ones to 100 municipalities chosen by the MoH as priorities for syphilis congenital response. In 2015, such localities represented 6895% of congenital syphilis cases in Brazil. In this context, SNP has implemented actions to strengthen epidemiological surveillance of acquired syphilis and congenital syphilis by instituting an integrated and collaborative response through health services networks and reinforcing interstate relations. Methods: A quasi-experimental study using time series analysis was conducted to assess immediate impacts and changes to the trend in national congenital syphilis before and after the project, from September 2016 to December 2019. Data were assessed considering rates of congenital syphilis per 1,000 live births in all priority municipalities (n=100) covered by the project and in non-priority municipalities (n=5,470) from all five macro-regions of Brazil. Findings: Priority municipalities showed a greater reduction (change in trend) in comparison to non-priority. The linear regression model revealed trend changes after the intervention, with both groups of municipalities showing a drop in the average monthly number of cases per 1,000 live births, with a reduction of -0·21 (CI 95% -0·33 to -0·09; p=0·0011) in priority municipalities and of -0·10 (CI 95% -0.19 to -0.02; p=0·0216) in non-priority municipalities. Interpretation: The study using ITS provides important evidence on the direction, timing, and magnitude of the effects of interventions introduced as part of the SNP on congenital syphilis in Brazil. Our results suggest that the Syphilis No! Project influenced the trends of congenital syphilis in Brazil from 2018, with higher reductions achieved in the priority municipalities. Funding: The research is funded by a grant to the Syphilis No! Project from Brazilian Ministry of Health (Project Number: 54/2017). The funders had no role in study design, analysis, decision to publish, or preparation of the manuscript.

9.
BMC Public Health ; 21(1): 1632, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488689

RESUMO

BACKGROUND: Public health campaigns aim to promote awareness, increase knowledge, and encourage a target population to adopt desirable attitudes and behaviors. Assessing their reach from a multidimensional perspective through information technology can facilitate the development of more effective campaigns in public health response. METHODS: We scrutinized seven data sources from different perspectives to assess a health campaign launched in Brazil named "Syphilis No!". This campaign is part of an Agenda for strategic actions to reduce syphilis in Brazil which includes dissemination of educommunication materials to remind people of the importance of syphilis prevention, emphasizing "test, treat and cure" concept. We developed a multidimensional analysis framework and implemented an information system to process the data from a time series perspective, and assessed the effects over time, both before and after the campaign. We descriptively analyzed data related to the campaign, including e-news, search engine activity, online courses, serological tests, medication distribution and case notification rates. FINDINGS: Regarding search engine activity, we observed the highest volume of search during the first week of campaigns in 2018 (between November 25th and December 7th). Nevertheless, analyzing this data in a trend plot revealed sustained growth until the end of 2019. From March 2018, the amount of e-news posts related to syphilis in Brazil, indexed by Google, followed an increasing slope, with a record peak in October 2019. In addition, data showed that 12 new online courses related to syphilis disease were available on the AVASUS Platform Learning Management System (LMS), to support efforts to promote lifelong learning for health professionals, teachers, and students. These courses reached more than 22,000 students between February 2019 and September 2020. Serological test data showed that the number of tests carried out in 2019 were 375·18% more than in 2015, even accounting for population growth. Finally, starting from the middle of 2018, the syphilis case notification rates followed a decreasing curve. INTERPRETATION: From this perspective, the "Syphilis No!" Project was a positive influence, inducing policy to fight syphilis in Brazil by supporting the implementation of a testing, treatment, and cure agenda (#TesteTrateCure). Certainly, this inference was made by analyzing multidimensional aspects and because, prior to 2018, the country had largely neglected this disease, with no records of communication actions during that period.


Assuntos
Epidemias , Sífilis , Brasil/epidemiologia , Promoção da Saúde , Humanos , Saúde Pública , Sífilis/epidemiologia , Sífilis/prevenção & controle
11.
Toxicon ; 197: 40-47, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-33887299

RESUMO

In order to determine the toxicity of swainsonine present in Ipomoea carnea for goats and sheep, 12 goats and 12 sheep were divided into 3 groups of 4 goats (G1, G2 and G3) and 3 groups of 4 sheep (S4, S5 and S6) each. Groups G1 and S4 were used as controls; G2 and S5 received 1 mg/kg body weight of swainsonine from plant material and G3 and S6 received 3 mg/kg. Groups G2 and G3 presented the first clinical signs, on average, after the 54th and 39th days of ingestion of the plant, respectively. Groups S5 and S6 presented the first clinical signs, on average, on the 64th and 42nd days of the experiment, respectively. In sheep, in addition to having a longer period of ingestion until the onset of clinical signs, these signs were less severe, being evident only after the animals were forced to move. These results demonstrated that goats are more susceptible to swainsonine poisoning than sheep. Complete regression of clinical signs was observed in 5 goats and 6 sheep. However, three goats and one sheep remained with clinical signs until 120 days of the experiment, suggesting that to control the poisoning the animals should be removed from the pastures immediately after the first clinical signs. There were no significant differences in weight between the different groups, suggesting that for goats ingesting the plant, toxic Ipomoea species can be used as forage for intermittent periods of 15-30 days.


Assuntos
Ipomoea , Intoxicação por Plantas , Animais , Peso Corporal , Cabras , Intoxicação por Plantas/etiologia , Intoxicação por Plantas/veterinária , Ovinos , Swainsonina/toxicidade
12.
Anat Rec (Hoboken) ; 304(6): 1242-1254, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33837650

RESUMO

Thyroid surgery is the primary treatment for substernal goiters, and iatrogenic injury to the recurrent laryngeal nerve (RNL) is always a risk. The literature suggests that iatrogenic lesions of the RNL post resection of substernal goiter are not equally distributed, being more frequent on the right recurrent laryngeal nerve (R-RLN) in comparison to the left recurrent laryngeal nerve (L-RLN). The relative paucity of basic anatomical and clinical reportages on R-RLN iatrogenic injuries and on the developmental factors that may help explain its higher incidence justifies this study's undertaking. Here we compare incidence of right versus left iatrogenic injuries to the RLN in surgical resections of substernal goiters and discuss the anatomical and embryological factors involved. This report is part of a larger retrospective observational cohort study of 239 patients surgically treated for substernal goiter in the Gaffrée and Guinle University Hospital, Rio de Janeiro, from 2006 to 2018. From 239 patients, 13 presented with iatrogenic RLN injury, one patient presented bilateral lesion, totalling 15 iatrogenic lesions. Our analysis showed that the R-RLN seems to be anatomically more vulnerable to injury due to the embryological underpinnings addressed in this review, R-RLN = 64.29% (n = 9) and L-RLN = 35.71% (n = 5). Pathological factors like malignancy and size of the mass are relevant issues to be considered. The knowledge of anatomical landmarks and embryological development of the thyroid and associated structures can improve our understanding and teaching of surgical anatomy, thus helping prevent and reduce the number of iatrogenic injuries on right RLNs.


Assuntos
Bócio Subesternal/cirurgia , Complicações Intraoperatórias/epidemiologia , Traumatismos do Nervo Laríngeo Recorrente/epidemiologia , Tireoidectomia/efeitos adversos , Brasil , Humanos , Incidência , Complicações Intraoperatórias/etiologia , Traumatismos do Nervo Laríngeo Recorrente/etiologia , Estudos Retrospectivos
13.
Viruses ; 13(4)2021 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-33806252

RESUMO

Intrauterine transmission of the Chikungunya virus (CHIKV) during early pregnancy has rarely been reported, although vertical transmission has been observed in newborns. Here, we report four cases of spontaneous abortion in women who became infected with CHIKV between the 11th and 17th weeks of pregnancy. Laboratorial confirmation of the infection was conducted by RT-PCR on a urine sample for one case, and the other three were by detection of IgM anti-CHIKV antibodies. Hematoxylin and eosin (H&E) staining and an electron microscopy assay allowed us to find histopathological, such as inflammatory infiltrate in the decidua and chorionic villi, as well as areas of calcification, edema and the deposition of fibrinoid material, and ultrastructural changes, such as mitochondria with fewer cristae and ruptured membranes, endoplasmic reticulum with dilated cisterns, dispersed chromatin in the nuclei and the presence of an apoptotic body in case 1. In addition, by immunohistochemistry (IHC), we found a positivity for the anti-CHIKV antibody in cells of the endometrial glands, decidual cells, syncytiotrophoblasts, cytotrophoblasts, Hofbauer cells and decidual macrophages. Electron microscopy also helped in identifying virus-like particles in the aborted material with a diameter of 40-50 nm, which was consistent with the size of CHIKV particles in the literature. Our findings in this study suggest early maternal fetal transmission, adding more evidence on the role of CHIKV in fetal death.


Assuntos
Feto Abortado/patologia , Aborto Espontâneo/patologia , Aborto Espontâneo/virologia , Febre de Chikungunya/complicações , Transmissão Vertical de Doenças Infecciosas , Feto Abortado/virologia , Adulto , Anticorpos Antivirais/sangue , Febre de Chikungunya/virologia , Vírus Chikungunya/patogenicidade , Feminino , Técnicas Histológicas , Humanos , Imunoglobulina M/sangue , Gravidez
15.
Fish Shellfish Immunol ; 112: 56-63, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33640538

RESUMO

The effects of dietary ß-glucan on innate immune responses have been shown in a number of different vertebrate species. However, there is conflicting information about the period of administration (shorter vs. longer), and it is also unclear to what extent ß-glucan's effects can be observed post-treatment in fish. Thus, we fed Nile tilapia for 0 (control group; 45 days of control diet), 15 (30 days of control followed by 15 days of ß-glucan), 30 (15 days of control followed by 30 days of ß-glucan) or 45 days with a diet containing 0.1% of ß-glucan (MacroGard®). We evaluated the growth performance at the end of the ß-glucan feeding trial and the innate immune function immediately after the feeding trial and 7 and 14 days post-feeding trial. In addition, at day 10 post-feeding trial, we assessed the tilapia's resistance against a bacterial infection. No significant differences were observed in growth performance between the groups; however, fish fed with ß-glucan for 30 and 45 days had higher (approx. 8%) relative weight gain compared to the control. Regardless of the administration period, fish fed with ß-glucan had higher innate immune responses immediately after the feeding trial such as lysozyme activity in plasma, liver and intestine and respiratory burst compared to the control, and in general these differences were gradually reduced over the withdrawal period (up to 14 days). No differences were observed in the plasma hemolytic activity of the complement or myeloperoxidase activity in plasma or intestine. Moreover, fish from the control group had early mortalities (2 vs. 4-5 days post-infection, respectively) and a lower survival rate (60 vs. 80%, respectively) compared to fish fed with ß-glucan for 15 or 30 days, and, interestingly, fish fed for 45 days with ß-glucan had no mortality. This study indicates that regardless of the administration period (i.e., 15 up to 45 days), the ß-glucan improved the innate immune responses and the tilapia's resistance to disease, and this protection could be observed up to 10 days post-feeding trial, adding in vivo evidence that ß-glucan may contribute to a trained innate immunity. Additionally, we showed that a longer period of administration did not cause immunosuppression as previously hypothesized but promoted further growth and immune performance. These findings are relevant to the aquaculture industry and demonstrate that a longer ß-glucan feeding protocol may be considered to achieve better results.


Assuntos
Ciclídeos/imunologia , Resistência à Doença/efeitos dos fármacos , Doenças dos Peixes/imunologia , Imunidade Inata/efeitos dos fármacos , beta-Glucanas/metabolismo , Aeromonas/fisiologia , Ração Animal/análise , Animais , Dieta/veterinária , Suplementos Nutricionais/análise , Resistência à Doença/imunologia , Doenças dos Peixes/microbiologia , Infecções por Bactérias Gram-Negativas/imunologia , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/veterinária , Distribuição Aleatória , Infecções Estreptocócicas/imunologia , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/veterinária , Streptococcus agalactiae/fisiologia , beta-Glucanas/administração & dosagem
16.
Front Public Health ; 9: 715403, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35087780

RESUMO

Evaluating the success of a public health campaign is critical. It helps policy makers to improve prevention strategies and close existing gaps. For instance, Brazil's "Syphilis No!" campaign reached many people, but how do we analyze its real impact on population awareness? Are epidemiologic variables sufficient? This study examined literature on using of information technology approaches to analyze the impact of public health campaigns. We began the systematic review with 276 papers and narrowed it down to 17, which analyzed campaigns. In addition to epidemiological variables, other types of variables of interest included: level of (i) access to the campaign website, (ii) subject knowledge and awareness, based on questionnaires, (iii) target population's interest, measured from both online search engine and engagement with Social Network Service, and (iv) campaign exposure through advertising, using data from television commercials. Furthermore, we evaluated the impact by considering several dimensions such as: communication, epidemiology, and policy enforcement. Our findings provide researchers with an overview of various dimensions, and variables-of-interest, for measuring public campaign impact, and examples of how and which campaigns have used them.


Assuntos
Meios de Comunicação , Promoção da Saúde/métodos , Humanos , Tecnologia da Informação
17.
Interface (Botucatu, Online) ; 25: e200076, 2021.
Artigo em Português | LILACS | ID: biblio-1154562

RESUMO

Compreender a consolidação das Diretrizes Curriculares Nacionais (DCN) demanda contextualizar a realidade de cada instituição. Sua implantação pressupõe (re) orientação do processo de formação na Saúde, com integração entre Projeto Pedagógico do Curso (PPC), Sistema Único de Saúde (SUS) e envolvimento docente. Para captar a percepção docente sobre o alinhamento entre PPC e DCN, realizou-se estudo exploratório com metodologia qualitativa e os docentes respondendo a um questionário. Utilizou-se análise de conteúdo para construção de categorias temáticas. Os docentes de uma escola reconhecem que o PPC não está alinhado às DCN. Revelam trabalho docente determinado por perfil profissional e pessoal. Em outra escola, cuja reforma curricular já adota metodologia de ensino-aprendizagem ativa, os docentes se sentem apropriados às DCN. Concluímos, portanto, que as mudanças no PPC são processos que demandam tempo, dedicação e comunicação, ou seja, maior mudança na instituição de ensino. (AU)


To understand the National Curriculum Guidelines (NCG) it is necessary to contextualize the reality of each educational institution. The effective implementation of the guidelines requires the (re)orientation of the health education process; promoting integration between the course educational project (CEP); Brazilian National Health System (SUS) and professor engagement. We conducted a qualitative exploratory study using questionnaires to capture professors' perceptions of the alignment between medicine CEPs and the NCG. Content analysis was performed to develop thematic categories. The professors at one school acknowledged that the CEP and NCG were not aligned and their responses revealed that teaching is determined by each professor's professional and personal background. In another school whose curriculum reform adopted active teaching-learning methodologies, the professors felt a sense of ownership in relation to the NCG. We therefore conclude that the CEP change process requires time, dedication and effective communication or, in other words, greater change within the education institution. (AU)


Comprender la consolidación de las Directrices Curriculares Nacionales demanda poner en contexto la realidad de cada institución. Su implantación presupone una (re)orientación del proceso de formación en la salud, con integración entre Proyecto Pedagógico del Curso, Sistema Brasileño de Salud (SUS) y envolvimiento docente. Para captar la percepción docente sobre el alineamiento entre PPC y DCN, se realizó un estudio exploratorio, con metodología cualitativa, en el que los docentes respondieron a un cuestionario. Se utilizó un análisis de contenido para la construcción de categorías temáticas. Los docentes de una escuela reconocen que el PPC no está alineado a las DCN. Revelan un trabajo docente determinado por perfil profesional y personal. En otra escuela, cuya reforma curricular ya adopta la metodología de enseñanza-aprendizaje activa, los docentes se sienten apropiados de las DCN. Concluimos, por lo tanto, que los cambios en los PPC son procesos que demandan tiempo, dedicación y comunicación, es decir, un mayor cambio en la institución de enseñanza. (AU)


Assuntos
Humanos , Faculdades de Medicina/legislação & jurisprudência , Educação de Graduação em Medicina/tendências , Docentes de Medicina/psicologia , Ensino/tendências , Aprendizagem
18.
Sci Rep ; 10(1): 22190, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33335128

RESUMO

Multiple sclerosis is an autoimmune disease that affects the myelinated central nervous system (CNS) neurons and triggers physical and cognitive disabilities. Conventional therapy is based on disease-modifying drugs that control disease severity but can also be deleterious. Complementary medicines have been adopted and evidence indicates that yeast supplements can improve symptoms mainly by modulating the immune response. In this investigation, we evaluated the therapeutic potential of Saccharomyces cerevisiae and its selenized derivative (Selemax) in experimental autoimmune encephalomyelitis (EAE). Female C57BL/6 mice submitted to EAE induction were orally supplemented with these yeasts by gavage from day 0 to day 14 after EAE induction. Both supplements determined significant reduction in clinical signs concomitantly with diminished Th1 immune response in CNS, increased proportion of Foxp3+ lymphocytes in inguinal and mesenteric lymph nodes and increased microbiota diversity. However, Selemax was more effective clinically and immunologically; it reduced disease prevalence more sharply, increased the proportion of CD103+ dendritic cells expressing high levels of PD-L1 in mesenteric lymph nodes and reduced the intestinal inflammatory process more strongly than S. cerevisiae. These results suggest a clear gut-brain axis modulation by selenized S. cerevisiae and suggest their inclusion in clinical trials.


Assuntos
Suplementos Nutricionais , Encefalomielite Autoimune Experimental/etiologia , Encefalomielite Autoimune Experimental/metabolismo , Imunomodulação , Mucosa Intestinal/imunologia , Mucosa Intestinal/metabolismo , Saccharomyces cerevisiae/imunologia , Animais , Sistema Nervoso Central/imunologia , Sistema Nervoso Central/metabolismo , Sistema Nervoso Central/patologia , Suscetibilidade a Doenças , Encefalomielite Autoimune Experimental/patologia , Tolerância Imunológica , Contagem de Linfócitos , Camundongos , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/metabolismo
20.
Front Immunol ; 11: 571844, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193354

RESUMO

Multiple sclerosis (MS) is an inflammatory and demyelinating disease of the central nervous system (CNS). The persistent inflammation is being mainly attributed to local oxidative stress and inflammasome activation implicated in the ensuing demyelination and axonal damage. Since new control measures remain necessary, we evaluated the preventive and therapeutic potential of a beta-selenium-lactic acid derivative (LAD-ßSe), which is a source of organic selenium under development, to control experimental autoimmune encephalomyelitis (EAE) that is an animal model for MS. Two EAE murine models: C57BL/6 and SJL/J immunized with myelin oligodendrocyte glycoprotein and proteolipid protein, respectively, and a model of neurodegeneration induced by LPS in male C57BL/6 mice were used. The preventive potential of LAD-ßSe was initially tested in C57BL/6 mice, the chronic MS model, by three different protocols that were started 14 days before or 1 or 7 days after EAE induction and were extended until the acute disease phase. These three procedures were denominated preventive therapy -14 days, 1 day, and 7 days, respectively. LAD-ßSe administration significantly controlled clinical EAE development without triggering overt hepatic and renal dysfunction. In addition of a tolerogenic profile in dendritic cells from the mesenteric lymph nodes, LAD-ßSe also downregulated cell amount, activation status of macrophages and microglia, NLRP3 (NOD-like receptors) inflammasome activation and other pro-inflammatory parameters in the CNS. The high Se levels found in the CNS suggested that the product crossed the blood-brain barrier having a possible local effect. The hypothesis that LAD-ßSe was acting locally was then confirmed by using the LPS-induced neurodegeneration model that also displayed Se accumulation and downmodulation of pro-inflammatory parameters in the CNS. Remarkably, therapy with LAD-ßSe soon after the first remitting episode in SJL/J mice, also significantly downmodulated local inflammation and clinical disease severity. This study indicates that LAD-ßSe, and possibly other derivatives containing Se, are able to reach the CNS and have the potential to be used as preventive and therapeutic measures in distinct clinical forms of MS.


Assuntos
Anti-Inflamatórios/uso terapêutico , Sistema Nervoso Central/efeitos dos fármacos , Encefalomielite Autoimune Experimental/tratamento farmacológico , Inflamassomos/metabolismo , Microglia/patologia , Esclerose Múltipla/tratamento farmacológico , Inflamação Neurogênica/tratamento farmacológico , Selênio/uso terapêutico , Animais , Sistema Nervoso Central/patologia , Modelos Animais de Doenças , Encefalomielite Autoimune Experimental/imunologia , Humanos , Ácido Láctico/química , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Esclerose Múltipla/imunologia , Glicoproteína Mielina-Oligodendrócito/imunologia , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Inflamação Neurogênica/imunologia , Selênio/química
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