Physical exercise and human adipose-derived mesenchymal stem cells ameliorate motor disturbances in a male rat model of Parkinson's disease.

Parkinson's disease (PD) is a disabling and highly costly neurodegenerative condition with worldwide prevalence. Despite advances in treatments that slow progression and minimize locomotor impairments, its clinical management is still a challenge. Previous preclinical studies, using mesenchymal stem cell (MSC) transplantation and isolated physical exercise (EX), reported beneficial results for treatment of PD. Therefore, this experimental randomized study aimed to elucidate the therapeutic potential of combined therapy using adipose-derived human MSCs (ADSCs) grafted into the striatum in conjunction with aerobic treadmill training, specifically in terms of locomotor performance in a unilateral PD rat model induced by 6-hydroxydopamine (6-OHDA). Forty-one male Wistar rats were categorized into five groups in accordance with the type of treatment to which they were subjected (Sham, 6-OHDA - injury, 6-OHDA + exercise, 6-OHDA + cells, and 6-OHDA + combined). Subsequently, dopaminergic depletion was assessed by the methylphenidate challenge and the specified therapeutic intervention was conducted in each group. The foot fault task was performed at the end of the experiment to serve as an assessment of motor skills. The results showed that despite disturbances in motor balance and coordination, locomotor dysfunction was ameliorated in all treatment categories in comparison to the injury group (sign test, p < 0.001, effect size: 0.71). The exercise alone and combined groups were the categories that exhibited the best recovery in terms of movement performance (p < 0.001). Overall, this study confirms that exercise is a powerful option to improve motor function and a promising adjuvant intervention for stem cell transplantation in the treatment of PD motor symptoms. OPEN PRACTICES: This article has been awarded Open Data. All materials and data are publicly accessible at https://figshare.com/s/18a543c101a17a1d5560. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki.

Extracellular Nucleotide Hydrolysis in Dermal and Limbal Mesenchymal Stem Cells: A Source of Adenosine Production.

Human Limbal (L-MSCs) and Dermal Mesenchymal Stem Cell (D-MSCs) possess many properties that increase their therapeutic potential in ophthalmology and dermatology. It is known that purinergic signaling plays a role in many aspects of mesenchymal stem cells physiology. They release and respond to purinergic ligands, altering proliferation, migration, differentiation, and apoptosis. Therefore, more information on these processes would be crucial for establishing future clinical applications using their differentiation potential, but without undesirable side effects. This study evaluated and compared the expression of ecto-nucleotidases, the enzymatic activity of degradation of extracellular nucleotides and the metabolism of extracellular ATP in D-MSCs and L-MSCs, isolated from discard tissues of human skin and sclerocorneal rims. The D-MSCs and L-MSCs showed a differentiation potential into osteogenic, adipogenic, and chondrogenic lineages and the expression of markers CD105+ , CD44+ , CD14- , CD34- , CD45- , as expected. Both cells hydrolyzed low levels of extracellular ATP and high levels of AMP, leading to adenosine accumulation that can regulate inflammation and tissue repair. These cells expressed mRNA for ENTPD1, 2, 3, 5 and 6, and CD73 that corresponded to the observed enzymatic activities. Thus, considering the degradation of ATP and adenosine production, limbal MSCs are very similar to dermal MSCs, indicating that from the aspect of extracellular nucleotide metabolism L-MSCs are very similar to the characterized D-MSCs. J. Cell. Biochem. 118: 2430-2442, 2017. © 2017 Wiley Periodicals, Inc.

Analysis of Anatomical Characteristics and Morphometric Aspects of Infraorbital and Accessory Infraorbital Foramina.

OBJECTIVE: This study aimed to perform a morphological and morphometric study of the characteristics of the infraorbital foramen (IOF) and accessory infraorbital foramen (AIOF) in Brazilian skulls. METHODS: A sample calculation determined a total of 94 human skulls to be evaluated by a trained examiner for number, shape, diameters, and location of IOF in relation to anatomical landmarks. Number, size, shape, diameters, location, orientation, position, and distances in relation to anatomical landmarks were evaluated for the AIOF. Descriptive analysis, paired t test, Wilcoxon test, Pearson and Spearman correlations were used. RESULTS: A total of 188 IOFs and 48 AIOFs were found. Circular outline was the predominant shape for both IOFs and AIOFs. Infraorbital foramens presented in left sides had a significantly greater transverse diameter and distance from medial margin of the orbit when compared with IOFs located on the right sides (P <0.001). Accessory infraorbital foramens were most frequently found on the left sides of the skulls and had a superomedial position in relation to the IOFs. Accessory infraorbital foramens located on right sides had a significantly greater distance to anterior nasal spine when compared with AIOFs located on the left sides (P <0.001). CONCLUSIONS: The results of this solid methodology-based study can help guide surgeons in accurately locating the IOF and AIOF, and consequently, their neurovascular bundles to perform safe procedures during maxillofacial interventions.

Impact of vertical positioning on lung aeration among mechanically ventilated intensive care unit patients: a randomized crossover clinical trial.

OBJECTIVE: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation. METHODS: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]). RESULTS: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99). CONCLUSION: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients.ClinicalTrials.gov registry: NCT04176445.

Evidence of Spread of Bemisia tabaci (Hemiptera: Aleyrodidae) Mediated by Internal Transportation of Ornamental Plants in Brazil.

Two Bemisia tabaci (Gennadius) species, Middle East-Asia Minor 1 (MEAM1) and Mediterranean (MED), are major pests that are dispersed throughout the world. While MEAM1 was introduced in Brazil in the 1990s, MED was reported recently with limited spread. Here, a survey was performed to examine whether MED whiteflies are widely present in the Federal District region, in central Brazil. Whiteflies were collected in various locations in the Federal District and surroundings between 2018 and 2020, including garden centers and small- and large-scale farms. The species were identified using RFLPand sequencing of the mitochondrial cytochrome c oxidase I subunit gene region. Out of 108 whitefly batches, 63.89% were composed exclusively by MEAM1, followed by 16.67% presenting only MED, and another 7.40% containing unidentified whitefly species (NI). Plant varieties serving as hosts for more than one whitefly species were observed in 12.04% of the samples, either by MEAM1/MED, MEAM1/NI, or MED/NI. This study highlights the still limited presence of MED in the Federal District and surroundings, predominantly in garden centers and in the green belt of Brasília, closer to urban areas. In contrast, only MEAM1 was identified in large-scale cultivated areas.

Bioglass 45S5: Structural characterization of short range order and analysis of biocompatibility with adipose-derived mesenchymal stromal cells in vitro and in vivo.

Bioactive glasses have potential applications in the field of regenerative medicine due to their bioactivity that permits interaction with both hard and soft tissues. In the same way, mesenchymal stromal cells (MSCs) have been experimentally tested as part of engineered constructs considering their self-renewal and multipotent capacities. However, to design an association, it is crucial to investigate the physical properties of bioglass 45S5, as well as its biocompatibility. Therefore, we investigated the structural short range order of the stoichiometric 45S5, by obtaining its total structure factors (S(K)) and total pair distribution function G(r). The in vitro compatibility of human MSCs with 45S5 was verified by viability, morphometry and osteoinduction assays, F-actin staining and scanning electron (SEM) analysis. The compatibility outcome was verified through a subcutaneous implantation in a murine model by grafting the 45S5 as a scaffold for allogeneic MSCs. The cell-substrate modulation includes the maintenance of the MSC viability and osteoinduction potential after being exposed to the 45S5 extract. A low spreading during cell adhesion was detected. Both normal actin cytoskeleton organization and nuclei irregularities were observed, besides an increase of hydroxyapatite (HA) depositions around cells. Cells showed satisfactory compatibility patterns when growing over 45S5 for 7, 30 and 90 days. The implant did not show any apparent toxicity for organs, or strong immunogenic reactions, and it was accompanied by a dense capsule formation around the graft. Our results indicate that MSCs can grow in the long term on the 45S5 while maintaining their characteristics. This fact, together with a non-toxicity to animals means that the 45S5 can be implemented in pre-clinical trials aiming MSC's transplantation leading to further bone and tissue repair.

Mechanically-enhanced polysaccharide-based scaffolds for tissue engineering of soft tissues.

Collagen-based materials are probably among the most used class of biomaterials in tissue engineering and regenerative medicine. Although collagen is often privileged for providing a suitable substrate on which cells can be cultured or a matrix in which cells can be dispersed, its mechanical properties represent a major limitation for clinical translation and even for handling of the obtained regenerated tissue. In this work, the combination of polysaccharides chitosan (Ch) and xanthan gum (X) was investigated as an alternative for scaffolds for soft tissue engineering. Moreover, in an attempt to reach a compromise between obtaining highly porous biomaterials while maintaining appropriate mechanical properties, a surfactant (Kolliphor® P188, K) was added to Ch-X matrices to generate pores, while silicone rubber (Silpuran® 2130A/B, S) was used to balance their mechanical properties. Addition of K (10 or 25% w/w) increased the porosity and pore-dimensions, while addition of S improved by up to 156% and 85% the elastic moduli and the elastic behavior of Ch-X-based scaffolds, under both compressive and tensile loads, respectively, at 50% strain. Relaxation tests confirmed that these materials do have a viscoelastic behavior. The presence of S increased thickness and microscale surface roughness and did not affect liquid uptake and stability, thrombogenicity, biodegradation and cytotoxicity of polysaccharide-based scaffolds. In conclusion, this work shows that Ch-X-S porous blends constitute suitable scaffolds for soft tissue engineering.

Comparison of Human Denuded Amniotic Membrane and Porcine Small Intestine Submucosa as Scaffolds for Limbal Mesenchymal Stem Cells.

Blinding corneal scarring is usually treated with allogeneic graft tissue. Nevertheless, the global shortage of donors leaves millions of patients in need of therapy. Traditional tissue engineering strategies involves the combination of cells, growth factors, and scaffolds that can supply cellular biological components allowing to restore the tissue function. The mesenchymal stem cells found in the limbal stroma (L-MSCs) have a self-renewal potential for multilineage differentiation. Thus, in this work we compared the potential of human amniotic membrane (hAM) and porcine small intestine submucosa (SIS) as scaffolds for L-MSCs, aiming at potential applications in corneal regeneration. For that, L-MSCs were seeded on hAM and SIS and we analyzed their viability, actin cytoskeleton, nuclei morphology, cell density, adhesion and surface markers. Our results showed that cells adhered and integrated into both membranes with a high cell density, an important characteristic for cell therapy. However, due to its transparency, the hAM allowed a better observation of L-MSCs. In addition, the analysis of surface markers expression on L-MSCs after two weeks showed a slight increase in the percentages of negative markers for MSCs grown on SIS membrane. Thus, considering a long-term culture, the hAM was considered better in maintaining the MSCs phenotype. Regarding the function as scaffolds, SIS was as efficient as the amniotic membrane, considering that these two types of biological matrices maintained the cell viability, actin cytoskeleton, nuclei morphology and mesenchymal phenotype, without causing cell death. Therefore, our data in vitro provides evidence for future pre-clinical studies were these membranes can be used as a support to transport mesenchymal stem cells to the injured area, creating a kind of temporary curative, allowing the release of bioactive molecules, such as cytokines and growth factors and then promoting the tissue regeneration, both in human and veterinary medicine.

Impact of vertical positioning on lung aeration among mechanically ventilated intensive care unit patients: a randomized crossover clinical trial / Impacto do posicionamento vertical na aeração pulmonar em pacientes de unidades de terapia intensiva ventilados mecanicamente: um estudo clínico transversal randomizado

ABSTRACT Objective: To assess the impact of different vertical positions on lung aeration in patients receiving invasive mechanical ventilation. Methods: An open-label randomized crossover clinical trial was conducted between January and July 2020. Adults receiving invasive mechanical ventilation for > 24 hours and < 7 days with hemodynamic, respiratory and neurological stability were randomly assigned at a 1:1 ratio to the sitting position followed by passive orthostasis condition or the passive orthostasis followed by the sitting position condition. The primary outcome was lung aeration assessed using the lung ultrasound score (score ranges from 0 [better] to 36 [worse]). Results: A total of 186 subjects were screened; of these subjects, 19 were enrolled (57.8% male; mean age, 73.2 years). All participants were assigned to receive at least one verticalization protocol. Passive orthostasis resulted in mean lung ultrasound scores that did not differ significantly from the sitting position (11.0 versus 13.7; mean difference, -2.7; [95%CI -6.1 to 0.71; p = 0.11). Adverse events occurred in three subjects in the passive orthostasis group and in one in the sitting position group (p = 0.99). Conclusion: This analysis did not find significant differences in lung aeration between the sitting and passive orthostasis groups. A randomized crossover clinical trial assessing the impact of vertical positioning on lung aeration in patients receiving invasive mechanical ventilation is feasible. Unfortunately, the study was interrupted due to the need to treat COVID-19 patients. ClinicalTrials.gov registry: NCT04176445

RESUMO Objetivo: Avaliar o impacto de diferentes posicionamentos verticais na aeração pulmonar em pacientes em ventilação mecânica invasiva. Métodos: Trata-se de ensaio clínico aberto, randomizado e transversal, realizado entre janeiro e julho de 2020. Adultos em ventilação mecânica invasiva por mais de 24 horas e menos de 7 dias com estabilidade hemodinâmica, respiratória e neurológica foram distribuídos aleatoriamente em uma proporção de 1:1 à postura sentada seguida da condição de ortostatismo passivo ou o ortostatismo passivo seguido de postura sentada. O desfecho primário foi a aeração pulmonar avaliada pelo lung ultrasound score. O escore varia de zero (melhor) a 36 (pior). Resultados: Foram selecionados 186 indivíduos; destes, 19 foram incluídos (57,8% do sexo masculino; média idade de 73,2 anos). Todos os participantes foram selecionados para receber pelo menos um protocolo de verticalização. O ortostatismo passivo resultou em escores médios de aeração pulmonar por ultrassonografia que não diferiram significativamente da postura sentada (11,0 versus 13,7; diferença média, -2,7; IC95% -6,1 a 0,71; p = 0,11). Ocorreram eventos adversos em três indivíduos no grupo ortostatismo passivo e em um no grupo postura sentada (p = 0,99). Conclusão: Esta análise não encontrou diferenças significativas na aeração pulmonar entre os grupos ortostatismo passivo e postura sentada. É factível conduzir um estudo clínico transversal randomizado para avaliar o impacto do posicionamento vertical na aeração pulmonar em pacientes em ventilação mecânica invasiva. Infelizmente, o estudo foi interrompido devido à necessidade de tratar pacientes com COVID-19. Registro ClinicalTrials.gov: NCT04176445

New therapy of skin repair combining adipose-derived mesenchymal stem cells with sodium carboxymethylcellulose scaffold in a pre-clinical rat model.

Lesions with great loss of skin and extensive burns are usually treated with heterologous skin grafts, which may lead rejection. Cell therapy with mesenchymal stem cells is arising as a new proposal to accelerate the healing process. We tested a new therapy consisting of sodium carboxymethylcellulose (CMC) as a biomaterial, in combination with adipose-derived stem cells (ADSCs), to treat skin lesions in an in vivo rat model. This biomaterial did not affect membrane viability and induced a small and transient genotoxicity, only at the highest concentration tested (40 mg/mL). In a rat wound model, CMC at 10 mg/mL associated with ADSCs increased the rate of cell proliferation of the granulation tissue and epithelium thickness when compared to untreated lesions (Sham), but did not increase collagen fibers nor alter the overall speed of wound closure. Taken together, the results show that the CMC is capable to allow the growth of ADSCs and is safe for this biological application up to the concentration of 20 mg/mL. These findings suggest that CMC is a promising biomaterial to be used in cell therapy.

Out-of-bed extubation: a feasibility study.

OBJECTIVE: In clinical intensive care practice, weaning from mechanical ventilation is accompanied by concurrent early patient mobilization. The aim of this study was to compare the success of extubation performed with patients seated in an armchair compared to extubation with patients in a supine position. METHODS: A retrospective study, observational and non-randomized was conducted in a mixed-gender, 23-bed intensive care unit. The primary study outcome was success of extubation, which was defined as the patient tolerating the removal of the endotracheal tube for at least 48 hours. The differences between the study groups were assessed using Student's t-test and chi-squared analysis. RESULTS: Ninety-one patients were included from December 2010 and June 2011. The study population had a mean age of 71 years ± 12 months, a mean APACHE II score of 21±7.6, and a mean length of mechanical ventilation of 2.6±2 days. Extubation was performed in 33 patients who were seated in an armchair (36%) and in 58 patients in a supine position (64%). There were no significant differences in age, mean APACHE II score or length of mechanical ventilation between the two groups, and a similar extubation success rate was observed (82%, seated group versus 85%, supine group, p>0.05). Furthermore, no significant differences were found between the two groups in terms of post-extubation distress, need for tracheostomy, duration of mechanical ventilation weaning, or intensive care unit stay. CONCLUSION: Our results suggest that the clinical outcomes of patients extubated in a seated position are similar to those of patients extubated in a supine position. This new practice of seated extubation was not associated with adverse events and allowed extubation to occur simultaneously with early mobilization.

Impacto precoce na redução de anormalidades cervicais em campos dos goytacazes, rj, brasil, depois da introdução de vacina quadrivalente de hpv em meninas de 11 a 15 anos: é hora de pensar em vacinas hpv para rapazes? / Early impact in reducing cervical abnormalities in campos dos goytacazes, rj, brazil, after introduction of the quadrivalent hpv vaccine for girls 11­15: is it time to think about hpv vaccine in boys?

O papilomavírus humano (HPV) é uma grande preocupação na saúde pública e privada. A prevenção dessa condição é a combinação do uso do exame de Papanicolaou, de preservativos e de vacinas contra o HPV. Campos dos Goytacazes é o primeiro município brasileiro a implementar em setembro de 2010 a vacina quadrivalente contra o HPV (Gardasil®) para meninas de 11 a 15 anos de idade em uma estratégia híbrida de vacinação (escolas e centros de saúde). Em 2014, a vacinação começou para os meninos na mesma época em que o Ministério da Saúde introduziu a vacina para as meninas. Objetivo: O objetivo do estudo foi analisar as tendências na redução de anormalidades cervicais de baixo grau cinco anos depois da introdução da vacina quadrivalente de HPV na cidade (resultado primário). Além disso, esta investigação avaliou o risco relativo de cada grupo analisado, de maneira a explicar o efeito protetor da vacina (resultado secundário). Métodos: A análise ecológica avaliou o impacto da vacinação contra o HPV como um fator protetor contra o baixo risco de anormalidades pelo HPV. Os resultados do teste de Papanicolaou, obtidos por meio do Sistema de Informação do Câncer do Colo do Útero (Siscolo) do Ministério da Saúde, foram categorizados em anormalidades de baixo grau (LGA) e anormalidades de alto grau (HGA). Este estudo preliminar foi centrado nas taxas de LGA, as quais foram estimadas para o período de um mês e estratificadas por quatro grupos etários (<20; 20-24; 25- 30; >30 anos) de 2007 a 2014. A comparação quantitativa das tendências temporais de LGA antes e depois da vacinação foi feita com análise de regressão de Quase-Poisson. O efeito protetor da vacina ao longo do tempo foi avaliado por cálculo do risco relativo em cada grupo de idade. Resultados: O estudo mostrou diminuição significativa de mais de 60% em LGA em mulheres de <20 anos de idade e de pelo menos cerca de 50% para os outros grupos. A vacina contra o HPV foi um fator de proteção, por causa do resultado do risco relativo de <0,0001 em todas as idades. Conclusões: Embora os estudos mostrem que as lesões pré-neoplásicas do HPV possam ser reversíveis espontaneamente, é inegável que a vacina contribuiu grandemente para as taxas elevadas de redução, associadas com a alta cobertura vacinal. Esses resultados são os primeiros no Brasil e podem dirigir no futuro a necessidade de discutir a vacinação dos meninos no contexto dos mesmos resultados obtidos na Austrália

Human papillomavirus (HPV) is a huge concern in public and private health. The prevention of this condition is the combination of the use of Papanicolaou smear test, condoms and HPV vaccines. Campos dos Goytacazes, RJ, is the first Brazilian municipality to implement in September 2010 the quadrivalent HPV vaccine (Gardasil®) for girls in the age group of 11­15 years, in a hybrid strategy of vaccination (schools and health centers). In 2014, the vaccination was started also for boys, at the same time that the Ministry of Health introduced it for girls. Objective: The aim of the study was to analyze the trends in reduction of low-grade cervical abnormalities five years after the introduction of the quadrivalent HPV vaccine in this municipality (primary outcome). Furthermore, this study evaluated the relative risk (RR) of each of the groups studied, in order to explain the protective effect of the vaccine (secondary outcome). Methods: The ecological analysis evaluated the impact of HPV vaccination as a protective factor against low risk of HPV abnormalities. Results of the Pap smear test obtained from the Brazilian Ministry of Health's Sistema de Informação do Câncer do Colo do Útero (SISCOLO) were categorized in low-grade abnormalities (LGA) and high-grade abnormalities (HGA). This preliminary study focused in LGA rates, which were estimated for a 1-month period and then stratified by four age groups (<20; 20­24; 25­30; >30 years) from 2007 to 2014. A quantitative comparison of LGA temporal trends before and after vaccination was done with Quasi-Poisson regression analysis. The protective effect of the vaccine over time was evaluated by calculating the RR in each age group. Results: The study showed significant decrease of more than 60% in LGA in women <20 years old, and less, almost 50% for the other groups. HPV vaccine was a protective factor, because the RR result was <0.0001 in all age groups. Conclusions: Although the studies show that the pre-HPV neoplastic lesions may be reversible spontaneously, it is undeniable that the vaccine contributes greatly to the high reduction rates, associated with high vaccination coverage. These results are the first in Brazil and in future may address the necessity to discuss the vaccination for boys in the context of the same results obtained in Australia.

Extubação fora do leito: um estudo de viabilidade / Out-of-bed extubation: a feasibility study

Objetivo: O desmame da ventilação mecânica é acompanhado, na prática clínica em terapia intensiva, de concomitante mobilização precoce do paciente. O objetivo deste estudo foi comparar o sucesso da extubação realizada com pacientes sentados em uma poltrona à extubação de pacientes na posição supina. Métodos: Foi realizado um estudo retrospectivo, observacional e não randomizado em uma unidade de terapia intensiva de 23 leitos, que atende pacientes clínicos e cirúrgicos. O desfecho primário do estudo foi o sucesso da extubação, definido como a tolerância da remoção do tubo endotraqueal por, pelo menos, 48 horas. As diferenças entre os grupos do estudo foram avaliadas utilizando-se o teste t de Student e o qui quadrado. Resultados: Foram incluídos 91 pacientes no período compreendido entre dezembro de 2010 e junho de 2011. A população do estudo tinha uma média de idade de 71 anos ± 12 meses, escore APACHE II médio de 21±7,6 e duração média da ventilação mecânica de 2,6±2 dias. A extubação foi realizada em 33 pacientes enquanto permaneciam sentados em uma poltrona (36%) e 58 pacientes mantidos em posição supina (64%). Não houve diferenças significantes entre os grupos em termos de idade, escore médio APACHE II ou duração da ventilação mecânica. Foi observada uma taxa de sucesso da extubação similar entre os grupos sentado (82%) e em posição supina (85%), com p>0,05. Além disso, não se encontraram diferenças significantes entre os dois grupos em termos de disfunção respiratória pós-extubação, necessidade de traqueostomia, duração do desmame da ventilação mecânica, ou tempo de permanência ...

Objective: In clinical intensive care practice, weaning from mechanical ventilation is accompanied by concurrent early patient mobilization. The aim of this study was to compare the success of extubation performed with patients seated in an armchair compared to extubation with patients in a supine position. Methods: A retrospective study, observational and non-randomized was conducted in a mixed-gender, 23-bed intensive care unit. The primary study outcome was success of extubation, which was defined as the patient tolerating the removal of the endotracheal tube for at least 48 hours. The differences between the study groups were assessed using Student's t-test and chi-squared analysis. Results: Ninety-one patients were included from December 2010 and June 2011. The study population had a mean age of 71 years ± 12 months, a mean APACHE II score of 21±7.6, and a mean length of mechanical ventilation of 2.6±2 days. Extubation was performed in 33 patients who were seated in an armchair (36%) and in 58 patients in a supine position (64%). There were no significant differences in age, mean APACHE II score or length of mechanical ventilation between the two groups, and a similar extubation success rate was observed (82%, seated group versus 85%, supine group, p>0.05). Furthermore, no significant differences were found between the two groups in terms of post-extubation distress, need for tracheostomy, duration of mechanical ventilation weaning, or intensive care unit stay. Conclusion: Our results suggest that the clinical outcomes of patients extubated in a seated position are similar to those of patients extubated in a supine position. This new practice of seated extubation was not associated with adverse events and allowed extubation to occur simultaneously with early mobilization. .

Movimento de mulheres negras: trajetória política, práticas mobilizatórias e articulações com o estado brasileiro / Afro-Brazilian women's social movement: political trajectory, mobilization practices and articulations with the Brazilian state

O presente artigo analisa a trajetória e consolidação do Movimento de Mulheres Negras (MMN) na cena pública brasileira ao longo dos últimos trinta anos. Através de entrevistas com militantes pioneiras e participantes desse movimento social bem como de levantamento de fontes documentais, o estudo teve o intuito de compreender quais processos subjazem a constituição desse novo sujeito coletivo, seus dilemas e redes de solidariedade com outros movimentos sociais, o lugar das hierarquias de gênero e raça em suas reivindicações, além do seu processo de institucionalização/burocratização e sua articulação com o Estado brasileiro.

This paper examines the trajectory and consolidation process of the Afro-Brazilian Women's Social Movement in the public sphere over the last thirty years. Trough interviews with activists and participants of this social movement as well as survey of documental sources, the study had the aim to understand those processes that underlying the constitution of these collective political subjects, and their dilemmas and solidarity networks with other social movements. Furthermore, this paper also discusses the role of hierarchies of gender and race in the Afro-Brazilian Women's Social Movement claims, and its process of institutionalization / bureaucratization along with its articulation with the Brazilian state.

Movimento de mulheres negras: trajetória política, práticas mobilizatórias e articulações com o Estado brasileiro / Afro-Brazilian women's social movement: political trajectory, mobilization practices and articulations with the Brazilian state

O presente artigo analisa a trajetória e consolidação do Movimento de Mulheres Negras (MMN) na cena pública brasileira ao longo dos últimos trinta anos. Através de entrevistas com militantes pioneiras e participantes desse movimento social bem como de levantamento de fontes documentais, o estudo teve o intuito de compreender quais processos subjazem a constituição desse novo sujeito coletivo, seus dilemas e redes de solidariedade com outros movimentos sociais, o lugar das hierarquias de gênero e raça em suas reivindicações, além do seu processo de institucionalização/burocratização e sua articulação com o Estado brasileiro.(AU)

This paper examines the trajectory and consolidation process of the Afro-Brazilian Women's Social Movement in the public sphere over the last thirty years. Trough interviews with activists and participants of this social movement as well as survey of documental sources, the study had the aim to understand those processes that underlying the constitution of these collective political subjects, and their dilemmas and solidarity networks with other social movements. Furthermore, this paper also discusses the role of hierarchies of gender and race in the Afro-Brazilian Women's Social Movement claims, and its process of institutionalization / bureaucratization along with its articulation with the Brazilian state.(AU)

O elogio da transversalidade / Eulogy of transversality

Refletindo sobre a relação entre cidadania e subjetividade e as formas de intervir nesta relação, os autores sustentam que ao lado do reconhecimento das diferenças, é também necessário superar as barreiras identitárias construídas por cada movimento de defesa de direitos, tais como os relacionados a gênero e etnia, para abrir o diálogo entre os grupos que afirmam suas diferenças, no sentido de melhor vir a esclarecer suas particularidades e transversalidades. Os autores baseiam a discussão em dados de pesquisa-ação desenvolvida com grupos sociais diversos, envolvendo os conceitos de gênero e de etnia. Comparam a questão de gênero e a questão étnica para argumentar que o conceito de identidade deve ser utilizado sempre em articulação com os conceitos de alteridade e de transversalidade, buscando-se superar uma suposta dicotomia entre o reconhecimento da diferença e a universalidade de direitos. Advogam considerar nem identidades isoladas nem a pretensão de um universalismo que não considere as diferenças, mas a busca de uma transversalidade onde as trocas entre os grupos e movimentos sociais possam esclarecer a sua dialética entre identidade/alteridade e suas questões em comum no contexto sóciohistórico(AU)

The authors reflect on the relationship between citizenship and subjectivity as well as the ways of working out this relationship. They argue that, side by side the recognition of differences, it is essential to go beyond the identity barriers each social movement constructs in the defense of its rights. Examples are those movements related to gender and ethnia. It is important to open the dialogue among these groups, to better understand its particularities and transversalities. The discussion is based on data from action-research with different groups, involving the issues of gender and ethnia. The authors compare the question of gender and that of ethnia and maintain that the concept of identity shall be intertwined with those of alterity and transversality. This is aimed to surpass the alleged dichotomy between difference and universality. The authors propose neither to consider isolated identities nor to accept a “universalism” that effaces differences. Instead, they propose to search for the transversality dimension through which groups and social movements could enlighten the dialectics between identity and alterity, as well as their common issues inthe social-historical context. (AU)

O elogio da transversalidade / Eulogy of transversality

Refletindo sobre a relação entre cidadania e subjetividade e as formas de intervir nesta relação, os autores sustentam que ao lado do reconhecimento das diferenças, é também necessário superar as barreiras identitárias construídas por cada movimento de defesa de direitos, tais como os relacionados a gênero e etnia, para abrir o diálogo entre os gruposque afirmam suas diferenças, no sentido de melhor vir a esclarecer suas particularidades e transversalidades.Os autores baseiam a discussão em dados de pesquisa-ação desenvolvida com grupos sociais diversos, envolvendo os conceitos de gênero e de etnia. Comparam a questão de gênero e a questão étnica para argumentar que o conceito de identidade deve serutilizado sempre em articulação com os conceitos de alteridade e de transversalidade, buscando-se superar uma suposta dicotomia entre o reconhecimento da diferença e auniversalidade de direitos. Advogam considerar nem identidades isoladas nem a pretensão de um universalismo que não considere as diferenças, mas a busca de uma transversalidade onde as trocas entre os grupos e movimentos sociais possam esclarecer a sua dialética entre identidade/alteridade e suas questões em comum no contexto sóciohistórico

The authors reflect on the relationship between citizenship and subjectivity as well as the ways of working out this relationship. They argue that, side by side the recognition of differences, it is essential to go beyond the identity barriers each social movementconstructs in the defense of its rights. Examples are those movements related to gender and ethnia. It is important to open the dialogue among these groups, in order to better understand its particularities and transversalities.The discussion is based on data from action-research with different groups, involving the issues of gender and ethnia. The authors compare the question of gender and that ofethnia and maintain that the concept of identity shall be intertwined with those of alterity and transversality. This is aimed to surpass the alleged dichotomy between difference and universality. The authors propose not to consider isolated identities nor to accept a“universalism” that effaces differences. Instead, they propose to search for thetransversality dimension through which groups and social movements could enlighten the dialectics between identity and alterity, as well as their common issues in the socialhistorical context

Oficinas em sexualidade humana com adolescentes / Workshop in human sexuality with adolescents

O presente trabalho tem por objetivo apresentar uma experiência de intervenção em orientação sexual com adolescentes em uma cidade do interior de Minas Gerais. Foram sujeitos da intervenção 50 estudantes da 8ª série do ensino fundamental de uma escola municipal da cidade, divididos em 4 grupos, sendo relatada aqui a experiência vivida em um deles, contando com 13 participantes, com idades variando entre 13 e 15 anos, sendo 8 do sexo masculino e 5 do sexo feminino. Utilizando a metodologia de Oficinas em Dinâmica de Grupo procurou-se, juntamente com os adolescentes, a reflexão e elaboração de sentimentos, comportamentos e conhecimentos compartilhados face à sexualidade, levando em consideração suas angústias e inseguranças relacionadas ao tema, e concentrando-se em dialogar sobre os aspectos afetivos e históricos envolvidos na vivência da sexualidade. A partir da análise dos processos grupais, articulados a uma conscientização ético-política dos sujeitos envolvidos, observou-se uma reconstrução/ressignificação dos sentidos atribuídos à sexualidade, ao pertencimento de gênero e ao contexto social mais amplo.

The objective of this study was to determine how the intervention in sexual guidance was experienced by adolescents in a small city in Minas Gerais. The research involved 50 8th grade students of the municipal elementary school, divided into 4 groups. This article focuses on only one of these groups, with 13 members, 8 male and 5 female, of ages varying from 13 to 15 years old. The methodology used was that of workshops in group dynamics in order for the adolescents to reflect on their feelings, behavior and knowledge, in relation to sexuality. Participants' distress and insecurity in facing the topic were taken into consideration, and emphasis was placed on the emotional aspect and the life history of the subjects involved, in their experiences with sexuality. The analysis of this group process, demonstrated a reconstruction / re-definition of meaning for the ideas related to sexuality, to gender and to the wider social context.

Oficinas em sexualidade humana com adolescentes / Workshop in human sexuality with adolescents

O presente trabalho tem por objetivo apresentar uma experiência de intervenção em orientação sexual com adolescentes em uma cidade do interior de Minas Gerais. Foram sujeitos da intervenção 50 estudantes da 8ª série do ensino fundamental de uma escola municipal da cidade, divididos em 4 grupos, sendo relatada aqui a experiência vivida em um deles, contando com 13 participantes, com idades variando entre 13 e 15 anos, sendo 8 do sexo masculino e 5 do sexo feminino. Utilizando a metodologia de Oficinas em Dinâmica de Grupo procurou-se, juntamente com os adolescentes, a reflexão e elaboração de sentimentos, comportamentos e conhecimentos compartilhados face à sexualidade, levando em consideração suas angústias e inseguranças relacionadas ao tema, e concentrando-se em dialogar sobre os aspectos afetivos e históricos envolvidos na vivência da sexualidade. A partir da análise dos processos grupais, articulados a uma conscientização ético-política dos sujeitos envolvidos, observou-se uma reconstrução/ressignificação dos sentidos atribuídos à sexualidade, ao pertencimento de gênero e ao contexto social mais amplo.(AU)

The objective of this study was to determine how the intervention in sexual guidance was experienced by adolescents in a small city in Minas Gerais. The research involved 50 8th grade students of the municipal elementary school, divided into 4 groups. This article focuses on only one of these groups, with 13 members, 8 male and 5 female, of ages varying from 13 to 15 years old. The methodology used was that of workshops in group dynamics in order for the adolescents to reflect on their feelings, behavior and knowledge, in relation to sexuality. Participants' distress and insecurity in facing the topic were taken into consideration, and emphasis was placed on the emotional aspect and the life history of the subjects involved, in their experiences with sexuality. The analysis of this group process, demonstrated a reconstruction / re-definition of meaning for the ideas related to sexuality, to gender and to the wider social context.(AU)