Dos películas -una española ambientada en Colombia, la otra belga- que tienen un denominador común, y provocan un cuestionamiento vocacional: ¿Cuál es el sentido de ser médico? ¿Por qué elegir esta profesión? Y, a continuación, la pregunta lógica: ¿Cómo formar médicos hoy en día, cuando parece que el sistema no ayuda? La construcción del profesionalismo médico enfrenta desafíos únicos que ven de dentro del sistema sanitario. La atención está centrada en procesos y resultados, y el paciente es, con mucha frecuencia, olvidado. El enfermo se transforma en un detalle o, peor, en un elemento que problematiza el sistema, diseñado para situaciones teóricas, sin contemplar la necesaria imprevisibilidad del ser humano. La solución posible sugiere la necesidad de formar una cultura en grupo, trabajar en conjunto con profesionales que son felices, y tiene orgullo de ser médicos y dedicarse vocacionalmente a cuidar de los pacientes. El médico es una conciencia frente a una confianza que el paciente le otorga. Por eso, reflexionar sobre la práctica médica es fundamental para el aprendizaje y el despertar de esta conciencia profesional. Sólo cuando pensamos en nuestro desempeño, en cómo aprendemos de cada encuentro con el paciente, podemos mejorar y adquirir nuevas actitudes. Postura que es integridad y al mismo tiempo dedicación y cuidado amoroso, donde se injerta la verdadera competencia y sabiduría, como la demostrada por los médicos ejemplares de todas las épocas. Aprender, que la sabiduría no es sólo saber las cosas, sino también amarlas. (AU)
Two films -one Spanish set in Colombia, the other Belgian- that have a common denominator, and provoke a vocational questioning: What is the meaning of being a doctor? Why we choose this profession? And then, the logical question: how to train doctors today, when it seems that the system does not help? Building medical professionalism faces unique challenges that come from within the healthcare system. Attention is focused on processes and results, and the patient is very often forgotten. The patient becomes a detail or, worse, an element that problematizes the system, designed for theoretical situations, without contemplating the necessary unpredictability of the human being. The possible solution suggests the need to form a culture-group, able to work together with professionals who are happy and proud to be doctors and dedicate themselves to caring for patients. The doctor is a conscience in the face of a trust that the patient gives him. For this reason, reflecting on medical practice is essential for learning and awakening this professional awareness. Only when we think about our performance, about how we learn from each encounter with the patient, we can improve and acquire new attitudes. Posture that is integrity and at the same time dedication and loving care, where true competence and wisdom are grafted, as demonstrated by exemplary doctors of all times. And at the bottom, to learn that wisdom is not only knowing things, but also loving them. (AU)
Humans , Education, Medical , Professionalism , Physicians/ethics , Motion Pictures , Physician-Nurse Relations
AIM: To develop a monoclonal antibody against dehydroepiandrosterone (DHEA) and miniaturize it, generating a single-chain antibody variable fragment (scFv) against DHEA as an adrenocortical carcinoma (ACC) marker. MATERIAL & METHODS: DHEA conjugated to keyhole limpet hemocyanin was used as an immunogen to obtain anti-DHEA hybridomas. Variable fragments were cloned from hybridoma 5B7 total RNA, and used to detect DHEA in normal adrenal tissue and ACC cells. RESULTS: IgM monoclonal antibody was highly specific, and the recombinant scFv preserved parental antibody characteristics, allowing tissue localization of DHEA. CONCLUSION: Undefined small lesions are challenges for clinicians and impact clinical adrenocortical tumor management. Generating an anti-DHEA scFv facilitates development of imaging tests for early diagnosis of pediatric ACC.
Adrenal Cortex Neoplasms/diagnosis , Adrenocortical Carcinoma/diagnosis , Biomarkers, Tumor/analysis , Dehydroepiandrosterone/analysis , Single-Chain Antibodies/metabolism , Animals , Biomarkers, Tumor/metabolism , Dehydroepiandrosterone/metabolism , Gene Expression , Humans , Mice, Inbred BALB C , Molecular Docking Simulation , Protein Conformation , Protein Engineering/methods , Recombinant Proteins/genetics , Recombinant Proteins/metabolism , Single-Chain Antibodies/genetics , Zona Reticularis/metabolism
Loxosceles spider bites often lead to serious envenomings and no definite therapy has yet been established. In such a context, it is of interest to consider an antibody-based targeted therapy. We have previously prepared a murine monoclonal IgG (LiMab7) that binds to 32-35kDa components of Loxosceles intermedia venom and neutralizes the dermonecrotic activity of the venom. Here, we re-engineered LiMab7 into a recombinant diabody. The protein was produced in bacteria and then it was functionally characterized. It proved to be efficient at neutralizing sphingomyelinase and hemolytic activities of the crude venom despite the slightly altered binding kinetic constants and the limited stability of the dimeric configuration. This is the first report of a specific recombinant antibody for a next-generation of Loxosceles antivenoms.
Antibodies, Monoclonal/therapeutic use , Antivenins/therapeutic use , Immunotherapy/methods , Phosphoric Diester Hydrolases/immunology , Recombinant Proteins/therapeutic use , Single-Chain Antibodies/therapeutic use , Spider Bites/therapy , Spider Venoms/immunology , Animals , Cells, Cultured , Gene Expression , Hemolysis , Mice , Protein Engineering , Sphingomyelin Phosphodiesterase/antagonists & inhibitors , Spider Bites/immunology , Spiders/immunology
RESUMO A educação médica brasileira apresenta desafios com o intuito de contribuir com a formação de recursos humanos para o Sistema Único de Saúde, em consonância com as principais políticas de saúde do País. A pedagogia de Paulo Freire apresenta uma visão crítica do processo ensino-aprendizagem enquanto processo de emancipação política e de ação transformadora da realidade. Tais valores são desejados na formação profissional dos médicos. O presente estudo visa avaliar a concepção de docentes de Faculdade de Medicina paulistana sobre o processo ensino-aprendizagem segundo os princípios da pedagogia problematizadora de Paulo Freire.
ABSTRACT Brazilian medical education presents challenges in providing human resources to the Unified Health System in line with the main national health policies. The pedagogy of Paulo Freire presents a critical view of the teaching-learning process including the political emancipation of the student and the ability to transform the reality. Such values are desired in the professional training of Brazilian physicians. This study aims to assess to what extent medical teachers from a São Paulo university understand the teaching-learning process in terms of the principles of Paulo Freire’s pedagogy.
Introdução: A promoção à saúde é um grande desafio no Sistema Único de Saúde. A realização de ações de promoção faz parte das competências necessárias ao egresso do curso de medicina, segundo as Diretrizes Curriculares Nacionais para o Curso de Graduação em Medicina (DCN). Objetivo: Este trabalho visa descrever a elaboração e implementação de ação lúdica, visando educação em saúde com enfoque em prevenção de acidentes domésticos na infância, por parte de alunos do primeiro ano do curso de medicina da Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP). Métodos: O uso da metodologia da problematização conduziu a construção do projeto, desde o reconhecimento do território da Unidade Básica de Saúde (UBS), discussão de problemas encontrados, levantamento bibliográfico, elaboração de hipóteses de solução e implementação de ação. Resultados: Os alunos do primeiro ano de medicina optaram por trabalhar com o tema de prevenção de acidentes domésticos na infância, em parceria com a UBS e com organização não-governamental (ONG) da região, que realiza atividades educativas e de lazer com crianças em idade escolar, após o horário da aula. Os alunos construíram jogos discutindo a prevenção de acidentes e folheto explicativo para pais e responsáveis. Foi realizada gincana em novembro de 2012, em que os alunos coordenaram os jogos com as crianças que utilizam a ONG. Os alunos construíram narrativa sobre a percepção da atividade, com boa avaliação da ação. Discussão: Há evidências do benefício de inserir o aluno precocemente em ações na comunidade, principalmente na participação ativa de atividades de promoção à saúde, visando à aprendizagem significativa. A problematização é estratégia privilegiada de ensino do tema de promoção à saúde e à construção das competências necessárias à elaboração destas ações.
Introduction: Health promotion is a great challenge in the Brazilian National Health System. The implementation of health promotion actions is part of the necessary skills of medical school undergraduates, according to the National Curriculum Guidelines for Undergraduate Medicine (DCN). Objective: This study aims to describe the development and implementation of games, seeking health education focusing on prevention of domestic accidents in childhood, made by students of the first year of medical school, Faculty of Medical Sciences of Santa Casa de São Paulo (FCMSCSP). Methods: The methodology of problematization led to construction of the project, started with the recognition of the territory of primary care service, discussion of found problems, evaluation of medical literature, towards the formulation of possible solutions and implementing an prevention action. Results: The first year medical students have chosen to work with prevention of domestic accidents in childhood, in partnership with UBS and a nongovernmental organization in the region, which conducts educational and recreational activities with children, in the after-school period. The students put up games discussing accident prevention and a leaflet for parents and guardians. Tournament was held in November 2012, in which medical students coordinated games with the children. Students constructed narrative about their perception of activity, with good evaluation of the health promotion action. Discussion: There is evidence of the benefit of early introduction of medical students in the community context, especially in active participation of health promotion activities, aiming to meaningful learning. The problematization strategy is a privileged teaching method aiming actions of health promotion and building the necessary skills for the production of these actions.
Humans , Male , Female , Accidents, Home , Accidents, Home/prevention & control , Leisure Activities , Child , Education, Medical , Students, Medical , Child Mortality , Health Promotion , Primary Health Care , Health Centers
Neurocysticercosis (NCC), the cerebral presence of Taenia solium metacestode (Cysticercus cellulosae), is responsible for neurological disorders worldwide. In order to validate an immunodiagnosis for public-health patients in the State of Parana-Brazil, crude antigen of Taenia crassicepsmetacestode (Cysticercus longicollis) was used as an alternative heterologous antigen to be used in ELISA and in electroimmunotransfer blotting (EITB) for active and inactive NCC diagnosis. Indirect ELISA was able to discriminate between active and inactive samples and presented high specificity and sensitivity. Any immunodominant band was able to distinguish the NCC stages, although the EITB showed 100 percent specificity. The immunological results proved to be an important auxiliary toll for NCC diagnosis, mainly for public-health systems in developing countries, where either the neuroimage techniques are not accessible or the resources are scarce.
Neurocisticercose (NCC), causada pela presença do metacestódeo do parasito Taenia solium (Cysticercus cellulosae) no sistema nervoso central, é uma doença mundialmente conhecida como responsável por distúrbios neurológicos. Com o objetivo de validar um imunodiagnóstico para pacientes da rede pública do estado do Paraná-Brasil, o extrato bruto do metacestódeo de T. crassiceps (C. longicollis) foi produzido e utilizado como antígeno heterólogo para o diagnóstico de NCC ativa e inativa utilizando-se ELISA e eletroimunotransferência (EITB). O ensaio de ELISA indireto foi capaz de discriminar a forma ativa e inativa da NCC, apresentando alta especificidade e sensibilidade. Ao se utilizar EITB, nenhuma proteína foi imunodominante de forma a distinguir os diferentes estágios da NCC, embora o ensaio tenha tido 100 por cento de especificidade. Os resultados mostram que os ensaios imunológicos podem ser uma ferramenta auxiliar importante para o diagnóstico da NCC, principalmente para o sistema público de saúde, cujo diagnóstico por imagem não é acessível ou cujos recursos financeiros são escassos.
