RESUMEN
Vertical transmission of Chikungunya virus (CHIKV) has been reported in humans, but the transmission routes have not been completely understood, and experimental animal models are needed to enable detailed investigation of the transmission and pathogenesis of congenital infections. The intertwining of immune response and virus components at the gestation/breastfeeding interfaces between mother and fetus/newborn may have effects during the offspring development. An experimental model of CHIKV was established by infecting pregnant BALB/c female mice that enabled confirmation that dams inoculated up to the 10th gestational day transmit CHIKV transplacentally to approximately 8.4% of the fetuses, resulting in severe teratogenic effects. CHIKV neutralizing antibodies were detected in sera from adult mice born to healthy females and breastfed by CHIKV-infected dams, while no neutralization was detected in sera from animals born to CHIKV-infected dams. Moreover, adult mice born to healthy dams and cross-fostered for breastfeeding by CHIKV-infected dams were resistant to challenge with CHIKV on the 90th day after birth. The animals also had reduced viral loads in brain and spleen as compared to controls. There was expression of fluorescent CHIKV non-structural protein, and detection of viral RNA by RT-PCR in breast tissue from infected dams. CHIKV RNA and proteins were also detected in breast milk retrieved from the stomachs of recently fed newborns. The experimental results were also complemented by the finding of CHIKV RNA in 6% of colostrum samples from healthy lactating women in a CHIKV-endemic area. Breastfeeding induces immune protection to challenge with CHIKV in mice.
Asunto(s)
Fiebre Chikungunya , Virus Chikungunya , Humanos , Embarazo , Femenino , Animales , Ratones , Virus Chikungunya/genética , Lactancia Materna , Lactancia , Anticuerpos Antivirales , Ratones Endogámicos BALB C , ARNRESUMEN
O presente ensaio visa apresentar, explorar e discutir sobre os desdobramentos da extinção do Ministério do Esporte no campo científico-acadêmico da educação Física. No cerne dos procedimentos metodológicos, tratase de um estudo exploratório de abordagem qualitativa, sendo a técnica de coleta e análise de dados documental. Para tal, foram analisados os artigos publicados em 2019 pela Revista de Educação Física, Esporte e Lazer conhecida nacionalmente como Motrivivência numa sessão temática, especificamente voltada para as discussões sobre a extinção do Ministério do Esporte. A edição foi composta por um editorial e seis artigos. Os dados analisados, demonstram que há uma tendência a um foco estrutural nas investigações. Por fim, novos estudos precisam ser realizados, com vistas a compreender as causalidades e os impactos a médio e longo prazo do fim do Ministério do Esporte no Brasil.
This essay aims to present, explore and discuss the consequences of the extinction of the Ministry of Sport in the scientific-academic field of Physical Education. At the heart of the methodological procedures, it is an exploratory study with a qualitative approach, the technique of collecting and analyzing data being documentary. To this end, articles published in 2019 by Revista de Educação Física, Esporte e Lazer nationally known as Motrivivência were analyzed in a thematic session, specifically focused on discussions on the extinction of the Ministry of Sport. The edition consisted of an editorial and six articles. The analyzed data demonstrate that there is a tendency towards a structural focus in the investigations. Finally, new studies need to be carried out, in order to understand the causalities and the medium and long-term impacts of the end of the Ministry of Sport in Brazil.
Este ensayo tiene como objetivo presentar, explorar y discutir las consecuencias de la extinción del Ministerio del Deporte en el campo científico-académico de la Educación Física. En el corazón de los procedimientos metodológicos, es un estudio exploratorio con enfoque cualitativo, siendo la técnica de recolección y análisis de datos documental. Para ello, artículos publicados en 2019 por la Revista de Educação Física, Esporte e Lazer conocida nacionalmente como Motrivivência fueron analizados en una sesión temática, específicamente enfocada en discusiones sobre la extinción del Ministerio del Deporte. La edición constó de un editorial y seis artículos. Los datos analizados demuestran que existe una tendencia hacia un enfoque estructural en las investigaciones. Finalmente, es necesario realizar nuevos estudios para comprender las causalidades y los impactos a mediano y largo plazo del fin del Ministerio del Deporte en Brasil.
RESUMEN
Introdução: A pandemia da COVID-19 teve repercussão significativa na educação médica, incluindo na formação de residentes afetando o ensino presencial e levando as instituições a adotar métodos de ensino à distância. Objetivo: Avaliar a percepção dos residentes em ginecologia e obstetrícia em relação ao impacto da pandemia em seu aprendizado, identificando sua segurança ao realizarem seus atendimentos e buscando investigar se os residentes considerariam estender sua residência. Métodos: Foi utilizado um questionário com perguntas fechadas e respostas em escala Likert, abordando diferentes aspectos da residência médica durante a pandemia para atender aos objetivos. Resultados: Dos 71 residentes a maioria era de mulheres (74,65%). A análise dos dados revelou que a prática cirúrgica foi afetada para a maioria deles (85,92%), com o adiamento de operações eletivas em ginecologia (97,18%). Em relação ao aprendizado prático, 42,25% consideraram que foi parcialmente satisfatório, enquanto 14,08% o consideraram insatisfatório. No campo teórico, a percepção dos residentes foi melhor, com 43,66% considerando o aprendizado satisfatório e 47,89% parcialmente. A pandemia afetou parcialmente a residência médica para a maioria dos residentes (85,92%), e foram adotadas alternativas para substituir a falta de aulas teóricas e atividades práticas. Conclusão: A pandemia teve efeito negativo na educação médica e na formação dos residentes. A interrupção das atividades presenciais afetou tanto o aprendizado prático quanto o teórico.
Introduction: The COVID-19 pandemic had a significant impact on medical education, including the training of residents, affecting in-person teaching and leading institutions to adopt distance learning methods. Objective: To evaluate the perception of residents in gynecology and obstetrics regarding the impact of the pandemic on their learning, identifying their safety when providing care and seeking to investigate whether residents would consider extending their residency. Methods: A questionnaire with closed questions and responses on a Likert scale was used, addressing different aspects of medical residency during the pandemic to meet the objectives. Results: Of the 71 residents, the majority were women (74.65%). Data analysis revealed that surgical practice was affected for the majority of them (85.92%), with the postponement of elective operations in gynecology (97.18%). Regarding practical learning, 42.25% considered it to be partially satisfactory, while 14.08% considered it unsatisfactory. In the theoretical field, residents' perception was better, with 43.66% considering the learning satisfactory and 47.89% partially so. The pandemic partially affected medical residency for the majority of residents (85.92%), and alternatives were adopted to replace the lack of theoretical classes and practical activities. Conclusion: The pandemic had a negative effect on medical education and resident training. The interruption of face-to-face activities affected both practical and theoretical learning.
RESUMEN
O ensaio apresenta alguns dos desenvolvimentos da noção de movência e justifica o seu alcance para pensar a Educação Física e o Esporte, bem como suas relações. Inicialmente, são sumarizados alguns dos posicionamentos teóricos sobre a Educação Física e o Esporte em nosso campo. Na sequência, se contextualiza o aparecimento do conceito de movência na trajetória do autor, para, no próximo tópico, defendê-lo como um universal antropológico. Finalmente, busca-se a partir da teoria da movência esboçada apontar o alcance da Educação Física e do Esporte como sistemas de conhecimento na contemporaneidade. Conclui-se que a movência expande o entendimento de Educação Física e Esporte, além de permitir equacionar alguns dos reconhecidos problemas epistemológicos de nosso ofício.(AU)
Este ensayo presenta algunos de los avances acerca de la noción del movimiento y justifica su alcance para pensar en la Educación Física y el deporte, así como en sus relaciones. Inicialmente, se resumen algunas de las posiciones teóricas sobre la Educación Física y el deporte en nuestro campo. Posteriormente, se contextualiza el surgimiento del concepto de movimiento en la trayectoria del autor, para, en el paso siguiente, defenderlo como un universal antropológico. Finalmente, a partir de la teoría del movimiento esbozada, se busca señalar el alcance de la Educación Física y el deporte como sistemas de conocimiento en la contemporaneidad. Se concluye que el movimiento amplía la comprensión de la Educación Física y el deporte, además de permitirnos equiparar algunos de los problemas epistemológicos reconocidos de nuestro oficio.(AU)
The essay presents some of the developments of the notion of movingness and justifies its reach to think about Physical Education and Sport, as well as their relationships. Initially, some of the theoretical positions about Physical Education and Sport in our field are summarized. Subsequently, the emergence of the concept of movingness in the author's trajectory is contextualized, in order, in the next topic, to defend it as an anthropological universal. Finally, from the theory of movingness outlined, we seek to point out the scope of Physical Education and Sport as knowledge systems in contemporaneity. It is concluded that the movingness expands the understanding of Physical Education and Sport, in addition to allowing us to equate some of the recognized epistemological problems of our craft.(AU)
Asunto(s)
Humanos , Masculino , FemeninoRESUMEN
Resumo As migrações globais no esporte são comuns na contemporaneidade e junto com o aumento dos fluxos migratórios também evidenciou o aumento das pesquisas relacionadas à temática. Diferentes abordagens, teorias e tipologias foram desenvolvidas nas últimas décadas buscando analisar questões especificas da migração. O presente artigo argumenta a necessidade de analisar o processo migratório em uma agenda que considere múltiplos fatores influenciadores para a decisão de migrar. Diante disso, apresenta uma discussão teórica que é base para o desenvolvimento de um modelo analítico da migração esportiva a partir da compreensão de quatro dimensões: cultural, política, econômica e pessoal.
Abstract Global migrations in sports are common nowadays, and along with the increase in migratory flows, it also evidenced the increase in research related to the subject. Different approaches, theories, and typologies have been developed in recent decades seeking to analyze specific migration issues. This paper argues the need to analyze the migration process in an agenda that considers multiple factors that influence the decision to migrate. Therefore, it presents a theoretical discussion that forms the basis for the development of an analytical model of sports migration, understanding four dimensions, cultural, political, economic, and personal.
Resumen Las migraciones globales en el deporte son comunes en la actualidad y junto con el aumento de los flujos migratorios, también se evidenció el aumento de las investigaciones relacionadas con el tema. En las últimas décadas se han desarrollado diferentes enfoques, teorías y tipologías que buscan analizar cuestiones específicas de la migración. Este trabajo argumenta la necesidad de analizar el proceso migratorio en una agenda que considere múltiples factores que influyen en la decisión de migrar. Por lo tanto, presenta una discusión teórica que es la base para el desarrollo de un modelo analítico de la migración deportiva desde la comprensión de cuatro dimensiones, la cultural, política, económica y personal.
RESUMEN
ABSTRACT This study discusses theoretical reverberations that stand out in the field of Physical Education (PE) in Brazil in the face of epistemological discussions demarcated within the scope of PE in the USA from the 1960s onwards, and due to the contributions of the Disciplinary Movement and the context by which Kinesiology then established its position as a scope in the field of American PE. An exploratory literature review was carried out with the following guiding question: what is the impact of the epistemological developments of North American PE on the configuration of the general theory of PE in Brazil? From this perspective, we verified the authors in the Brazilian field who took a position on the resonances and limits arising from the conjectures of the scientific field of PE in the USA. Through this investigation, some processes of inhibition were highlighted by which the proposal of Kinesiology could not increase reflections in Brazil, with few exceptions.
RESUMO Este estudo discute reverberações teóricas que se destacaram no campo da Educação Física (EF) no Brasil diante das investigações epistemológicas demarcadas no âmbito da EF nos EUA a partir da década de 1960, e devido às contribuições do Movimento Disciplinar e ao contexto pelo qual a Cinesiologia se estabeleceu então como escopo no campo da EF americana. Foi realizada uma revisão exploratória da literatura com a seguinte questão norteadora: qual impacto dos desenvolvimentos epistemológicos da EF norte-americana na configuração da teoria geral da EF no Brasil? Nessa perspectiva, verificamos os autores do campo brasileiro que adotaram uma posição sobre as ressonâncias e limites decorrentes das conjecturas do campo científico da EF nos EUA. Através desta investigação, foram destacados alguns processos de inibição pelos quais a proposta da Cinesiologia não conseguiu aumentar reflexões no Brasil, com poucas exceções.
RESUMEN
OBJECTIVE: assess pain and opioid consumption in patients undergoing anesthetic techniques of spinal erector plane block and local anesthetic block in video-assisted thoracic surgery in the immediate postoperative period. METHODS: ninety-two patients undergoing video assisted thoracic surgery were randomized to receive ESPB or BAL before starting the surgical procedure. Using the numerical verbal scale, the primary outcome assessed was the patient's pain in the immediate postoperative period (POI). The secondary outcome comprises the assessment of opioid consumption in the IPP by quantifying the medication used in an equianalgesic dose of morphine expressed in milligrams, in the immediate post-anesthetic recovery period, 6h, 12h, and 24h after surgery. RESULTS: the EVN scores in the LBA and ESPB group in the POI had a mean of 0,8 (±1,89) vs 0,58 (±2,02) in the post-anesthesia care room (REPAI), 1,06 (±2,00) vs 1,30 (±2,30) in 6 hours of POI, 0,84 (±1,74) vs 1,19 (±2,01) within 12 hours of POI and 0,95 (±1,88) vs 1 ( ±1,66) within 24 hours of POI, all with p>0.05. Mean opioid consumption in the BAL and ESPB groups in the POI was 12.9 (± 10.4) mg vs 14.9 (±10.2) mg, respectively, with p = 0.416. Sixteen participants in the ESPB group and seventeen in the BAL group did not use opioids during the first 24 hours of the PO analyzed. CONCLUSION: local anesthesic block and ESP block techniques showed similar results in terms of low pain scores and opioid consumption during the period evaluated.
Asunto(s)
Analgésicos Opioides , Bloqueo Nervioso , Analgésicos Opioides/uso terapéutico , Anestésicos Locales , Humanos , Bloqueo Nervioso/métodos , Dolor Postoperatorio/tratamiento farmacológico , Cirugía Torácica Asistida por Video , Ultrasonografía IntervencionalRESUMEN
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces mild or asymptomatic COVID-19 in most cases, but some patients develop an excessive inflammatory process that can be fatal. As the NLRP3 inflammasome and additional inflammasomes are implicated in disease aggravation, drug repositioning to target inflammasomes emerges as a strategy to treat COVID-19. Here, we performed a high-throughput screening using a 2560 small-molecule compound library and identified FDA-approved drugs that function as pan-inflammasome inhibitors. Our best hit, niclosamide (NIC), effectively inhibits both inflammasome activation and SARS-CoV-2 replication. Mechanistically, induction of autophagy by NIC partially accounts for inhibition of NLRP3 and AIM2 inflammasomes, but NIC-mediated inhibition of NAIP/NLRC4 inflammasome are autophagy independent. NIC potently inhibited inflammasome activation in human monocytes infected in vitro, in PBMCs from patients with COVID-19, and in vivo in a mouse model of SARS-CoV-2 infection. This study provides relevant information regarding the immunomodulatory functions of this promising drug for COVID-19 treatment.
Asunto(s)
Tratamiento Farmacológico de COVID-19 , Inflamasomas , Animales , Humanos , Agentes Inmunomoduladores , Ratones , Proteína con Dominio Pirina 3 de la Familia NLR , SARS-CoV-2RESUMEN
The global emergence of coronavirus disease 2019 (COVID-19) has caused substantial human casualties. Clinical manifestations of this disease vary from asymptomatic to lethal, and the symptomatic form can be associated with cytokine storm and hyperinflammation. In face of the urgent demand for effective drugs to treat COVID-19, we have searched for candidate compounds using in silico approach followed by experimental validation. Here we identified celastrol, a pentacyclic triterpene isolated from Tripterygium wilfordii Hook F, as one of the best compounds out of 39 drug candidates. Celastrol reverted the gene expression signature from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected cells and irreversibly inhibited the recombinant forms of the viral and human cysteine proteases involved in virus invasion, such as Mpro (main protease), PLpro (papain-like protease), and recombinant human cathepsin L. Celastrol suppressed SARS-CoV-2 replication in human and monkey cell lines and decreased interleukin-6 (IL-6) secretion in the SARS-CoV-2-infected human cell line. Celastrol acted in a concentration-dependent manner, with undetectable signs of cytotoxicity, and inhibited in vitro replication of the parental and SARS-CoV-2 variant. Therefore, celastrol is a promising lead compound to develop new drug candidates to face COVID-19 due to its ability to suppress SARS-CoV-2 replication and IL-6 production in infected cells.
Asunto(s)
Antivirales , Tratamiento Farmacológico de COVID-19 , Proteasas 3C de Coronavirus , Triterpenos Pentacíclicos , Humanos , Antivirales/farmacología , Proteasas 3C de Coronavirus/antagonistas & inhibidores , Interleucina-6 , Simulación del Acoplamiento Molecular , Triterpenos Pentacíclicos/farmacología , Inhibidores de Proteasas/farmacología , SARS-CoV-2/efectos de los fármacos , Proteínas no Estructurales Virales/genética , Proteínas no Estructurales Virales/metabolismoRESUMEN
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a hyperinflammatory state and lymphocytopenia, a hallmark that appears as both signature and prognosis of disease severity outcome. Although cytokine storm and a sustained inflammatory state are commonly associated with immune cell depletion, it is still unclear whether direct SARS-CoV-2 infection of immune cells could also play a role in this scenario by harboring viral replication. We found that monocytes, as well as both B and T lymphocytes, were susceptible to SARS-CoV-2 infection in vitro, accumulating double-stranded RNA consistent with viral RNA replication and ultimately leading to expressive T cell apoptosis. In addition, flow cytometry and immunofluorescence analysis revealed that SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from coronavirus disease 2019 (COVID-19) patients. The rates of SARS-CoV-2-infected monocytes in peripheral blood mononuclear cells from COVID-19 patients increased over time from symptom onset, with SARS-CoV-2-positive monocytes, B cells, and CD4+ T lymphocytes also detected in postmortem lung tissue. These results indicated that SARS-CoV-2 infection of blood-circulating leukocytes in COVID-19 patients might have important implications for disease pathogenesis and progression, immune dysfunction, and virus spread within the host.
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COVID-19 , SARS-CoV-2 , Síndrome de Liberación de Citoquinas , Humanos , Leucocitos Mononucleares , MonocitosRESUMEN
A utilização de desenho manual e de videoaula são estratégias comumente utilizadas pelo médico para instruir o paciente sobre sua doença. Com o objetivo de identificar se alguma dessas estratégias proporciona melhor aprendizado, foi desenvolvido este estudo prospectivo e randomizado, no qual um grupo de pacientes foi informado sobre o diagnóstico da síndrome do manguito rotador através de desenhos produzidos em tempo real, e outro, por meio de uma videoaula. Ambas as estratégias explanadas pelo médico, durante o atendimento. Após terminar a consulta, foi aplicado aos pacientes um questionário para verificar o conhecimento adquirido. Participaram da pesquisa 88 pacientes, dispostos em dois grupos de 44 pessoas. Os desenhos mostraram-se significativamente mais eficazes em comparação à videoaula (p=0,0457), com relação à aquisição de conhecimentos pelo paciente, o que permite concluir que estratégias de ensino que envolvam ações de maior proximidade entre médico e paciente, podem interferir positivamente no aprendizado do paciente.
Handmade drawing and videoclasses are strategies commonly applied by doctors to instruct patients about their disease. In order to identify whether any of these methods provide better learning, this prospective and randomized study was developed with two groups of patients: one that was informed about the diagnosis of rotator cuff syndrome through drawings performed in real time, and the other through a videoclass. The physician explained both strategies during the medical consultation. Following consultation, a questionnaire was applied to the patients to assess the knowledge acquired. The study included 88 patients, 44 in each group. The drawing technique proved to be significantly more effective than the videoclass (p=0.0457) in what regards the acquisition of knowledge by the patient, leading to the conclusion that health teaching strategies, involving actions that strengthen the doctor-patient relationship, can positively interfere in the patient's comprehension.
El uso del dibujo manual y los videotutoriales son estrategias comúnmente utilizadas para informar al paciente sobre su enfermedad. Con la finalidad de identificar si alguna de estas estrategias proporciona un mejor aprendizaje, se desarrolló este estudio prospectivo y aleatorio que se informó a un grupo de pacientes sobre la presencia del síndrome del manguito de los rotadores con dibujos realizados por el médico durante la atención, otro con una lección en video explicada durante el servicio. Finalizada la consulta, se aplicó un cuestionario a los pacientes para averiguar los conocimientos adquiridos. El estudio incluyó a 88 pacientes, 44 en cada grupo. El uso de los dibujos demostró significativamente ser más efectivo si comparamos al videotutorial (p=0,0457) con la adquisición de conocimientos del paciente, permitiéndonos concluir que las estrategias de enseñanza de la salud, que implican acciones de mayor proximidad entre médico y paciente, pueden ser positiva para el aprendizaje del paciente.
Asunto(s)
Relaciones Médico-Paciente , Educación en Salud , Manguito de los RotadoresRESUMEN
A pandemia ocasionada pela Covid-19, reforçou a necessidade intrínseca de treinamento e avaliação de habilidades técnicas que envolvam a manipulação das vias aéreas, buscando estabilizar a vítima conforme suas demandas. O procedimento de cricotireoidostomia por punção é raro no departamento de emergência, porém é uma habilidade requerida quando as demais alternativas falharam. Nesse sentido, o objetivo deste estudo foi: construir e validar um cenário simulado na modalidade de Exame Clínico Objetivo Estruturado (OSCE) para avaliação da habilidade técnica de cricotireoidostomia por punção. Estudo metodológico, sendo respeitadas as etapas de tradução, construção e validação pertinentes ao método. A pesquisa originou um roteiro para uma estação de OSCE para o ensino da habilidade de cricotireoidostomia por punção. Concluiu-se que a eficácia e confiabilidade da avaliação de habilidades técnicas pode ser realizada dentro de uma OSCE, com instrumentos validados, que forneçam uma avaliação padronizada e replicável em diversos locais.
Covid-19 pandemic reinforced the intrinsic need for training and evaluation of technical skills involving airway manipulation to stabilize the victim according to their needs. Puncture cricothyroidotomy is a rare procedure in the emergency department, although being a required skill when other alternatives fail. In this regard, this study's objective was to build and validate a simulated setting in the Objective Structured Clinical Examination modality to evaluate the technical skill to perform puncture cricothyroidotomy. This is a methodological study, respecting the stages of translation, construction and validation inherent to the method. The research originated a script for the Objective Structured Clinical Examination station for teaching the puncture cricothyroidotomy skills. It was concluded that the evaluation of technical skills can be done with efficacy and reliability in an Objective Structured Clinical Examination setting, using validated instruments that provide a standardized and replicable evaluation in several places.
La pandemia causada por el Covid-19 reforzó la necesidad intrínseca de capacitación y evaluación de habilidades técnicas que involucran la manipulación de las vías respiratorias, buscando estabilizar a La víctima de acuerdo con sus demandas. El procedimiento de cricotiroidotomía por punción es poco frecuente en el servicio de urgencias, pero es una habilidad requerida cuando otras alternativas han fallado. En este sentido, el objetivo de este estudio fue: Construir y validar un escenario simulado en la modalidad de Examen Clínico Estructurado Objetivo (ECOE) para evaluarla técnica de cricotiroidotomía por punción. Estudio metodológico, siendo respetado como etapas de traducción, construcción y criterios relevantes al método. La investigación resulto en un guion para una estación de la ECOE para enseñar la habilidad de la cricotiroidostomía por punción. Se concluyó que la efectividad y confiabilidad de la evaluación de las competencias técnicas puede realizarse dentro de una ECOE que proporcionan una evaluación normalizada y replicable en varios lugares.
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Humanos , Estudio de Validación , Evaluación EducacionalRESUMEN
ABSTRACT This study aimed to group some perspectives on Go Tani's epistemological activity in the context of Brazilian Physical Education (PE), establishing his contributions and reflections on Kinesiology for the structuring of undergraduate and graduate Physical Education in Brazil. This is a bibliographical and exploratory study, which prioritized Tani's production on the most varied platforms and the materials that circulated about Kinesiology in national and international literature. Finally, through the theoretical review, it was possible to identify that the PE field is a scenario full of disputes and that even with the transformations of paradigms that infer the legitimate alternatives in the scientific context, the relationships that are established between the different schools of PE thought have erupted in a process of mutual incomprehension that contributes to the circularity of perspectives and the maintenance of beliefs in the field.
RESUMO O presente estudo objetivou agrupar algumas perspectivas sobre a atividade epistemológica de Go Tani no contexto da Educação Física (EF) brasileira, estabelecendo suas contribuições e reflexões a partir da Cinesiologia para a estruturação da graduação e da pós-graduação em Educação Física no Brasil. Trata-se de um estudo bibliográfico e exploratório, o qual priorizou a produção de Tani nas mais variadas plataformas, bem como os materiais que circularam sobre a Cinesiologia na literatura nacional e internacional. Por fim, através da referida revisão teórica, foi possível identificar que o campo da EF é um cenário repleto de disputas e que mesmo com as transformações dos paradigmas que inferem nas alternativas legítimas no contexto científico, as relações que são estabelecidas entre as distintas escolas de pensamento da EF têm eclodido num processo de interincompreensão que contribui com a circularidade de perspectivas e a manutenção de crenças no campo.
Asunto(s)
Educación y Entrenamiento Físico/métodos , Ciencia/educación , Quinesiología Aplicada/educación , Brasil , Conocimiento , Curriculum , Educación de Postgrado/métodosRESUMEN
ABSTRACT Objective: assess pain and opioid consumption in patients undergoing anesthetic techniques of spinal erector plane block and local anesthetic block in video-assisted thoracic surgery in the immediate postoperative period. Methods: ninety-two patients undergoing video assisted thoracic surgery were randomized to receive ESPB or BAL before starting the surgical procedure. Using the numerical verbal scale, the primary outcome assessed was the patient's pain in the immediate postoperative period (POI). The secondary outcome comprises the assessment of opioid consumption in the IPP by quantifying the medication used in an equianalgesic dose of morphine expressed in milligrams, in the immediate post-anesthetic recovery period, 6h, 12h, and 24h after surgery. Results: the EVN scores in the LBA and ESPB group in the POI had a mean of 0,8 (±1,89) vs 0,58 (±2,02) in the post-anesthesia care room (REPAI), 1,06 (±2,00) vs 1,30 (±2,30) in 6 hours of POI, 0,84 (±1,74) vs 1,19 (±2,01) within 12 hours of POI and 0,95 (±1,88) vs 1 ( ±1,66) within 24 hours of POI, all with p>0.05. Mean opioid consumption in the BAL and ESPB groups in the POI was 12.9 (± 10.4) mg vs 14.9 (±10.2) mg, respectively, with p = 0.416. Sixteen participants in the ESPB group and seventeen in the BAL group did not use opioids during the first 24 hours of the PO analyzed. Conclusion: local anesthesic block and ESP block techniques showed similar results in terms of low pain scores and opioid consumption during the period evaluated.
RESUMO Objetivo: avaliar a dor e o consumo de opioides dos pacientes submetidos a técnicas anestésicas de bloqueio do plano eretor da espinha (ESPB) e bloqueio anestésico local (LBA) em cirurgia torácica vídeo assistida no período pós-operatório imediato (POI). Métodos: noventa e dois pacientes submetidos a cirurgia torácica videotoracoscópica foram randomizados aleatoriamente para receberem ESPB ou LBA antes do início do procedimento cirúrgico. O desfecho primário avaliado foi a dor do paciente no POI através da escala verbal numérica. O desfecho secundário avaliou o consumo de opioides através da quantificação da medicação usada em dose equianalgésica de morfina expressa em miligramas, no período de recuperação pós-anestésica imediata, 6h, 12h e 24h após a cirurgia. Resultados: os escores da Escala Verbal Numérica de dor (EVN) no grupo LBA e ESPB no POI, respectivamente, tiveram média de 0,8 (±1,89) vs 0,58 (±2,02) na sala de recuperação pós anestesia (REPAI), 1,06 (±2,00) vs 1,30 (±2,30) em 6 horas do POI, 0,84 (±1,74) vs 1,19 (±2,01) em 12 horas do POI e 0,95 (±1,88) vs 1 ( ±1,66) em 24 horas do POI, todos com p>0,05. O consumo médio de opioides no grupo LBA e ESPB foi de 12,9 (±10,4) mg vs 14,9 (±10.2) mg, respectivamente, com p=0.416. Dezesseis participantes do grupo ESPB e dezessete do grupo LBA não utilizaram opioides durante as primeiras 24 horas do PO. Conclusões: as técnicas de bloqueio LBA e ESPB apresentaram resultados semelhantes em termos de baixos escores de dor e consumo de opioides durante o período avaliado.
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Oropouche virus (OROV) is an emerging arbovirus in South and Central Americas with high spreading potential. OROV infection has been associated with neurological complications and OROV genomic RNA has been detected in cerebrospinal fluid from patients, suggesting its neuroinvasive potential. Motivated by these findings, neurotropism and neuropathogenesis of OROV have been investigated in vivo in murine models, which do not fully recapitulate the complexity of the human brain. Here we have used slice cultures from adult human brains to investigate whether OROV is capable of infecting mature human neural cells in a context of preserved neural connections and brain cytoarchitecture. Our results demonstrate that human neural cells can be infected ex vivo by OROV and support the production of infectious viral particles. Moreover, OROV infection led to the release of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-α) and diminished cell viability 48 h post-infection, indicating that OROV triggers an inflammatory response and tissue damage. Although OROV-positive neurons were observed, microglia were the most abundant central nervous system (CNS) cell type infected by OROV, suggesting that they play an important role in the response to CNS infection by OROV in the adult human brain. Importantly, we found no OROV-infected astrocytes. To the best of our knowledge, this is the first direct demonstration of OROV infection in human brain cells. Combined with previous data from murine models and case reports of OROV genome detection in cerebrospinal fluid from patients, our data shed light on OROV neuropathogenesis and help raising awareness about acute and possibly chronic consequences of OROV infection in the human brain.
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Resumo Fundamento Tendo em vista os casos de lactentes sintomáticos com Tetralogia de Fallot (TF), baixo peso ao nascimento e anatomia complexa, o implante de stent na via de saída do ventrículo direito (VSVD) tem sido indicado alternativamente à cirurgia de Blalock-Taussig (BT). Objetivo Avaliar o implante endovascular de stent na VSVD como abordagem primária no lactente com TF e não candidato à cirurgia de BT, bem como relatar seus resultados a médio prazo e até a retirada do stent na cirurgia corretiva. Métodos Entre outubro de 2015 e abril de 2018, uma série de seis lactentes portadores de TF receberam stents para desobstrução da VSVD. Os parâmetros hemodinâmicos foram comparados em períodos pré e pós-implante. Resultados As medianas de idade e peso no momento do procedimento foram de 146,5 dias e 4,9 kg, respectivamente. O gradiente sistólico máximo diminuiu de 63,5 mmHg para 50,5 mmHg, enquanto o diâmetro dos ramos pulmonares direito e esquerdo aumentou de 3,5 mm para 4,9 mm e 4,3 mm, respectivamente. O índice de Nakata aumentou de 96,5 mm para 108,3 mm; assim como o peso, de 4,9 kg para 5,5 kg. A saturação de oxigênio aumentou de 83,5% para 93%. Houve um caso de migração do stent e dois óbitos, um deles devido à embolização do stent e o outro não teve relação com o procedimento. Conclusões O implante de stent na VSVD como procedimento paliativo na TF se mostra uma alternativa promissora para o tratamento de lactentes com má anatomia e baixo peso ao nascimento.
Abstract Background Endovascular stent placement in the right ventricular outflow tract (RVOT) has been an alternative to Blalock-Taussig (BT) surgery in the treatment of Tetralogy of Fallot (TOF) in symptomatic infants with low birth weight and complex anatomy. Objective To evaluate endovascular stent placement in the RVOT as a primary treatment for infants with TOF who are not candidates for BT surgery, and evaluate medium-term outcomes until the stent is removed during corrective surgery. Methods Six infants with TOF were treated with RVOT stenting from October 2015 to April 2018. Hemodynamic parameters were compared between the pre- and post-stenting periods. Results At the time of stenting, participants had a median age and weight of 146.5 days and 4.9 kg, respectively. Peak systolic gradient decreased from 63.5 mm Hg to 50.5 mm Hg, while the diameter of the left and right pulmonary arteries increased from 3.5 mm to 4.9 mm and 4.3 mm, respectively. The Nakata index increased from 96.5 mm to 108.3 mm; weight increased from 4.9 kg to 5.5 kg; and oxygen saturation, from 83.5% to 93%. There was one case of stent migration and two deaths, one caused by stent embolization and the other unrelated to study procedures. Conclusions RVOT stenting is a promising alternative for the palliative treatment of TOF in infants with low birth weight and complex anatomy.
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Humanos , Lactante , Tetralogía de Fallot/cirugía , Procedimiento de Blalock-Taussing , Cuidados Paliativos , Arteria Pulmonar/cirugía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Oropouche virus (OROV) infection of humans is associated with a debilitating febrile illness that can progress to meningitis or encephalitis. First isolated from a forest worker in Trinidad and Tobago in 1955, the arbovirus OROV has since been detected throughout the Amazon basin with an estimated 500,000 human infections over 60 years. Like other members of the family Peribunyaviridae, the viral genome exists as 3 single-stranded negative-sense RNA segments. The medium-sized segment encodes a viral glycoprotein complex (GPC) that is proteolytically processed into two viral envelope proteins, Gn and Gc, responsible for attachment and membrane fusion. There are no therapeutics or vaccines to combat OROV infection, and we have little understanding of protective immunity to infection. Here, we generated a replication competent chimeric vesicular stomatitis virus (VSV), in which the endogenous glycoprotein was replaced by the GPC of OROV. Serum from mice immunized by intramuscular injection with VSV-OROV specifically neutralized wild-type OROV, and using peptide arrays we mapped multiple epitopes within an N-terminal variable region of Gc recognized by the immune sera. VSV-OROV lacking this variable region of Gc was also immunogenic in mice producing neutralizing sera that recognize additional regions of Gc. Challenge of both sets of immunized mice with wild-type OROV shows that the VSV-OROV chimeras reduce wild-type viral infection and suggest that antibodies that recognize the variable N terminus of Gc afford less protection than those that target more conserved regions of Gc. IMPORTANCE Oropouche virus (OROV), an orthobunyavirus found in Central and South America, is an emerging public health challenge that causes debilitating febrile illness. OROV is transmitted by arthropods, and increasing mobilization has the potential to significantly increase the spread of OROV globally. Despite this, no therapeutics or vaccines have been developed to combat infection. Using vesicular stomatitis (VSV) as a backbone, we developed a chimeric virus bearing the OROV glycoproteins (VSV-OROV) and tested its ability to elicit a neutralizing antibody response. Our results demonstrate that VSV-OROV produces a strong neutralizing antibody response that is at least partially targeted to the N-terminal region of Gc. Importantly, vaccination with VSV-OROV reduces viral loads in mice challenged with wild-type virus. These data provide novel evidence that targeting the OROV glycoproteins may be an effective vaccination strategy to combat OROV infection.
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Infecciones por Bunyaviridae/prevención & control , Genoma Viral , Orthobunyavirus/genética , Vesiculovirus/genética , Vesiculovirus/inmunología , Proteínas del Envoltorio Viral/genética , Animales , Anticuerpos Neutralizantes , Infecciones por Bunyaviridae/inmunología , Masculino , Ratones , Ratones Endogámicos C57BL , Estomatitis Vesicular/virología , Replicación ViralRESUMEN
BACKGROUND: Endovascular stent placement in the right ventricular outflow tract (RVOT) has been an alternative to Blalock-Taussig (BT) surgery in the treatment of Tetralogy of Fallot (TOF) in symptomatic infants with low birth weight and complex anatomy. OBJECTIVE: To evaluate endovascular stent placement in the RVOT as a primary treatment for infants with TOF who are not candidates for BT surgery, and evaluate medium-term outcomes until the stent is removed during corrective surgery. METHODS: Six infants with TOF were treated with RVOT stenting from October 2015 to April 2018. Hemodynamic parameters were compared between the pre- and post-stenting periods. RESULTS: At the time of stenting, participants had a median age and weight of 146.5 days and 4.9 kg, respectively. Peak systolic gradient decreased from 63.5 mm Hg to 50.5 mm Hg, while the diameter of the left and right pulmonary arteries increased from 3.5 mm to 4.9 mm and 4.3 mm, respectively. The Nakata index increased from 96.5 mm to 108.3 mm; weight increased from 4.9 kg to 5.5 kg; and oxygen saturation, from 83.5% to 93%. There was one case of stent migration and two deaths, one caused by stent embolization and the other unrelated to study procedures. CONCLUSIONS: RVOT stenting is a promising alternative for the palliative treatment of TOF in infants with low birth weight and complex anatomy.
FUNDAMENTO: Tendo em vista os casos de lactentes sintomáticos com Tetralogia de Fallot (TF), baixo peso ao nascimento e anatomia complexa, o implante de stent na via de saída do ventrículo direito (VSVD) tem sido indicado alternativamente à cirurgia de Blalock-Taussig (BT). OBJETIVO: Avaliar o implante endovascular de stent na VSVD como abordagem primária no lactente com TF e não candidato à cirurgia de BT, bem como relatar seus resultados a médio prazo e até a retirada do stent na cirurgia corretiva. MÉTODOS: Entre outubro de 2015 e abril de 2018, uma série de seis lactentes portadores de TF receberam stents para desobstrução da VSVD. Os parâmetros hemodinâmicos foram comparados em períodos pré e pós-implante. RESULTADOS: As medianas de idade e peso no momento do procedimento foram de 146,5 dias e 4,9 kg, respectivamente. O gradiente sistólico máximo diminuiu de 63,5 mmHg para 50,5 mmHg, enquanto o diâmetro dos ramos pulmonares direito e esquerdo aumentou de 3,5 mm para 4,9 mm e 4,3 mm, respectivamente. O índice de Nakata aumentou de 96,5 mm para 108,3 mm; assim como o peso, de 4,9 kg para 5,5 kg. A saturação de oxigênio aumentou de 83,5% para 93%. Houve um caso de migração do stent e dois óbitos, um deles devido à embolização do stent e o outro não teve relação com o procedimento. CONCLUSÕES: O implante de stent na VSVD como procedimento paliativo na TF se mostra uma alternativa promissora para o tratamento de lactentes com má anatomia e baixo peso ao nascimento.
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Procedimiento de Blalock-Taussing , Tetralogía de Fallot , Humanos , Lactante , Cuidados Paliativos , Arteria Pulmonar/cirugía , Estudios Retrospectivos , Tetralogía de Fallot/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVE: interstitial lung disease comprises a group of lung diseases with wide pathophysiological varieties. This paper aims to report the video thoracoscopic surgical biopsy in patients with interstitial lung disease through a single minimal chest incision, without orotracheal intubation, without chest drainage, and without the use of neuromuscular blockers. METHODS: this study is a series of 14 cases evaluated retrospectively, descriptively, where patients underwent a pulmonary surgical biopsy from January 2019 to January 2020. The patients included in the study had diffuse interstitial lung disease without a defined etiological diagnosis. RESULTS: none of the patients had transoperative complications, there was no need for chest drainage in the postoperative period, and the patients pain, assessed using the verbal scale, had a mode of 2 (minimum value of 1 and maximum of 4) in the post immediate surgery and 1 (minimum value of 1 and maximum of 3) at the time of hospital discharge. The length of hospital stay was up to 24 hours, with 12 patients being discharged on the same day of hospitalization. CONCLUSION: therefore, it is concluded in this series of cases that the performance of uniportal video-assisted thoracoscopic surgery procedures to perform lung biopsies, without orotracheal intubation, without chest drainage, and without the use of neuromuscular blockers, bring benefits to the patient without compromising his safety. Further larger studies are necessary to confirm the safety and efficiency of this method.
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Enfermedades Pulmonares Intersticiales , Cirugía Torácica Asistida por Video , Biopsia , Drenaje , Humanos , Intubación Intratraqueal , Estudios RetrospectivosRESUMEN
Cholesteatomas are frequent middle ear benign tumors of unknown etiology. Infectious agents have been considered as possible contributing factors in the pathogenesis of cholesteatomas. Aiming to investigate the presence of respiratory viruses in primary cholesteatoma tissues, 26 formalin-fixed paraffin-embedded primary cholesteatoma tissues obtained from patients seen at the of the Clinical Hospital of the University of São Paulo School of Medicine, in Ribeirão Preto, Brazil were tested by real-time polymerase chain reaction (PCR). Considering the PCR results, 35% of the tissues were positive for human rhinovirus (HRV), 15.3% for human enterovirus (EV), 3.8% for human metapneumovirus (HMPV), and 3.8% for human bocavirus (HBoV). Serial immunohistochemistry for virus antigens and cell surface markers evidenced that the viruses were associated with fibroblasts, dendritic cells, macrophages, B lymphocytes, CD4+ , and CD8+ T lymphocytes. These findings indicate for the first time the presence of active respiratory virus infection in primary cholesteatoma tissues, suggesting that persisting virus infection in the middle could play a role in the pathogenesis and evolution of cholesteatomas.