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O artigo busca analisar as variações temporais na incidência de neoplasias malignas dos brônquios e pulmões na cidade de São Paulo, considerando intervenções e políticas públicas de combate à poluição e ao tabagismo. O estudo quantitativo, descritivo e transversal utilizou dados do DATASUS, Vigitel Brasil 2021, IBGE e BasePop do INCA. Entre 1996 e 2021, houve aumento na taxa de mortalidade feminina de 7,3 por 100 mil habitantes, enquanto a masculina sofreu uma queda de 2,5 por 100 mil habitantes. Apesar das políticas antitabaco, a mortalidade geral aumentou em 2,56 em cada 100 mil habitantes, enquanto a taxa de incidência caiu 12,63 para cada 100 mil habitantes. Apesar das políticas públicas relacionadas ao controle do tabaco desde 1950 e de outros fatores de risco como exposição ocupacional e poluição atmosférica, o câncer de pulmão continua sendo uma ameaça significativa, sugerindo a necessidade de revisão das estratégias implementadas. Além disso, historicamente o tabagismo feminino, mostra como mudanças sociais e culturais influenciaram o aumento do consumo entre as mulheres, apontando para a necessidade de políticas públicas mais rígidas e ações de conscientização. Reconhece-se ainda que a falta de dados detalhados sobre fatores de risco e a eficácia das medidas implementadas ressalta a complexidade do desafio de reduzir a incidência de câncer de pulmão e brônquios.
The article seeks to analyze temporal variations in the incidence of malignant neoplasms of the bronchi and lungs in the city of São Paulo, considering interventions and public policies to combat pollution and smoking. The quantitative, descriptive and cross-sectional study used data from DATASUS, Vigitel Brasil 2021, IBGE and BasePop from INCA. Between 1996 and 2021, there was an increase in the female mortality rate of 7.3 per 100 thousand inhabitants, while the male mortality rate suffered a drop of 2.5 per 100 thousand inhabitants. Despite anti-smoking policies, overall mortality increased by 2.56 per 100,000 inhabitants, while the incidence rate fell by 12.63 per 100,000 inhabitants. Despite public policies related to tobacco control since 1950 and other risk factors such as occupational exposure and air pollution, lung cancer continues to be a significant threat, suggesting the need to review implemented strategies. Furthermore, historically, female smoking shows how social and cultural changes have influenced the increase in consumption among women, pointing to the need for stricter public policies and awareness-raising actions. It is also recognized that the lack of detailed data on risk factors and the effectiveness of implemented measures highlights the complexity of the challenge of reducing the incidence of lung and bronchial cancer.
ABSTRACT
RESUMO Adolescentes que cumprem medida socioeducativa de liberdade assistida têm a frequência escolar como uma obrigação. Nesse cenário, o professor tem papel central na promoção de relações proximais que auxiliem esses alunos. Objetivou-se caracterizar os recursos e as dificuldades relatadas por professores quanto ao processo de ensino-aprendizagem de adolescentes em liberdade assistida. Participaram 10 professores de alunos em liberdade assistida, de escolas públicas de uma cidade do interior paulista, os quais responderam a uma entrevista semiestruturada. As análises foram pautadas na técnica do Discurso do Sujeito Coletivo, apontando os recursos dos professores quanto ao planejamento, à didática e ao estabelecimento de vínculos; como dificuldades foram relatadas a ausência da família na escola, as lacunas de aprendizado e a não valorização da educação. Conclui-se como importantes intervenções que potencializem as habilidades sociais educativas de professores e promovam relações entre os microssistemas família e escola do alunado em liberdade assistida.
RESUMEN Los adolescentes que cumplen medida socioeducativa de libertad asistida tienen la frecuencia escuela como obligación. En este escenario, el profesor desempeña un papel central en la promoción de relaciones proximales que ayuden a estos alumnos. se ha objetivado caracterizar los recursos y las dificultades señaladas por los profesores en relación con el proceso de enseñanza-aprendizaje de los adolescentes en libertad asistida. Participaron diez profesores de alumnos en libertad asistida, de escuelas públicas de una ciudad del interior de São Paulo, que respondieron a una entrevista semiestructurada. Los análisis se basaron en la técnica del Discurso del Sujeto Colectivo, señalando los recursos de los profesores para planificar, enseñar y establecer vínculos; se señalaron como dificultades la ausencia de la familia de la escuela, las lagunas en el aprendizaje y la no valoración de la educación. Se llega a la conclusión de la importancia de las intervenciones que potencien las habilidades sociales educativas de los profesores y fomenten las relaciones entre los microsistemas familiar y escolar de los alumnos en libertad asistida.
ABSTRACT Adolescents who comply with a socio-educational measure of probation have to attend school as an obligation. In this scenario, the teacher has a central role in promoting close relationships that help these students. The objective was to characterize the resources and difficulties reported by teachers regarding the teaching-learning process of adolescents on probation. Ten teachers of students on probation participated, from public schools in a city in the countryside of the state of São Paulo, who provided answers to a semi-structured interview. The analyzes were based on the Collective Subject Discourse technique, pointing out the teachers' resources regarding planning, teaching, and establishing bonds; as the difficulties reported were the family's absence at school, learning gaps and the lack of value for education. It is concluded that interventions that enhance the teachers' social educational skills and promote relationships between the family and school microsystems of students on probation are important.
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Objetivo: identificar o grau do conhecimento técnico e científico dos enfermeiros no procedimento intubação traqueal. Método: pesquisa de campo com caráter descritivo-exploratória e quantitativa tendo identificado, através do resultado de um questionário aplicado a 23 profissionais enfermeiros, em um Hospital Geral do Vale do Paraíba, o grau de conhecimento técnico e científico sobre o procedimento de intubação traqueal. A coleta dos dados foi realizada nos meses de setembro e outubro de 2021. Resultados: a enfermagem participa e desempenha papel importante no procedimento de intubação, desde os diagnósticos até a avaliação contínua dos principais sinais e sintomas, estabelecendo um plano de cuidados, intervenções e atividades que permitirão fornecer o melhor atendimento ao paciente. Conclusão: O conhecimento do enfermeiro durante o procedimento de intubação traquel é de extrema importância, visando a qualidade da assistência, e a segurança do paciente.(AU)
Objective: To identify the degree of technical and scientific knowledge of nurses in the tracheal intubation procedure. Method: descriptive-exploratory and quantitative field research, having identified, through the result of a questionnaire applied to 23 nursing professionals, in a General Hospital of the Paraíba Valley, the degree of technical and scientific knowledge about the tracheal intubation procedure. Data were collected in September and October 2021. Results: nursing participates and plays an important role in the intubation procedure, from diagnoses to continuous evaluation of the main signs and symptoms, establishing a care plan, interventions and activities that will allow providing the best patient care. Conclusion: The knowledge of nurses during the traquel intubation procedure is extremely important, aiming at the quality of care, and patient safety.(AU)
Objetivo: identificar el grado de conocimiento técnico y científico de las enfermeras en el procedimiento de intubación traqueal. Método: investigación de campo descriptiva-exploratoria y cuantitativa, habiendo identificado, a través del resultado de un cuestionario aplicado a 23 profesionales de enfermería, en un Hospital General del Valle de Paraíba, el grado de conocimiento técnico y científico sobre el procedimiento de intubación traqueal. Los datos fueron recolectados en septiembre y octubre de 2021. Resultados: La enfermería participa y juega un papel importante en el procedimiento de intubación, desde el diagnóstico hasta la evaluación continua de los principales signos y síntomas, estableciendo un plan de cuidados, intervenciones y actividades que permitan brindar la mejor atención al paciente. Conclusión: El conocimiento de las enfermeras durante el procedimiento deintubación de traquel es extremadamente importante, apuntando a la calidad de la atención y la seguridad del paciente.(AU)
Subject(s)
Respiratory Insufficiency , Nursing , Education, Continuing , IntubationABSTRACT
Vaccine development against the SARS-CoV-2 virus focuses on the principal target of the neutralizing immune response, the spike (S) glycoprotein. Adenovirus-vectored vaccines offer an effective platform for the delivery of viral antigen, but it is important for the generation of neutralizing antibodies that they produce appropriately processed and assembled viral antigen that mimics that observed on the SARS-CoV-2 virus. Here, we describe the structure, conformation and glycosylation of the S protein derived from the adenovirus-vectored ChAdOx1 nCoV-19/AZD1222 vaccine. We demonstrate native-like post-translational processing and assembly, and reveal the expression of S proteins on the surface of cells adopting the trimeric prefusion conformation. The data presented here confirms the use of ChAdOx1 adenovirus vectors as a leading platform technology for SARS-CoV-2 vaccines.
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BACKGROUND During routine Coronavirus disease 2019 (COVID-19) diagnosis, an unusually high viral load was detected by reverse transcription real-time polymerase chain reaction (RT-qPCR) in a nasopharyngeal swab sample collected from a patient with respiratory and neurological symptoms who rapidly succumbed to the disease. Therefore we sought to characterise the infection. OBJECTIVES We aimed to determine and characterise the etiological agent responsible for the poor outcome. METHODS Classical virological methods, such as plaque assay and plaque reduction neutralisation test combined with amplicon-based sequencing, as well as a viral metagenomic approach, were performed to characterise the etiological agents of the infection. FINDINGS Plaque assay revealed two distinct plaque phenotypes, suggesting either the presence of two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains or a productive coinfection of two different species of virus. Amplicon-based sequencing did not support the presence of any SARS-CoV-2 genetic variants that would explain the high viral load and suggested the presence of a single SARS-CoV-2 strain. Nonetheless, the viral metagenomic analysis revealed that Coronaviridae and Herpesviridae were the predominant virus families within the sample. This finding was confirmed by a plaque reduction neutralisation test and PCR. MAIN CONCLUSIONS We characterised a productive coinfection of SARS-CoV-2 and Herpes simplex virus 1 (HSV-1) in a patient with severe symptoms that succumbed to the disease. Although we cannot establish the causal relationship between the coinfection and the severity of the clinical case, this work serves as a warning for future studies focused on the interplay between SARS-CoV-2 and HSV-1 coinfection and COVID-19 severity.
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Since the outbreak of the SARS-CoV-2 pandemic, there have been intense structural studies on purified recombinant viral components and inactivated viruses. However, investigation of the SARS-CoV-2 infection in the native cellular context is scarce, and there is a lack of comprehensive knowledge on SARS-CoV-2 replicative cycle. Understanding the genome replication, assembly and egress of SARS-CoV-2, a multistage process that involves different cellular compartments and the activity of many viral and cellular proteins, is critically important as it bears the means of medical intervention to stop infection. Here, we investigated SARS-CoV-2 replication in Vero cells under the near-native frozen-hydrated condition using a unique correlative multi-modal, multi-scale cryo-imaging approach combining soft X-ray cryo-tomography and serial cryoFIB/SEM volume imaging of the entire SARS-CoV-2 infected cell with cryo-electron tomography (cryoET) of cellular lamellae and cell periphery, as well as structure determination of viral components by subtomogram averaging. Our results reveal at the whole cell level profound cytopathic effects of SARS-CoV-2 infection, exemplified by a large amount of heterogeneous vesicles in the cytoplasm for RNA synthesis and virus assembly, formation of membrane tunnels through which viruses exit, and drastic cytoplasm invasion into nucleus. Furthermore, cryoET of cell lamellae reveals how viral RNAs are transported from double-membrane vesicles where they are synthesized to viral assembly sites; how viral spikes and RNPs assist in virus assembly and budding; and how fully assembled virus particles exit the cell, thus stablishing a model of SARS-CoV-2 genome replication, virus assembly and egress pathways.
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Pesquisas criminológicas destacam as variáveis relativas a aspectos da personalidade como os melhores preditores do comportamento delituoso persistente. Este estudo objetivou verificar se adolescentes infratores violentos e não violentos apresentam padrões de personalidade diferentes, avaliados pela versão brasileira do Inventário de Jesness. Cento e vinte e nove adolescentes do sexo masculino em conflito com a lei, de 15 a 18 anos, com histórico de três boletins de ocorrência, em média, foram divididos entre os que haviam cometido delitos violentos (GV=88) e os que não haviam (GNV=41). Os grupos foram comparados nas 13 escalas do Inventário e os resultados indicaram diferenças significativas entre GV e GNV em seis das 13 escalas. Do ponto de vista da interpretação do instrumento e suas escalas, GV pontuou em um sentido pior que GNV. As escalas que diferenciaram os grupos relacionam-se a um funcionamento psicológico que remete a problemas de controle dos impulsos, manejo da raiva/sentimentos negativos e atitudes hostis/agressivas.
Criminological research highlights variables related to personality aspects as the best predictors of persistent criminal behavior. This study aimed to verify if violent and non-violent adolescent offenders show different personality patterns, evaluated by the Brazilian version of the Jesness Inventory. 129 male adolescents in conflict with the law, aged 15 to 18 years, with a history of 3 offense records on average, were divided between those who had committed violent crimes (GV = 88) and those who had not (GNV = 41). The groups were compared in the 13 scales of the Inventory. The results indicated significant differences between GV and GNV in 6 of the 13 scales. Regarding the interpretation of the instrument and its scales, GV scored in a worse direction than GNV. The scales that differentiate the groups are related to psychological functioning that refers to problems of impulse control, anger/negative feelings management and hostile/aggressive attitudes.
Subject(s)
Personality , Behavior , Violence , Adolescent Behavior , Juvenile DelinquencyABSTRACT
SARS-CoV-2 is the cause of the ongoing COVID-19 pandemic. Here, we investigated the interaction of this new coronavirus with Vero cells using high resolution scanning electron microscopy. Surface morphology, the interior of infected cells and the distribution of viral particles in both environments were observed 2 and 48 hours after infection. We showed areas of viral processing, details of vacuole contents, and viral interactions with the cell surface. Intercellular connections were also approached, and viral particles were adhered to these extensions suggesting direct cell-to-cell transmission of SARS-CoV-2. HighlightsWe used high resolution scanning electron microscopy to investigate Vero cells infected with SARS-CoV-2 at 2 and 48 hours post-infection. The central conclusions of this work include: O_LIInfected cells display polarization of their cytosol forming a restricted viroplasm-like zone dedicated to virus production and morphogenesis. C_LIO_LIThis is the first demonstration of SARS-CoV-2 attachment by scanning electron microscopy. C_LIO_LIThis is the first scanning electron microscopy images of the interior of SARS-CoV-2 infected cells and exploration of their vacuole contents. C_LIO_LIPerspective-viewing of bordering vesicles in close association with vacuoles. C_LIO_LIObservation of membrane ruffles and structures suggestive of exocytosis on the surface of infected cells. C_LIO_LIThe first demonstration of viral surfing in cell-to-cell communication on SARS-CoV-2 infection. C_LI
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OBJETIVO: Descrever as causas de aposentadoria por incapacidade permanente entre servidores municipais de Uberlândia, Minas Gerais, e associar com fatores sociodemográficos. MÉTODOS: Foi realizado um levantamento epidemiológico no período de janeiro de 1990 a dezembro de 2009, utilizando dados secundários sobre os servidores da Prefeitura Municipal de Uberlândia. RESULTADOS: Foram avaliadas 403 aposentadorias. Em 46% delas os indivíduos tinham idade inferior a 50 anos. A maioria (96%) se aposentou devido à doença. Os transtornos mentais e comportamentais (22,6%) e as doenças do sistema osteomuscular (23,6%) foram os mais frequentes quando o motivo da aposentadoria foi determinado por causa única ou por causa múltipla, respectivamente. Os indivíduos do gênero masculino se aposentaram mais velhos e com maior contribuição de tempo de serviço. Mesmo assim, o tempo perdido de produtividade foi maior neste gênero. CONCLUSÃO: o estudo revelou o impacto negativo das doenças crônicas em uma população em idade produtiva, com alta percentagem de aposentadorias precoces. Políticas públicas no âmbito ocupacional com o objetivo de promoção, prevenção e reabilitação dos trabalhadores constituem em ações imperativas para a reversão deste quadro. .
OBJECTIVE: To describe the causes of retirement for permanent disability among workers at the Municipality of Uberlândia, Minas Gerais, associating them with sociodemographic factors. METHODS: An epidemiological survey was conducted from January 1990 to December 2009, using data on the employees of the municipality of Uberlândia. RESULTS: Were evaluated 403 retirements. In 46% of these individuals were younger than 50 years. Most (96%) retired due to illness. Mental and behavioral disorders (22.6%) and diseases of the musculoskeletal system (23.6%) were the most frequent reason of retirement when it was determined because single or multiple causes, respectively. The male individuals retired older and with more service time contribution. Still, the time lost productivity was higher in this genre. CONCLUSION: The study revealed the negative impact of non-communicable chronic diseases in a population of working age, with a high percentage of early retirements. Public policies in the occupational context with the objective of promotion, prevention and rehabilitation of workers constitute mandatory actions to reverse this situation. .
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FUNDAMENTO: Estudar o papel do sistema renina-angiotensina-aldosterona na hipertrofia miocárdica induzida pelo hormônio tireoideano, utilizando-se a espironolactona. OBJETIVO: Analisar as alterações morfológicas no miocárdio induzidas pelo hormônio tireoideano e os efeitos da espironolactona nesse processo. MÉTODOS: Foram estudados 40 ratos Wistar, divididos em quatro grupos, que receberam: veículo utilizado para a diluição do hormônio tireoideano (C); levotiroxina sódica (50 µg/rato/dia) (H); espironolactona (0,3 mg/kg/dia) (E) e hormônio tireoideano + espironolactona (HE), nas mesmas doses citadas, durante 28 dias consecutivos. Todos os animais foram submetidos a pesagem, coleta de sangue para dosagens hormonais e realização de ECG no início e no final do experimento. Ao final do período de estudo, os animais foram sacrificados para determinação do peso do ventrículo esquerdo (VE) e obtenção de cortes de VE para análise morfológica. RESULTADOS: Houve aumento dos níveis de T3 no plasma, perda de peso corporal e aumento da freqüência cardíaca nos animais que receberam o hormônio. O peso do VE foi maior nos grupos H e HE. A análise histométrica mostrou maiores diâmetros dos miócitos no grupo H, com os valores decrescentes nos grupos HE, E e C, sendo as diferenças estatisticamente significantes entre todos os grupos. A espironolactona associada ao hormônio tireoideano (HT) diminuiu em 14,6 por cento a hipertrofia transversal dos miócitos. CONCLUSÃO: Em ratos tratados com hormônio tireoideano ocorre hipertrofia cardíaca com aumento do peso do VE e do diâmetro do miócito. A associação de espironolactona ao hormônio tireoideano previne parcialmente essa hipertrofia por mecanismos ainda desconhecidos.
BACKGROUND: To study the possible role of aldosterone on thyroid hormone-induced myocardium hypertrophy, using spironolactone. OBJECTIVE: To evaluate morphological changes in the myocardium induced by thyroid hormone and the possible effects of spironolactone use on these alterations. METHODS: Forty Wistar rats were studied. The animals were allocated to four groups and were given: the vehicle used for dilution of the thyroid hormone (C); sodium levothyroxin at 50 µg/rat/day (H); spironolactone, 0.3 mg/kg/day (S); or thyroid hormone plus spironolactone (HS), at the same doses mentioned above, for 28 consecutive days. All the animals were weighed, had blood drawn for hormonal measurements and underwent ECG at the start and the end of the experiment. At the end of experiment all animals were euthanized, the weight of the left ventricle (LV) was determined and LV slices were obtained for morphological analysis. RESULTS: There was an increase in T3 levels, decrease of body weight and higher heart rate in the animals from group H. The LV weight was significantly higher in the H e HS groups. The histometric analyses that measured the diameter of the myocytes showed higher values in group H and a progressive decrease in groups HS, S and C, with a significant difference among all the groups. The addition of spironolactone decreased the transversal myocyte hypertrophy by 14.6 percent. CONCLUSION: Rats treated with thyroid hormone present cardiac hypertrophy with increased LV weight and greater myocyte diameter. Spironolactone, when associated with thyroid hormone, can partially prevent this hypertrophy through mechanisms that are yet to be determined.
Subject(s)
Animals , Male , Rats , Mineralocorticoid Receptor Antagonists/therapeutic use , Heart/drug effects , Hypertrophy, Left Ventricular/chemically induced , Spironolactone/therapeutic use , Thyroid Hormones/adverse effects , Analysis of Variance , Body Weight/drug effects , Heart Rate/drug effects , Hypertrophy, Left Ventricular/prevention & control , Models, Animal , Organ Size/drug effects , Rats, Wistar , Thyroid Hormones/blood , Thyroxine/adverse effects , Thyroxine/blood , Triiodothyronine/adverse effects , Triiodothyronine/bloodABSTRACT
CONTEXT: Carney complex (CNC), a familial multiple neoplasm syndrome with dominant autosomal transmission, is characterized by tumors of the heart, skin, endocrine and peripheral nervous system, and also cutaneous lentiginosis. This is a rare syndrome and its main endocrine manifestation, primary pigmented nodular adrenal disease (PPNAD), is an uncommon cause of adrenocorticotropic hormone-independent Cushing's syndrome. CASE REPORT: We report the case of a 20-year-old patient with a history of weight gain, hirsutism, acne, secondary amenorrhea and facial lentiginosis. Following the diagnosing of CNC and PPNAD, the patient underwent laparoscopic bilateral adrenalectomy, and she evolved with decreasing hypercortisolism. Screening was also performed for other tumors related to this syndrome. The diagnostic criteria, screening and follow-up for patients and affected family members are discussed.
CONTEXTO: O complexo de Carney (CNC), uma síndrome de neoplasia múltipla familiar com transmissão autossômica dominante, caracteriza-se por tumores cardíacos, cutâneos, endócrinos e do sistema nervoso periférico, além de lentiginose cutânea. RELATO DE CASO: Devido à raridade da síndrome, bem como de sua principal manifestação endócrina, a doença adrenal nodular pigmentada primária (PPNAD), causa incomum de síndrome de Cushing ACTH-independente, relatamos o caso de uma paciente de 20 anos com história de ganho de peso, hirsutismo, acne, amenorréia secundária e lentiginose em face. Após estabelecido o diagnóstico de CNC e PPNAD, a paciente foi submetida a adrenalectomia bilateral via laparoscópica, evoluindo com melhora do hipercortisolismo. Também foi realizado rastreamento para os demais tumores relacionados à síndrome. Serão discutidos os critérios diagnósticos, o rastreamento e o acompanhamento dos pacientes e familiares afetados.
Subject(s)
Humans , Female , Adolescent , Adrenal Cortex Diseases/pathology , Cushing Syndrome/diagnosis , Lentigo/complications , Multiple Endocrine Neoplasia/diagnosis , Luminescent Measurements , Adrenal Cortex Diseases/blood , Adrenal Cortex Diseases/complications , Adrenal Cortex Diseases , Adrenalectomy , Cushing Syndrome/complications , Cushing Syndrome/etiology , Cushing Syndrome/surgery , Immunoassay , Lentigo/genetics , Multiple Endocrine Neoplasia/genetics , Tomography, X-Ray ComputedABSTRACT
Os autores relatam um caso de paciente portador de lipoatrofia generalizada congênita que desenvolveu diabetes mellitus aos 20 anos de idade e síndrome nefrótica diagnosticada aos 26 anos. A biópsia de rim mostrou ser compatível com nefroesclerose diabética e a urografia excretora revelou sinais de neuropatia autônoma. Alguns aspectos clínicos e etiopatogênicos desta patologia bastante rara säo discutidos
Subject(s)
Adult , Humans , Male , Diabetes Mellitus/complications , Lipodystrophy/complications , Nephrotic Syndrome/complicationsABSTRACT
O artigo descreve um programa de atendimento a criancas excepcionais, desenvolvido com base na observacao de comportamentos da crianca e no levantamento de atitudes e expectativas da familia. Foram atendidas 13 criancas, de idades entre 10 meses e 3 anos e 11 meses. A intervencao foi programada para cada caso individualmente e desenvolvida na propria casa da crianca. Consistiu em: a) orientacao geral a familia, atraves da discussao dos problemas; b) treinamento da mae ou outra pessoa da casa na execucao de programas para desenvolver habilidades verbais e motoras (atraves de instrucoes e demonstracoes). Os resultados indicaram que, apos 3 meses de programa observaram-se mudancas na atitude das familias e no comportamento das criancas.