La experimentación en la formación de especialistas en Bioquímica Clínica / Experimentation in the training of specialists in Clinical Biochemistry

Fundamento: la bioquímica es una ciencia experimental, por lo que la Bioquímica Clínica es muy apropiada para la creación de habilidades de trabajo experimental, en la carrera de Medicina. Objetivo: diseñar actividades prácticas para el módulo Proteínas, a fin de contribuir a la adquisición de las habilidades experimentales en la formación de los especialistas desde la Bioquímica Clínica. Métodos: se realizó una investigación cualitativa transversal observacional en la Facultad de Medicina, durante el año 2019. Los métodos teóricos utilizados fueron el analítico-sintético y el inductivo-deductivo; y empírico: el análisis documental; además, los métodos de diseño inverso para la planificación de las actividades prácticas, y el de aprendizaje por indagación en el desarrollo de los seminarios y de las actividades prácticas. Resultados: se diseñaron las actividades, teniendo en cuenta las unidades didácticas, habilidades experimentales a crear y las actividades prácticas de laboratorio. Se brindaron tareas específicas para desarrollar el pensamiento crítico, la resolución de problemas y la evaluación de situaciones complejas. Para su correcta aplicación se elaboraron guías y se orientó la bibliografía, lo cual facilitó el trabajo independiente. Conclusiones: las actividades prácticas diseñadas para el módulo Proteínas contribuyeron a que los residentes de Bioquímica Clínica adquirieran las habilidades del trabajo experimental, imprescindible para alcanzar la competencia profesional en la docencia, la investigación y la asistencia médica.

Background: biochemistry is an experimental science, so Clinical Biochemistry is very appropriate for the creation of experimental work skills in the Medicine career. Objective: design practical activities for the Proteins module, in order to contribute to the acquisition of experimental skills in the training of specialists from Clinical Biochemistry. Methods: a qualitative cross-sectional observational research was carried out at the Faculty of Medicine during 2019. The theoretical methods used were analytical-synthetic and inductive-deductive; and empirical ones: documentary analysis; In addition, reverse design methods for planning practical activities, and inquiry learning in the development of seminars and practical activities. Results: the activities were designed, taking into account the teaching units, experimental skills to be created and the practical laboratory activities. Specific tasks were provided to develop critical thinking, problem solving, and evaluating complex situations. For its correct application, guides were prepared and the bibliography was oriented, which facilitated independent work. Conclusions: the practical activities designed for the Proteins module contributed to the Clinical Biochemistry residents acquiring the skills of experimental work, essential to achieve professional competence in teaching, research and medical care.

Construção do guia de plantas medicinais de Florianópolis, SC, Brasil / Production of the guide to medicinal plants in Florianópolis, Santa Catarina, Brazil / Construcción de la guía de plantas medicinales de Florianópolis, Estado de Santa Catarina, Brasil

Há escassez relativa de experiências com plantas medicinais e de orientações para confecção de materiais didáticos sobre elas na Atenção Primária à Saúde (APS). Uma equipe interinstitucional (Universidade Federal de Santa Catarina e Secretaria Municipal de Saúde de Florianópolis) produziu um guia de plantas medicinais em Florianópolis, SC. O objetivo deste trabalho é apresentar essa experiência e o guia, que é voltado para profissionais da APS e que valorizou saberes científicos, populares e profissionais, evitando uma abordagem colonizadora do tema. Após alguns tópicos introdutórios, o guia apresenta 38 plantas medicinais comumente usadas em Florianópolis (nomes científicos e populares; partes usadas; fotos; características botânicas; uso popular; informações científicas; uso clínico; modo de usar; reações adversas e contraindicações; plantas na gestação; toxicidade; glossário; e referências). Espera-se contribuir para a construção de outros guias adaptados aos contextos locais e para a valorização do uso de plantas medicinais na APS. (AU)

Experiences with medicinal plants and guidance for producing educational resources about these plants for use in primary health care (PHC) are relatively scarce. A team from the Santa Catarina Federal University and Florianópolis City Council Department of Health produced the "Guide to Medicinal Plants in Florianópolis". This article presents this experience and the guide, which is aimed at PHC professionals and values scientific, traditional and professional knowledge, avoiding a colonizing approach to the topic. After presenting some introductory topics, the guide describes 38 medicinal plants commonly used in Florianópolis (scientific and common names, parts used, photo, botanical characteristics, common uses, scientific information, clinical use, adverse reactions and contraindications, plants during pregnancy, toxicity, glossary and references). It is hoped this guide will contribute to the production of other guides adapted to local contexts and recognition of the value of medicinal plants in PHC. (AU)

Hay una escasez relativa de experiencias con plantas medicinales y de orientaciones para la confección de materiales didácticos sobre ellas en la atención primaria de la salud (APS). Un equipo interinstitucional (Universidad Federal de Santa Catarina y Secretaría Municipal de Salud de Florianópolis) produjo una guía de plantas medicinales en Florianópolis, estado de Santa Catarina. El objetivo de este trabajo es presentar esa experiencia y la guía, dirigida a los profesionales de la APS y que valorizó saberes científicos populares y profesionales, evitando un abordaje colonizador del tema. Después de algunos tópicos de introducción, la guía presenta 38 plantas medicinales comúnmente utilizadas en Florianópolis (nombres científicos y populares, partes usadas, foto, características botánicas, uso popular, informaciones científicas, uso clínico, modo de usar, reacciones adversas y contraindicaciones, plantas en la gestación, toxicidad, glosario y referencias). Se espera contribuir para la construcción de otras guías adaptadas a los contextos locales y para la valorización del uso de plantas medicinales en la APS. (AU)

La guía de estudio, un recurso didáctico en la enseñanza médica de la asignatura enfermedades infecciosas / The study guide, a didactic resource in the medical education of the subject infectious diseases

El objetivo de la enseñanza de Enfermedades Infecciosas en el Ciclo Clínico de la Carrera de Medicina de la Facultad de Medicina de la UBA es desarrollar los contenidos de la asignatura que le permitan al alumno adquirir las competencias, habilidades y destrezas necesarias para el ejercicio de la Atención Primaria de la Salud. Las guías didácticas constituyen un recurso del proceso de enseñanza y aprendizaje que tienen el propósito de orientar metodológicamente al estudiante en su actividad independiente, al mismo tiempo que sirven de apoyo a la dinámica del proceso docente y orientan la actividad del alumno en su aprendizaje. Es el documento que orienta el estudio, acercando a los procesos cognitivos del alumno el material didáctico, con el fin de que pueda trabajarlos. Una guía de estudios en la signatura Enfermedades Infecciosas es una herramienta colaborativa en el cumplimiento de las metas propuestas.

The primary function of the teaching of Infectious Diseases in the Clinical Cycle of the Medical Career of the UBA School of Medicine is to develop the contents of the subject that allow the student to acquire the necessary skills, abilities and skills for the exercise of Primary Health Care. The didactic guides are a resource of the teaching-learning process that have the purpose of methodologically guiding the student in their independent activity, at the same time that they support the dynamics of the teaching process and guide the student's activity in their learning. It is the document which guides the study, bringing the teaching material closer to the cognitive processes of the student, so that he can work on them. A study guide in the Infectious Diseases subject is a collaborative tool in fulfilling the proposed goals.

Experiencias de capacitación a manipuladores de alimentos desde la promoción de salud / Experiences of the food handlers´ training from the health promotion

Introducción: las personas que manipulan alimentos son responsables de la elaboración inocua de los mismos, son claves para desarrollar y fomentar una cultura alimentaria saludable. Objetivo: describir el desarrollo del curso “El manipulador de alimentos y la promoción de Salud” impartido por la Escuela Nacional de Salud Pública, durante el curso 20152016. Materiales y métodos: se realizó un estudio descriptivo, de corte transversal. El universo lo constituyó 97 cursistas. Resultados: las principales necesidades de aprendizaje fueron: normas jurídicas cubanas para la manipulación de alimentos inocuos, (97=100 %); buenas prácticas de manufactura en la limpieza y desinfección en establecimientos de alimentos, (96=93,12%); conocimiento de enfermedades trasmitidas por los alimentos, (89= 86,33 %); la necesidad de poseer conocimientos relacionados con los alimentos saludables y factores que influyen en su calidad, (60=58,20 %). Las principales expectativas declaradas al inicio del curso fueron cumplidas en un 100 %. El 91,75 % de los cursistas expresaron sentirse muy satisfechos. Conclusiones: el curso impartido desde la perspectiva de la promoción de la salud, posibilitó que los manipuladores de alimentos se empoderen de los conocimientos necesarios para contribuir a garantizar la inocuidad de los alimentos, en sus comunidades y escenarios laborales y así lograr una alimentación saludable y de calidad (AU).

Introduction: people handling food are responsible for their innocuous elaboration and are very important for developing and fomenting a healthy food culture. Objective: to describe the conduction of the training “The Food Handler and Health Promotion”, taught at the National School of Public Health, during the school year 2015-2016. Materials and methods: a cross-sectional, descriptive study was carried out. The universe was formed by 97 trainees. Results: the main learning necessities were: Cuban juridical norms for handling innocuous food (97=100 %); good manufacturing practices in food establishments cleaning and disinfestation (96=93.12%); knowledge on food-transmitted diseases (89= 86.33 %); necessity of having knowledge related to healthy food and factors influencing on their quality (60=58.20 %). The main expectations declared at the beginning of the training were 100 % fulfilled. 91.70 % of the trainees said they were satisfied. Conclusions: the training from the point of view of health promotion provided the food handlers the necessary knowledge for them to contribute to warrant the food innocuousness in their communities and working places, achieving that way a healthy, qualitative feeding (AU).

Experiencias de capacitación a manipuladores de alimentos desde la promoción de salud / Experiences of the food handlers´ training from the health promotion

RESUMEN Introducción: las personas que manipulan alimentos son responsables de la elaboración inocua de los mismos, son claves para desarrollar y fomentar una cultura alimentaria saludable. Objetivo: describir el desarrollo del curso "El manipulador de alimentos y la promoción de Salud" impartido por la Escuela Nacional de Salud Pública, durante el curso 2015-2016. Materiales y métodos: se realizó un estudio descriptivo, de corte transversal.El universo lo constituyó 97 cursistas. Resultados: las principales necesidades de aprendizaje fueron: normas jurídicas cubanas para la manipulación de alimentos inocuos, (97=100 %); buenas prácticas de manufactura en la limpieza y desinfección en establecimientos de alimentos, (96=93,12%); conocimiento de enfermedades trasmitidas por los alimentos, (89= 86,33 %); la necesidad de poseer conocimientos relacionados con los alimentos saludables y factores que influyen en su calidad, (60=58,20 %). Las principales expectativas declaradas al inicio del curso fueron cumplidas en un 100 %. El 91,75 % de los cursistas expresaron sentirse muy satisfechos. Conclusiones: el curso impartido desde la perspectiva de la promoción de la salud, posibilitó que los manipuladores de alimentos se empoderen de los conocimientos necesarios para contribuir a garantizar la inocuidad de los alimentos, en sus comunidades y escenarios laborales y así lograr una alimentación saludable y de calidad... (AU)

ABSTRACT Introduction: people handling food are responsible for their innocuous elaboration and are very important for developing and fomenting a healthy food culture. Objective: to describe the conduction of the training "The Food Handler and Health Promotion", taught at the National School of Public Health, during the school year 2015-2016. Materials and methods: a cross-sectional, descriptive study was carried out. The universe was formed by 97 trainees. Results: the main learning necessities were: Cuban juridical norms for handling innocuous food (97=100 %); good manufacturing practices in food establishments cleaning and disinfestation (96=93.12%); knowledge on food-transmitted diseases (89= 86.33 %); necessity of having knowledge related to healthy food and factors influencing on their quality (60=58.20 %). The main expectations declared at the beginning of the training were 100 % fulfilled. 91.70 % of the trainees said they were satisfied. Conclusions: the training from the point of view of health promotion provided the food handlers the necessary knowledge for them to contribute to warrant the food innocuousness in their communities and working places, achieving that way a healthy, qualitative feeding... (AU)

Effect of flowable composites on the clinical performance of non-carious cervical lesions: A systematic review and meta-analysis.

OBJECTIVES: To answer the following PICO question (participant, intervention, comparator and outcome): Does flowable resin composite restorations compared with regular resin composites improve the marginal adaptation, marginal discoloration and retention rates of restorations placed in non-carious cervical lesions [NCCLs] of adults?, through a systematic review and meta-analysis. SOURCE: MEDLINE, Scopus, Web of Science, LILACS, BBO, Cochrane Library and SIGLE were searched without restrictions, as well as the abstracts of the IADR, clinical trials registries, dissertations and theses in May 2016 (updated in April 2017). STUDY SELECTION: We included randomized clinical trials (RCTs) that answered the PICO question. RCTs were excluded if cavities other than NCCLs were treated; indirect restorations; polyacid-based resins instead of composite resins were employed, restorations in primary teeth and restorations were placed in carious cervical lesions. The risk of bias tool of the Cochrane Collaboration was applied in the eligible studies and the GRADE tool was used to assess the quality of the evidence. DATA: After duplicates removal, 5137 articles were identified. After abstract and title screening, 8 studies remained. Six were at "unclear" risk of bias. The study follow-ups ranged from 1 to 3 years. No significant difference was observed between groups for loss of retention and marginal discoloration in all follow-ups. Better marginal adaptation was observed for restorations performed with flowable composites. At 1-year (risk ratio=0.27 [0.10 to 0.70]) and 3-year (risk ratio=0.34 [0.17 to 0.71]) follow-ups, flowable composites showed a risk 73% and 66% lower than regular composites for lack of adaptation, respectively. The evidence was graded as moderate quality for loss or retention at 3 years due to risk of bias and low and very low for all other outcomes due to risk of bias, imprecision and inconsistency. CONCLUSIONS: We have moderate confidence that the resin composite viscosity does not influence the retention rates at 3 years. Similar marginal discoloration and better marginal adaptation was observed for flowable composites but the quality of evidence is doubtful. (PROSPERO CRD42015019560).

Methods to study ovarian function in monovulatory species using the cow as a model

In this review, we discuss the utility of the cow as an in vivo model to study the regulation of ovarian functions in monovular species. It is increasingly becoming clear that besides endocrine control locally produced factors play pivotal roles during dominant follicle selection, oocyte maturation, ovulation and luteolysis. Although in vitro culture systems have been used to study these processes, definitive understanding the interactions between endocrine and local factors requires appropriate in vivo models. Most of the experimental approaches to study ovarian functionsin vivo in large animals are based on the use of ultrasonography and considerable progress in this field has been made during the last thirty years. It has been shown that cows are an excellent model to collect samples (e.g., follicular fluid, granulosa cells, oocytes) from live animals at specific stages of follicular development in order to study mechanisms of intrafollicular factors in a physiological endocrine environment. In addition to support fundamental studies, the cow model has contributed immensely to the refinement of assisted reproductive technologies, which are now widely used not only in farm animals but also in humans.

Methods to study ovarian function in monovulatory species using the cow as a model

In this review, we discuss the utility of the cow as an in vivo model to study the regulation of ovarian functions in monovular species. It is increasingly becoming clear that besides endocrine control locally produced factors play pivotal roles during dominant follicle selection, oocyte maturation, ovulation and luteolysis. Although in vitro culture systems have been used to study these processes, definitive understanding the interactions between endocrine and local factors requires appropriate in vivo models. Most of the experimental approaches to study ovarian functionsin vivo in large animals are based on the use of ultrasonography and considerable progress in this field has been made during the last thirty years. It has been shown that cows are an excellent model to collect samples (e.g., follicular fluid, granulosa cells, oocytes) from live animals at specific stages of follicular development in order to study mechanisms of intrafollicular factors in a physiological endocrine environment. In addition to support fundamental studies, the cow model has contributed immensely to the refinement of assisted reproductive technologies, which are now widely used not only in farm animals but also in humans.(AU)

Guia para o processo de ajuda interpessoal de enfermagem ao familiar do paciente crítico / Guía para el proceso de ayuda interpersonal de enfermería al familiar del paciente crítico / Guide for interpersonal process of help in nursing to relatives of the critical patient

RESUMO Fundamentando-se no referencial de Viktor Frankl, propõe-se um guia sobre o processo de ajuda interpessoal entre a enfermeira e o familiar do paciente em estado crítico. Trata-se de uma estratégia sustentada em uma perspectiva humanista, existencial e personalista para despertar, no profissional enfermeiro, sua atuação ética, consciente e responsável pelo cuidado. O tema surgiu da tríade trágica: sofrimento, culpa e morte, vivenciada pelo familiar do paciente em estado crítico hospitalizado em uma Unidade de Terapia Intensiva (UTI), de um hospital geral e privado da cidade de Salvador, Brasil. Considerando-se que do trágico emerge o otimismo e este possibilita a resiliência para direcionar o cuidado do enfermeiro até o familiar do paciente em estado crítico, a proposta do guia possui quatro etapas: diagnóstico triádico, planejamento de ajuda, aplicação das estratégias de ajuda e avaliação do processo de ajuda. Com esta ferramenta, espera-se apoiar a transformação da tríade trágica, ou seja, transformar o sofrimento em atitude, a culpa em reflexões para a mudança e a possibilidade de morte, em ações responsáveis.

ABSTRACT Based on Viktor Frankl's logotherapy, a guide on the process of interpersonal help between the nurse and the relatives of the critically-ill patient is proposed. This is a strategy based on a humanist, existential and person-alistic perspective, to awake, in the professional nurse, their ethical, conscious and responsible action towards caring. The theme arose from Frankl's tragic triad: suffering, guilt and death, experienced by the relative of the critically-ill patient treated in an Intensive Care Unit (ICU), of a general and private hospital in the city of Salvador, Brazil. Considering the fact that from tragic events optimism emerges and it generates resilience to direct the care of the nurse towards the relatives of the patient in critical condition, the proposed guide has four stages: triadic diagnosis, aid planning, application of the aid strategies and evaluation of the aid process. With this tool it is expected to support the transformation of the tragic triad, that is, to transform suffering into attitude, guilt into reflections for change, and the possibility of death into responsible actions.

RESUMEN Fundamentada en el referencial de Víctor Frankl se propone una guía sobre el proceso de ayuda interpersonal de enfermería hacia el familiar del paciente crítico. Se trata de una estratégia sustentada en una perspectiva humanista, existencial y personalista para despertar, en el profesional de enfermería, su actuar ético, consciente y responsable por el cuidado. El tema surge de la tríada trágica -sufrimiento, culpa y muerte- vivenciada por el familiar del paciente crítico hospitalizado en una Unidad de Cuidados Intensivos (UCI), de un hospital general y privado de la ciudad de Salvador, Brasil. Considerando que de lo trágico emerge el optimismo que hace posible la resiliencia para iluminar el cuidado de enfermería hacia el familiar del paciente crítico, la guía propuesta posee 4 etapas: diagnóstico triádico, planificación de ayuda, aplicación de estrategias de ayuda y evaluación del proceso de ayuda. Con esta herramienta se espera apoyar la transformación de la tríada trágica, es decir, el sufrimiento en actitud, la culpa en reflexiones para el cambio y la posibilidad de muerte en acciones responsables.

Guías de atención integral para toxoplasmosis basadas en evidencia: una contribución de Colombia para el mundo: [Editorial] / Evidence-based comprehensive care guidelines for toxoplasmosis: a contribution from Colombia to the world: [Editorial]

Colombia ha recorrido un largo camino para desarrollar guías de atención integral basadas en evidencia. En 2009, el Ministerio de la Protección Social y Colciencias elaboraron la Guía Metodológica para la elaboración de Guías de Atención Integral (GAI) en el Sistema General de Seguridad Social en Salud Colombiano (Guía de Guías) proyecto que fue llevado a cabo por la Fundación Santafé de Bogotá - Centro de Estudios e Investigación en Salud en alianza con la Facultad de Salud Pública de la Universidad de Harvard. Las guías desarrolladas bajo este protocolo integran los tres componentes: clínico, económico y de impacto en el presupuesto.

Colombia has come a long way in developing evidence-based comprehensive care guidelines. In 2009, the Ministry of Social Protection and Colciencias developed the Methodological Guide for the Development of Comprehensive Care Guidelines (GAI) in the Colombian General System of Social Security in Health (Guía de Guías), a project that was carried out by the Fundación Santafé de Bogotá - Centro de Estudios e Investigación en Salud in alliance with the Harvard School of Public Health. The guidelines developed under this protocol integrate the three components: clinical, economic and budget impact.