El cuidado de niños y adolescentes negros con problemas de salud mental en la interseccionalidad entre género y raza / The care provided to black-skinned children and adolescents with mental health problems in the intersection between gender and race / O cuidado de crianças e adolescentes negros com problemas de saúde mental na interseccionalidade entre gênero e raça

Objetivo: caracterizar el perfil sociofamiliar de niños y adolescentes negros con problemas de salud mental y describir desde un enfoque interseccional quién es responsable de su cuidado. Método: estudio exploratorio descriptivo de enfoque cualitativo, llevado a cabo en un Centro de Atención Psicosocial Infantil y Juvenil de la región norte del municipio de São Paulo. La recolección de datos se realizó con 47 familiares de niños y adolescentes negros, con el soporte de un guion con variables predefinidas, sometidas a análisis estadístico. Resultados: se realizaron 49 entrevistas, 95,5% con mujeres, con edad promedio de 39 años, 88,6% madres, 85,7% negras. La renta familiar procede del salario para el 100% de los cuidadores hombres y el 59% de las mujeres. Entre las cuidadoras negras, 25% tienen casa propia y, entre las pardas, 46,2%. Del total de cuidadores, el 10% vive en casas ocupadas, el 20% vive en viviendas cedidas, el 35% tiene casa propia y el 35% alquila. La red de contención social es mayor entre los blancos (16,7%), seguidos por los pardos (3,8%) y está ausente entre los negros (0%). Conclusión: las responsables por el cuidado de niños y e adolescentes negros atendidos en el CAPSij, son, casi en su totalidad mujeres, "madres o abuelas" negras (o mulatas), con acceso desigual a educación, trabajo y vivienda, derechos sociales constitucionales en Brasil.

Objective: to characterize the sociofamily profile of black-skinned children and adolescents with mental health problems and to intersectionally describe who assumes responsibility for their care. Method: a descriptive and exploratory study with a quantitative approach, developed in the Psychosocial Care Center for Children and Adolescents from the North region of the municipality of São Paulo. The data were collected from 47 family members of black-skinned children and adolescents, using a script with predefined variables submitted to statistical analysis. Results: a total of 49 interviews were conducted: 95.5% women with a mean age of 39 years old, 88.6% mothers and 85.7% black-skinned. Family income comes from wages for all the male caregivers and for 59% of the women. Among the black-skinned female caregivers, 25% live in their own house, whereas this percentage is 46.2% among the brown-skinned ones. Of all the caregivers, 10% have a job, 20% live in transferred properties, 35% in houses of their own and 35% in rented places. The social support network is larger among white-skinned people (16.7%), followed by brown-skinned (3.8%), and absent among black-skinned individuals (0%). Conclusion: those responsible for the care of black-skinned children and adolescents monitored by the CAPS-IJ are almost entirely women, black-skinned (black or brown) "mothers or grandmothers", with unequal access to education, work and housing, constitutional social rights in Brazil.

Objetivo: caracterizar o perfil sociofamiliar de crianças e adolescentes negros com problemas de saúde mental e descrever interseccionalmente quem se responsabiliza por seus cuidados. Método: estudo descritivo exploratório de abordagem quantitativa, desenvolvido em um Centro de Atenção Psicossocial Infantojuvenil da região norte do município de São Paulo. Os dados foram coletados com 47 familiares de crianças e adolescentes negros, utilizando um roteiro com variáveis pré-definidas, submetidas à análise estatística. Resultados: foram realizadas 49 entrevistas, sendo 95,5% com mulheres, média de idade de 39 anos, 88,6% mães, 85,7% negras. A renda familiar é proveniente de salário, para 100% dos cuidadores homens e para 59% das mulheres. Dentre as cuidadoras pretas, 25% possuem casa própria, sendo que, dentre as pardas, 46,2%. Do total de cuidadores, 10% vivem em condições de ocupação, 20% habitam moradias cedidas, 35% casas próprias e 35% alugadas. A rede social de suporte é maior entre os brancos (16,7%), seguido pelos pardos (3,8%) e ausente entre os pretos (0%). Conclusão: as responsáveis pelo cuidado de crianças e adolescentes negros acompanhados pelo CAPSij, são na quase totalidade mulheres, "mães ou avós" negras (pretas ou pardas), com acesso desigual à educação, trabalho e moradia, direitos sociais constitucionais no Brasil.

The care provided to black-skinned children and adolescents with mental health problems in the intersection between gender and race. / El cuidado de niños y adolescentes negros con problemas de salud mental en la interseccionalidad entre género y raza.

OBJECTIVE: to characterize the sociofamily profile of black-skinned children and adolescents with mental health problems and to intersectionally describe who assumes responsibility for their care. METHOD: a descriptive and exploratory study with a quantitative approach, developed in the Psychosocial Care Center for Children and Adolescents from the North region of the municipality of São Paulo. The data were collected from 47 family members of black-skinned children and adolescents, using a script with predefined variables submitted to statistical analysis. RESULTS: a total of 49 interviews were conducted: 95.5% women with a mean age of 39 years old, 88.6% mothers and 85.7% black-skinned. Family income comes from wages for all the male caregivers and for 59% of the women. Among the black-skinned female caregivers, 25% live in their own house, whereas this percentage is 46.2% among the brown-skinned ones. Of all the caregivers, 10% have a job, 20% live in transferred properties, 35% in houses of their own and 35% in rented places. The social support network is larger among white-skinned people (16.7%), followed by brown-skinned (3.8%), and absent among black-skinned individuals (0%). CONCLUSION: those responsible for the care of black-skinned children and adolescents monitored by the CAPS-IJ are almost entirely women, black-skinned (black or brown) "mothers or grandmothers", with unequal access to education, work and housing, constitutional social rights in Brazil.

Translational Bioinformatics Applied to the Study of Complex Diseases.

Translational Bioinformatics (TBI) is defined as the union of translational medicine and bioinformatics. It emerges as a major advance in science and technology by covering everything, from the most basic database discoveries, to the development of algorithms for molecular and cellular analysis, as well as their clinical applications. This technology makes it possible to access the knowledge of scientific evidence and apply it to clinical practice. This manuscript aims to highlight the role of TBI in the study of complex diseases, as well as its application to the understanding and treatment of cancer. An integrative literature review was carried out, obtaining articles through several websites, among them: PUBMED, Science Direct, NCBI-PMC, Scientific Electronic Library Online (SciELO), and Google Academic, published in English, Spanish, and Portuguese, indexed in the referred databases and answering the following guiding question: "How does TBI provide a scientific understanding of complex diseases?" An additional effort is aimed at the dissemination, inclusion, and perpetuation of TBI knowledge from the academic environment to society, helping the study, understanding, and elucidating of complex disease mechanics and their treatment.

Effect of Dietary Inorganic and Chelated Trace Mineral Supplementation on the Growth Performance and Skeletal Deformities of European Seabass and Senegalese Sole Post-larvae.

Trace elements such as Cu, Fe, Mn and Zn are essential minerals in fish diets, especially important at early larval stages. The chemical speciation of these elements directly influences their uptake efficiency and metabolic utilization. In order to optimize the form of trace elements incorporated into larval feed, two experiments were conducted using two commercial fish species, European seabass (Dicentrarchus labrax) and Senegalese sole (Solea senegalensis), and two chemical forms (inorganic and glycinate chelates). Several fish performance parameters were measured, as well as bone status parameters to assess which form of mineral results in optimal fish biological performance. European seabass and Senegalese sole post-larvae were unresponsive (P > 0.05) to dietary treatments in terms of dry weight (DW), standard length (SL), relative growth rate (RGR) or feed conversion rates (FCR) when fed diets supplemented with chelated over inorganic trace minerals. This study suggests that replacing dietary inorganic mineral supplementation by their organic glycinate-chelated forms brings no beneficial effects on somatic growth and bone development in Senegalese sole and European seabass post-larvae fed high-quality commercial microdiets. Additionally, we show that mineral leaching from diets can be significant, but the use of chelated minerals can potentially mitigate this leaching phenomenon. Therefore, the selection of the dietary mineral form should take into account not only their economic value, but also their biological effect and environmental impact. Data generated in this trial provides new knowledge in trace mineral nutrition of early-stage marine fish.

Effect of Dietary Manganese and Zinc Levels on Growth and Bone Status of Senegalese Sole (Solea senegalensis) Post-Larvae.

Essential dietary trace elements, such as zinc (Zn) and manganese (Mn), critically influence a wide range of physiological, metabolic, and hormonal processes in fish larvae and post-larvae. Despite their importance for normal fish growth and skeletal development, trace mineral nutrition has not been extensively studied in the early stages of development of fish. Post-larvae of an emergent aquaculture species, Senegalese sole (Solea senegalensis), were the subject of this study in order to better understand the effects of diet supplementation of trace minerals upon fish larval development and performance. Sole post-larvae were fed a combination of organic Mn (45 and 90 mg kg-1 feed) and organic Zn (100 and 130 mg kg-1 feed) and survival, growth, mineral deposition rates, and vertebral bone status were assessed. Our results showed that although no significant effect was found on the growth performance of Senegalese sole post-larvae, Mn and Zn supplementation to a commercial microdiet for marine fish larvae at higher dietary levels (Mn at 90 mg kg-1 and Zn at 130 mg kg-1) improved larval survival, decreased the severity of vertebral malformations, and increased the deposition of Mn in bone.

Relatório técnico do diálogo deliberativo: o processo de cuidar em saúde mental da criança e do adolescente negro usuário de CAPS IJ

O diálogo deliberativo “O processo de cuidar em saúde mental da criança/adolescente negro usuário de CAPS IJ” foi realizado em 28 de agosto de 2020 virtualmente pela ferramenta Google Meet, pelo link de acesso meet.google.com/zyf--hegf-dyz e gravada com o consentimento dos participantes. Ele é um dos temas abordado no projeto “O processo de cuidar em saúde mental da criança/adolescente negro em CAPS infantil” desenvolvido pelo grupo de pesquisa Enfermagem e Políticas da Saúde Mental da Escola de Enfermagem da Universidade de São Paulo, entre 2018-2020, com apoio financeiro da Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp), sob o nº de processo 2018/07251-2.

Effect of Trace Minerals and B Vitamins on the Proliferation/Cytotoxicity and Mineralization of a Gilthead Seabream Bone-Derived Cell Line.

Trace minerals and vitamins are known modulators of bone metabolism, and dietary optimization of these components may improve skeletal development and reduce the occurrence of skeleton deformities in farmed fish. As for larval stages, mineral and water-soluble vitamin nutrition requirements are lacking in research efforts and knowledge is scarce. An in vitro cell system developed from gilthead seabream vertebra and capable of mineralization was used to assess the effect of B vitamins (thiamin and pyridoxine) and trace minerals (copper, manganese, and zinc in a sulfated and chelated form) on cell proliferation and extracellular matrix (ECM) mineralization. Dependent on dose, inhibition of cellular proliferation and/or cytotoxic effects was observed for all nutrients tested and LD50 values were determined: copper, 67.4-69.5 ppm; manganese, 20.9-29.8 ppm; zinc, 37.1-42.8 ppm in sulfated and chelated form respectively; thiamin, 6273 ppm; pyridoxine, 14226 ppm. ECM mineralization was enhanced by mineral (dose and form dependent) and vitamin (dose dependent) supplementation, at non-toxic concentrations below the determined LD50s. This in vitro work confirmed the mineralogenic action of trace minerals and water-soluble vitamins and provided valuable insights for subsequent in vivo nutritional trials.

Expansion of the interprofessional clinical practice of Primary Care nurses.

OBJECTIVE: To analyze the clinical practice of nurses in the interprofessional context of the Family Health Strategy. METHOD: Case study in a basic health unit of the city of São Paulo with a professional team of the Family Health Strategy and of the Family Health Support Center. Direct observation and interviews with thematic analysis and triangulation were conducted. RESULTS: Four empirical categories were identified: interprofessional actions guided by the logic of the user's health needs; interprofessional actions guided by the logic of expediting service; interprofessional actions with a biomedical approach and interprofessional actions with an integral/holistic approach. Six interprofessional actions that indicated the expansion of the clinical practice of the Family Health Strategy's nurses were also identified. CONCLUSION: The results express the world trend of interprofessional practice and expansion of the scope of practice of different professions, particularly that of nurses, which requires consolidation based on the population's health needs.

Expansion of the interprofessional clinical practice of Primary Care nurses / Ampliación de la práctica clínica de la enfermería de Atención Básica en el trabajo interprofesional / Ampliação da prática clínica da enfermeira de Atenção Básica no trabalho interprofissional

ABSTRACT Objective: To analyze the clinical practice of nurses in the interprofessional context of the Family Health Strategy. Method: Case study in a basic health unit of the city of São Paulo with a professional team of the Family Health Strategy and of the Family Health Support Center. Direct observation and interviews with thematic analysis and triangulation were conducted. Results: Four empirical categories were identified: interprofessional actions guided by the logic of the user's health needs; interprofessional actions guided by the logic of expediting service; interprofessional actions with a biomedical approach and interprofessional actions with an integral/holistic approach. Six interprofessional actions that indicated the expansion of the clinical practice of the Family Health Strategy's nurses were also identified. Conclusion: The results express the world trend of interprofessional practice and expansion of the scope of practice of different professions, particularly that of nurses, which requires consolidation based on the population's health needs.

RESUMEN Objetivo: Analizar la ampliación de la práctica clínica de la enfermera en el contexto interprofesional de la Estrategia de Salud de la Familia. Método: Estudio de caso en una unidad básica de salud de la ciudad de São Paulo con un equipo de profesionales de la estrategia de salud de la familia y el núcleo de apoyo a la salud de la familia. Se realizaron observación directa y entrevista con análisis temáticos y triangulación. Resultados: Se identificaron cuatro categorías empíricas: acciones interprofesionales orientadas por la lógica de las necesidades de salud del usuario; acciones interprofesionales orientadas por la lógica de agilizar la atención; acciones interprofesionales con enfoque biomédico, y acciones interprofesionales con enfoque integral/holístico. También se identificaron seis acciones interprofesionales en las que la enfermera participa, que evidenciaron la ampliación de la práctica clínica de la enfermera de la Estrategia de Salud de la Familia. Conclusión: Los resultados expresan la tendencia mundial de trabajo interprofesional y de ampliación del alcance de la práctica de las profesiones, en especial, de la práctica clínica de la enfermera, que requiere la consolidación a partir de las necesidades de salud de la población.

RESUMO Objetivo: Analisar a ampliação da prática clínica da enfermeira no contexto interprofissional da Estratégia Saúde da Família. Método: Estudo de caso em unidade básica de saúde do município de São Paulo com profissionais de uma equipe da Estratégia Saúde da Família e do Núcleo de Apoio à Saúde da Família. Realizaram-se observação direta e entrevista com análise temática e triangulação. Resultados: Foram identificadas quatro categorias empíricas: ações interprofissionais orientadas pela lógica das necessidades de saúde do usuário; ações interprofissionais orientadas pela lógica de agilizar o atendimento; ações interprofissional com abordagem biomédica e ações interprofissionais com abordagem integral/holística. Também foram identificadas seis ações interprofissionais nas quais a enfermeira participa, que evidenciaram a ampliação da prática clínica da enfermeira da Estratégia Saúde da Família. Conclusão: Os resultados expressam a tendência mundial de trabalho interprofissional e de ampliação do escopo de prática das profissões, em especial, da prática clínica da enfermeira, que requer a consolidação a partir das necessidades de saúde da população.

CPP-Ts: a new intracellular calcium channel modulator and a promising tool for drug delivery in cancer cells.

Scorpion sting envenoming impacts millions of people worldwide, with cardiac effects being one of the main causes of death on victims. Here we describe the first Ca2+ channel toxin present in Tityus serrulatus (Ts) venom, a cell penetrating peptide (CPP) named CPP-Ts. We show that CPP-Ts increases intracellular Ca2+ release through the activation of nuclear InsP3R of cardiomyocytes, thereby causing an increase in the contraction frequency of these cells. Besides proposing a novel subfamily of Ca2+ active toxins, we investigated its potential use as a drug delivery system targeting cancer cell nucleus using CPP-Ts's nuclear-targeting property. To this end, we prepared a synthetic CPP-Ts sub peptide14-39 lacking pharmacological activity which was directed to the nucleus of specific cancer cell lines. This research identifies a novel subfamily of Ca2+ active toxins and provides new insights into biotechnological applications of animal venoms.

Presence of Mycobacterium avium subs. paratuberculosis DNA in milk used to feed calves in Portugal.

This Technical Research communication describes results of a study aimed at detecting the presence of Map in milk fed to calves, and identifying possible risk factors for that presence. A questionnaire was performed on 37 dairy farms and waste milk samples were collected on 3 occasions separated by a minimum of 1 week. For farms not feeding waste milk, bulk tank milk samples were collected instead. A real time PCR for the detection of the IS900 sequence was performed for the detection of Map. A majority of farms (89·2%) fed waste milk, with only one pasteurising the milk before feeding it to calves. Results of the PCR showed that 51·5% of the farms that were feeding waste milk had a positive result for Map on that milk. None of the studied risk factors were significantly associated with the presence of Map in milk samples, possibly due to the small number of farms entering the study. However, the prevalence of positive samples for Map on PCR was 3·5 times higher for farms that bought in animals from a single origin and 1·9 times higher for farms that bought from multiple farms, when compared with closed farms. Having a calving area for multiple cows also increased the risk of a positive Map result by 1·5 when compared with single pens. The risk of having a positive Map result on waste milk was 1·6 times higher for farms feeding that milk to male calves and 1·4 for farms feeding to both male and female calves, when compared with farms not feeding waste milk. This study highlights paratuberculosis as one of the potential risks of feeding waste milk to calves, and the need for mitigation strategies to be in place to avoid unnecessary disease transmission.

Esteatosis Pancreática secundaria a tratamiento prolongado con esteroide. Reporte de un caso / Secondary Pancreatic Esteatosis to Prolonged Steroid Treatment. Reporting a Case

Introducción: El reemplazo graso del páncreas, esteatosis o lipomatosis pancreática es un proceso difuso o focal en cualquier segmento del órgano y se ha asociado a obesidad, diabetes mellitus y fibrosis quística. El ultrasonido abdominal y en especial la ecoendoscopia , permiten una mejor caracterización del parénquima de la glándula. Caso Clínico: adolescente femenina de 13 años referida por dolor abdominal crónico. Antecedentes: Gastritis crónica por Helicobacter pylori, Alergia alimentaria múltiple y en tratamiento con Metilprednisolona durante siete años por Artritis Reumatoidea Juvenil. Examen físico : Peso 40,9Kg y talla 134cm, fascie redondeada, catarata bilateral, cuello con hiperqueratosis e hiperpigmentación . Abdomen: globoso, blando, sin visceromegalia. Hipotrofia muscular miembros inferiores. Laboratorio : amilasa: 32U/L, lipasa 12.3U/L, colesterol 206mg%, triglicéridos 117 mg%, aminotransferasa pirúvica 60U/L, PCR ultrasensible 11,6 mg/l, relación insulina/glicemia postprandial alta, 25OHvitamina D: 5,5ng/ ml (déficit), cortisol y androstenediona bajos, exámenes negativos para enfermedad autoinmune En heces: esteatocrito 4.5% y Sudan III:15 a 20 gotas pequeñas. Edad ósea radiológica 11años. Ultrasonido abdominal: hiperecogenicidad periportal, páncreas ligeramente aumentado de tamaño con aumento difuso de su ecogenicidad, cabeza: 30mm, cuerpo:13mm y cola:30mm. Ultrasonido endoscópico: Proceso uncinado y cabeza con parénquima homogéneo, ecogenicidad conservada. En el itsmo, cuerpo y cola parénquima heterogéneo , con tendencia a la hiperecogenicidad. Wirsung: calibre normal. Diagnóstico clínico: Esteatosis pancreática, Síndrome de Cushing Exógeno y Resistencia a la Insulina con déficit vitamina D. Discusión : Se considera que existe relación positiva entre el uso prolongado de esteroide para el reemplazo graso del páncreas y las patologías asociadas como se evidencia en este caso.

Introduction: Fatty pancreas replacement, steatosis or pancreatic lipomatosis is a diffuse or focal process in any organ segment and has been associated with obesit y, diabetes mellitus and cystic fibrosis. Abdominal ultrasound and, in particular, ultrasound endoscopy allow a better characterization of the parenchyma of the gland. Case Clinical: 13 - year - old female adolescent referred for chronic abdominal pain. Backgr ound: Chronic gastritis by Helicobacter pylori, multiple food allergy and treatment with Methylprednisolone for seven years for Juvenile Rheumatoid Arthritis. Physical examination: Weight 40.9Kg and size 134cm, rounded fascia, bilateral cataract, neck with hyperkeratosis and hyperpigmentation. Abdomen: globose, soft, without visceromegaly. Muscle lower limb hypotrophy. Laboratory: amylase: 32U / L, lipase 12.3U / L, cholesterol 206mg%, triglycerides 117mg%, pyruvic aminotransferase 60U / L, ultrasensitive 1 1.6mg / l, insulin ratio / high postprandial glycemia, 25OH vitamin D: 5ng / ml (deficit), cortisol and low Androstenedione, negative tests for autoimmune disease Feces: steatocrit 4.5% and Sudan III: 15 to 20 small drops. Radiologic bone age 11 years. Abd ominal ultrasound: periportal hyperechogenicity, slightly enlarged pancreas with diffuse increase of its echogenicity, head: 30mm, body: 13mm and tail: 30mm. Endoscopic ultrasound: Uncinate process and head with homogeneous parenchyma, preserved echogenici ty. In the ismo, body and parenchyma heterogeneous, with tendency to hyperechogenicity. Wirsung: normal caliber. Clinical diagnosis: Pancreatic steatosis, Exogenous Cushing's Syndrome and Insulin Resistance with vitamin D deficit. Discussion: It is considered that t here is a positive relationship between prolonged steroid use for fatty replacement of the pancreas and associated pathologies as evidenced in this case.

Pseudobstruccion aguda de colon postquimioterapia en pediatria. Reporte de caso / Acute Pseudoobstruction of Colon Post Chemotherapy in Pediatrics. Case Report

Introducción: la pseudobstrucción aguda de colon se caracteriza por dilatación marcada en ausencia de obstrucción mecánica, siendo poco frecuente en niños. Se señala un desequilibrio del sistema nervioso autonómico desencadenado por fármacos, isquemia intestinal, inflamación sistémica o local del peritoneo entre otras. Caso clínico : escolar masculino de 8 años, con dolor abdominal de fuerte intensidad, tipo cólico, asociado fiebre, y quinto día sin evacuar. Anteceden te de Rabdomiosarcoma Embrionario Testicular, quimioterapia reciente con Vincristina, Ifosfamida, Dacinomicina y Adriamicina. Examen físico: facies dolorosa, aftas en mucosa oral y queilitis. Taquicardia 120xmin. Abdomen: timpanico, defensa voluntaria en fosa iliaca derecha e hipogastrio, masa no móvil en la zona, ruidos hidroaéreos escasos. Eritema y exudado. Bolsa escrotal derecha vacía. Neurológico sin focalización. Laboratorio: anemia, leucocitosis con neutrofilia, cultivos negativos (sangre - orina - heces ). Radiografía de abdomen: aumento del contenido neúmico desde cámara gástrica a colon, patrón fecal aumentado en colon derecho y distensión. Tomografía de abdomen con contraste oral: No progresión del contraste desde íleon terminal hacia ciego después de 9 horas, distensión de colon con aire a predominio derecho con aumento del contenido fecal, líquido en recto. Diagnóstico clínico: Pseudobstrucción colónica aguda. Se indica desimpactación oral con Colayte ® y Trimebutina. Terapia del dolor: dipirona, tramadol y gabapentina. Buena evolución a las 72 horas. Discusión: la dilatación del colon en niños con estreñimiento después de la quimioterapia es altamente sugestiva de la pseudobstrucción y los estudios por imágenes son importantes para el diagnóstico en pacientes pediátricos.

Introduction: pseudo - obstruction of the colon is characterized by marked dilatation in the absence of mechanical obstruction, being uncommon in children. It indicates an imbalance of the autonomic nervous system triggered by drugs, intestinal ischemia, systemic or local inflammation of th e peritoneum among others. Clinical case : male schoolboy of 8 years old, with abdominal pain of strong intensity, colic type, associated with fever, and fifth day without evacuation. Background of Testicular Embryonal Rhabdomyosarcoma, recent chemotherapy with Vincristine, Ifosfamide, Dacinomycin and Adriamycin. Physical examination: painful facies, oral mucosa ulcers and cheilitis. Tachycardia 120xmin. Abdomen: tympanic, voluntary defense in the right iliac fossa and hypogastrium, non - mobile mass in the ar ea, scarce hydroaéreo noises. Erythema and exudate. Right scrotal pouch empty. Neurological without targeting. Laboratory: anemia, leukocytosis with neutrophilia, negative cultures (blood - urine - feces). Abdominal x - ray: increased neural content from gastric chamber to colon, fecal pattern increased in right colon and distention. Tumor tomography with oral contrast: No progression of contrast from terminal ileum to cecum after 9 hours, distension of the colon with air to right predominance with increased feca l content, fluid in the rectum. Clinical diagnosis: Acute colonic pseudobstruction. Oral detoxification is indicated with Colayte ® and Trimebutina. Pain therapy: dipyrone, tramadol and gabapentin. Good evolution at 72 hours. Discussion: Colon dilatation i n children with constipation after chemotherapy is highly suggestive of pseudobstruction and imaging studies are important for the diagnosis in pediatric patients.

A influência da intensidade emocional no reconhecimento de emoções em faces por criancas brasileiras / The importance of emotional intensity on the recognition of facial emotions by Brazilian children

The ability to recognize emotions in faces is essential to human interaction and occurs since childhood. Hypothesis: research using the morphing technique assume that children require greater or lesser intensity of emotional expression to perceive it. Objective: to examine the emotional recognition of faces in childhood, using a task with emotional intensity variation. Method: it was applied a Test of Facial Emotion Recognition for Children to 28 children between 7 and 11 years, of both sexes, which presented 168 faces manipulated by the morphing technique, of the six basic emotions. Results: age as a trend growth of the likelihood of success at the task; more right answers for happiness and worst performances for fear; and the emotional intensity increasing at 42% the chance of success by every unit of intensity. Conclusion: these findings are relevant because they show the recognition of emotions at different levels as a more sensitive method.

GPR91: expanding the frontiers of Krebs cycle intermediates.

Since it was discovered, the citric acid cycle has been known to be central to cell metabolism and energy homeostasis. Mainly found in the mitochondrial matrix, some of the intermediates of the Krebs cycle are also present in the blood stream. Currently, there are several reports that indicate functional roles for Krebs intermediates out of its cycle. Succinate, for instance, acts as an extracellular ligand by binding to a G-protein coupled receptor, known as GPR91, expressed in kidney, liver, heart, retinal cells and possibly many other tissues, leading to a wide array of physiological and pathological effects. Through GPR91, succinate is involved in functions such as regulation of blood pressure, inhibition of lipolysis in white adipose tissue, development of retinal vascularization, cardiac hypertrophy and activation of stellate hepatic cells by ischemic hepatocytes. Along the current review, these new effects of succinate through GPR91 will be explored and discussed.

Dolor abdominal crónico orgánico y funcional en niños: prevalencia en la consulta especializada / CHRONIC ABDOMINAL PAIN, ORGANIC AND FUNCTIONAL IN CHILDREN: PREVALENCE IN THE SPECIALIZED CONSULTATION

Introducción: El dolor abdominal crónico se presenta en forma frecuente e interfiere en la calidad de vida del niño; conocer su verdadera prevalencia en la consulta, contribuye a mejorar el abordaje diagnóstico y esclarecer la causa orgánica o funcional para indicar tratamiento específico. Objetivo: determinar la prevalencia de dolor abdominal crónico orgánico y funcional en la consulta de gastroenterología. Pacientes y Método: estudio descriptivo, retrospectivo y longitudinal (enero 2014-marzo 2015). Definición de dolor crónico, orgánico y funcional. Criterios de Roma III. Variables: edad, sexo, clínica, laboratorio, ecografía y endoscopia. Resultados: 137 niños con dolor abdominal crónico de un total de 1194 pacientes evaluados, para una prevalencia general en la consulta de 11,45% (IC 99%: 9,10-13,85). Edad promedio 9,8 años (rango 4-19), femenino 56,20% y masculino 43,8%; el grupo más afectado entre 10-15 años. En la identificación de la causa se realizó videogastroscopia al 64,96%, hallazgos anormales en ultrasonido abdominal en 11,67%. El dolor abdominal de origen orgánico se encontró en 92/137(67,15%) para una prevalencia real de 7,71% (IC 99%: 5,72-9,69), las causas: Gastroduodenitis con o sin infección Helicobacter pylori 71/92(77,17%), Enteropatía alérgica 12/92(13,04%), Parasitosis 5/92(5,43%), otras causas 4/92 (4,36%). Origen funcional 45/137(32,85%) con una prevalencia 3,77% (IC99%: 2,32-5,19), siendo el estreñimiento lo más frecuente, 30/45(66,66%), dispepsia 8/45(17,78%) y Síndrome de intestino irritable 7/45(15,56%). Conclusiones: el dolor abdominal crónico tiene una prevalencia importante en la consulta, la causa orgánica fue más frecuente que la funcional, y la utilización de definiciones claras permitió una mejor evaluación del paciente, identificar la causa e indicar el tratamiento específico.

Introduction: Chronic abdominal pain occurs on a frequent basis and interferes with the quality of life of the child; know its true prevalence in the consultation helps to improve the diagnostic approach and clarify the organic or functional cause to indicate specific treatment. Objective: determine the prevalence of organic and functional chronic abdominal pain in gastroenterology consultation. Patients and methods: A descriptive, retrospective and longitudinal study (January 2014-March 2015). Defintion of chronic abdominal pain, organic and functional. Rome III criteria. Variables: age, sex, clinical features, laboratory, ultrasound and upper endoscopy. Results: 137 children with chronic abdominal pain of a total of 1194 patients evaluated, for an overall prevalence in the consultation of 11.45% (99% CI: 9.10 to 13.85). Average age 9.8 years (range 4-19), 56.20% female and 43.8% male; the most affected age group 10-15. Upper endoscopy was performed at 64.96%, an abdominal ultrasound was altered in 11.67%. Abdominal pain of organic origin was found in 92/137 (67.15%) for a real prevalence of 7.71% (99% CI: 5.72 to 9.69), causes: gastroduodenitis with or without Helicobacter pylori infection 71/92 (77.17%), allergic enteropathyn 12/92 (13.04%), parasitosis 5/92 (5.43%), other causes 4/92 (4.36%). Functional abdominal pain 45/137 (32.85%) with a prevalence 3.77% (IC99%: 2.32 to 5.19), the most frequent was constipation, 30/45 (66.66%), dyspepsia 8/45 (17.78%) and irritable bowel syndrome 7/45 (15.56%). Conclusions: chronic abdominal pain is a significant prevalence in the consultation, the organic cause was more common than functional, and use of clear definitions allowed for better patient assessment, identify the cause and indicate the specific treatment.

Dignidade humana e o direito ao lazer entre universitários do Alto Tietê - São Paulo / Human dignity and the right to leisure among university students in Alto Tietê region - São Paulo

Este estudo objetiva descrever a importância que os universitários atribuem ao lazer, assim como busca-se compreender como eles investem seu tempo disponível em atividades que lhes tragam descontração e bem estar, respeitando o princípio da dignidade humana. Para tanto realizou-se uma pesquisa descritiva de corte transversal, utilizando-se um questionário constituído de questões abertas e fechadas para apurar a realidade cotidiana dos entrevistados, alunos do curso Tecnólogo de Gestão em Recursos Humanos, período noturno de uma universidade particular da região do Alto Tietê. Os resultados encontrados sugerem que os universitários têm pouco tempo para o lazer e por isso aproveitam o tempo livre da semana, principalmente para descansar, estar com a família e fazer atividades que os façam relaxar e esquecer o estresse do dia a dia.

This study aims to describe the importance that college students tribute to leisure, and also look for a deep comprehension on how they invest their available time in activities that bring them relaxation and well being, respecting the principle of human dignity. For this descriptive study, was used a tool, developed for this purpose for the authors, consisting of open and closed questions to determine the daily reality of respondents which are all nighttime students of a Technological Course in Human Resources Management from a private university in the Upper Tietê River Region, in State of São Paulo, Brazil. All them work a great time along the day. The results suggest that students have little time for leisure, because of it they enjoy their free time on weekends, mainly to relax, to be with family and doing activities that do relax and forget the stress of their stressed.

Dynamics on human Toll-like receptor 4 complexation to MD-2: the coreceptor stabilizing function.

The interaction between human Toll-like receptor 4 (hTLR4) and its coreceptor, myeloid differentiation factor 2 (MD-2), is important in Gram-negative bacteria lipopolysaccharide (LPS) recognition. In this process, MD-2 recognizes LPS and promotes the dimerization of the complex hTLR4-MD-2-LPS, triggering an intracellular immune signaling. In this study, we employed distinct computational methods to explore the dynamical properties of the hTLR4-MD-2 complex and investigated the implications of the coreceptor complexation to the structural biology of hTLR4. We characterized both global and local dynamics of free and MD-2 complexed hTLR4, in both (hTLR4-MD-2)1 and (hTLR4-MD-2)2 states. Both molecular dynamics and normal mode analysis reveled a stabilization of the terminal regions of hTLR4 upon complexation to MD-2. We are able to identify conserved important residues involved on the hTLR4-MD-2 interaction dynamics and disclose C-terminal motions that may be associated to the signaling process upon oligomerization.

Succinate causes pathological cardiomyocyte hypertrophy through GPR91 activation.

BACKGROUND: Succinate is an intermediate of the citric acid cycle as well as an extracellular circulating molecule, whose receptor, G protein-coupled receptor-91 (GPR91), was recently identified and characterized in several tissues, including heart. Because some pathological conditions such as ischemia increase succinate blood levels, we investigated the role of this metabolite during a heart ischemic event, using human and rodent models. RESULTS: We found that succinate causes cardiac hypertrophy in a GPR91 dependent manner. GPR91 activation triggers the phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2), the expression of calcium/calmodulin dependent protein kinase IIδ (CaMKIIδ) and the translocation of histone deacetylase 5 (HDAC5) into the cytoplasm, which are hypertrophic-signaling events. Furthermore, we found that serum levels of succinate are increased in patients with cardiac hypertrophy associated with acute and chronic ischemic diseases. CONCLUSIONS: These results show for the first time that succinate plays an important role in cardiomyocyte hypertrophy through GPR91 activation, and extend our understanding of how ischemia can induce hypertrophic cardiomyopathy.

Atuação do enfermeiro da atenção básica no âmbito da articulação interprofissional / Nurse actions in basic healthcare in the scope of interprofessional articulation

Introdução: O estudo propõe analisar o trabalho do enfermeiro na atenção básica de saúde, no contexto das relações entre trabalhadores da equipe de saúde da família e do núcleo de apoio à saúde da família (NASF), para conhecer como se dá a participação do enfermeiro na promoção de ações interprofissionais. Objetivos: Identificar as ações interprofissionais nas quais o enfermeiro participa e analisar as concepções dos profissionais de saúde das unidades básicas de saúde (UBS) sobre a participação do enfermeiro nas ações interprofissionais e sobre o trabalho em equipe. Método: Estudo de caso com abordagem qualitativa realizado em uma UBS da região sul do município de São Paulo. Coleta de dados através de observação direta do trabalho das equipes e entrevista com base na técnica de incidente crítico, com 15 profissionais de uma Equipe de Saúde da Família, Saúde Bucal e NASF. Na análise utilizou-se análise temática e triangulação. Resultados: Foram identificados oito tipos de ações interprofissionais nas quais o enfermeiro participa: consulta compartilhada, consulta de enfermagem que se desdobra em consulta compartilhada, atendimento compartilhado, espaço de troca e oportunidades de articulação, discussão de dúvidas, coordenação do cuidado, encaminhamentos pela enfermeira para outros profissionais e encaminhamentos de outros profissionais para a enfermeira. Os resultados mostraram o predomínio de consultas compartilhadas com médico e profissionais do NASF e que o conjunto das ações interprofissionais são orientadas por duas lógicas distintas: lógica das necessidades de saúde do usuário e lógica de agilizar o atendimento, ou a combinação de ambas. Independentemente da orientação da ação, foram identificadas duas abordagens também distintas: biomédica ou atenção integral à saúde.Conclusão: As ações interprofissionais observadas evidenciam características de trabalho em equipe integrado e prática colaborativa, destacando-se a atuação da enfermeira como agente de distribuição e convergência de informações e sua participação na ação interprofissional, em especial relacionada à prática clínica. Nas ações interprofissionais orientadas pela lógica das necessidades de saúde, houve o predomínio da abordagem pautada na busca da integralidade e nas ações interprofissionais voltadas à lógica de agilizar o atendimento, predominou a abordagem biomédica, com foco na doença e aspectos a ela relacionados. As ações desenvolvidas em conjunto entre enfermeira e profissionais do NASF, evidenciam a atuação deste como recurso de matriciamento e de apoio técnico-pedagógico, pois tanto representa a extensão da abordagem das necessidades de saúde de usuários, como educação permanente dos envolvidos.

Introduction: In this study we propose to analyze the work of the basic healthcare nurse in the context of the relationship between workers of the family healthcare team and the support nucleus of the family healthcare (NASF -- núcleo de apoio à saúde da família) to acknowledge how the participation of the nurse in the promotion of interprofessional actions occurs. Objective: Identify the interprofessional actions where the nurse takes part and analyze the ideas of the healthcare professionals of the healthcare basic units (UBS -- unidades básicas de saúde) on nurse participation in interprofessional actions and in teamwork. Method: Case study with a qualitative approach conducted in a UBS of the southern area of the municipality of São Paulo. Data collection through direct observation of the work of the teams, and interviews based on the critical incidents technique, with 15 professionals of a Family Health Team, Buccal Health, and NASF. For the analysis, thematic analysis and triangulation were applied. Results: Eight types of interprofessional actions where the nurse takes part were identified: Shared visits, nurse visits that turns into a shared visit, shared care, a space for exchanges and articulation opportunities, discussion of issues, care coordination, referrals by the nurse to other professionals, and referrals of the other professionals to the nurse. The results have shown the predominance of shared visits with physicians and NASF professionals, and that the whole of interprofessional actions are guided by two different reasoning: Reasoning of the health needs of the user, and reasoning of speeding up the care, or a combination of both. Regardless of the action guidance, two approaches, also different, were identified: Biomedical or integral healthcare.Conclusion: The interprofessional actions observed point to integrated teamwork and collaborative practice characteristics, with the nurse action standing out as an agent of information delivery and convergence, and their participation in the interprofessional action, mainly in relation with the clinical practice. The interprofessional actions guided by the reasoning of health needs have shown the predominance of the approach ruled by the search of integrality, and in the interprofessional actions, directed by the reasoning of speeding up care, biomedical approach has prevailed, with focus on disease and their related aspects. The actions developed together by nurses and NASF professionals, point to its action as a matrix and technical and pedagogical support resource, for they represent the extension of the approach of health needs of the user as well as the permanent education of the involved.