Regulations on the Use of Antibiotics in Livestock Production in South America: A Comparative Literature Analysis.

As a global health problem, antimicrobial resistance (AMR) crosses national borders, leading UN (United Nations) multilateral agencies to call for all countries to improve the stewardship of antibiotics in humans and animals. South American countries have changed their regulations regarding antibiotic use in livestock production. This literature review examines how far the five largest meat-producing countries in South America (Argentina, Brazil, Chile, Colombia, and Uruguay) have come in terms of the relevant legislation. Rules on market entry (marketing authorization and official distribution systems) are already set in all countries examined. Four countries do not allow growth promoters based on critically important antibiotics, and countries have also begun to set guidelines and minimum welfare and biosecurity requirements to reduce the therapeutic demand for antibiotics. Nonetheless, there are aspects related to the distribution, use, and disposal of antibiotics that need to be developed further. In conclusion, legislation in South American countries is moving towards the goals set by UN multilateral agencies, but more can be done. Differences between countries' rules and the gold standards set by the World Organization for Animal Health (OIE), World Health Organization (WHO), and Food and Agriculture Organization of the United Nations (FAO) reveal possible adaptations to the countries' realities. Further studies must examine compliance with the legislation already set and investigate other tools that can be used alongside legislation as a driving force to change stakeholder behaviour.

Ensuring vaccine safety: Case studies of falsified influenza vaccines detected in Brazil.

Falsifications related to health technologies-including vaccines-are a growing threat to patient safety and health systems on a global scale and can cause serious harm to the population (especially vulnerable groups). In Brazil, the manufacturing and spread of counterfeit medicines are prevented through joint actions between different government agencies. In this study, we analyzed three cases of influenza vaccines suspected of counterfeiting. The samples were seized by officials and received by the National Institute for Quality Control in Health (INCQS), the national quality control reference laboratory of the Ministry of Health of Brazil, in 2010, 2017, and 2020. We report the results of our analytical investigations and emphasize the importance of strengthening the partnerships between various national agencies. The seized samples were visually inspected, and their information was compared with that of genuine vaccines (as recorded in the INCQS database). The specific analytical tests were based on quality control tests for biological products. Our results confirmed that all seized samples were falsified. We emphasize the importance of fostering international and intra-national collaborations between various national agencies (such as drug regulatory authorities, official laboratories, customs departments, police forces, and civil society). As demonstrated here, such collaborative actions are essential for combating the release of falsified medical products, safeguarding public health, and strengthening health systems.

Abordaje del duelo en una unidad de cuidado intensivo neonatal: entre el protocolo y la intuición / Approaching grief in a neonatal intensive care unit: protocol versus intuition

Objetivo: comprender las prácticas implementadas por el personal de salud con los familiares, ante la muerte del neonato hospitalizado en la unidad de cuidado intensivo neonatal (UCIN). Introducción: la muerte del recién nacido mantiene cierto grado de presentación epidemiológica a nivel global y nacional, aun cuando los desarrollos tecnológicos y de salud pública lo han reducido. La muerte o posibilidad de muerte del neonato en la UCIN es una vivencia que impacta emocionalmente a la familia del paciente y a los miembros del equipo técnico, generando maneras particulares de relación al interior de esta subcultura hospitalaria. De gran importancia es conocer el tipo de atención que la UCIN le brinda al dolor y al duelo. Metodología: estudio cualitativo con enfoque de etnografía focalizada, desarrollado en la UCIN de un hospital de IV nivel de Bogotá. Se realizó observación participante diaria de junio 2015 a septiembre 2016 y entrevistas semiestructuradas a informantes clave de 2015 a 2017. Resultados: a partir de las fuentes de datos se construyeron 3 categorías emergentes: 1) cotidianidad en la UCIN; 2) proceso de acompañamiento en el duelo entre el protocolo y la intuición; y 3) la muerte como desenlace siempre inesperado. Conclusiones: la muerte o su inminencia distorsionan los vínculos, la comunicación y el quehacer general en la UCIN.

Objective: to identify bereavement interventions delivered by healthcare staff to families following the death of a newborn in a neonatal intensive care unit (NICU). Introduction: neonatal death maintains a certain degree of epidemiological presentation at a global and national level, even though technological and public health developments have reduced it. Neonatal death in the NICU, or its possibility, emotionally affects both families and staff, leading to context-specific relationships within this hospital subculture. Identifying NICU-led bereavement care provided for pain and grief is very important. Methodology: a qualitative focused ethnographic study, conducted in the NICU of a level IV hospital in Bogotá. Daily participant observation from June 2015 to September 2016 and semi-structured interviews to key informants from 2015 to 2017, were conducted. Results: three emerging categories were constructed from data sources feedback: 1) daily life in the NICU; 2) accompaniment process during grief using protocol versus intuition and 3) death as an always unexpected outcome. Conclusions: death or its imminence distorts bonds, communication, and overall work in the NICU

Integra Project: strengthening social participation in the agenda of health policies, services, and technologies. / Projeto Integra: fortalecimento da participação social na agenda das políticas, serviços e tecnologias em saúde.

The 16th National Health Conference illustrated the interest of health councils to intervene in public policies in order to guarantee the right to health technologies. The INTEGRA project (Integration of policies for Health Surveillance, Pharmaceutical Care, Science, Technology, and Innovation in Health) is a partnership among the National Health Council, the National School of Pharmacists, and the Oswaldo Cruz Foundation (Fiocruz), with support from the Pan American Health Organization (PAHO), with the goal of strengthening participation and social engagement in the theme, as well as the integration of health policies and practices within different sectors of society (social movements, health councils, and health professionals), with the various stages related to the access to medicines (research, incorporation, national production, and services) being the main theme in the context of the COVID-19 pandemic. It seeks to offer training for leadership groups in the health regions and activities with a broad national and political scope, and it hopes to establish an intersectorial and integrated network of leaders capable of acting collaboratively to defend the development of science, public policies, national sovereignty, and social control of health.

A 16ª Conferência Nacional de Saúde demonstrou o interesse do controle social em intervir sobre as políticas públicas a fim de garantir o direito às tecnologias de saúde. O projeto Integra - Integração das Políticas de Vigilância em Saúde, Assistência Farmacêutica, Ciência, Tecnologia e Inovação em Saúde -, nasce da parceria entre o Conselho Nacional de Saúde, a Escola Nacional dos Farmacêuticos e a Fundação Oswaldo Cruz (Fiocruz), com apoio da Organização Pan-Americana de Saúde (OPAS) com objetivo de fortalecimento da participação e engajamento social na temática e a integração das políticas e práticas de saúde em diferentes setores da sociedade (movimentos sociais, controle social e profissionais de saúde), tendo as diversas etapas relacionadas ao acesso aos medicamentos (pesquisa, incorporação, produção nacional e serviços) como mote principal, no cenário da pandemia de COVID-19. Oferta-se, neste projeto, capacitação para grupos de lideranças nas regiões de saúde e atividades de grande abrangência nacional e política. Espera-se alcançar o estabelecimento de uma rede intersetorial, integrada de lideranças capazes de atuar colaborativamente para a defesa do desenvolvimento da ciência, das políticas públicas, da soberania nacional e do controle social da saúde.

Projeto Integra: fortalecimento da participação social na agenda das políticas, serviços e tecnologias em saúde / Integra Project: strengthening social participation in the agenda of health policies, services, and technologies

Resumo A 16ª Conferência Nacional de Saúde demonstrou o interesse do controle social em intervir sobre as políticas públicas a fim de garantir o direito às tecnologias de saúde. O projeto Integra - Integração das Políticas de Vigilância em Saúde, Assistência Farmacêutica, Ciência, Tecnologia e Inovação em Saúde -, nasce da parceria entre o Conselho Nacional de Saúde, a Escola Nacional dos Farmacêuticos e a Fundação Oswaldo Cruz (Fiocruz), com apoio da Organização Pan-Americana de Saúde (OPAS) com objetivo de fortalecimento da participação e engajamento social na temática e a integração das políticas e práticas de saúde em diferentes setores da sociedade (movimentos sociais, controle social e profissionais de saúde), tendo as diversas etapas relacionadas ao acesso aos medicamentos (pesquisa, incorporação, produção nacional e serviços) como mote principal, no cenário da pandemia de COVID-19. Oferta-se, neste projeto, capacitação para grupos de lideranças nas regiões de saúde e atividades de grande abrangência nacional e política. Espera-se alcançar o estabelecimento de uma rede intersetorial, integrada de lideranças capazes de atuar colaborativamente para a defesa do desenvolvimento da ciência, das políticas públicas, da soberania nacional e do controle social da saúde.

Abstract The 16th National Health Conference illustrated the interest of health councils to intervene in public policies in order to guarantee the right to health technologies. The INTEGRA project (Integration of policies for Health Surveillance, Pharmaceutical Care, Science, Technology, and Innovation in Health) is a partnership among the National Health Council, the National School of Pharmacists, and the Oswaldo Cruz Foundation (Fiocruz), with support from the Pan American Health Organization (PAHO), with the goal of strengthening participation and social engagement in the theme, as well as the integration of health policies and practices within different sectors of society (social movements, health councils, and health professionals), with the various stages related to the access to medicines (research, incorporation, national production, and services) being the main theme in the context of the COVID-19 pandemic. It seeks to offer training for leadership groups in the health regions and activities with a broad national and political scope, and it hopes to establish an intersectorial and integrated network of leaders capable of acting collaboratively to defend the development of science, public policies, national sovereignty, and social control of health.

Effects of Dentine Pretreatment Solutions Containing Flavonoids on the Resin Polymer-Dentine Interface Created Using a Modern Universal Adhesive.

The aim of the present study was to evaluate the influence of several experimental pretreatment crosslinker solutions on the resin polymer-dentine interface created using a representative universal adhesive system, by means of microtensile bond strength testing (µTBS), nanomechanical properties and ultramorphology confocal laser scanning microscopy (CLSM). Five experimental solutions containing different flavonoids were applied as dentine pretreatment after acid etching. A control pretreatment group containing no flavonoid was also employed. A representative modern universal adhesive was then applied, followed by a 3 mm thick composite built up. Specimens were sectioned into sticks and submitted to a µTBS test or nanoindentation analysis along the interface (24 h or 25,000 thermocycles). The ultramorphology of the polymer-resin interface was also evaluated using CLSM. The results were analyzed using two-way ANOVA and Bonferroni's post hoc test (α = 0.05). All flavonoids improved short- and long-term µTBS values (p < 0.01), while only some specific such solutions improved the nanomechanical properties (p < 0.05) and preserved the structural morphology of the interface after aging. Pretreatment of acid-etched dentine using specific flavonoid-containing solutions may be a promising approach to improve both the nanomechanical properties and the durability of modern universal adhesive systems.

Clinical performance of a micro invasive treatment based on demineralization-remineralization for dental fluorosis: case report

Introduction: Dental fluorosis manifests clinically as white to brown spots on the enamel teeth that were exposed to excessive fluoride during the formation process. Esthetic treatments were described in the literature to reduce or eliminate the fluorotic stains on the enamel surface. Objective: The aim of this study is to present an alternative treatment for fluorosis-stained teeth. Case report: This case report describes the clinical performance of a treatment of a 12-year-old male patient whose teeth presented moderate fluorosis. This treatment is based on tooth demineralization and remineralization. The material has an acid phase made by hydrochloric acid with tricarboxylic acid, and an alkaline phase made by Calcium Hydroxide. Results: This pain less and fast treatment presented good results. The treatment eliminated the spots during the follow-up and preserved most of the dental structure, improving the appearance of the patient's teeth. Conclusion: The appearance of the treated enamel showed a surface almost completely free of fluorotic stains, demonstrating the satisfactory results of this treatment.

Introdução: A fluorose dentária manifesta-se clinicamente como manchas brancas a marrons no esmalte de dentes expostos ao excesso de flúor durante o processo de formação. Tratamentos estéticos foram descritos na literatura para reduzir ou eliminar as manchas fluoróticas na superfície do esmalte. Objetivo: Apresentar uma alternativa de tratamento para dentes manchados por fluorose dentária. Relato do caso: Este relato de caso descreve o desempenho clínico do tratamento para dentes com fluorose moderada em um paciente de 12 anos. Esse tratamento foi baseado numa técnica de desmineralização e remineralização do dente. O material possui uma fase ácida composta por ácido clorídrico com ácido tricarboxílico, e uma fase alcalina composta por Hidróxido de Cálcio. Resultados: Observou-se que esse tratamento, sem dor e rápido, apresentou resultados satisfatórios, pois eliminou as manchas durante o acompanhamento. Além disso, preservou ao máximo a estrutura dentária, beneficiando o paciente com uma melhor aparência dos seus dentes. Conclusão: O aspecto do esmalte tratado mostrou uma superfície quase sem manchas fluoróticas, demonstrando resultados satisfatórios deste tratamento.

The influence of the U.S. response to COVID-19 in Global Health. / A influência da resposta dos EUA à COVID-19 no contexto da Saúde Global.

The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.

A resposta americana à pandemia envolve um proeminente volume de recursos federais, em especial destinados ao desenvolvimento e aquisição de produtos no uso interno, como diagnósticos ou vacinas. As justificativas para esse desembolso se baseiam em mecanismos de investimentos e aspectos históricos. Assim, a construção social do nacionalismo na formação na sociedade americana prejudica o acesso a tecnologias em saúde. A revisão desses aspectos demonstra como os Estados Unidos (EUA) garantiram compra de grande quantitativo de produtos em potencial, inclusive assegurando excessiva produção local. Essa política externa unilateral tem influenciado outros países ou blocos regionais e prejudicado a cooperação e a solidariedade global com impacto na saúde coletiva de diversas nações.

A influência da resposta dos EUA à COVID-19 no contexto da Saúde Global / The influence of the U.S. response to COVID-19 in Global Health

Resumo A resposta americana à pandemia envolve um proeminente volume de recursos federais, em especial destinados ao desenvolvimento e aquisição de produtos no uso interno, como diagnósticos ou vacinas. As justificativas para esse desembolso se baseiam em mecanismos de investimentos e aspectos históricos. Assim, a construção social do nacionalismo na formação na sociedade americana prejudica o acesso a tecnologias em saúde. A revisão desses aspectos demonstra como os Estados Unidos (EUA) garantiram compra de grande quantitativo de produtos em potencial, inclusive assegurando excessiva produção local. Essa política externa unilateral tem influenciado outros países ou blocos regionais e prejudicado a cooperação e a solidariedade global com impacto na saúde coletiva de diversas nações.

Abstract The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.

Influence of flavonoids on long-term bonding stability on caries-affected dentin.

OBJECTIVES: To evaluate the effect of experimental dentin pre-treatment solutions formulated with different flavonoids on microtensile bond strength (µTBS), nanohardness (NH) and ultra-morphological characteristics of artificial caries-affected dentin (CAD) bonded using a universal bonding system. METHODS: A microbiological method was used to create an artificial CAD in 91 human molars. Five experimental pre-treatment solutions were created using the following flavonoids: quercetin (QUE); hesperidin (HES); rutin (RUT); naringin (NAR), or proanthocyanidin (PRO). A placebo solution (PLA) with no flavonoids added was also evaluated. The flavonoids or placebo solutions were applied to the CAD prior to the application and photoactivation of a universal adhesive (Scotchbond Universal, 3M Oral Care). A control group (CON), in which only the bonding agent was applied without any flavonoid solution, was also evaluated. A 3-mm-thick block of resin composite (Opallis, FGM) was built up on the flat bonded CAD surfaces and was light-cured following the manufacturer's instructions. Specimens were sectioned to obtain resin-dentin slices and sticks (cross-sectional area of 0.8 mm2). The µTBS, NH, and confocal ultramorphology analysis of resin-dentin interface was evaluated at 24 h and after thermo-cycling aging (25,000 cycles). The results were analyzed using 2-way ANOVA followed by Bonferroni's post hoc test (pre-set α = 0.05). RESULTS: The specimens from groups QUE, NAR, and RUT presented greater µTBS values than those from CON group (p<0.05). Specimens from some of these experimental groups presented greater nanomechanical properties (p<0.05), and no morphological degradation at the resin-dentin interface after aging. SIGNIFICANCE: The use of exogenous cross-linkers as dentin pre-treatment before bonding procedures may represent a suitable strategy to improve the longevity of universal adhesive systems applied to caries-affected dentin.

Fluxo digital na reabilitação de uma prótese unitária do setor / Digital workflow in the rehabilitation of a unitary anterior prosthesis

A era digital da odontologia e as ferramentas disponíveis no mercado para o planejamento de casos clínicos proporcionam novas possibilidades de diagnóstico e de plano de tratamento. Com isso, é possível o planejamento dos diversos casos clínicos digitalmente, permitindo um workflow no qual as diversas áreas da odontologia podem interagir, proporcionando para o paciente e os clínicos melhor prognóstico, maior agilidade e precisão nos diversos procedimentos, sendo eles menos invasivos; ou até mesmo tratamento mais complexos dentro das diversas áreas da odontologia como a ortodontia, periodontia, cirurgias, procedimentos restaurativos ou protéticos. Este artigo relata um caso clínico realizado com fluxo digital e aborda alguns temas referentes ao passado, presente e futuro da era digital na odontologia. (AU).

The digital era of dentistry and the tools available in the market provide new possibilities for clinical planning, diagnosis, and treatment plan. These permit to plan the various clinical cases digitally, allowing a workflow in which the different áreas of dentistry can Interact. Their implementation can lead to two desired outcomes. First, better diagnosis for patients and clinicians, more expedited diagnoses, and more precise procedures. Second, less invasive procedures within complex treatments in orthodontics, periodontics, surgery, and dental restoration. This article Will report a clinical case carried out with digital flow and Will address some issues related to the past, present, and future of the digital age in dentistry.

Zinc oxide and copper nanoparticles addition in universal adhesive systems improve interface stability on caries-affected dentin.

This study evaluated the MMP inhibition of the zinc oxide and copper nanoparticles (ZnO/CuNp), and the effects of their addition into adhesives on antimicrobial activity (AMA), ultimate tensile strength (UTS), in vitro degree of conversion (in vitro-DC), as well as, resin-dentin bond strength (µTBS), nanoleakage (NL) and in situ-DC on caries-affected dentin. Anti-MMP activity was evaluated for several MMPs. ZnO/CuNp (0% [control]; 5/0.1 and 5/0.2 wt%) were added into Prime&Bond Active (PBA) and Ambar Universal (AMB). The AMA was evaluated against Streptococcus mutans. UTS were tested after 24 h and 28d. After induced caries, adhesives and composite were applied to flat dentin surfaces, and specimens were sectioned to obtain resin-dentin sticks. µTBS, NL, in vitro-DC and in situ-DC were evaluated after 24 h. ANOVA and Tukey's test were applied (α = 0.05). ZnO/CuNp demonstrated anti-MMP activity (p < 0.05). The addition of ZnO/CuNp increased AMA and UTS (AMB; p < 0.05). UTS for PBA, in vitro-DC, in situ-DC and µTBS for both adhesives were maintained with ZnO/CuNp (p > 0.05). However, lower NL was observed for ZnO/CuNp groups (p < 0.05). The addition of ZnO/CuNp in adhesives may be an alternative to provide antimicrobial, anti-MMP activities and improves the integrity of the hybrid layer on caries-affected dentin.

Biological, mechanical and adhesive properties of universal adhesives containing zinc and copper nanoparticles.

OBJECTIVES: To evaluate the effect of addition of zinc oxide and copper nanoparticles (ZnO/CuNp) into universal adhesives, on antimicrobial activity (AMA), cytotoxicity (CTX), water sorption (WS) and solubility (SO), microhardness (MH) and in vitro degree of conversion (DC), as well as resin-dentin microtensile bond strength (µTBS), nanoleakage (NL) and in situ DC. METHODS: ZnO/CuNp (0% [control]; 5/0.1 and 5/0.2 wt%) were added in Prime&Bond Active (PBA) and Ambar Universal (AMB). The AMA was evaluated against Streptococcus mutans. For CTX, Saos-2 cell-line was used. For WS and SO, specimens were tested for 28d. For MH, specimens were tested after 24 h and 28d and for in vitro DC, specimens were evaluated after 24 h. After, the adhesives were applied to flat dentine surfaces, composite resin build-ups, specimens were sectioned to obtain resin-dentine sticks. It was evaluated in µTBS, NL and in situ DC after 24 h of water storage. ANOVA and Tukey's test were applied (α = 0.05). RESULTS: The addition of 5/0.2 ZnO/CuNp increase AMA and WS, but decrease the SO when compared to control (p < 0.05). The CTX and µTBS were maintaining with adhesive-containing ZnO/CuNp (p > 0.05). MH, in vitro DC and in situ DC was significant increase (AMB) or maintaining (PBA) with ZnO/CuNp addition. However, significantly lower NL was observed for ZnO/CuNp groups (p < 0.05). CONCLUSIONS: The addition of ZnO/CuNp in the tested concentrations in universal adhesive systems may be an alternative to provide antimicrobial activity and improves the integrity of the hybrid layer, without jeopardizing biological, adhesives and mechanical properties. SIGNIFICANCE: This is the first study that demonstrates that the addition of zinc oxide and copper nanoparticles in concentrations up to 5/0.2 wt% in two universal adhesive systems is a feasible approach and may be an alternative to adhesive interfaces with antimicrobial properties and less defects in the resin-dentin interface.

Cirurgia guiada de implante dentário ­ relato de caso / Guided dental implant surgery ­ case report

Uma das opções para o tratamento com implantes é o implante dentário guiado, conhecido também como cirurgia guiada por computador, que consiste em uma técnica realizada primeiramente de forma digital, no computador, através de uma tomografia computadorizada cone beam da arcada dentária. Após o planejamento cirúrgico digital, o implante é realizado através de um guia cirúrgico prototipado. Dessa forma, não há necessidade de cortes e incisões na gengiva, apenas pequenas perfurações nos tecidos moles da arcada dentária. Este artigo relata um caso clínico de implante dentário guiado (AU).

One of the options for the treatment with implants is the guided dental implant, also known like computer guided surgery, that consists of a technique realized first of digital form in the computer, through a computed tomography cone beam of the dental arcade. After the digital surgical planning, the implant is performed through a prototype surgical guide. In this way, there is no need for cuts and incisions in the gum, only small perforations in the soft tissues of the dental arch. This paper reports a clinical case of guided dental implant (AU).

Science, Technology and Pharmaceutical Policy on the agenda: contributions from the society to the 16th National Conference on Health. / Ciência, Tecnologia e Assistência Farmacêutica em pauta: contribuições da sociedade para a 16ª Conferência Nacional de Saúde.

The Plenary of the National Health Council (CNS) approved the Resolution 568/2017, convening the 16th National Health Conference to be held in 2019 and decided to promote thematic activities in eight areas, including Pharmaceutical Policy and Science and Technology. CNS partnership with FIOCRUZ and the National School of Pharmacists proposed the 8th National Symposium on Science and Technology and Pharmaceutical Policy, preceded by ten regional preparatory meetings for the symposium throughout the country. The purpose of this article is to present and analyze the results of the first stage of meetings. A participatory methodology was developed for the meetings that included the presentation of problem situations reported in the form of "cases" built by real narratives, fictitious or adapted from reality. Debates in groups and proposals construction, compilation and weighting, with general discussion completed the meetings. The set of 150 proposals from the 5 meetings was read individually by each of the members of the analysis team and pre-categorized. The 5 meetings had a total of 238 participants. Four categories were defined: Health as a right; Consolidation of SUS principles; Adequate and sufficient financing for SUS; Participatory democracy.

O Pleno do Conselho Nacional de Saúde (CNS) aprovou a Resolução nº 568/2017 que convoca a 16ª Conferência Nacional de Saúde, a ser realizada no ano de 2019 e deliberou pela realização de atividades temáticas, em oito áreas, incluindo Assistência Farmacêutica e Ciência e Tecnologia. Uma parceria do CNS com a Fiocruz e a Escola Nacional dos Farmacêuticos propôs a realização do 8º Simpósio Nacional de Ciência e Tecnologia e Assistência Farmacêutica, antecedido por dez encontros regionais preparatórios para o simpósio em todo o país. O objetivo deste artigo é apresentar e analisar os resultados dessa primeira etapa de encontros. Foi desenvolvida uma metodologia participativa para os encontros que inclui a apresentação de situações-problema em forma de "casos" com narrativas reais, fictícias ou adaptadas da realidade. Debates em grupos e construção de propostas, compilação e ponderação, com discussão geral completaram os encontros. As 150 propostas oriundas de cinco encontros foram lidas por cada membro da equipe de análise e pré-categorizado. Esses encontros reuniram 238 participantes. Quatro categorias foram definidas: Saúde como direito; Consolidação dos princípios do SUS; Financiamento adequado e suficiente para o SUS; Democracia participativa.

Mixoma auricular asociado a evento cerebrovascular isquémico / Atrial myxoma related with ischemic cerebrovascular event

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