Team-Based Learning online: percepção dos graduandos de saúde e influência do perfil comportamental do estudante / Online Team-Based Learning: perception of health undergraduates and influence of the student's behavioral profile

Resumo Introdução: O Team-Based Learning (TBL) é uma metodologia ativa que tem se mostrado efetiva para a formação de profissionais de saúde. Em 2020, devido à pandemia da Covid-19, a aplicação do TBL migrou da modalidade presencial para online síncrona. Objetivos: Este estudo objetivou avaliar a percepção de graduandos de saúde sobre o TBL online e analisar se existe diferença de percepção dessa modalidade entre os grupos de estudantes com níveis distintos de exposição anterior às sessões presenciais e online do método, além de verificar se tal percepção pode ser afetada pelo perfil comportamental do estudante. Método: Trata-se de um estudo observacional, transversal de caráter descritivo-exploratório, comparativo, relacional, de abordagem quantitativa, realizado nos cursos de graduação em Medicina e Enfermagem, entre setembro e dezembro de 2021. Aplicou-se, virtualmente, um questionário sobre os dados sociodemográficos, além dos instrumentos Avaliação da Percepção do Aluno-Team-Based Learning (APA-TBL) e Teste de Perfil Comportamental DISC. Resultados: Dos 241 estudantes participantes, houve predominância do sexo feminino (81%), na faixa etária de 20,8 a 24,4 anos, que já tinham frequentado mais de 10 sessões de TBL presencial (90%) e TBL online (53%). Das 24 questões do APA-TBL, 17 obtiveram índice igual ou superior a 75% na soma das respostas "concordo totalmente"/"concordo", valores considerados como percepção positiva neste estudo. Os alunos com exposição a mais de 10 sessões do TBL online apresentaram uma percepção significativamente mais negativa em três das quatro dimensões do APA-TBL, quando comparados aos menos expostos. O grupo que havia participado de mais de 10 sessões de TBL presencial apresentou uma percepção significativamente mais negativa em apenas uma dimensão do instrumento, quando comparados aos menos expostos. O principal fator DISC encontrado entre os perfis comportamentais dos participantes foi a estabilidade ("S"). Não houve correlação entre o perfil comportamental do aluno e sua percepção sobre o método na versão online. Conclusões: Observou-se uma percepção favorável dos graduandos de saúde sobre o TBL online. A exposição anterior prolongada ao método, tanto no modo online, quanto presencial, impactou negativamente a percepção dos estudantes sobre o TBL online. Não foi evidenciada influência do perfil comportamental do estudante em sua percepção do método.

Abstract Introduction: Team-Based Learning (TBL) is an active methodology that has shown to be effective for the training of health professionals. In 2020, due to the COVID-19 pandemic, TBL utilization migrated from the in-person to the synchronous online mode. Objectives: This study aimed to evaluate the perception of health undergraduate students about online TBL and to analyze whether there is a difference regarding this perception between groups of students with different levels of exposure prior to in-person and online sessions of the teaching method, in addition to verifying whether such perception can be affected by the student's behavioral profile. Method: This is an observational, cross-sectional, descriptive-exploratory level II comparative study with a quantitative approach, carried out in undergraduate Nursing and Medicine courses between September and December 2021. A questionnaire on sociodemographic data was applied virtually, in addition to the Assessment of Student Perception-Team-Based Learning (ASP-TBL) and the DISC Personality Test instruments. Results: Of the 241 participating students, most were females (81%), aged between 20.8 and 24.4 years, who had already attended more than 10 sessions of in-person TBL (90%) and online TBL (53%). Of the 24 ASP-TBL questions, 17 obtained an index equal to or greater than 75% in the sum of the answers "I totally agree"/"I agree", values considered as a positive perception in this study. Students exposed to more than 10 online TBL sessions had a significantly more negative perception in three of the four dimensions of the ASP-TBL, when compared to less exposed students. The group that had participated in more than 10 in-person TBL sessions had a significantly more negative perception in only one dimension of the instrument, when compared to the less exposed ones. The main DISC Personality test factor found among the participants' behavioral profiles was submission ("S"). There was no correlation between the student's behavioral profile and their perception of the method in the online version. Conclusions: There was a favorable perception of health undergraduate students regarding online TBL. Previous prolonged exposure to the method, both online and in-person, represented a significant difference in the students' perception of online TBL. There was no evidence of the influence of the student's behavioral profile on their perception of the teaching method.

Mycological diagnosis of paracoccidioidomycosis in a hospital from a nonendemic area: classical and molecular methods / Diagnóstico micológico de paracoccidioidomicosis en un hospital de área no endémica: metodología clásica y molecular

Introduction: Paracoccidioidomycosis is a systemic mycosis endemic in Latin America. Climate change and host migration emphasize the need to optimize this infection diagnosis. Objective: To evaluate the implementation of Paracoccidioides spp. DNA detection in the mycological diagnosis of patients with suspected paracoccidioidomycosis. Materials and methods: It is a retrospective study with laboratory data from patients with clinical suspicion of paracoccidioidomycosis, who consulted a university hospital from a non-endemic area. Results: We analyzed the laboratory results of samples from 19 patients with suspected paracoccidioidomycosis. Seventeen out of 19 patients were born in or had visited an endemic area in Latin America. Fourteen adult male patients were confirmed to have paracoccidioidomycosis by conventional diagnosis: the direct examination was positive in 12 samples while fungal growth was found only in 4. Anti-Paracoccidioides spp. antibodies were detected in 10 patients, 8 of them with proven paracoccidioidomycosis. Nested PCR for Paracoccidioides spp. detection was performed on clinical samples from 14 patients, and positive results were obtained for 9 out of 10 patients with the conventional diagnosis of paracoccidioidomycosis. Conclusions: The incorporation of molecular techniques to detect Paracoccidioides spp. DNA complements the conventional diagnosis of paracoccidioidomycosis. This tool allows the prescription of antifungal treatment in those cases where the fungus is not observed in the clinical samples.

Introducción: La paracoccidioidomicosis es una micosis sistémica y endémica en Latinoamérica. El cambio climático y el movimiento migratorio del huésped enfatizan la necesidad de optimizar el diagnóstico de esta infección. Objetivo: Evaluar la implementación de la detección de ADN de Paracoccidioides spp. al diagnóstico micológico de pacientes con sospecha de paracoccidioidomicosis. Materiales y métodos. Estudio retrospectivo con datos de laboratorio de pacientes con sospecha de paracoccidioidomicosis en un hospital de área no endémica. Resultados: Se analizaron los resultados de las muestras de 19 pacientes con sospecha clínica de paracoccidioidomicosis. El 90 % de los pacientes había nacido o visitado un área endémica de esta micosis en Latinoamérica. En 14 pacientes varones adultos se confirmó paracoccidioidomicosis por diagnóstico convencional. El examen directo fue positivo en 12 pacientes con enfermedad comprobada y en 4 de ellos se obtuvo crecimiento del hongo. Se detectaron anticuerpos contra Paracoccidioides spp. en ocho pacientes con la enfermedad. Se realizó PCR anidada con muestras de 14 pacientes para detectar ADN de Paracoccidioides spp. En 9 de los 10 pacientes con diagnóstico convencional de paracoccidioidomicosis se obtuvo una prueba de PCR positiva. Conclusiones: La implementación de técnicas moleculares para detectar ADN de Paracoccidioides spp. complementa el diagnóstico convencional de paracoccidioidomicosis y permite instaurar el tratamiento antifúngico, sobre todo en los casos clínicos donde no se observa la presencia del hongo en las muestras clínicas. La migración actual de poblaciones humanas dificulta el diagnóstico de paracoccidioidiomicosis y otras infecciones endémicas, por lo que se requiere optimizar el diagnostico micológico en los laboratorios clínicos para tratar pacientes con este tipo micosis desatendida.

Diagnóstico micológico de paracoccidioidomicosis en un hospital de área no endémica: metodología clásica y molecular

Introducción. La paracoccidioidomicosis es una micosis sistémica y endémica en Latinoamérica. El cambio climático y el movimiento migratorio del huésped enfatizan la necesidad de optimizar el diagnóstico de esta infección. Objetivo. Evaluar la implementación de la detección de ADN de Paracoccidioides spp. al diagnóstico micológico de pacientes con sospecha de paracoccidioidomicosis. Materiales y métodos. Estudio retrospectivo con datos de laboratorio de pacientes con sospecha de paracoccidioidomicosis en un hospital de área no endémica. Resultados. Se analizaron los resultados de las muestras de 19 pacientes con sospecha clínica de paracoccidioidomicosis. El 90 % de los pacientes había nacido o visitado un área endémica de esta micosis en Latinoamérica. En 14 pacientes varones adultos se confirmó paracoccidioidomicosis por diagnóstico convencional. El examen directo fue positivo en 12 pacientes con enfermedad comprobada y en 4 de ellos se obtuvo crecimiento del hongo. Se detectaron anticuerpos contra Paracoccidioides spp. en ocho pacientes con la enfermedad. Se realizó PCR anidada con muestras de 14 pacientes para detectar ADN de Paracoccidioides spp. En 9 de los 10 pacientes con diagnóstico convencional de paracoccidioidomicosis se obtuvo una prueba de PCR positiva. Conclusiones. La implementación de técnicas moleculares para detectar ADN de Paracoccidioides spp. complementa el diagnóstico convencional de paracoccidioidomicosis y permite instaurar el tratamiento antifúngico, sobre todo en los casos clínicos donde no se observa la presencia del hongo en las muestras clínicas. La migración actual de poblaciones humanas dificulta el diagnóstico de paracoccidioidiomicosis y otras infecciones endémicas, por lo que se requiere optimizar el diagnostico micológico en los laboratorios clínicos para tratar pacientes con este tipo micosis desatendida.

Introduction. Paracoccidioidomycosis is a systemic mycosis endemic in Latin America. Climate change and host migration emphasize the need to optimize this infection diagnosis. Objective. To evaluate the implementation of Paracoccidioides spp. DNA detection in the mycological diagnosis of patients with suspected paracoccidioidomycosis. Materials and methods. It is a retrospective study with laboratory data from patients with clinical suspicion of paracoccidioidomycosis, who consulted a university hospital from a non-endemic area. Results. We analyzed the laboratory results of samples from 19 patients with suspected paracoccidioidomycosis. Seventeen out of 19 patients were born in or had visited an endemic area in Latin America. Fourteen adult male patients were confirmed to have paracoccidioidomycosis by conventional diagnosis: the direct examination was positive in 12 samples while fungal growth was found only in 4. Anti-Paracoccidioides spp. antibodies were detected in 10 patients, 8 of them with proven paracoccidioidomycosis. Nested PCR for Paracoccidioides spp. detection was performed on clinical samples from 14 patients, and positive results were obtained for 9 out of 10 patients with the conventional diagnosis of paracoccidioidomycosis. Conclusions. The incorporation of molecular techniques to detect Paracoccidioides spp. DNA complements the conventional diagnosis of paracoccidioidomycosis. This tool allows the prescription of antifungal treatment in those cases where the fungus is not observed in the clinical samples. Current human migrations difficult the mycological diagnosis of paracoccidioidomycosis and other fungal infections. For this reason, it is necessary to improve mycological diagnosis in clinical laboratories to adequately treat patients with this neglected mycosis.

Association between Polyphenol Intake and Lipid Profile of Adults and Elders in a Northeastern Brazilian Capital.

This research was aimed at evaluating the relationship between the estimated polyphenol intake and the atherogenic lipid profile in adult and elder residents in the city of Teresina, located in the Northeastern Region of Brazil. This study was a cross-sectional population-based survey with 501 adults and elders, conducted in Teresina, Brazil. Food intake was obtained by 24-h food recall. The estimated polyphenol intake was calculated by multiplying the food consumption data from the recall by the polyphenol content in the foods described in the Phenol-Explorer database. The mean intake of total polyphenols was 1006.53 mg/day. The phenolic acids was the class with the highest intake, followed by the flavonols. Coffee, beans and apples were the main foods contributing to the total polyphenol intake. In the individuals with elevated serum concentrations of total cholesterol and triglycerides, the intake of total polyphenols was significantly higher. The intake of total polyphenols, phenolic acids and lignans was higher in the subjects with dyslipidemia. This article provides, for the first time, data on the intake of the total polyphenol classes and subclasses in the evaluated population and the relationship with the lipid profile. The individuals with a higher intake of total polyphenols had a worse lipid profile, which may be a consequence of an improved diet in those individuals who present with dyslipidemia.

Usefulness of Sona Aspergillus Galactomannan LFA with digital readout as diagnostic and as screening tool of COVID-19 associated pulmonary aspergillosis in critically ill patients. Data from a multicenter prospective study performed in Argentina.

COVID-19-associated pulmonary aspergillosis (CAPA) incidence varies depending on the country. Serum galactomannan quantification is a promising diagnostic tool since samples are easy to obtain with low biosafety issues. A multicenter prospective study was performed to evaluate the CAPA incidence in Argentina and to assess the performance of the lateral flow assay with digital readout (Sona Aspergillus LFA) as a CAPA diagnostic and screening tool. The correlation between the values obtained with Sona Aspergillus LFA and Platelia® EIA was evaluated. In total, 578 serum samples were obtained from 185 critically ill COVID patients. CAPA screening was done weekly starting from the first week of ICU stay. Probable CAPA incidence in critically ill patients was 10.27% (19/185 patients when LFA was used as mycological criteria) and 9% (9/100 patients when EIA was used as mycological criteria). We found a very good correlation between the two evaluated galactomannan quantification methods (overall agreement of 92.16% with a Kappa statistic value of 0.721). CAPA diagnosis (>0.5 readouts in LFA) were done during the first week of ICU stay in 94.7% of the probable CAPA patients. The overall mortality was 36.21%. CAPA patients' mortality and length of ICU stay were not statistically different from for COVID (non-CAPA) patients (42.11 vs 33.13% and 29 vs 24 days, respectively). These indicators were lower than in other reports. LFA-IMMY with digital readout is a reliable tool for early diagnosis of CAPA using serum samples in critically ill COVID patients. It has a good agreement with Platelia® EIA. LAY SUMMARY: The incidence of COVID-associated pulmonary aspergillosis (CAPA) in critically-ill Argentinian patients was established (10.27%). Serum galactomannan quantification was useful as a screening tool for this mycosis. A good agreement between Platelia® EIA and Sona Aspergillus LFA is reported.

The Neglected Role of Education in Brazilian Research Regarding Nuclear Theme versus Scientific and Technological Knowledge, Perception and Risk Communication.

Studies of risk perception and risk communication concerning the nuclear area are quite common in scientific literature. However, though numerous studies on this topic point to the importance of scientific and technological knowledge in facilitating the reduction of perceived risks, there are few papers that effectively discuss the role of education in risk communication on the subject, particularly in Brazil. The objective of the present work was to reflect on this problem by analyzing the results obtained from two case studies on the implementation of the Brazilian Multipurpose Reactor, in the city of Iperó, in the state of São Paulo, Brazil. As was verified in the investigation, most participants of the study had high perception of risk with respect to the implementation of the reactor. Nevertheless, although important in the project of the reactor implementation, it was verified that the state, municipal and community schools of the city of Iperó had not participated, in the public hearings nor had they discussed the issue inside the school community, until the moment of the research.

Effects of "Bacuri" Seed Butter (Platonia insignis Mart.) on Metabolic Parameters in Hamsters with Diet-Induced Hypercholesterolemia.

This study aimed to evaluate the effects of the treatment with bacuri seed butter (BB) on body weight, growth, body mass index, lipid profile, atherosclerotic indices, and liver function in dyslipidemic hamsters. Freshly weaned, male hamsters were divided into four groups: (1) normal group (NG)-maintained with standard chow (AIN-93G); (2) dyslipidemia group (DG)-maintained with hyperlipidemic chow (AIN-93G modified) throughout the follow-up period; (3) bacuri seed butter 25 mg/kg/day (BB-25); and (4) bacuri seed butter 50 mg/kg/day (BB-50). BB groups (25 and 50 mg/kg/day) were also maintained with hyperlipidemic chow throughout the follow-up period, and the treatment started after 21 days receiving a hyperlipidemic diet to induce hypercholesterolemia and maintained for 28 days. No significant differences in triglycerides and total cholesterol were observed for BB-25 and BB-50 groups when compared with NG and DG groups. On the contrary, BB-25 and BB-50 induced both increase of HDL-c (51.40 ± 1.69 and 51.00 ± 2.34, respectively) and decrease of LDL-c (103.80 ± 6.87 and 100.50 ± 3.95, respectively) when compared with DG (41.00 ± 2.94 and 132.70 ± 9.41, respectively). In addition, BB promoted a reduction in the risk of atherosclerotic disease by decreasing (p < 0.05) the atherogenic index, coronary artery risk index, and LDL/CT ratio (p < 0.05) and increasing HDL/CT ratio. On the contrary, no changes were observed in total cholesterol and triglyceride levels or in body weight, growth, body mass index, or liver function parameters. Thus, bacuri seed butter at doses of 25 and 50 mg/kg/day has positive repercussions on the lipid profile, more precisely on plasma HDL-c and LDL-c, and additionally promotes reduction in the risk of atherosclerosis in hamsters.

Ventilator-associated pneumonia involving Aspergillus flavus in a patient with coronavirus disease 2019 (COVID-19) from Argentina.

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, emerged in Wuhan, China, in December 2019 and rapidly spread around the world. Invasive aspergillosis has been reported as a complication of severe influenza pneumonia among intensive care patients. Similarities between COVID-19 and influenza pneumonia, together with limited published case series, suggest that aspergillosis may be an important complication of COVID-19. This report describes a case of ventilator-associated pneumonia involving Aspergillus flavus in a patient with COVID-19 from Buenos Aires, Argentina.

Public space, socio-environmental responsibility and citizenship: a case study on a Brazilian borough.

Some researchers point out the decline in contemporary cities of the use of public spaces, whether free or restricted access. In this sense, the present essay proposes a reflection on a "public sphere of organized presence", according to Habermas classification, as a rescue of the importance of this space for the exercise of citizenship and social-environmental responsibility. The reflection was based on the results obtained from a study in the district of Riacho Grande, São Bernardo do Campo, São Paulo, Brazil, in which the environmental perception of the participants of the meetings about the region was known by documentary analysis, direct observation and interviews with questionnaires. It was possible to verify that this public space can facilitate a greater integration between the public administrators and citizens, helping even in the defense to the environment.

Diagnosis of Idiopathic GHD in Children Based on Response to rhGH Treatment: The Importance of GH Provocative Tests and IGF-1.

Purpose: Serum IGF-1 (Insulin like growth factor 1) and Growth Hormone (GH) provocative tests are reasonable tools for screening and diagnosis of idiopathic GH Deficiency (IGHD). However, the average cut-off points applied on these tests have a lower level of evidence and produce large amounts of false results. The aim of this study is to evaluate the sensitivity, specificity, and accuracy of IGF-1 and GH stimulation tests as diagnostic tools for IGHD, using clinical response to recombinant human GH (rhGH) treatment as diagnostic standard [increase of at least 0.3 in height standard deviation (H-SD) in 1 year]. Methods: We performed a prospective study with 115 children and adolescents presenting short stature (SS), without secondary SS etiologies such as organic lesions, genetic syndromes, thyroid disorders. They were separated into Group 1 [patients with familial SS or constitutional delay of growth and puberty (CDGP), not treated with rhGH], Group 2 (patients with suspicion of IGHD with clinical response to rhGH treatment), and Group 3 (patients with suspicion of IGHD without growth response to rhGH treatment). Then, they were assessed for diagnostic performance of IGF-1, Insulin Tolerance Test (ITT) and clonidine test (CT) alone and combined at different cut-off points. Results: Based on the ROC curve, the best cut-off points found for IGF-1, ITT, and CT when they were used isolated were -0.492 SDS (sensitivity: 50%; specificity: 53.8%; accuracy: 46.5%), 4.515 µg/L (sensitivity: 75.5%; specificity: 45.5%; accuracy: 52.7%), and 4.095 µg/L (sensitivity: 54.5%; specificity: 52.6%; accuracy: 56.9%), respectively. When we had combined IGF-1 with-2SD as cut-off alongside ITT or CT, we found 7 µg/L as the best cut-off point. In this situation, ITT had sensitivity, specificity and accuracy of 93.9, 81.8, and 90.1%, while CT had 93.2, 68.4, and 85.7%, respectively. Conclusion: Our data suggest that diagnosis of IGHD should be established based on a combination of clinical expertise, auxologic, radiologic, and laboratorial data, using IGF-1 at the -2SD threshold combined, with ITT or CT at the cut-off point of 7 µg/L. Additional studies, similar to ours, are imperative to establish cut-off points based on therapeutic response to rhGH in IGHD, which would be directly related to a better treatment outcome.

Lycopene-Rich Extract from Red Guava (Psidium guajava L.) Decreases Plasma Triglycerides and Improves Oxidative Stress Biomarkers on Experimentally-Induced Dyslipidemia in Hamsters.

This work assessed the effects of a 28-day treatment with lycopene-rich extract (LRE) from red guava fruit (Psidium guajava L.) on the lipid profile and oxidative stress in an experimental model of dyslipidemia. Male hamsters (116.5 ± 2.16 g) were fed with the AIN 93G diet containing casein (20%), coconut fat (13.5%) and cholesterol (0.1%). The animals were divided into four groups: normolipidemic control (standard feed; NC, n = 7); hypercholesterolemic control (HC, n = 7); LRE 25 mg/kg/day (LRE-25, n = 7) and LRE 50 mg/kg/day (LRE-50, n = 9). After treatment, plasma concentrations of triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol (LDL-c), high-density lipoprotein (HDL) cholesterol (HDL-c), malondialdehyde (MDA-p) and myeloperoxidase (MPO), as well as erythrocytic superoxide dismutase (SOD-e) and the atherogenic index, were determined. Malondialdehyde (MDA-h), catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD-h) levels were assessed. Feed intake (FI) and weight gain (WG) were also determined. The LRE-25 group presented significantly lower TG levels and atherogenic index than did the HC group (p < 0.05). Both LRE-25 and LRE-50 groups presented lower levels of MDA-p and MPO than did the HC group (p < 0.05). LRE demonstrated a promising effect against dyslipidemia and oxidative stress.

Ankle-brachial index and peripheral arterial disease: An evaluation including a type 2 diabetes mellitus drug-naïve patients cohort.

BACKGROUND: Peripheral arterial disease in patients with type 2 diabetes mellitus is an important risk factor for vascular events. Recommendations about whether ankle-brachial index should be performed differ depending on the source; therefore, it is necessary to re-evaluate the most important risk factors associated with peripheral arterial disease and whether it is useful to perform ankle-brachial index in newly diagnosed and drug-naïve patients with diabetes, independent of age or peripheral arterial disease symptoms. METHODS: A total of 711 subjects were divided into groups: group 1, 600 type 2 diabetes mellitus patients, symptomatic or not for peripheral arterial disease; group 2, 61 type 2 diabetes mellitus patients newly diagnosed and drug naïve; and group 3, 50 subjects without diabetes. Ankle-brachial index, medical records and physical examination were performed in all patients, accessing cardiovascular risk factors. RESULTS: Analysing group 1 asymptomatic patient to peripheral arterial disease, we found abnormal ankle-brachial index in 49% (77/156) ⩾50 years and 42% (16/38) <50 years (p = not significant). Considering drug-naïve patients, a peripheral arterial disease prevalence of 39% (24/61) was found; among these, 48% (13/27) were <50 years and 32% (11/34) were ⩾50 years (p = not significant). A forward stepwise regression model was developed, with type 2 diabetes mellitus duration (r2 = 0.12) and sedentary lifestyle (r2 = 0.14) found as independent variable predictors of severity of peripheral arterial disease, related to ankle-brachial index. CONCLUSION: We suggest that, in type 2 diabetes mellitus, ankle-brachial index should be measured at diagnosis. In addition, sedentary lifestyle was strongly associated with presence and severity of peripheral arterial disease.

Cholesterol-Lowering and Liver-Protective Effects of Cooked and Germinated Mung Beans (Vigna radiata L.).

We investigated the hypocholesterolemic and liver-protective effects of cooked and germinated whole mung beans. Hamsters were fed for 28 days on diets rich in saturated fatty acids and cholesterol, differing only in protein source (20%): casein, cooked whole mung bean, and germinated mung bean. After 28 days, we found reduced plasma concentrations of total cholesterol and non-HDL cholesterol, increased faecal cholesterol excretion, and reduced levels of asparagine aminotransferase and alanine aminotransferase enzymes in the liver. Reduction in hepatic lipid deposition was observed between each of the mung bean groups relative to the casein group. In addition, the animals of the geminated mung bean group showed a lack of inflammatory infiltrate and better vascularisation of the hepatic tissue. Results from this study show significant hypocholesterolemic and liver-protective properties of the mung bean, which are further enhanced after germination.

Utilização das medicações imunossupressoras pelas pessoascom transplante renal / Utilización de las medicaciones inmunosupresoras por las personas contrasplante renal / Utilization of immunosuppressants by people with renal transplant

Objetivo: Analisar a utilização de imunossupressores pelas pessoas com transplante renal. Métodos: Utilizou-se abordagem qualitativa do tipo descritivo, realizada com 20 pessoas transplantadas renais, no período de maio a julho de 2013. A coleta de dados ocorreu por meio de entrevista semiestruturada e utilizou-se a análise temática. Resultados: Participaram dez homens e dez mulheres, com idade entre 30 e 66 anos, a maioria da raça branca, católica, casada, com Ensino Fundamental incompleto e aposentada. Foram identificadas três categorias: rotina do uso das medicações imunossupressoras; presença dos efeitos colaterais das medicações imunossupressoras; e dispensação das medicações imunossupressoras. Conclusão: O estudo apresenta singularidades da experiência de pessoas dependentes de um tratamento medicamentoso contínuo; portanto, fornece subsídios teóricos que poderão qualificar as práticas de atenção direcionadas a quem vivencia a dependência destes medicamentos.

Objective: To analyze the use of immunosuppressants for people with renal transplant. Methods: It was used qualitative approach descriptive, conducted with 20 people renal transplanted, in the period from May to July 2013. The data collection was through semi-structured interview and used the thematic analysis. Results: Participated ten men and ten women, aged between 30 and 66 years, mostly of the white race, Catholic, married, with incomplete primary education and retired. Three categories were identified: routine use of immunosuppressants; presence of side effects of immunosuppressants; and dispensing of immunosuppressants. Conclusion: The study presents singularities of dependents experience an ongoing drug treatment therefore provides theoretical subsidies that may qualify the care practices aimed at people living in the dependence of these drugs.

Objetivo: Analizar la utilización de inmunosupresores por las personas con trasplante renal. Métodos: Utilizó abordaje cualitativa del tipo descriptivo, realizado con 20 personas trasplantadas renales, en el período de mayo a julio de 2013. La recolección de datos ocurrió a través de entrevista semiestructurada y utilizó el análisis temático. Resultados: Participaron diez hombres y diez mujeres, con edades entre 30 y 66 años, la mayoría de la raza blanca, católica, casada, con educación fundamental incompleto y jubilada. Fueran identificadas tres categorías: rutina de lo uso de las medicaciones inmunosupresoras; presencia de los efectos secundarios de las medicaciones inmunosupresoras; y dispensación de las medicaciones inmunosupresoras. Conclusión: El estudio presenta singularidades de la experiencia de personas dependientes de un tratamiento medicamentoso continuado, por lo tanto, fornece subsidios teóricos que pueden calificar las prácticas de atención direccionadas a quien vivencia la dependencia de estos medicamentos.

Epidemiología, especies, resistencia antifúngica y evolución de las candidemias en un hospital universitario de Buenos Aires, Argentina, durante 16 años / Epidemiology, species, antifungal resistance and outcome of candidemia in a university hospital in Buenos Aires, Argentina for 16 years

Resumen Introducción: La epidemiologia de las candidemias varía en cada región. Objetivos: Conocer la epidemiología de las candidemias en un hospital durante 16 años. Material y Métodos: Se revisaron los episodios de candidemia ocurridos en el Hospital de Clínicas de Buenos Aires desde 01/01/98 al 31/12/13. Resultados: Se identificaron 374 episodios de candidemia. La incidencia fue de 2,21/1.000 egresos y aumentó de 1,96 (1998-2005) a 2,25 (2006-2013) (p = 0,023). Se diagnosticaron: 5,4% en neonatos, 1,7% en lactantes, 6,5% en niños mayores, 31,8% en adultos y 52,7% en adultos mayores de 64 años. Los episodios fueron causados por C. albicans (40,9%), C. parapsilosis (21,7%), C. tropicalis (15,5%), C. glabrata (13,9%), otras especies de Candida (5,1%) y candidemias multiespecies (2,9%). El 5,3% de los aislados fue resistente a fluconazol. Setenta y cuatro por ciento de los pacientes recibió tratamiento; 70,3% lo inició con fluconazol, 25% con anfotericina B desoxicolato y 4,7% con equinocandinas o anfotericinas lipídicas. Se retiró 81% de los catéteres venosos centrales. La mortalidad fue de 47,9%, pero fue de 60,8% para los adultos mayores. Conclusión: La incidencia de candidemias se incrementó a través de los años, fue mayor en los adultos mayores y esta población tuvo peor evolución.

Background: The epidemiology of candidemia vary by region. Aim: To determine the epidemiology of candidemia in a hospital for 16 years. Material and Methods: Episodes of candidemia occurred in the Hospital de Clinicas of Buenos Aires were reviewed, from 01/01/98 to 31/12/13. Results: 374 episodes of candidemia were identified. The incidence was 2.21/1,000 discharges and increased from 1.96 (1998-2005) to 2.25 (2006-2013) (p = 0.023). Candidemia was diagnosed: 5.4% in neonates, 1.7% in infants, 6.5% in children, 31.8% in adults and 52.7% in elderly adults over 64 years old. The episodes were caused by C. albicans (40.9%), C. parapsilosis (21.7%), C. tropicalis (15.5%), C. glabrata (13.9%), other species of Candida (5.1%) and more than one species of Candida (2.9%). The 5.3% of the isolates were resistant to fluconazole. 74% of patients were treated. Initial treatments were with fluconazole (70.3%), amphotericin B deoxycholate (25%), echinocandins or lipidic amphotericin (4,7%). The 81% of central venous catheters were taken off. Mortality rate was of 47.9%, but in the elderly adults was of 60.8%. Conclusion: The incidence of candidemia showed an increase over the years. It was higher in the elderly adults, being the group with worse outcomes.

[Epidemiology, species, antifungal resistance and outcome of candidemia in a university hospital in Buenos Aires, Argentina for 16 years]. / Epidemiología, especies, resistencia antifúngica y evolución de las candidemias en un hospital universitario de Buenos Aires, Argentina, durante 16 años.

BACKGROUND: The epidemiology of candidemia vary by region. AIM: To determine the epidemiology of candidemia in a hospital for 16 years. MATERIAL AND METHODS: Episodes of candidemia occurred in the Hospital de Clinicas of Buenos Aires were reviewed, from 01/01/98 to 31/12/13. RESULTS: 374 episodes of candidemia were identified. The incidence was 2.21/1,000 discharges and increased from 1.96 (1998-2005) to 2.25 (2006-2013) (p = 0.023). Candidemia was diagnosed: 5.4% in neonates, 1.7% in infants, 6.5% in children, 31.8% in adults and 52.7% in elderly adults over 64 years old. The episodes were caused by C. albicans (40.9%), C. parapsilosis (21.7%), C. tropicalis (15.5%), C. glabrata (13.9%), other species of Candida (5.1%) and more than one species of Candida (2.9%). The 5.3% of the isolates were resistant to fluconazole. 74% of patients were treated. Initial treatments were with fluconazole (70.3%), amphotericin B deoxycholate (25%), echinocandins or lipidic amphotericin (4,7%). The 81% of central venous catheters were taken off. Mortality rate was of 47.9%, but in the elderly adults was of 60.8%. CONCLUSION: The incidence of candidemia showed an increase over the years. It was higher in the elderly adults, being the group with worse outcomes.

Transcriptome-Based Identification of Highly Similar Odorant-Binding Proteins among Neotropical Stink Bugs and Their Egg Parasitoid.

Olfaction plays a fundamental role in insect survival through resource location and intra and interspecific communications. We used RNA-Seq to analyze transcriptomes for odorant-binding proteins (OBPs) from major stink bug pest species in Brazil, Euschistus heros, Chinavia ubica, and Dichelops melacanthus, and from their egg parasitoid, Telenomus podisi. We identified 23 OBPs in E. heros, 25 OBPs in C. ubica, 9 OBPs in D. melacanthus, and 7 OBPs in T. podisi. The deduced amino acid sequences of the full-length OBPs had low intraspecific similarity, but very high similarity between two pairs of OBPs from E. heros and C. ubica (76.4 and 84.0%) and between two pairs of OBPs from the parasitoid and its preferred host E. heros (82.4 and 88.5%), confirmed by a high similarity of their predicted tertiary structures. The similar pairs of OBPs from E. heros and C. ubica may suggest that they have derived from a common ancestor, and retain the same biological function to bind a ligand perceived or produced in both species. The T. podisi OBPs similar to E. heros were not orthologous to any known hymenopteran OBPs, and may have evolved independently and converged to the host OBPs, providing a possible basis for the host location of T. podisi using E. heros semiochemical cues.