Gene Expression of GABAA Receptor Subunits and Association with Patient Survival in Glioma.

Rapid neuronal inhibition in the brain is mediated by γ-aminobutyric acid (GABA) activation of GABAA receptors. The GABRA5 gene, which encodes the α5 subunit of the GABAA receptor, has been implicated in an aggressive subgroup of medulloblastoma (MB), a type of pediatric brain tumor. However, the possible role of GABAA receptor subunits in glioma remains poorly understood. Here, we examined the expression of genes encoding GABAA receptor subunits in different types of glioma, and its possible association with patient prognosis assessed by overall survival (OS). Data were obtained from the French and The Cancer Genome Atlas Brain Lower Grade Glioma (TCGA-LGG) datasets and analyzed for expression of GABAA receptor subunit genes. OS was calculated using the Kaplan-Meier estimate. We found that genes GABRA2, GABRA3, GABRB3, GABRG1, and GABRG2 showed a significant association with OS, with higher gene expression indicating better prognosis. In patients with GBM, high expression of GABRA2 was associated with shorter OS, whereas, in contrast, higher levels of GABRB3 were associated with better prognosis indicated by longer OS. In patients with lower grade gliomas, GABRA3, GABRB3, GABRG1, and GABRG2, were associated with longer OS. High GABRB3 expression was related to longer survival when low grade glioma types were analyzed separately. Our results suggest an overall association between higher expression of most genes encoding GABAA receptor subunits and better prognosis in different types of glioma. Our findings support the possibility that down-regulation of GABAA receptors in glioma contributes to promoting tumor progression by reducing negative inhibition. These findings might contribute to further evaluation of GABAA receptors as a therapeutic target in glioma.

Gene Expression of CSF3R/CD114 Is Associated with Poorer Patient Survival in Glioma.

Gliomas comprise most cases of central nervous system (CNS) tumors. Gliomas afflict both adults and children, and glioblastoma (GBM) in adults represents the clinically most important type of malignant brain cancer, with a very poor prognosis. The cell surface glycoprotein CD114, which is encoded by the CSF3R gene, acts as the receptor for the granulocyte colony stimulating factor (GCSF), and is thus also called GCSFR or CSFR. CD114 is a marker of cancer stem cells (CSCs), and its expression has been reported in several cancer types. In addition, CD114 may represent one among various cases where brain tumors hijack molecular mechanisms involved in neuronal survival and synaptic plasticity. Here, we describe CSF3R mRNA expression in human gliomas and their association with patient prognosis as assessed by overall survival (OS). We found that the levels of CSF3R/CD114 transcripts are higher in a few different types of gliomas, namely astrocytoma, pilocytic astrocytoma, and GBM, in comparison to non-tumoral neural tissue. We also observed that higher expression of CSF3R/CD114 in gliomas is associated with poorer outcome as measured by a shorter OS. Our findings provide early evidence suggesting that CSF3R/CD114 shows a potential role as a prognosis marker of OS in patients with GBM.

Comment on Boyde et al. (2023), 'Fleas and lesions in armadillo osteoderms'.

Boyde et al. (2023) stated that Moura et al. (2021) did not explain how fleas generated cavities in armadillo osteoderms, which is wrongly stated, also presenting a misrepresentation of what is written about this in Moura et al. (2021).

Visual performance and photic disturbances with diffractive and nondiffractive EDOF intraocular lenses using mini-monovision: randomized trial.

PURPOSE: To compare visual performance and photic visual disturbances of patients implanted with 2 different extended depth-of-focus (EDOF) intraocular lenses (IOLs) using mini-monovision. SETTING: Ambulatory surgical center at the University of São Paulo in Ribeirão Preto, Brazil. DESIGN: Prospective, examiner-masked, randomized clinical trial. METHODS: Patients were assigned to either a bilateral Symfony (SYM) or Vivity (VIV) IOL group, with 1 eye targeted for myopia (-0.75 diopter [D]). Defocus curve, contrast sensitivity (Pelli-Robson), Patient-Reported Spectacle Independence Questionnaire, and Quality of Vision questionnaire were recorded at 3 months postoperatively. RESULTS: A total of 126 patients finished the follow-up: group SYM: n = 60 and group VIV: n = 66. Regarding near visual acuity, 80% of patients in the SYM group and 84% of patients in the VIV group achieved J2 or better on the near-planned eye ( P = .3840). No significant differences were found between groups for distance visual acuity, defocus profiles, PRISC, contrast sensitivity, or reading speed ( P > .05). Notably, significant between-group differences were observed for bothersome visual disturbances ( P = .0235), with 45% of patients in the SYM group with a score of 0 for bothersome disturbances compared with 66% in the VIV group. CONCLUSIONS: Mini-monovision using these EDOF IOLs was well-tolerated in the patient cohort. No significant differences were found for visual performance tests between the VIV and SYM groups. However, the data suggest that Vivity IOL is associated with a lower probability of bothersome visual disturbances compared with Symfony IOL.

Contribuições dos enfermeiros no processo de adesão ao tratamento da tuberculose / Contributions of nurses in the process of adherence to tuberculosis treatment

Objetivo: Identificar as contribuições de enfermeiros no processo de adesão ao tratamento da tuberculose. Métodos: Revisão integrativa nas bases de dados Cumulative Index toNursing and Allied Health Literature, Medline completeEbsco, PubMed Central, Science Direct,Scopuse Web of Sciencea partir da utilização dos descritores Patient Compliance, Medication adherence, Treatment adherence and compliance, Tuberculosise Nurse's Role. Resultados: A partir dos artigos que compuseram a amostra final, as contribuições de enfermeiros no processo de adesão que emergiram consistiram em aconselhamento, visitas domiciliares, uso de tecnologias e de programas, tais como o Tratamento Diretamente Observado, supervisão por vídeo e suporte social. Conclusão: O enfermeiro é um profissional que contribui na implementação desses métodos. O uso de tecnologia sem fio adicionada aos métodos eletrônicos é promissor e pode significar um grande avanço, uma vez que a supervisão direta não vem se mostrando viável e factível em diversas realidades. Descritores: Tuberculose; Cooperação do Paciente; Adesão à Medicação; Enfermagem; Saúde Pública

Objective: To identify the contributions of nurses in the process of adherence to tuberculosis treatment. Methods: Integrative review in the Cumulative Index to Nursing and Allied Health Literature, Medline complete Ebsco, PubMed Central, Science Direct, Scopus and Web of Science databases using the descriptors Patient Compliance, Medication adherence, Treatment adherence and compliance, Tuberculosis and Nurse's Role. Results: From the articles that composed the final sample, the contributions of nurses in the adherence process that emerged consisted of counseling, home visits, use of technologies and programs such as Directly Observed Treatment, video supervision and social support. Conclusion: Nurses are professionals who contribute to the implementation of these methods. The use of wireless technology added to electronic methods is promising and can mean a great advance, since direct supervision has not been economically viable and feasible in several realities.Descriptors:Tuberculosis; Patient cooperation; Adherence to medication; Nursing; Public health

Discursos de gestantes sobre a sexualidade na gestação: possibilidade para promoção da saúde / Pregnant women's discourses about sexuality during pregnancy: possibility for health promotion

Analisar os discursos das gestantes sobre a sexualidade na gestação em uma Unidade Básica de Saúde da Família. Trata-se de estudo descritivo com abordagem qualitativa, realizado com 14 gestantes em acompanhamento pré-natal em uma Unidade Básica de Saúde da cidade de Cajazeiras, Paraíba, Brasil. Para a coleta de dados, utilizou-se entrevista semiestruturada, após a aprovação do Comitê de Ética e Pesquisa. Empregou-se o Discurso do Sujeito Coletivo para organização e análise dos resultados.Identificou-se, no decorrer dos discursos, a falta de conhecimento acerca do conceito de sexualidade, a sexualidade como prazer e bem-estar na possibilidade para autoestima da gestante, o medo de machucar o bebê durante o ato sexual, dores como obstáculo para relações sexuais durante a gestação e a importância da participação ativa do parceiro no período gestacional. Dessa maneira, é importante que, durante o pré-natal, as práticas educativas sejam reforçadas, para ampliar o conhecimento sobre a sexualidade.

To analyze the discourses of pregnant women about sexuality during pregnancy in a Basic Family Health Unit. This is a descriptive study with a qualitative approach, carried out with 14 pregnant women in prenatal care in a Basic Health Unit in the city of Cajazeiras, Paraíba, Brazil. For data collection, semi-structured interviews were used, after the approval of the Ethics and Research Committee. The Collective Subject Discourse was used to organize and analyze the results. During the subjects' discourses, we found a lack of knowledge about the concept of sexuality, what it means as pleasure, and well-being in the possibility of self-esteem of pregnant women; moreover, the fear of hurting the baby during the sexual act, pain as an obstacle to sexual intercourse during pregnancy, and the importance of their partners' active participation throughout the gestational period. In this way, it is important that educational practices be strengthened throughout the prenatal period in order to expand pregnant women's knowledge about sexuality

Race-Based Differences in ST-Segment-Elevation Myocardial Infarction Process Metrics and Mortality From 2015 Through 2021: An Analysis of 178 062 Patients From the American Heart Association Get With The Guidelines-Coronary Artery Disease Registry.

BACKGROUND: Systems of care have been developed across the United States to standardize care processes and improve outcomes in patients with ST-segment-elevation myocardial infarction (STEMI). The effect of contemporary STEMI systems of care on racial and ethnic disparities in achievement of time-to-treatment goals and mortality in STEMI is uncertain. METHODS: We analyzed 178 062 patients with STEMI (52 293 women and 125 769 men) enrolled in the American Heart Association Get With The Guidelines-Coronary Artery Disease registry between January 1, 2015, and December 31, 2021. Patients were stratified into and outcomes compared among 3 racial and ethnic groups: non-Hispanic White, Hispanic White, and Black. The primary outcomes were the proportions of patients achieving the following STEMI process metrics: prehospital ECG obtained by emergency medical services; hospital arrival to ECG obtained within 10 minutes for patients not transported by emergency medical services; arrival-to-percutaneous coronary intervention time within 90 minutes; and first medical contact-to-device time within 90 minutes. A secondary outcome was in-hospital mortality. Analyses were performed separately in women and men, and all outcomes were adjusted for age, comorbidities, acuity of presentation, insurance status, and socioeconomic status measured by social vulnerability index based on patients' county of residence. RESULTS: Compared with non-Hispanic White patients with STEMI, Hispanic White patients and Black patients had lower odds of receiving a prehospital ECG and achieving targets for door-to-ECG, door-to-device, and first medical contact-to-device times. These racial disparities in treatment goals were observed in both women and men, and persisted in most cases after multivariable adjustment. Compared with non-Hispanic White women, Hispanic White women had higher adjusted in-hospital mortality (odds ratio, 1.39 [95% CI, 1.12-1.72]), whereas Black women did not (odds ratio, 0.88 [95% CI, 0.74-1.03]). Compared with non-Hispanic White men, adjusted in-hospital mortality was similar in Hispanic White men (odds ratio, 0.99 [95% CI, 0.82-1.18]) and Black men (odds ratio, 0.96 [95% CI, 0.85-1.09]). CONCLUSIONS: Race- or ethnicity-based disparities persist in STEMI process metrics in both women and men, and mortality differences are observed in Hispanic White compared with non-Hispanic White women. Further research is essential to evolve systems of care to mitigate racial differences in STEMI outcomes.

Formas de enfrentamento do câncer de mama: discurso de mulheres mastectomizadas / Ways of coping with breast cancer: discourse of mastectomized women

Introdução: Na neoplasia de mama ocorrem inúmeras transformações na vida da pessoa acometida e de todas as pessoas próximas, sentimentos como medo, angústia e tristeza. Diante disso, a identificação dos métodos usados para enfrentar a neoplasia de mama faz-se crucial, visto que proporciona melhor vivência desse momento por parte da mulher e de todos os envolvidos. Objetivo: Compreender as formas de enfrentamento do câncer de mama por meio do discurso de participantes de um grupo de apoio. Metodologia: Pesquisa descritiva com abordagem qualitativa realizada com 10 mulheres que participam de um grupo geral de apoio, localizado em um município da Paraíba, Brasil. Para a coleta de dados, utilizou-se entrevista semiestruturada, e como processo metodológico para a análise dos dados, o Discurso do Sujeito Coletivo. Resultados: Foi possível a compreensão de três ideias centrais em relação às formas de enfrentamento do câncer de mama: ''Ancoragem na fé e espiritualidade''; ''Suporte familiar''; e ''Grupo de apoio''. Conclusão: O estudo atingiu seu objetivo de identificar as principais formas de enfrentamento do câncer de mama por mulheres mastectomizadas, podendo elucidar a importância da fé e espiritualidade, o suporte familiar e a participação em grupos de apoio por meio do discurso das participantes.

Introducción: Con el cáncer de mama se producen numerosos cambios en la vida de la persona afectada y de las personas cercanas, en los que se manifiestan sentimientos como el miedo, la angustia y la tristeza. Ante eso, la identificación de los métodos utilizados para enfrentar el cáncer de mama es crucial, ya que permite una mejor vivencia de ese momento para la mujer y los involucrados. Objetivo: Comprender las formas de afrontamiento del cáncer de mama, a través del discurso de mujeres mastectomizadas en un grupo de apoyo. Metodología: Investigación descriptiva con enfoque cualitativo realizada con 10 mujeres que participan en un grupo de apoyo, ubicado en un municipio de Paraíba, Brasil. Para la recolección de datos, se utilizaron entrevistas semiestructuradas. Además, como proceso metodológico de análisis de datos, se aplicó el Discurso Colectivo del Sujeto. Resultados: Fue posible comprender tres ideas centrales sobre las formas de enfrentamiento del cáncer de mama: ''Anclaje en la fe y la espiritualidad''; ''Apoyo familiar''y ''Grupo de apoyo''. Conclusión: El estudio alcanzó su objetivo de identificar las principales formas de enfrentamiento del cáncer de mama por parte de las mujeres con mastectomía. Se pudo dilucidar la importancia de la fe y la espiritualidad, el apoyo familiar y la participación en grupos de apoyo, a través del discurso de las participantes.

Introduction: When facing breast cancer, patients and their loving ones experiment many changes in their lives filled with feelings such as fear, anguish, and sadness. In the light of this, the identification of the coping methods used to face breast cancer is crucial to provide a better experience for all those involved. Objective: To understand the ways of coping with breast cancer through the discourse of mastectomized women in a support group. Methodology: Descriptive research with a qualitative approach carried out with 10 women who participate in a support group, located in a municipality in Paraíba, Brasil. For data collection, semi-structured interviews were conducted and as a methodological process for data analysis, the Collective Subject Discourse was used. Results: It was possible to understand three central coping mechanisms: ''Anchoring in faith and spirituality''; ''Family support'', and ''Support group''. Conclusion: The study reached its objective of identifying the main ways of coping with breast cancer by women who had mastectomies, their discourse highlighted the importance of faith and spirituality, the support of their families, and their participation in support groups.

The origin of an invasive air sac system in sauropodomorph dinosaurs.

One of the most remarkable features in sauropod dinosaurs relates to their pneumatized skeletons permeated by a bird-like air sac system. Many studies described the late evolution and diversification of this trait in mid to late Mesozoic forms but few focused on the origin of the invasive respiratory diverticula in sauropodomorphs. Fortunately, it is possible to solve this thanks to the boom of new species described in the last decade as well as the broad accessibility of new technologies. Here we analyze the unaysaurid sauropodomorph Macrocollum itaquii from the Late Triassic (early Norian) of southern Brazil using micro-computed tomography. We describe the chronologically oldest and phylogenetically earliest unambiguous evidence of an invasive air sac system in a dinosaur. Surprisingly, this species presented a unique pattern of pneumatization in non-sauropod sauropodomorphs, with pneumatic foramina in posterior cervical and anterior dorsal vertebrae. This suggests that patterns of pneumatization were not cladistically consistent prior to the arrival of Jurassic eusauropods. Additionally, we describe the protocamerae tissue, a new type of pneumatic tissue with properties of both camellae and camerae. This reverts the previous hypothesis which stated that the skeletal pneumatization first evolved into camarae, and derived into delicate trabecular arrangements. This tissue is evidence of thin camellate-like tissue developing into larger chambers. Finally, Macrocollum is an example of the gradual evolution of skeletal tissues responding to the fastly specializing Respiratory System of saurischian dinosaurs.

New proposal of viral genome representation applied in the classification of SARS-CoV-2 with deep learning.

BACKGROUND: In December 2019, the first case of COVID-19 was described in Wuhan, China, and by July 2022, there were already 540 million confirmed cases. Due to the rapid spread of the virus, the scientific community has made efforts to develop techniques for the viral classification of SARS-CoV-2. RESULTS: In this context, we developed a new proposal for gene sequence representation with Genomic Signal Processing techniques for the work presented in this paper. First, we applied the mapping approach to samples of six viral species of the Coronaviridae family, which belongs SARS-CoV-2 Virus. We then used the sequence downsized obtained by the method proposed in a deep learning architecture for viral classification, achieving an accuracy of 98.35%, 99.08%, and 99.69% for the 64, 128, and 256 sizes of the viral signatures, respectively, and obtaining 99.95% precision for the vectors with size 256. CONCLUSIONS: The classification results obtained, in comparison to the results produced using other state-of-the-art representation techniques, demonstrate that the proposed mapping can provide a satisfactory performance result with low computational memory and processing time costs.

Case report: intravenous leiomyomatosis with intracaval and intracardiac growth.

Background: Intravenous leiomyomatosis (IVL) is a rare, benign smooth muscle cell tumour that extends beyond the pelvis. These tumours grow within vascular channels and can progress to involve the heart and pulmonary vasculature. Case Summary: A 44-year-old female initially presented to her primary care physician for subacute bloating. In the weeks leading up to her presentation, she was in good health. On admission, computed tomography (CT) imaging of the abdomen and pelvis was notable for a mixed solid and cystic mass arising from the fundal myometrium with invasion into the inferior vena cava (IVC). Transthoracic echocardiogram (TTE) was notable for mobile mass in the right atrium originating from the IVC. The mass was further evaluated by cardiac magnetic resonance (CMR) imaging before a multidisciplinary, single-staged thoracoabdominal resection was performed. The procedure was well tolerated, and the entire mass was successfully removed without complication. Subsequently, pathological analysis of the resected tumour revealed benign smooth muscle cells, confirming the diagnosis of IVL. Discussion: Intravenous leiomyomatosis is a rare cause of right-sided cardiac tumours but should be considered in premenopausal females, even those with a prior history of hysterectomy. The clinical presentation of patients with IVL is varied and imaging including CMR, CT, and TTE to evaluate the tissue characteristics and source of the cardiac mass should be performed. Finally, while imaging revealing a freely mobile pelvic mass extending into the IVC and right heart chambers is strongly suggestive of IVL, definitive diagnosis requires pathological analysis of resected tissue.

SARS-CoV-2 virus classification based on stacked sparse autoencoder.

Since December 2019, the world has been intensely affected by the COVID-19 pandemic, caused by the SARS-CoV-2. In the case of a novel virus identification, the early elucidation of taxonomic classification and origin of the virus genomic sequence is essential for strategic planning, containment, and treatments. Deep learning techniques have been successfully used in many viral classification problems associated with viral infection diagnosis, metagenomics, phylogenetics, and analysis. Considering that motivation, the authors proposed an efficient viral genome classifier for the SARS-CoV-2 using the deep neural network based on the stacked sparse autoencoder (SSAE). For the best performance of the model, we explored the utilization of image representations of the complete genome sequences as the SSAE input to provide a classification of the SARS-CoV-2. For that, a dataset based on k-mers image representation was applied. We performed four experiments to provide different levels of taxonomic classification of the SARS-CoV-2. The SSAE technique provided great performance results in all experiments, achieving classification accuracy between 92% and 100% for the validation set and between 98.9% and 100% when the SARS-CoV-2 samples were applied for the test set. In this work, samples of the SARS-CoV-2 were not used during the training process, only during subsequent tests, in which the model was able to infer the correct classification of the samples in the vast majority of cases. This indicates that our model can be adapted to classify other emerging viruses. Finally, the results indicated the applicability of this deep learning technique in genome classification problems.

Dificuldades na prevenção do câncer de colo uterino: discurso de mulheres quilombolas / Dificultades en la prevención del cáncer cervicouterino: discurso de las mujeres quilombolas / Difficulties in Preventing Cervical Cancer: Discourse of Quilombola Women

Introdução: observa-se que a população negra está mais vulnerável para algumas enfermidades devido a questões genéticas, ambientais, econômicas e sociais. Na saúde da mulher negra evidencia-se a necessidade de maior atenção ao desenvolvimento do câncer do colo uterino. Objetivo: identificar as dificuldades para prevenção do câncer do colo uterino a partir do discurso de mulheres quilombolas. Método: pesquisa descritiva de abordagem qualitativa, mediatizada pela metodologia da pesquisa-ação, realizada na comunidade remanescente de quilombolas intitulada "Os Quarenta", localizada na cidade de Triunfo, Paraíba, Brasil, no ano de 2019. Resultados: Notou-se, a partir dos discursos das participantes, duas Ideias Centrais acerca dos problemas ou dificuldades que impossibilitam o diagnóstico precoce do câncer do colo de útero: vergonha como obstáculo para à prática do exame preventivo e autonegligência como fator determinante na ausência da procura pelos serviços de saúde. Conclusões: percebe-se que ao inserir às informações em saúde é importante levar em consideração os fatores sociais e culturais da comunidade visando adequar às práticas de acordo com representações a respeito do tema.

Introducción: se observa que la población negra es más vulnerable frente a algunas enfermedades por cuestiones genéticas, ambientales, económicas y sociales. En la salud de la mujer negra se evidencia la necesidad de una mayor atención al desarrollo del cáncer de cuello uterino. Objetivo: identificar las dificultades en la prevención del cáncer de cuello uterino desde el discurso de las mujeres quilombolas. Método: investigación descriptiva con enfoque cualitativo, mediada por la metodología de investigación acción, realizada en la comunidad quilombola remanente denominada Os Quarenta, ubicada en la ciudad de Triunfo, Paraíba, Brasil, en 2019. Resultados: se constató en los discursos de las participantes, dos ideas centrales sobre los problemas o dificultades que impiden el diagnóstico precoz del cáncer de cuello uterino: la vergüenza como obstáculo para la práctica del examen preventivo y la auto negligencia como factor determinante en la ausencia de demanda de servicios de salud. Conclusiones: se advierte que al insertar información de salud es importante tener en cuenta los factores sociales y culturales de la comunidad para adecuar las prácticas de acuerdo con las representaciones sobre el tema.

Introduction: It is observed that black population is more vulnerable to some diseases due to genetic, environmental, economic and social issues. In the health of black women, the need for greater attention to the development of cervical cancer is evident. Objective: To identify the difficulties in preventing cervical cancer from the discourse of quilombola women. Method: Descriptive research with a qualitative approach, mediated by the action research methodology. It was carried out in the remaining quilombola community entitled Os Quarenta, located in the city of Triunfo, Paraíba, Brazil, in 2019. Results: In the participant's discourse two central ideas were noted about the problems or difficulties that prevent early diagnosis of cervical cancer: shame as an obstacle to the practice of preventive examination and self-negligence as a determining factor in the absence of demand for health services. Conclusions: It is noticed that when inserting health information, it is important to consider the social and cultural factors of the community in order to adapt practices according to representations on the subject.

Ações educativas como possibilidade no empoderamento de adolescentes acerca da depressão / Educational actions as a possibility in the empowerment of adolescents about depression / Las acciones educativas como posibilidad en el empoderamiento de los adolescentes sobre la depresión

Objetivo: compreender como propostas de educação em saúde podem contribuir para o conhecimento e atitudes dos adolescentes frente a depressão. Método: trata-se do recorte de um trabalho de conclusão de curso de graduação em enfermagem da Universidade Federal de Campina Grande, realizado no ano de 2018, fundamentado no método da pesquisa-ação e analisado por meio do Discurso do Sujeito Coletivo. Resultados: após realização do diagnóstico situacional foi possível realizar o planejamento e execução de três encontros para realização de ações educativas com uso de dinâmicas e metodologias que proporcionaram a participação dos jovens, bem como o diálogo do grupo e a construção de conhecimentos relacionados a depressão. Considerações finais: os atos educativos apresentaram-se positivos como oportunidade para a autonomia de adolescentes acerca da depressão, mostrando o quão significativo pode ser o uso deste tipo de metodologia para a transformação de realidade e resolubilidade de problemas sociais

Objective: to understand how health education proposals can contribute to adolescents' knowledge and attitudes towards depression. Method: this is the conclusion cut of a course of study of a field of work in nursing at the Federal University of Grande, carried out in 2018, based on the research and scientific method through the Collective Subject Discourse. Results: after carrying out the situational diagnosis, it was possible to carry out the planning and execution of three meetings to carry out educational actions using dynamics and methodologies that will provide a participation of dynamics and methodologies that will provide a participation of young people, as well as the group dialogue and the construction of knowledge related to depression. Final considerations: the studies proved to be positive as an opportunity for autonomy to deepen the resolution of these acts, how significant the use of this type of methodology can be for the transformation of reality and the capacity for social problems

Objetivo: comprender cómo las propuestas de educación para la salud pueden contribuir al conocimiento y las actitudes de los adolescentes frente a la depresión. Método: este es el recorte de un trabajo de conclusión de curso de graduación en enfermería de la Universidad Federal de Campina Grande, realizado en 2018, basado en el método de investigación acción y analizado a través del Discurso del Sujeto Colectivo. Resultados: luego de realizar el diagnóstico situacional, se logró planificar y ejecutar tres encuentros para realizar acciones educativas utilizando dinámicas y metodologías que propiciaron la participación de los jóvenes, así como el diálogo grupal y la construcción de saberes relacionados con la depresión. Consideraciones finales: los actos educativos fueron positivos como oportunidad para la autonomía de los adolescentes sobre la depresión, mostrando cuán significativo puede ser el uso de este tipo de metodología para la transformación de la realidad y la resolución de problemas sociales

Case Report: Abdominal Wall Reconstruction in a High-Risk Patient With Incisional Hernia and Complications From Oncological Treatment.

Introduction: A high risk patient with evisceration underwent to abdominal wall reconstruction without mesh or drains. We present a case of a 62 years-old female patient with a significant medical history of Wilson's disease-related hepatopathy Child-Pugh class B classification, sequelae of a stroke, and relevant surgical background including total hysterectomy, oophorectomy, and Hartmann's procedure for ovarian neoplasm stage 3. The patient developed a large incisional hernia in the midline incision while undergoing Bevacizumab (Avastin) treatment for clinical oncology. During an attempt at skin closure due to erosion and necrosis, there was progressive deterioration leading to evisceration. We opted for abdominal wall reconstruction by transposing the hernia sac without using mesh and employing hemostatic powder (Arista) to mitigate the risk of bleeding in a high-risk patient due to recent bevacizumab use and hepatopathy. The patient had a favorable postoperative course without any other intervention in abdominal wall. Patient developed worsening hepatic function with the presence of ascites, constipation, and disorientation. On the 6th day postoperative, a tomography was performed, which showed colonic distension without obstructive factors and a slight amount of supra-aponeurotic fluid. The patient was discharged on the 10th day postoperative after improvement of the condition with clinical treatment. The patient has been progressing under outpatient follow-up for 5 months, with a resumption of chemotherapy cycles and no evidence of hernia recurrence. Conclusion: Further studies and long-term follow-up are necessary to evaluate the efficacy and safety of hernia sac transposition as a mesh-free technique and the use of hemostatic powder without drains in high-risk patients. However, our case highlights the potential feasibility of these approaches in carefully selected cases.

Da igualdade ao equânime: singularidades do cuidado do enfermeiro à mulher negra na atenção básica / From equality to equity: singularities of nursing care for black women in primary care / De la igualdad a la equidad: singularidades de la atención de enfermería a mujeres negras en la atención primaria

Objetivo: analisar, a partir dos discursos dos enfermeiros, a relação do cuidado igualitário e equânime à mulher negra na Atenção Básica. Método: estudo descritivo, com abordagem qualitativa, realizado entre os meses de março e maio de 2017 com oito enfermeiros da Atenção Básica do município de Cajazeiras, Paraíba. Para a coleta de dados foi utilizada uma entrevista semiestruturada, após a aprovação do Comitê de Ética e Pesquisa. Utilizou-se a Análise de Discurso para análise dos resultados. Resultados: constatou-se no discurso dos enfermeiros certa confusão nos significados entre assistência igualitária e assistência equânime, porém também se verificou a possibilidade de uma ruptura no padrão de cuidados ofertados a mulher negra. Conclusão: é necessário que a abordagem dos assuntos relacionados a saúde da mulher negra seja trabalhada em toda a formação acadêmico/profissional afim de proporcionar ruptura nas lacunas do senso comum, considerando as relações étnicas, raciais, culturais e sociais. (AU).

Objective: to analyze, from the nursing professionals' speeches, the relation between equal and equitable care for black women in Primary Care. Method: descriptive study, with a qualitative approach, performed between March and May 2017 with eight nurses from the Primary Health Care in the town of Cajazeiras, Paraíba. In order to collect data, we used a semi-structured interview, after approval by the Research Ethics Committee. Discourse Analysis was used to analyze the results. Results: in the nurses' speech, we found some confusion in the meanings between equal assistance and equitable assistance; however, in their speeches, we also noted the possibility of a rupture in the standard of care offered to black women. Conclusion: it is necessary that the approach to issues related to the health of black women be worked in all academic/professional training in order to provide a rupture in the gaps of common sense, considering ethnic, racial, cultural and social relationships. (AU).

Objetivo: analizar, a partir de los discursos de los enfermeros, la relación de la atención igualitaria y equitativa a las mujeres negras en la Atención Primaria. Método: estudio descriptivo, con un planteamiento cualitativo, llevado a cabo entre marzo y mayo de 2017 con ocho enfermeros de la Atención Primaria de Salud en la ciudad de Cajazeiras, Paraíba. Para la recopilación de datos, se utilizó una entrevista semiestructurada, tras la aprobación del Comité de Ética e Investigación. Se utilizó el análisis del discurso para analizar los resultados. Resultados: Se encontró, en el discurso de los enfermeros, una cierta confusión en los significados entre asistencia igualitaria y asistencia equitativa, pero, en dicho discurso, también se notó la posibilidad de una ruptura en el estándar de atención ofrecido a las mujeres negras. Conclusión: es necesario que el planteamiento de los problemas relacionados con la salud de las mujeres negras se trabaje en toda la formación académica/profesional con miras a proporcionar una ruptura en las brechas del sentido común, considerando las relaciones étnicas, raciales y culturales y sociales. (AU).

Saberes e sentimentos dos adultos jovens acerca das infecções sexualmente transmissíveis / Knowledge and feelings of young adults regarding sexually transmitted infections / Conocimientos y sentimientos de los jóvenes adultos sobre las infecciones de transmisión sexual

Objetivo: investigar o conhecimento dos adultos jovens relacionado às Infecções Sexualmente Transmissíveis. Método: Estudo com delineamento descritivo e abordagem qualitativa, realizado na modalidade pesquisa-ação, desenvolvido com 15 estudantes do ensino médio da Educação de Jovens e Adultos de uma Escola Estadual, na cidade de Cajazeiras Paraíba, no alto Sertão Paraibano, no ano de 2019. Os dados foram apurados após aprovação do Comitê de Ética e Pesquisa, e analisados por meio do Discurso do Sujeito Coletivo. Resultados: Com a obtenção dos dados, verificou-se um nível menor de entendimento dos adultos jovens sobre as Infecções Sexualmente Transmissíveis, demonstrando assim uma vulnerabilidade vigente que merece atenção para esta faixa etária, exposta a diversos fatores intrínsecos e extrínsecos. Conclusão: A inclusão da educação em saúde para os adultos jovens apresenta-se como forma de ampliação do conhecimento e direitos legais, para entendimento crucial e necessário referentes à educação sexual e reprodutiva (AU).

Objective: to investigate the knowledge of young adults related to Sexually Transmitted Infections. Method: Study with descriptive design and qualitative approach, carried out in the action-research modality, developed with 15 high school students from Youth and Adult Education of a State School, in the city of Cajazeiras Paraíba, in the high Sertão Paraibano, in the year 2019. Data were obtained after approval by the Ethics and Research Committee, and displacement through the Collective Subject Discourse. Results: With data collection, there was a lower level of understanding among young adults about Sexually Transmitted Infections, thus demonstrating a current vulnerability that deserves attention for this age group, exposed to several intrinsic and extrinsic factors. Conclusion: The inclusion of health education for young adults is a way of expanding knowledge and legal rights, for a crucial and necessary understanding regarding sexual and reproductive education (AU).

Objetivo: Tuvo como objetivo investigar los conocimientos de los adultos jóvenes relacionados con las Infecciones de Transmisión Sexual. Método: Estudio con diseño descriptivo y enfoque cualitativo, realizado en la modalidad de investigación-acción, desarrollado con 15 estudiantes de secundaria de Educación de Jóvenes y Adultos de una Escuela Estatal, en la ciudad de Cajazeiras Paraíba, en el alto Sertão Paraibano, en el año 2019. Los datos se obtuvieron tras la aprobación del Comité de Ética e Investigación, y el desplazamiento por el Discurso del Sujeto Colectivo. Resultados: Con la recolección de datos, se verificó un menor nivel de comprensión de los adultos jóvenes sobre las Infecciones de Transmisión Sexual, demostrando así una vulnerabilidad actual que merece atención para este grupo etario, expuesto a diversos factores intrínsecos y extrínsecos. Conclusión: La inclusión de la educación en salud para jóvenes adultos es una forma de ampliar conocimientos y derechos jurídicos, para una comprensión crucial y necesaria en torno a la educación sexual y reproductiva (AU).

Ações educativas como possibilidade de repensar a sexualidade da pessoa idosa / Educational actions as a possibility of rethinking the sexuality of the elderly person / Acciones educativas como posibilidad para repensar la sexualidad de las personas mayores

Objetivo: descrever atividades educativas sobre a sexualidade desenvolvidas com os idosos. Método: Trata-se de a um estudo descritivo, com abordagem qualitativa, fundamentado nos pressupostos da pesquisa-ação, mediada pelo questionamento se as atividades podem possibilitar o repensar sobre a sexualidade da pessoa idosa. Resultados: As atividades desenvolvidas permitiram que os participantes pudessem ter uma visão diferenciada e uma compreensão maior sobre o que realmente significa sexualidade, e como ela está diretamente envolvida com o processo de envelhecimento, proporcionando a concepção de que a sexualidade pode ser vivida em qualquer fase da vida e de várias formas. Conclusão: Notou-se, após as atividades educativas desenvolvidas, não somente a melhor compreensão sobre a temática, mas a ruptura do receio de falar sobre um assunto permeado de tabus nesse segmento populacional (AU).

Objective: to describe educational activities about sexuality developed with the elderly. Method: This is a descriptive study, with a qualitative approach, based on the assumptions of action research, mediated by questioning whether the activities can enable rethinking about the sexuality of the elderly. Results: The activities developed allowed the participants to have a different view and a greater understanding of what sexuality really means, and how it is directly involved with the aging process, providing the conception that sexuality can be experienced at any stage of life and of shapes. Conclusion: It was noted, after the educational activities developed, not only a better understanding of the theme, but the fear of talking about a subject permeated by taboos in this population segment (AU).

Objetivo: describir actividades educativas sobre sexualidad desarrolladas con ancianos. Método: Se trata de un estudio descriptivo, con abordaje cualitativo, pautado en los supuestos de la investigación-acción, mediada por el cuestionamiento de si las actividades pueden posibilitar repensar la sexualidad de los ancianos. Resultados: Las actividades desarrolladas permitieron a los participantes tener una mirada diferente y una mayor comprensión de lo que realmente significa la sexualidad, y cómo ella está directamente involucrada con el proceso de envejecimiento, brindando la concepción de que la sexualidad puede ser experimentada en cualquier etapa de la vida y de formas. Conclusión: Se constató, después de las actividades educativas desarrolladas, no sólo una mejor comprensión del tema, sino el temor de hablar sobre un tema permeado por tabúes en este segmento de la población (AU).

Cuidados em saúde às mulheres homossexuais: discursos de enfermeiros da Atenção Primária à Saúde / Health care for homosexual women: discourses of Primary Health Care nurses

A assistência em saúde se configura ainda como questão de difícil manejo para a população homossexual, por vezes, percebe-se despreparo dos enfermeiros na assistência direcionada às questões relacionadas à orientação sexual das mulheres inclusas nesse grupo, deixando implícito que todas as mulheres são heterossexuais. Dessa forma, o presente estudo teve como objetivo analisar os cuidados de enfermagem ofertado às mulheres homossexuais na atenção primária à saúde sob perspectiva do enfermeiro. Trata-se de um estudo qualitativo de natureza descritiva, realizado com treze enfermeiros atuantes na atenção Primária em cidade no interior do estado da Paraíba, Nordeste do Brasil. A coleta de dados ocorreu entre junho e julho de 2020, por meio da entrevista semiestruturada, e analisada pela técnica do Discurso do Sujeito Coletivo. Os depoimentos foram sintetizados em três categorias: Cuidados de enfermagem às mulheres homossexuais; Fragilidades no plano de cuidados: da igualdade ao equânime e Limitações nos saberes acerca das políticas públicas em saúde às mulheres homossexuais. Dentre as percepções encontradas, destaca-se a realização de cuidados sem direcionamento, o não reconhecimento das necessidades específicas de saúde, bem como desconhecimento dos enfermeiros acerca das políticas públicas envolvendo as mulheres homossexuais.

Healthcare is still a difficult issue to handle for the homosexual population, sometimes it is apparent that nurses are unprepared in providing care directed at issues related to the sexual orientation of women included in this group, implying that all women are heterosexual. Thus, the present study aimed to analyze the nursing care offered to homosexual women in primary health care from the nurse's perspective. This is a qualitative study of a descriptive nature, carried out with thirteen nurses working in Primary Care in a city in the interior of the state of Paraiba, Northeastern Brazil. Data collection took place between June and July 2020, through semi-structured interviews, and analyzed using the Collective Subject Discourse technique. The statements were synthesized into three categories: 1) Nursing care for homosexual women; 2) Weaknesses in the care plan: from equality to fairness; and 3) Limitations in knowledge about public health policies for homosexual women. Among the perceptions identified, we highlight the performance of care without direction, the non-recognition of specific healthcare needs, as well as the nurses' lack of knowledge about public policies involving homosexual women.

Dificuldades experienciadas no cotidiano dos adolescentes em ambiente escolar: gatilhos para o surgimento do sofrimento mental / Difficulties experienced in the daily life of adolescents in the school environment: triggers for the emergency of mental suffering / Dificultades vivendas en el cotidiano de los adolescentes en el ámbito escolar: desencadenantes de la emergencia del sufrimiento mental

A adolescência é um período de experimentação e autodescoberta marcada por inúmeras transformações. Estas transformações quando associada a outras condições em que o adolescente não consegue lidar, podem culminar em depressão. Diante disso, este estudo tem por objetivo analisar, por meio dos discursos, saberes e experiências dos adolescentes acerca das dificuldades vivenciadas no cotidiano que levam ao sofrimento mental. Trata-se de estudo descritivo, com abordagem qualitativa, mediado pela pesquisa- ação. Participaram do estudo dezessete adolescentes estudantes da Escola Técnica localizada na Paraíba, estado do Nordeste do Brasil. Para proceder à ordenação e organização dos dados empíricos, produzidos nas entrevistas semiestruturadas, recorreu- se ao processo metodológico do Discurso do Sujeito Coletivo. O estudo teve início após a aprovação pelo Comitê de Ética em Pesquisa. Considerou-se três temáticas: obstáculos no vivenciar do ambiente escolar como geradoras de angústias nos adolescentes, desestrutura nas relações familiares no surgimento do sofrimento mental e o bullying velado nas brincadeiras. Foi possível identificar problemáticas pertinentes à depressão, também possibilitou a discussão e análise sobre saberes e experiências dos adolescentes acerca das dificuldades vivenciadas no cotidiano que levam ao sofrimento mental. Ainda, oportunizou o compartilhamento das experiências vividas e um maior conhecimento sobre a relação desses adolescentes com os motivos pelos quais surge esse estresse psicológico.

Adolescence is a period of experimentation and self-discovery marked by numerous transformations. These transformations, when associated with other conditions that the teenager cannot deal with, can culminate in depression. Therefore, this study aims to analyze, through the speeches, knowledge and experiences of adolescents about the difficulties experienced in everyday life that lead to mental suffering. This is a descriptive study, with a qualitative approach, mediated by action research. Seventeen adolescent students from the Technical School located in Paraíba, in the Northeast of Brazil, participated in the study. To order and organize the empirical data produced in the semi- structured interviews, the methodological process of the Discourse of the Collective Subject was used. The study began after approval by the Research Ethics Committee. Three themes were considered: obstacles in experiencing the school environment as generators of anguish in adolescents, disruption of family relationships in the emergence of mental suffering and veiled bullying in games. It was possible to identify issues related to depression, also enabling the discussion and analysis of knowledge and experiences of adolescents about the difficulties experienced in everyday life that lead to mental suffering. Still, it provided opportunities for sharing experiences and greater knowledge about the relationship of these adolescents with the reasons why this psychological stress arises.

La adolescencia es un período de experimentación y autodescubrimiento marcado por numerosas transformaciones. Estas transformaciones, cuando se asocian a otras condiciones que el adolescente no puede afrontar, pueden culminar en depresión. Por lo tanto, este estudio tiene como objetivo analizar, a través de los discursos, los conocimientos y experiencias de los adolescentes sobre las dificultades vividas en la vida cotidiana que conducen al sufrimiento mental. Se trata de un estudio descriptivo, con abordaje cualitativo, mediado por la investigación acción. Participaron del estudio diecisiete adolescentes estudiantes de la Escuela Técnica ubicada en Paraíba, en el Nordeste de Brasil. Para ordenar y organizar los datos empíricos producidos en las entrevistas semiestructuradas se utilizó el proceso metodológico del Discurso del Sujeto Colectivo. El estudio se inició después de la aprobación por el Comité de Ética en Investigación. Se consideraron tres temas: obstáculos en la vivencia del ambiente escolar como generador de angustia en los adolescentes, ruptura de las relaciones familiares en la aparición del sufrimiento psíquico y acoso velado en los juegos. Fue posible identificar cuestiones relacionadas con la depresión, posibilitando también la discusión y el análisis de saberes y experiencias de los adolescentes sobre las dificultades vividas en el cotidiano que conducen al sufrimiento psíquico. Aún así, brindó oportunidades para compartir experiencias y un mayor conocimiento sobre la relación de estos adolescentes con las causas por las que surge este estrés psicológico.