Ensino interprofissional em saúde: análise qualitativa da experiência de estudantes, preceptores e tutores / Interprofessional teaching in health: qualitative analysis of the experience of students, preceptors and tutors / Enseñanza interprofesional en sanidad: análisis cualitativo de la experiencia de estudiantes, preceptores y tutores

A reorientação da formação profissional por meio de políticas públicas ofereceu a oportunidade para a criação de componentes curriculares, para formar estudantes que exercitem práticas interprofissionais. Este trabalho faz uma análise do contexto e implicações sobre a implantação de uma disciplina interprofissional nos cursos da saúde em uma universidade pública. Foi realizado um estudo com perfil exploratório de abordagem qualitativa utilizando-se grupos focais constituídos por tutores, preceptores e estudantes. Definidas as categorias e seus descritores foi utilizado o modelo 3P para a análise de conteúdo e dos resultados. Vale destacar a ressignificação do papel docente, a percepção dos estudantes frente aos desafios do ensino interprofissional e a aproximação com o serviço de saúde. Correlacionamos na discussão geral deste texto linhas de discussão junto à assistência à pessoa, à sociologia e à pedagogia. A inovação proposta pela disciplina interprofissional de Atenção em Saúde seguiu o ideário de uma agenda internacional. Os relatos de tutores, preceptores e estudantes foram um estímulo decisivo para prosseguir avançando nas demais séries dos cursos, em atividades colaborativas e práticas interprofissionais.

The reorientation of professional training through public policies offered the opportunity for the creation of curricular components to train students to exercise interprofessional practices. This paper makes an analysis of the context and implications on the implementation of an interprofessional discipline in health courses at a public university. A qualitative exploratory study was carried out using focus groups made up of tutors, preceptors and students. Once the categories and descriptors were defined, the 3P model was used for the content and results analysis. It is worth highlighting the redefinition of the teaching role, the students' perception of the challenges of interprofessional teaching, and the approximation with the health service. We correlate in the general discussion of this text lines of discussion with the person care, sociology, and pedagogy. The innovation proposed by the interprofessional discipline of Health Care followed the ideology of an international agenda. The reports from tutors, preceptors and students were a decisive stimulus to continue advancing in the other series of courses, in collaborative activities and interprofessional practices.

La reorientación de la formación profesional a través de políticas públicas ofreció la oportunidad para la creación de componentes curriculares para capacitar a los estudiantes en el ejercicio de prácticas interprofesionales. Este trabajo hace un análisis del contexto y de las implicaciones en la implementación de una disciplina interprofesional en cursos de salud en una universidad pública. Se realizó un estudio cualitativo exploratorio mediante grupos focales formados por tutores, preceptores y estudiantes. Una vez definidas las categorías y los descriptores, se utilizó el modelo 3P para el análisis de contenido y de resultados. Cabe destacar la redefinición del rol docente, la percepción de los estudiantes sobre los desafíos de la enseñanza interprofesional y la aproximación con el servicio de salud. Correlacionamos en la discusión general de este texto líneas de discusión con el cuidado de la persona, la sociología y la pedagogía. A inovação proposta pela disciplina interprofesional da Saúde seguiu a ideologia de uma agenda internacional. Los informes de tutores, preceptores y estudiantes fueron un estímulo decisivo para seguir avanzando en la otra serie de cursos, en actividades colaborativas y prácticas interprofesionales.

Antibacterial and antibiofilm activity of carvacrol against Salmonella enterica serotype Typhimurium

ABSTRACT The present study evaluated the antibacterial and antibiofilm activity of carvacrol against Salmonella Typhimurium. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined and the time-kill curve and scanning electron microscopy (SEM) were performed to evaluate antibacterial activity. Antibiofilm activity was evaluated by quantifying total biomass using crystal violet assay, and metabolic activity was determined using MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. The action of carvacrol against preformed biofilm on polypropylene and stainless steel was also evaluated by colony counting and SEM. The MIC and MBC was 312 µg mL-1. Carvacrol at MIC and 2 x MIC eliminated cells after 6 and 1 h of treatment, respectively, as exhibited in the time-kill curve. The greatest reduction in biofilm biomass and metabolic activity was 1,719 OD550 and 0,089 OD550 respectively, both at 4 x MIC of carvacrol. In carvacrol treated biofilms of S. Typhimurium on polypropylene, a reduction of 5.12 log was observed with 4 x MIC, while on stainless steel, carvacrol at 4 x MIC reduced bacterial counts by 5 log. The results showed that carvacrol exhibits antibacterial activity and can be used as an alternative for the control of S. Typhimurium biofilms.

Shiga-toxin genes and genetic diversity of Escherichia coli isolated from pasteurized cow milk in Brazil.

UNLABELLED: This study evaluated the genetic similarity and prevalence of the stx1, stx2, eae, and ehxA genes in Escherichia coli isolated from pasteurized cow milk. Eighty-seven E. coli isolates from pasteurized cow milk from 22 dairies located in northwestern Paraná state, Brazil, were analyzed. Genetic similarity was evaluated using enterobacterial repetitive intergenic consensus sequence polymerase chain reaction (ERIC-PCR) and repetitive extragenic palindromic sequence PCR (REP-PCR). E. coli isolates were also analyzed by PCR to investigate the presence of the stx1, stx2, eae, and ehxA genes. ERIC-PCR and REP-PCR clustered 87 bacterial isolates in 76 and 81 genomic profiles, respectively. Both techniques revealed high genetic diversity among the E. coli isolates, confirming the possibility of their use in epidemiological studies. The stx1, stx2, eae, and ehxA virulence genes were not detected in E. coli isolates, indicating a low prevalence of Shiga toxin-producing E. coli in milk produced in the region studied. PRACTICAL APPLICATION: Knowledge about the presence of diarrheagenic Escherichia coli in pasteurized milk is important developing and implementing control measures in milk and dairy production.

Genetic heterogeneity of Escherichia coli isolated from pasteurized milk in State of Paraná, Brazil

Food contamination caused by enteric pathogens is a major cause of diarrheal disease worldwide, resulting in high morbidity and mortality and significant economic losses. Bacteria are important agents of foodborne diseases, particularly diarrheagenic Escherichia coli. The present study assessed the genetic diversity and antimicrobial resistance of E. coli isolates from pasteurized milk processed in 21 dairies in northwestern State of Parana, Brazil. The 95 E. coli isolates were subjected to antimicrobial susceptibility testing according to the recommendations of the Clinical and Laboratory Standards Institute and assessed genotypically by Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction (ERIC-PCR). The highest rate of resistance was observed for cephalothin (55.78%). ERIC-PCR revealed high genetic diversity, clustering the 95 bacterial isolates into 90 different genotypic patterns. These results showed a heterogeneous population of E. coli in milk samples produced in the northwestern region of Paraná and the need for good manufacturing practices throughout the processing of pasteurized milk to reduce the risk of foodborne illnesses.

A contaminação de alimentos por patógenos entéricos é uma das principais causas de doenças diarréicas em todo o mundo, resultando em altas taxas de morbidade e mortalidade e perdas econômicas significativas. As bactérias são importantes agentes de doenças de origem alimentar, particularmente Escherichia coli diarreiogênicas. O presente estudo teve como objetivo avaliar a diversidade genética e a resistência a antimicrobianos de E. coli isoladas de leite pasteurizado, processados em 21 laticínios na região noroeste do Paraná - Brasil. Os 95 isolados de E. coli foram submetidos a testes de suscetibilidade aos antimicrobianos de acordo com as recomendações do Clinical and Laboratory Standards Institute e avaliados genotipicamente por ERIC-PCR (Enterobacterial Repetitive Intergenic Consensus - Polymerase Chain Reaction). O principal perfil de resistência encontrado entre os isolados foi resistência à cefalotina (55,78%). ERIC-PCR revelou alta diversidade genética, agrupando os 95 isolados bacterianos em 90 diferentes perfis genotípicos. Estes resultados mostraram uma população heterogênea de E. coli em amostras de leite produzido na região noroeste do Paraná e a necessidade de boas práticas na manipulação de todo o processamento de leite pasteurizado, a fim de reduzir o risco de doenças transmitidas por alimentos.

Western blotting is an efficient tool for differential diagnosis of paracoccidioidomycosis and pulmonary tuberculosis.

Sputum and sera from 134 patients screened for tuberculosis (TB) were analyzed to investigate TB and paracoccidioidomycosis (PCM). Of these patients, 11 (8.2%) were confirmed to have TB, but six (4.5%) were positive only for PCM. All patients with PCM presented anti-43-kDa-component antibodies in Western blotting (WB) assays, while in the TB-positive patients these antibodies did not appear. This preliminary study suggests WB as a potential tool for differential laboratory diagnosis between TB and PCM.

Can Lactobacillus acidophilus influence the adhesion capacity of Candida albicans on the combined contraceptive vaginal ring?

BACKGROUND: This study was conducted to evaluate the influence of Lactobacillus acidophilus on the adhesion capacity of Candida albicans on the combined contraceptive vaginal ring (CCVR). STUDY DESIGN: Two vaginal isolates of C. albicans and an ATCC strain of lactobacilli were used. Isolated and associated yeasts and bacteria (co-aggregated) were employed on the CCVR adherence assays and scanning electron microscopy (SEM). RESULTS: Isolated yeasts and lactobacilli adhered strongly to the CCVR. After the co-aggregation, there were an increase in adhesion capacity of the yeasts (p<.001) and a diminished adhesion of the lactobacilli (p<.001). SEM showed the isolated and co-aggregated microorganisms intimately attached to the irregularities of the CCVR. CONCLUSIONS: If these findings correlated with the conditions in vivo, the use of probiotics based on L. acidophilus or its presence in the vaginal microbiota would not protect against the adhesion of C. albicans to the ring.

Susceptibilidad de levaduras vaginales a los antifúngicos más utilizados en Maringá, Paraná, Brasil / Susceptibility to vaginal yeast in most used antifungal in Maringá, Paraná, Brazil

Se determinó la susceptibilidad antifúngica in vitro de 78 cepas de levaduras aisladas de mujeres de la ciudad de Maringá/Paraná, Brasil, con candidiasis vulvovaginal (CVV), atendidas en el Laboratorio de Enseñanza e Investigación en Análisis Clínicos (LEPAC) de la Universidad Estatal de Maringá, desde el 1 de enero 2005 al 31 de diciembre 2006. Su sensibilidad in vitro fue investigada por el método de microdilución frente a ketoconazol (KETO), fluconazol (FLU), itraconazol (ITRA), nistatina (NIS) y anfotericina B (AMB). Para KETO, 41,5% de las cepas de C. albicans y 96% de Candida no-albicans presentaron resistencia (100% de C. glabrata) y para FLU solamente el 3,8% de los aislamientos de C. albicans y el 8,0% de C. glabrata fueron resistentes. Sólo 1,9% de las cepas de C. albicans y 20% de las de C. no-albicans fueron resistentes a ITRA y el 5,7% de las C. albicans y el 8% de las C. no-albicans (sólo C. glabrata) fueron resistentes a AMB. No hubo aislamientos resistentes a NIST, pero sí una elevada frecuencia de sensibilidad dosis dependiente "in vitro". Estos datos avalan la creciente necesidad de la realización de pruebas de identificación y susceptibilidad in vitro a los antifúngicos para establecer el correcto tratamiento de la CVV.

In vitro antifungal susceptibility was determined in the 78 yeasts isolated from patients with vulvovaginal candidiasis (VVC) from the city of Maringá/Parana/Brazil, assisted in the Laboratory of Teaching and Research in Clinical Analysis of the State University of Maringá, from 01 January 2005 to December 31, 2006. Its sensibility in vitro was tested according to microdilution method in front of ketoconazol (KETO), fluconazole (FLU), itraconazole (ITRA), nistatin (NIS) and amphotericin B (AMB). For KET, 41.5% of the C. albicans and 96.0% of the C. non-albicans showed resistance (100.0% of C. glabrata) and for FLU, only 3.8% of the isolates of C. albicans and 8.0% of C. glabrata showed resistance. Only 1.9% of the C. albicans and 20% of the C. no-albicans were resistant. For AMB, 5.7% of the C. albicans and 8% of the C. no-albicans (only C. glabrata), were resistant. There were no isolations resistant from NIST, however, there was a high frequency of dose-dependent sensibility (SDD) in vitro. These data makes it possible to confirm the growing necessity of the performance of identification tests and in vitro antifungal susceptibility to antifungals to establish the correct treatment of CVV.

Perfil clínico, laboratorial e epidemiológico de pacientes com paracoccidioidomicose em um serviço de referência no noroeste do Estado do Paraná / Clinical-laboratorial and epidemiologic profile of patients with paracoccidioidomycosis in a reference service of Northwesthern Paraná

Há indicativos de que a paracoccidioidomicose (PCM) seja endêmica no Noroeste do Paraná, porém pouco ainda é documentado sobre essa doença na região. No presente estudo, são descritas as características clínico-laboratoriais e epidemiológicas de 45 indivíduos com PCM, atendidos em um serviço de referência, no Noroeste do Estado do Paraná, no período de março de 1996 a novembro de 2006. Observou-se que a manifestação clínica que motivou a procura por assistência foi lesões na orofaringe em 28 (62,2%) casos, seguida do comprometimento pulmonar em 9 (20,0%), sendo que 10 dos 45 pacientes (22,2%) foram encaminhados ao serviço por cirurgiões-dentistas. A proporção homem/mulher foi de 14:1, houve predomínio de maiores de 41 anos de idade; da forma crônica da doença e profissão vinculada à agricultura. Os hábitos de tabagismo e consumo de bebida alcoólica foram freqüentes. Como método de diagnóstico, o mais realizado foi o histopatológico, e a associação sulfametoxazol-trimetropim foi o tratamento farmacológico mais prescrito.

There are indications that paracoccidioidomycosis (PCM) is endemic in northwestern Paraná, but little is documented about this disease in the region. This study outlines the clinical-laboratory and epidemiologic features of 45 individuals with PCM, attended at a referral service in northwestern Paraná from March 1996 to November 2006. It was observed that the clinical manifestation that motivated the search for assistance were lesions of the oropharynx in 28 (62.2%) instances, followed by lung damage in nine (20.0%). Ten of the 45 patients (22.2%) were sent to the service by dental surgeons. The male/female ratio was 14:1. There was a predominance of patients older than 41, bearing the chronic form of the disease, and from a profession linked to agriculture. Smoking and alcohol drinking habits were frequent. The most employed diagnostic method was histopathological, and the most prescribed pharmacological treatment was the sulphametoxazole-trimethoprimassociation.

Hay indicativos de que la paracoccidioidomicosis (PCM) sea endémica en el Noroeste del Paraná, pero pocoaún se documenta sobre esa enfermedad en la región. En el presente estudio, son descritas las características clínico-laboratoriales y epidemiológicas de 45 pacientes con PCM, atendidos en un servicio de referencia, en el Noroeste del Estado del Paraná, en el período de marzo de 1996 a noviembre de 2006. Se observó que la manifestación clínica que motivó la búsqueda por la asistencia fue lesiones en la orofaringe en 28 (62,2%) delos casos, seguida del comprometimiento pulmonar en 9 (20,0%), siendo que 10 de los 45 pacientes (22,2%)fueron encaminados al servicio por cirujanos-dentistas. La proporción hombre / mujer fue de 14:1; hubo predominio de mayores de 41 años de edad, de la forma crónica de la enfermedad y de profesión vinculada a laagricultura. Los hábitos de tabaquismo y de consumo de alcohol fueron frecuentes. Como método de diagnóstico, lo más realizado fue el histopatológico, y la asociación sulfametoxazol-trimetropim fue el tratamiento farmacológico más prescrito.

Vaginal yeast adherence to the combined contraceptive vaginal ring (CCVR).

BACKGROUND: The purpose of this study was to evaluate the in vitro adherence of different yeasts, isolated from vaginal exudates of patients with vulvovaginal candidiasis (VVC), to the combined contraceptive vaginal ring--NuvaRing. STUDY DESIGN: Four isolates of Candida sp. and one isolate of Saccharomyces cerevisiae were used. Adherence assays were carried out through colony-forming units per milliliter (CFU/mL), radiolabeled quantification and scanning electron microscopy (SEM) of the ring, and the cell surface hydrophobicity (CSH) of the yeasts was determined. RESULTS: All the yeasts were capable of adhering to the vaginal ring, as determined by CFU/mL and in the radiolabeled assay. CSH was compatible with the adherence by CFU/mL. CONCLUSION: SEM proved the adhesion, which was different between Candida albicans and C. tropicalis. The adherence of the tested yeasts to the ring could potentially facilitate the development of VVC and recurrent VVC in susceptible patients using this contraceptive method.

Expression of constructs of the neuronal isoform of myosin-Va interferes with the distribution of melanosomes and other vesicles in melanoma cells.

Myosin-Va has been implicated in melanosome translocation, but the exact molecular mechanisms underlying this function are not known. In the dilute, S91 melanoma cells, melanosomes move to the cell periphery but do not accumulate in the tips of dendrites as occurs in wild-type B16 melanocytes; rather, they return and accumulate primarily at the pericentrosomal region in a microtubule-dependent manner. Expression of the full-length neuronal isoform of myosin-Va in S91 cells causes melanosomes to disperse, occupying a cellular area approximately twice that observed in non-transfected cells, suggesting a partial rescue of the dilute phenotype. Overexpression of the full tail domain in S91 cells is not sufficient to induce melanosome dispersion, rather it causes melanosomal clumping. Overexpression of the head and head-neck domains of myosin-Va in B16 cells does not alter the melanosome distribution. However, overexpression of the full tail domain in these cells induces melanosome aggregation and the appearance of tail-associated, aggregated particles or vesicular structures that exhibit variable degrees of staining for melanosomal and Golgi beta-COP markers, as well as colocalization with the endogenous myosin-Va. Altogether, the present data suggest that myosin-Va plays a role in regulating the direction of microtubule-dependent melanosome translocation, in addition to promoting the capture of melanosomes at the cell periphery as suggested by previous studies. These studies also reinforce the notion that myosin-V has a broader function in melanocytes by acting on vesicular targeting or intracellular protein trafficking.