Morbimortality profile by COVID-19 in telework and on-site work in an oil and gas company in Brazil.

BACKGROUND: As a reflection of the health emergency caused by COVID-19, many countries adopted guidelines, which included activity restrictions. As a result, some companies maintained their activities with on-site work and telework. OBJECTIVE: Analyzing the morbidity and mortality profile due to COVID-19 of workers in telework and on-site work in an oil and gas company. METHODS: Cross-sectional, quantitative, and analytical study that included 8,394 workers diagnosed with COVID-19 at an oil and gas company in Brazil, from June 2020 to June 2021. The company's Surveillance Program database was used as an information source. RESULTS: The total prevalence of cases was 21.7% . For teleworking and face-to-face workers, they were 20.7% and 23.3%, respectively. There was a predominance of women (19.7%), white ethnicity/colour (64.7%), higher level position (52.6%), age group over 40 years (36.7%), married (53, 8%), working at the company for a period that ranges from 7 to 10 years (17%), administrative activity (68.5%), and a higher number of symptomatic workers and deaths in telework compared to on-site work. CONCLUSIONS: The results suggest that testing is important to refrain the virus spread in the company's work environments, as it allowed asymptomatic workers to be diagnosed with COVID-19. The study suggested that on-site work was not a transmission facilitator in the occupational environment, which points out the importance of preventive measures in the workplace and the adoption of remote work for the largest possible number of workers to improve the safety of employees, workers who remained in the on-site work modality.

Food and nutrition actions to face Noncommunicable Diseases from the perspective of Primary Health Care in Brazil: a scoping review / Ações de alimentação e nutrição para o enfrentamento das Doenças Não Transmissíveis na perspectiva da Atenção Primária à Saúde no Brasil: uma revisão de escopo

Introdução: as Doenças Não Transmissíveis (DNT) são consideradas um grande problema de saúde pública, o que torna fundamental o desenvolvimento de intervenções de promoção, prevenção e tratamento. Objetivo: sintetizar e avaliar as evidências sobre as ações de alimentação e nutrição para o enfrentamento das DNT em adultos e idosos na perspectiva da APS no Brasil. Método: trata-se de uma revisão de escopo da literatura, guiada pelas diretrizes do JBI e seguida as etapas de Itens de Relatórios Preferenciais para Revisões Sistemáticas e Extensão de Meta-Análises para Revisões de Escopo. A busca ocorreu em 5 bases de dados eletrônicas: MEDLINE, Web of Science, EMBASE, Central Cochrane Library e LILACS, e a literatura cinza, contemplando os sítios eletrônicos oficiais do governo e a Rede de Alimentação e Nutrição do SUS. Resultados: foram identificados um total de 1844 artigos e apenas 42 artigos se enquadraram nos critérios de elegibilidade da metodologia proposta. Foi identificado que entre as evidências científicas disponibilizadas, as ações de alimentação e nutrição na APS, encontram-se concentradas em estratégias de educação e orientação de hábitos saudáveis para tratamento de DNT baseados em Políticas e Diretrizes Públicas de Nutrição designadas em sua maioria por uma população composta de adultos e uma parte reduzida de idosos. Conclusão: há necessidade de mais estudos publicados sobre ações de alimentação e nutrição na APS, pois as evidências científicas disponíveis não correspondem a 50% dos estados brasileiros, sendo insuficientes para impactar positivamente a situação nutricional do país. Além disso, mais pesquisas com abordagem preventiva às DNT são essenciais, uma vez que a APS caracteriza-se por um conjunto de ações relacionadas à saúde que têm como foco principal a promoção e proteção da saúde.

Introduction: Noncommunicable Diseases (NCDs) are considered a major public health problem, which makes it essential to develop interventions for promotion, prevention and treatment. Objective: To synthesize and evaluate the evidence on food and nutrition actions for coping with NCDs in adults and the elderly from the perspective of PHC in Brazil. Methods: This is a literature scoping review, guided by JBI guidelines and following the steps of Preferred Reporting Items for Systematic Reviews and Extended Meta-Analyses for Scoping Reviews. The search took place in 5 electronic databases: MEDLINE, Web of Science, EMBASE, Central Cochrane Library and LILACS, and the gray literature, including the official government websites and the SUS Food and Nutrition Network. Results: A total of 1844 articles were identified and only 42 articles met the eligibility criteria of the proposed methodology. It was identified that, among the available scientific evidence, food and nutrition actions in PHC are concentrated in education strategies and guidance on healthy habits for the treatment of NCD based on Public Nutrition Policies and Guidelines, mostly designated by a population composed of adults and a small proportion of elderly people. Conclusion: there is a need for more studies published on food and nutrition actions in PHC, as the available scientific evidence does not correspond to 50% of the Brazilian states, being insufficient to positively impact the country's nutritional situation. In addition, more research with a preventive approach to NCDs is essential, since PHC is characterized by a set of health-related actions that have as their main focus the promotion and protection of health.

Effect of omega-3 supplementation on the nutritional status of patients with pancreatic cancer: A protocol for systematic review of clinical trials.

BACKGROUND: Globally, pancreatic cancer is the seventh most common cause of cancer-related death in both sexes, accounting for 466,003 deaths and 495,773 new cases in 2020. The purpose of this study was to synthesize and evaluate evidence on the effects of omega-3 supplementation on the nutritional status of patients with pancreatic cancer. METHODS: This systematic review protocol will be guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Five databases will be searched: MEDLINE/PubMed, CENTRAL Cochrane, EMBASE, Web of Science, and SCOPUS, with no restrictions on the publication date nor language. The internal validity and risk of bias of randomized controlled trials will be assessed using the revised Cochrane Risk-Of-Bias tool for randomized trials (RoB 2), whereas the risk of bias in non-randomized studies of interventions will be evaluated using the ROBINS-I. The heterogeneity among the studies will be assessed using the I2 statistic. Based on the results of this test, we will verify whether the meta-analysis would be feasible. If feasibility would be confirmed, a random-effect model analysis will be performed. For data analysis, the calculation of the pooled effect estimates will have a 95% confidence interval, while the alpha will be set to 0.05 using the R statistical software version 4.0.4. All methodological steps of this review will be performed independently by two reviewers and will be conducted and managed in the EPPI-Reviewer Software™. RESULTS: This review may be of particular interest to researchers and clinicians, given the low survival and overall burden of patients with pancreatic cancer. Furthermore, the results of this systematic review may contribute to the development of new nutritional interventions in these patients. CONCLUSION: To the best of our knowledge, this will be the first study to critically assess the scientific evidence and estimate the effect of omega-3 supplementation on the nutritional status of patients with pancreatic cancer. The review will perform a rigorous approach, adhering to the PRISMA Statement 2020 using a comprehensive and systematic search strategy in five databases and additional sources with no time period nor language restrictions.

Cancer symptom clusters in adult patients undergoing chemotherapy: A systematic review and meta-analysis protocol.

BACKGROUND: In oncology, the prevalence of symptoms is preferentially analyzed in isolation instead of being considered in clusters. However, clinical practice shows that symptoms rarely occur separately but rather form clusters that share common underlying mechanisms in terms of intensity and severity, creating a synergistic effect among them, which can even help predict the development of future symptoms. OBJECTIVE: To identify and gather evidence on the prevalence, composition, severity, and predictors of cancer symptom clusters in adult cancer patients undergoing chemotherapy. METHODS: This systematic review and meta-analysis protocol was developed in compliance with PRISMA-P. Observational and experimental study designs will be included. MEDLINE/PubMed, Cochrane Library, Embase, CINAHL, PsycINFO, Web of Science, Scopus, LILACS, clinical trials.gov-NIH, the British Library, Google Scholar, and preprints [medRXiv] will be searched with no restrictions on idioms, dates, or settings. Two investigators will independently select the studies, perform data extraction, and critically appraise the risk of bias of the included studies. Heterogeneity among the studies will be assessed using the I2 statistic. If meta-analysis was feasible, a random-effect model analysis will be carried out. For data analysis, the pooled effect will be estimated considering 95% confidence interval and α = 5%. In addition, the certainty of evidence will be rated based on Cochrane methods in accordance with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). DISCUSSION: To the best of our knowledge, this systematic review and meta-analysis will be the first to identify and critically assess evidence regarding the prevalence, composition, severity, and predictors of cancer symptom clusters in adult cancer patients undergoing chemotherapy. We intend to provide health professionals with subsidies to reflect on a better understanding of symptom clusters in adult cancer patients, with the aim of contributing to the development of evidence-based therapeutic interventions and success in clinical practice. PROSPERO REGISTRATION NUMBER: CRD42021248406.

Impact of long-term COVID on workers: A systematic review protocol.

INTRODUCTION: Part of the patients infected by COVID-19 have at least one lasting sequel of the disease and may be framed in the concept of long Covid. These sequelae can compromise the quality of life, increase dependence on other people for personal care, impair the performance of activities of daily living, thus compromising work activities and harming the health of the worker. This protocol aims to critically synthesize the scientific evidence on the effects of Covid-19 among workers and its impact on their health status and professional life. METHOD: Searches will be performed in MEDLINE via PubMed, EMBASE, Cochrane Library Central, Web of Science, Scopus, LILACS and Epistemonikos. Included studies will be those that report the prevalence of long-term signs and symptoms in workers and/or the impact on their health status and work performance, which may be associated with Covid-19 infection. Data extraction will be conducted by 3 reviewers independently. For data synthesis, a results report will be carried out, based on the main outcome of this study. DISCUSSION: This review will provide evidence to support health surveillance to help decision makers (i.e. healthcare providers, stakeholders and governments) regarding long-term Covid. TRIAL REGISTRATION: PROSPERO registration number: CRD42021288120. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021288120.

First report and risk of infection of Fasciola hepatica (Linnaeus, 1761) in water buffaloes (Bubalus bubalis - Linnaeus, 1758) in Mexico.

The aim of this study was to determine the prevalence and risk of Fasciola hepatica infection in water buffaloes (Bubalus bubalis) during peripartum in southeastern Mexico. An observational study was designed, in which 94 pregnant buffalo cows near calving and naturally exposed to F. hepatica were included. Farm visits were made on days 60, 30, 15 prepartum, at calving, and on days 15 and 30 postpartum. Feces were obtained from all animals to confirm the presence of F. hepatica eggs. A group of 49 animals was randomly treated twice at day 60 prepartum and at calving with nitroxynil and the other group (n = 45) was kept untreated. Buffaloes would be treated once presenting a positive coproparasitological diagnosis up to 30 days postpartum. F. hepatica was detected in 5.3% of the buffaloes (5/94) with a prevalence between 1.7 and 12%. It was observed that treated buffaloes had a lower risk (4.08%) of being positive than untreated buffaloes (6.67%) (P > 0.05). It was also found that untreated animals had 1.6 times more risk of being positive than treated buffaloes. This paper presents the first report of F. hepatica in water buffaloes in Mexico, demonstrating that the two preventive treatments reduced F. hepatica egg shedding during parturition. These findings highlight the need for monitoring for F. hepatica even in unreported/silent potential disease areas.

Phylogeny of Anopheles darlingi (Diptera:Culicidae) based on the antimicrobial peptide genes cecropin and defensin.

Cecropins and defensins are the main classes of antimicrobial peptides in the mosquito innate immune system, acting against bacteria, fungi and protozoa. There is a knowledge gap concerning these peptide genes in anopheline mosquitoes from the Brazilian Amazon. Thus, this work aimed to describe molecular techniques for detecting the genes encoding the antimicrobial peptides cecropin A (CecA) and defensin in Anopheles darlingi mosquitoes and to perform molecular phylogeny of the sequenced genes using the maximum likelihood method and Bayesian inference with other species from different geographic areas. Our results show, for the first time, a molecular biology method for detecting CecA and defensin in Anopheles darlingi that allows for the use of these molecular markers for phylogenetic analysis in anopheline species, separating the species into single and monophyletic clades.

Para quem serve a avaliação psicopedagógica? / Who is the psychopedagogical evaluation for?

O presente estudo tem como objetivo compreender o papel da avaliação psicopedagógica a partir da abordagem teórica da Psicopedagogia Dinâmica, que amplia a compreensão do aprender para além das concepções da reeducação e que extrapola os enquadramentos fragmentados do sujeito diagnosticado. A motivação para a realização desse trabalho é desvincular a visão reducionista dos diagnósticos e laudos que fragmentam, enquadram e conferem ao sujeito da aprendizagem um caráter patológico, caminhando desse modo em direção às experiências que mobilizam a construção de sua autoria de pensamento. Nesse cenário, são consideradas as relações do sujeito aprendente nos diferentes sistemas nos quais se encontra, como se expressa, pensa e revela seu potencial de aprendizagem. A metodologia estabelecida é fundamentada em uma pesquisa bibliográfica, tratando-se de uma revisão de literatura sobre o tema.

This study aims to light up the role of Dynamic Psychopedagogy approach psychopedagogy evaluation, leading the learning comprehension to beyond the conceptions of reeducation, that goes beyond the fragmented frameworks of the diagnosed subject. Furthermore, the study elucidates a dissociation with the diagnostics and reports reductionist perspective which break, define the leaning-subject to a pathological character, leading to their experiences authorship of thoughts. In these circumstances, there are considered the relationship of learner subject insert on various systems, how they express, think, show their learning potential. The methodology is based on a reviewed-focused bibliographic research.

Long-term outcomes after kidney transplant failure and variables related to risk of death and probability of retransplant: Results from a single-center cohort study in Brazil.

BACKGROUND: Returning to dialysis after kidney graft loss (GL) is associated with a high risk of mortality, mainly in the first 3-6 months. The follow-up of patients with GL should be extended to better understand crude patient outcomes, mainly in emerging countries, where the transplantation activity has increased. METHODS: This is a historical single-center cohort study conducted in an emerging country (Brazil) that included 115 transplant patients with kidney allograft failure who were followed for 44.1 (21.4; 72.6) months after GL. The outcomes were death or retransplantation after GL calculated by Kaplan-Meier and log-rank tests. Proportional hazard ratios for death and retransplantation were assessed by Cox regression. RESULTS: The 5-year probability of retransplantation was 38.7% (95% CI: 26.1%-51.2%) and that of death was 37.7% (95% CI: 24.9%-50.5%); OR = 1.03 (95% CI: 0.71-1.70) and P = 0.66. The likelihood of retransplantation was higher in patients who resumed dialysis with higher levels of hemoglobin (HR = 1.22; 95% CI = 1.04-1.43; P = 0.01) and lower in blood type O patients (HR = 0.48; 95% CI = 0.25-0.93; P = 0.03), which was associated with a lower frequency of retransplantation with a subsequent living-donor kidney. On the other hand, the risk of death was significantly associated with Charlson comorbidity index (HR for each point = 1.37; 95% CI 1.19-1.50; P<0.001), and residual eGFR at the time when patients had resumed to dialysis (HR for each mL = 1.14; 95% CI = 1.05-1.25; P = 0.002). The trend toward a lower risk of death when patients had resumed to dialysis using AV fistula access was observed (HR = 0.50; 95% CI 0.25-1.02; P = 0.06), while a higher risk seems to be associated with the number of previous engraftment (HR = 2.01; 95% CI 0.99-4.07; P = 0.05). CONCLUSIONS: The 5-year probability of retransplantation was not less than that of death. Variables related to the probability of retransplantation were hemoglobin level before resuming dialysis and ABO blood type, while the risk of death was associated with comorbidities and residual eGFR.

Awareness-raising workshops on (geronto)technologies for elderly/family care: contributions to knowledge.

OBJECTIVE: to describe the contributions of awareness-raising workshops to the knowledge of students in health courses about care (geronto)technologies for elderly people/family. METHODS: a strategic action research, developed with 12 students from the last semester of nursing, physiotherapy, dentistry and occupational therapy from a university in Rio Grande do Sul, Brazil. Data were collected from September to December 2019, through semi-structured interviews, before and after awareness-raising workshops, and submitted to content analysis. RESULTS: the analyzed data, before the workshops, allowed constructing two categories that dealt with lack of knowledge and non-use of care (geronto)technologies. After the workshops, five categories made it possible to understand (geronto)technologies in the form of products and in the form of processes/strategies/knowledge. CONCLUSION: carrying out awareness-raising workshops contributed to knowledge production regarding the conceptual aspect and identification of their usefulness in the care setting.

Awareness-raising workshops on (geronto)technologies for elderly/family care: contributions to knowledge / Talleres de sensibilización sobre (geronto)tecnologías para el cuidado de ancianos/familiares: contribuciones al conocimiento / Oficinas de sensibilização sobre (geronto)tecnologias de cuidado ao idoso/família: contribuições ao conhecimento

ABSTRACT Objective: to describe the contributions of awareness-raising workshops to the knowledge of students in health courses about care (geronto)technologies for elderly people/family. Methods: a strategic action research, developed with 12 students from the last semester of nursing, physiotherapy, dentistry and occupational therapy from a university in Rio Grande do Sul, Brazil. Data were collected from September to December 2019, through semi-structured interviews, before and after awareness-raising workshops, and submitted to content analysis. Results: the analyzed data, before the workshops, allowed constructing two categories that dealt with lack of knowledge and non-use of care (geronto)technologies. After the workshops, five categories made it possible to understand (geronto)technologies in the form of products and in the form of processes/strategies/knowledge. Conclusion: carrying out awareness-raising workshops contributed to knowledge production regarding the conceptual aspect and identification of their usefulness in the care setting.

RESUMEN Objetivo: describir los aportes de los talleres de sensibilización al conocimiento de los académicos de los cursos de salud sobre las (geronto)tecnologías de atención al anciano/familia. Métodos: investigación acción estratégica, desarrollada con 12 académicos del último semestre de enfermería, fisioterapia, odontología y terapia ocupacional en una Universidad de Rio Grande do Sul, Brasil. Los datos fueron recolectados de septiembre a diciembre de 2019, mediante entrevistas semiestructuradas, antes y después de los talleres de sensibilización, sometidos a análisis de contenido. Resultados: los datos analizados, antes de los talleres, permitieron la construcción de dos categorías que abordaron el desconocimiento y el no uso de (geronto)tecnologías de cuidado. Después de los talleres, cinco categorías permitieron entender las (geronto)tecnologías en forma de productos y en forma de procesos/estrategias/conocimientos. Conclusión: los talleres de sensibilización contribuyeron a la producción de conocimiento sobre el aspecto conceptual y la identificación de su utilidad en el escenario assistencial.

RESUMO Objetivo: descrever as contribuições de oficinas de sensibilização para o conhecimento dos acadêmicos dos cursos da área da saúde acerca das (geronto)tecnologias de cuidado à pessoa idosa/família. Métodos: pesquisa-ação estratégica, desenvolvida com 12 acadêmicos do último semestre de enfermagem, fisioterapia, odontologia e terapia ocupacional de uma universidade do Rio Grande do Sul, Brasil. Os dados foram coletados de setembro a dezembro de 2019, mediante entrevista semiestruturada, antes e após oficinas de sensibilização, submetidos à análise de conteúdo. Resultados: os dados analisados, antes das oficinas, permitiram a construção de duas categorias que versaram sobre o desconhecimento e a não utilização de (geronto)tecnologias de cuidado. Após as oficinas, cinco categorias possibilitaram a compreensão das (geronto)tecnologias na forma de produto e na forma de processo/estratégias/conhecimento. Conclusão: as oficinas de sensibilização contribuíram para produção do conhecimento no que se refere ao aspecto conceitual e na identificação da sua utilidade no cenário de cuidados.

(Geronto)Tecnologias cuidativas para pessoas idosas com doença de Alzheimer e suas famílias: contribuição de oficinas de sensibilização/capacitação / (Geronto)Technologies of care for old people with Alzheimer's disease and their families: contribution of awareness/training workshops

Resumo Objetivo Descrever (geronto)tecnologias cuidativas para pessoas idosas com a doença de Alzheimer e suas famílias, a partir de oficinas de sensibilização/capacitação. Métodos Pesquisa-ação estratégica desenvolvida com 12 acadêmicos de enfermagem, Fisioterapia, Odontologia e Terapia Ocupacional de uma universidade do Rio Grande do Sul, Brasil. Os dados coletados de setembro a dezembro de 2019, mediante entrevista semiestruturada, após oficinas de sensibilização sobre (geronto)tecnologias de cuidado às pessoas idosas e suas famílias, foram submetidos a análise textual discursiva. Resultados Permitiram a descrição de (geronto)tecnologia na forma de produto: placas de identificação dos objetos e cômodos; produtos para organização da medicação; crachá de identificação; barras de apoio, arredondadores, tapetes antiderrapantes e adaptações diversas; calendário do banho; jogos, livros e atividades manuais. E, na forma de processo/conhecimento/estratégias: diálogo, lembranças e negociações; acompanhar o idoso e orientar vizinhos sobre a doença de Alzheimer; e divisão de responsabilidades. Conclusão As oficinas de sensibilização/capacitação contribuíram para o conhecimento dos estudantes de diferentes núcleos de formação e apresentaram potencial de contribuição para o cuidado da pessoa idosa com a doença de Alzheimer e sua família, por meio das (geronto)tecnologias sugeridas.

Abstract Objective To describe (geronto)technologies of care for old people with Alzheimer's disease and their families, from awareness/training workshops. Methods Strategic action research, developed with 12 nursing, physiotherapy, dentistry and occupational therapy students from a University of Rio Grande do Sul, Brazil. The data collected from September to December 2019, through semi-structured interview, after awareness-raising workshops on care (geronto) technologies for old people and their families, were subjected to textual discursive analysis. Results They allowed the description of (geronto)technology in the form of a product: identification plates for objects and rooms; products for organizing medication; Identification badge; support bars, rounders, non-slip mats and various adaptations; bath calendar; Games, books and manual activities. And, in the form of process/knowledge/strategies: dialogue, memories and negotiations; accompanying the old people and advising neighbors on Alzheimer's disease; and, division of responsibilities. Conclusion The awareness/training workshops contributed to the knowledge of students from different training centers and showed potential to contribute to the care of old people with Alzheimer's disease and their families, through suggested (geronto)technologies.

Adulterants in crack cocaine in Brazil.

INTRODUCTION: Brazil is the world's biggest consumer of crack cocaine, and dependence is a major public health issue. This is the first study to investigate the prevalence of potentially harmful adulterants present in hair samples from Brazilian patients with crack cocaine dependence. METHOD: We evaluated adulterants in hair samples extracted by convenience from 100 patients admitted at the 48 hour-observation unit of Centro de Referência de Álcool, Tabaco e Outras Drogas (CRATOD), Brazil's largest center for addiction treatment. A cross-sectional analysis was performed with the data obtained. RESULTS: Adulterants were found in 97% of the analyzed hair samples. The most prevalent adulterant was lidocaine (92%), followed by phenacetin (69%) and levamisole (31%). CONCLUSION: Adulterants were widely prevalent in hair samples from crack users treated at CRATOD: at least one adulterant was present in virtually all the hair samples collected. This points to a need to monitor adverse effects in the clinical setting in order to provide this high-risk group of patients with prompt and effective care related to the acute and chronic complications associated with these adulterants.

Adulterants in crack cocaine in Brazil / Adulterantes no crack vendido na "Cracolândia"

Abstract Introduction Brazil is the world's biggest consumer of crack cocaine, and dependence is a major public health issue. This is the first study to investigate the prevalence of potentially harmful adulterants present in hair samples from Brazilian patients with crack cocaine dependence. Method We evaluated adulterants in hair samples extracted by convenience from 100 patients admitted at the 48 hour-observation unit of Centro de Referência de Álcool, Tabaco e Outras Drogas (CRATOD), Brazil's largest center for addiction treatment. A cross-sectional analysis was performed with the data obtained. Results Adulterants were found in 97% of the analyzed hair samples. The most prevalent adulterant was lidocaine (92%), followed by phenacetin (69%) and levamisole (31%). Conclusion Adulterants were widely prevalent in hair samples from crack users treated at CRATOD: at least one adulterant was present in virtually all the hair samples collected. This points to a need to monitor adverse effects in the clinical setting in order to provide this high-risk group of patients with prompt and effective care related to the acute and chronic complications associated with these adulterants.

Resumo Introdução O Brasil é o maior consumidor mundial de crack, e a dependência é um grande problema de saúde pública. Este é o primeiro estudo a investigar a prevalência de adulterantes potencialmente nocivos presentes em amostras de cabelo de pacientes brasileiros com dependência de crack. Métodos Foram avaliados adulterantes em amostras de cabelos extraídos por conveniência de 100 pacientes internados na unidade de observação de 48 horas do Centro de Referência de Álcool, Tabaco e Outras Drogas (CRATOD), o maior centro de tratamento de dependência do Brasil. Uma análise transversal foi realizada com os dados obtidos. Resultados Foram encontrados adulterantes em 97% das amostras de cabelo analisadas. O adulterante mais prevalente foi a lidocaína (92%), seguida da fenacetina (69%) e levamisol (31%). Conclusão Os adulterantes foram amplamente prevalentes em amostras de cabelo de usuários de crack tratados no CRATOD: pelo menos um adulterante estava presente em praticamente todas as amostras de cabelo coletadas. Isso aponta para a necessidade de monitorar os efeitos adversos no ambiente clínico, a fim de proporcionar a esse grupo de pacientes de alto risco cuidados imediatos e efetivos relacionados às complicações agudas e crônicas associadas a esses adulterantes.

Bion e Winnicott: um diálogo a posteriori / Bion and Winnicott: an a posteriori dialogue / Bion y Winnicott: un diálogo a posteriori / Bion et Winnicott: un dialogue a posteriori

Uma carta escrita por Winnicott a Bion em 1955 nos serviu de estímulo para colocar os autores em diálogo sobre dois temas levantados por Winnicott. O primeiro tema critica os efeitos do kleinismo nos analistas; o segundo discute o papel do ambiente e da interpretação no trabalho com psicóticos. Embora distintos, esses temas compartilham uma mesma questão, tratada por ambos os autores: o problema da comunicação na análise, e entre os analistas na transmissão da psicanálise. Considerando a questão da comunicação no contexto em que essa carta foi escrita, realizamos o entrecruzamento de textos de Bion e Winnicott para expor uma possibilidade de diálogo sobre o papel do grupo na transmissão psicanalítica e seus efeitos na formação. Igualmente, evidenciamos como poderiam ter debatido a clínica da psicose na década de 1950. Não há registro de resposta de Bion a Winnicott e eles pouco se mencionam. Porém, essa leitura nos permite mostrar como eles teriam se contraposto e respondido um ao outro.

A letter from Winnicott to Bion from 1955 is considered, in order to put the authors in conversation on two topics that were raised by Winnicott. The first topic is the criticism of the effects of Kleinian theory on psychoanalysts, and the second is the role of the environment and interpretation in working with psychotic patients. Though they are distinct, the two topics have an aspect in common: the problem of communication, both within the analytic setting and during the transmission of psychoanalytic theories. By intertwining of texts by Bion and Winnicott, we consider the context in which the 1955 letter was written and discuss the role that psychoanalytic groups have in the transmission of psychoanalysis, as well as their effect in psychoanalytic training. Similarly, we evidence how Bion and Winnicott could have debated the issue of analyzing psychotic patients, in the 1950s. There is no known replay made by Bion to Winnicott, and they hardly mention each other in their respective works. However, our reading renders a possibility to think how they might have responded to each other's ideas.

Una carta escrita por Winnicott a Bion en 1955 nos sirvió de estímulo para colocar a los autores en un diálogo sobre dos temas abordados por Winnicott. El primer tema critica los efectos del kleinismo en los analistas, el segundo discute el papel del ambiente y de la interpretación en el trabajo con psicóticos. Aunque distintos, estos temas comparten una misma cuestión, tratada por ambos autores: el problema de la comunicación en el análisis, y entre los analistas en la transmisión del psicoanálisis. Considerando la cuestión de la comunicación en el contexto en que esta carta fue escrita, realizamos el entrecruzamiento de textos de Bion y Winnicott para exponer una posibilidad de diálogo sobre el papel del grupo en la transmisión psicoanalítica, y sus efectos en la formación. Igualmente, evidenciamos cómo podrían haber debatido la clínica de la psicosis en la década de 1950. No hay registro de la respuesta de Bion a Winnicott y ellos se mencionan poco. Sin embargo, esta lectura nos permite mostrar cómo se habrían contrapuesto y respondido el uno al otro.

Une lettre écrite par Winnicott à Bion en 1955 nous a encouragé à mettre ces deux auteurs en dialogue sur deux thèmes soulevés par Winnicott. Le premier thème critique les effets du kleinisme sur les analystes , le second discute le rôle de l'environnement et de l'interprétation dans le travail avec des psychotiques. Bien que distincts, ces thèmes partagent une même question traitée par les deux auteurs: le problème de la communication dans l'analyse, et entre les analystes dans la transmission de la psychanalyse. Considérant la question de la communication dans le contexte dans lequel cette lettre a été écrite, nous avons fait l'entrecroisement de textes de Bion et de Winnicott pour exposer une possibilité de dialogue sur le rôle du groupe dans la transmission psychanalytique, et ses effets dans la formation. Nous avons également mis en évidence la manière dont ils auraient pu débattre la clinique de la psychose dans les années 1950. Il n'y a pas de réponse connue de Bion à Winnicott et ils ne se mentionnent guère. Pourtant, cette lecture nous permet de montrer comment ils se seraient opposés et ce que l'un aurait répondu à l'autre.

O manifesto do funk ostentação: Uma leitura psicanalítica do discurso de dois adolescentes e a sua relação com o funk / The manifest of funk ostentação: a psychoanalytic reading of the discourse of two adolescents and their relation with brazilian funk music / El manifiesto del funk ostentação: una lectura psicoanalítica del discurso de dos adolescentes y su relación con el funk

Este artigo se propõe fazer uma reflexão teórica movida a partir de fragmentos de falas de dois adolescentes que vivem em um contexto social de criminalidade violenta proeminente e suas singulares relações com o funk ostentação. Fundamentadas na teoria psicanalítica, buscamos compreender como as composições deste gênero musical podem ocupar um lugar privilegiado na dinâmica psíquica desses adolescentes. Nestas circunstâncias, lançamos mão de contribuições importantes da psicanálise sobre a intrínseca vinculação entre o sujeito e a civilização. A análise das duas falas nos conduziu aos conceitos freudianos de "narcisismo" e de "sublimação". Os adolescentes relatam um laço particular com a música que pode se apresentar como confirmação do envolvimento com a criminalidade ou, em oposição, como uma construção sublimatória para o excesso de agressividade, via a composição musical.

This article proposes to make a theoretical reflection based on fragments of speeches by two adolescents living in a social context of violent criminality and their unique relations with funk ostentação (Brazilian music genre which has ostentation as its lyrics' main subject). Based on psychoanalytical theory, we sought to comprehend how compositions associated to this musical genre can occupy a privileged place in these adolescents' psychic dynamic. In these circumstances, important psychoanalytical contributions regarding the intrinsic bond between individuals and civilization have been considered. The analysis of the two speeches led us to the Freudian concepts of "narcissism" and "sublimation". Both adolescents report a particular bond with music that may present itself as confirmation of the link with criminality or, in opposition, as a sublimatory construction for the excess of aggressiveness by way of musical composition.

Este artículo se propone a hacer una reflexión teórica movida a partir de fragmentos de discurso de dos adolescentes que viven en un contexto social de criminalidad violenta prominente y sus singulares relaciones con el funk ostentação (género de la música brasileña que tiene ostentación como tema principal de sus letras). Desde una orientación fundamentada en la teoría psicoanalítica, buscamos comprender cómo las composiciones de este género musical pueden ocupar un lugar privilegiado en la dinámica psíquica de esos adolescentes. En estas circunstancias, utilizamos contribuciones importantes del psicoanálisis sobre la intrínseca vinculación entre el sujeto y la civilización. El análisis de los dos discursos nos condujo a los conceptos freudianos "narcisismo" y "sublimación". Los adolescentes relatan un lazo particular con la música que puede presentarse como confirmación de la participación con la criminalidad o, en oposición, como una construcción sublimatoria para el exceso de agresividad vía la composición musical.

Expanding the pool of kidney donors: use of kidneys with acute renal dysfunction.

Given the shortage of organs transplantation, some strategies have been adopted by the transplant community to increase the supply of organs. One strategy is the use of expanded criteria for donors, that is, donors aged >60 years or 50 and 59 years, and meeting two or more of the following criteria: history of hypertension, terminal serum creatinine >1.5mg/dL, and stroke as the donor´s cause of death. In this review, emphasis was placed on the use of donors with acute renal failure, a condition considered by many as a contraindication for organ acceptance and therefore one of the main causes for kidney discard. Since these are well-selected donors and with no chronic diseases, such as hypertension, renal disease, or diabetes, many studies showed that the use of donors with acute renal failure should be encouraged, because, in general, acute renal dysfunction is reversible. Although most studies demonstrated these grafts have more delayed function, the results of graft and patient survival after transplant are very similar to those with the use of standard donors. Clinical and morphological findings of donors, the use of machine perfusion, and analysis of its parameters, especially intrarenal resistance, are important tools to support decision-making when considering the supply of organs with renal dysfunction.

Expanding the pool of kidney donors: use of kidneys with acute renal dysfunction / Ampliando o pool de doadores de rim: utilização de órgãos com disfunção renal aguda

ABSTRACT Given the shortage of organs transplantation, some strategies have been adopted by the transplant community to increase the supply of organs. One strategy is the use of expanded criteria for donors, that is, donors aged >60 years or 50 and 59 years, and meeting two or more of the following criteria: history of hypertension, terminal serum creatinine >1.5mg/dL, and stroke as the donor´s cause of death. In this review, emphasis was placed on the use of donors with acute renal failure, a condition considered by many as a contraindication for organ acceptance and therefore one of the main causes for kidney discard. Since these are well-selected donors and with no chronic diseases, such as hypertension, renal disease, or diabetes, many studies showed that the use of donors with acute renal failure should be encouraged, because, in general, acute renal dysfunction is reversible. Although most studies demonstrated these grafts have more delayed function, the results of graft and patient survival after transplant are very similar to those with the use of standard donors. Clinical and morphological findings of donors, the use of machine perfusion, and analysis of its parameters, especially intrarenal resistance, are important tools to support decision-making when considering the supply of organs with renal dysfunction.

RESUMO Diante da escassez de órgãos para transplante, algumas estratégias têm sido adotadas pela comunidade transplantadora, no sentido de ampliar a oferta de órgãos. Uma delas é a utilização de rins de doadores com critérios expandidos, ou seja, doadores com idade >60 anos ou entre 50 e 59 anos, e que atendem a dois ou mais dos seguintes critérios: história de hipertensão, creatinina sérica terminal >1,5mg/dL e acidente vascular cerebral como causa de morte do doador. Nesta revisão, foi dada ênfase à utilização de doadores com disfunção renal aguda, condição considerada por muitos uma contraindicação para a aceitação de órgãos e, portanto, uma das principais causas de descarte de órgãos. Desde que sejam doadores bem selecionados e que não tenham doença renal crônica, como hipertensão ou diabetes, muitos trabalhos mostraram que o uso de doadores com disfunção renal aguda deve ser encorajado, pois, em geral, a disfunção renal aguda é de caráter reversível. Embora, a maioria dos estudos tenha demonstrado que há uma maior taxa de função retardada do enxerto com a utilização desses órgãos, os resultados de sobrevida do enxerto e do paciente após o transplante são muito semelhantes aos resultados obtidos da utilização de doadores padrão. Os achados clínicos e morfológicos do doador, a utilização da máquina de perfusão e a análise de seus parâmetros, principalmente a resistência intrarrenal, são importantes ferramentas de apoio para tomada de decisão no momento da oferta de órgãos com disfunção renal.

Análise e proposta de melhorias do fluxo de notificação de valores críticos de um Hospital Público de Porto Alegre

Este projeto pretende propor um estudo com os trabalhadores de um laboratório de análises clínicas (LAC) de um hospital público da zona norte de Porto Alegre, através de uma pesquisa qualitativa. Tem como objetivo analisar o atual fluxo de notificação de valores críticos e propor melhorias ao mesmo. A forma atual é feita de forma frágil no que se refere ao detalhamento do processo principalmente pelo fato de ele ser complexo. Essa complexidade se dá devido ao número de hospitais atendidos pelo LAC, pela quantidade de pessoas envolvidas no processo, grande número de exames feitos diariamente e a importância que esse resultado tem para o atendimento adequado ao paciente. Diminuindo o tempo de resposta do médico para sua intervenção, pode-se diminuir os custos de internação e de procedimentos, além de diminuir o impacto na recuperação física e emocional do paciente. Para isso, será feito um grupo focal de 7 a 12 farmacêuticos bioquímicos que fazem notificação de valores críticos, a fim de avaliar o atual fluxo, destacando pontos positivos, negativos e, por fim, dando sugestões para a sua melhoria. Para análise das informações será utilizada o referencial de Bardin (1977) nas quais serão identificados elementos que poderão ser incluídos, alterados ou excluídos, a fim de auxiliar na proposta de melhorias do atual fluxo de notificação de valores críticos