Conhecimento e experiências vividas por cirurgiões-dentistas quanto à importunação sexual e perseguição em Pernambuco, Brasil / Knowledge and experiences lived by dentists regarding sexual harassment and persecution in Pernambuco, Brazil

Importunação Sexual e Perseguição são práticas configuradas como crime pelo Código Penal Brasileiro - CPB. Sendo o tema pouco explorado na área da saúde, este trabalho teve como objetivo verificar o nível de conhecimento do cirurgião-dentista atuante no estado de Pernambuco (Brasil), sobre estes dois tipos penais, suas experiências no exercício profissional e atitudes tomadas para resolutividade da questão. Para isto foi realizado estudo descritivo de corte transversal, com aplicação de um questionário online semiestruturado, através da plataforma Google Forms®, utilizando a metodologia "bola de neve", sendo coletados dados sociodemográficos, questões relacionadas ao conhecimento de Importunação Sexual e Perseguição, e por fim, questões relacionadas a experiências sofridas no exercício de sua profissão. Foram incluídos neste estudo 69 questionários, 22% respondidos por homens e 78% por mulheres. A maioria dos participantes respondeu que já ouviu falar sobre Importunação Sexual e sobre Perseguição, no entanto, grande parte demonstrou dificuldade em reconhecer a definição de Importunação, estabelecida pelo CPB. Os que informaram ter tido vivência com algum destes tipos penais, relataram que contaram o fato a um amigo, a algum familiar ou não fizeram nada a respeito. Conclui-se sobre existência de situações dentro da prática profissional odontológica que podem configurar, sobretudo, o crime de Importunação sexual. E, contar a um amigo, a um familiar ou mesmo não fazer nada a respeito foram as atitudes mais comumente realizadas por estes profissionais

Sexual Harassment and persecution are acts configured as a crime by the Brazilian Penal Code - CPB. As the subject is little explored in the health area, this work aimed to verify the level of knowledge of the dentists working in the state of Pernambuco (Brazil), about these two criminal types, their experiences in professional practice and attitudes taken to resolve the issue. For this, a descriptive cross-sectional study was carried out, with the application of a semi-structured online questionnaire, through the google forms platform, using the "snowball" methodology, collecting sociodemographic data, questions related to the knowledge of sexual harassment and persecution, and by finally, questions related to the experiences suffered in the exercise of their profession. 69 questionnaires were included in this study, 22% answered by men and 78% by women. Most participants answered that they had already heard about sexual harassment and persecution, however, most of them showed difficulty in recognizing the definition of harassment, established by the CPB. Those who reported having had experience with one of these criminal types, reported that they told the fact to a friend, to a family member or did nothing about it. It concludes on the existence of situations within professional dental practice that can configure, above all, the crime of sexual harassment. And telling a friend, a family member or even doing nothing about it were the attitudes most commonly performed by these professionals

Assessment of interleukin-10 promoter variant (-1082A/G) and cytokine production in patients with hemolytic uremic syndrome.

Introduction: Hemolytic uremic syndrome (HUS) is a condition that results in acute kidney failure mainly in children, which is caused by Shiga toxin-producing Escherichia coli and inflammatory response. Although anti-inflammatory mechanisms are triggered, studies on the implication in HUS are scarce. Interleukin-10 (IL-10) regulates inflammation in vivo, and the interindividual differences in its expression are related to genetic variants. Notably, the single nucleotide polymorphism (SNP) rs1800896 -1082 (A/G), located in the IL-10 promoter, regulates cytokine expression. Methods: Plasma and peripheral blood mononuclear cells (PBMC) were collected from healthy children and HUS patients exhibiting hemolytic anemia, thrombocytopenia, and kidney damage. Monocytes identified as CD14+ cells were analyzed within PBMC by flow cytometry. IL-10 levels were quantified by ELISA, and SNP -1082 (A/G) was analyzed by allele-specific PCR. Results: Circulating IL-10 levels were increased in HUS patients, but PBMC from these patients exhibited a lower capacity to secrete this cytokine compared with those from healthy children. Interestingly, there was a negative association between the circulating levels of IL-10 and inflammatory cytokine IL-8. We observed that circulating IL-10 levels were threefold higher in HUS patients with -1082G allele in comparison to AA genotype. Moreover, there was relative enrichment of GG/AG genotypes in HUS patients with severe kidney failure. Discussion: Our results suggest a possible contribution of SNP -1082 (A/G) to the severity of kidney failure in HUS patients that should be further evaluated in a larger cohort.

Etiological diagnosis of post-diarrheal hemolytic uremic syndrome (HUS): humoral response contribution.

BACKGROUND: Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolysis, thrombocytopenia, and thrombus formation leading to tissue injury. HUS is classified according to its etiology as post-diarrheal or atypical HUS. Differential diagnosis of both entities continues to be a challenge for pediatric physicians. METHODS: The aim was to improve the rapid etiological diagnosis of post-diarrheal HUS cases based on the detection of Shiga toxin (Stx)-producing Escherichia coli (STEC) infection by screening of stx1/stx2 and rfbO157 in cultured stools by multiplex PCR, and the additional detection of anti-lipopolysaccharide (anti-LPS) O157, O145, and O121 antibodies by Glyco-iELISA test. In addition, we studied patients' relatives to detect circulating pathogenic strains that could contribute to HUS diagnosis and/or lead to the implementation of measures to prevent dissemination of familial outbreaks. This study describes the diagnosis of 31 HUS patients admitted to Hospital Municipal de Niños Prof Dr Ramón Exeni during the 2017-2020 period. RESULTS: Stool PCR confirmed the diagnosis of STEC associated with HUS in 38.7% of patients (12/31), while anti-LPS serology did in 88.9% (24/27). In those patients in which both methods were carried out (n = 27), a strong association between the results obtained was found. We found that 30.4% of HUS patients had at least one relative positive for STEC. CONCLUSIONS: We could identify 96.3% (26/27) of HUS cases as secondary to STEC infections when both methods (genotyping and serology) were used. The results demonstrated a high circulation of STEC in HUS families and the prevalence of the STEC O157 serotype (83%) in our pediatric cohort. A higher-resolution version of the Graphical abstract is available as Supplementary information.

[Clinical practice guideline for the diagnosis and management of urinary tract infections: 2022 update]. / Guía para el diagnóstico, estudio y tratamiento de la infección urinaria: actualización 2022.

In 2015, the "New recommendations regarding the current controversies in urinary infection" were published in the Archivos Argentinos de Pediatría. Given the fact that in these past years, new evidence has emerged regarding the diagnosis and treatment of urinary infection, the Pediatric Nephrology Committee of Sociedad Argentina de Pediatría has decided to update these recommendations. The main goal is to provide the pediatrician with the necessary tools to make a correct diagnosis, define the most appropriate treatment, select the patients who will benefit from antibiotic prophylaxis, and decide which imaging studies will be necessary, avoiding costly and invasive interventions. These guidelines also include the management of children with urinary tract infections associated with special situations such as: bladder bowel dysfunction, the newborn, children with neurogenic bladder, kidney transplant patients and fungal urinary tract infections.

En 2015 se publicaron en Archivos Argentinos de Pediatría las "Nuevas recomendaciones frente a las actuales controversias en infección urinaria". Dado que en estos años surgieron evidencias con respecto al diagnóstico, la forma de estudio y el tratamiento de la infección urinaria, el Comité de Nefrología Pediátrica de la Sociedad Argentina de Pediatría decidió actualizar dichas recomendaciones. El objetivo principal es brindar al pediatra las herramientas para realizar un correcto diagnóstico, definir el tratamiento más adecuado, seleccionar a los pacientes que se beneficiarán con la profilaxis antibiótica y decidir cuáles serán los estudios de imágenes necesarios, para evitar intervenciones costosas e invasivas. En estas guías se incluyen, además, los lineamientos para el manejo de niños con infecciones urinarias asociadas a situaciones especiales como la disfunción vesicointestinal, el recién nacido, los portadores de vejiga neurogénica, los receptores de trasplante renal y las infecciones urinarias micóticas.

Análise das características e viabilidade de amostras questionadas de tecidos rígidos submetidas a exame de DNA forense / Analysis of characteristics and feasibility of questioned samples submitted to forensic DNA examination

Este estudo teve como objetivo analisar as características das amostras questionadas de tecidos rígidos enviadas para análise de DNA forense, especificando o tipo e a região anatômica alvo de coleta, bem como a viabilidade da amostra após o processamento. Caracterizada por ser de corte transversal, com abordagem quantitativa e descritiva, utilizou dados secundários extraídos de planilhas do Instituto, com os quais construiu banco de dados, posteriormente analisado. Os resultados demonstraram que ossos e dentes são coletados como amostra para os testes de DNA, representando o percentual de 47,4% de todos os exames recebidos no ano de 2020, sendo 99,5% provenientes de crimes contra a vida. Das amostras obtidas de tecido rígido, 42% tiveram processamento concluído (39,1% para dentes e 42,6% para ossos), 10% não concluído (17,2% para dentes e 8,5% para ossos) e 48% constavam como não informado. Todas as amostras compostas por dente não especificaram a classificação dentária. Já as amostras compostas por ossos corresponderam a fragmento ósseo não especificado em 81% dos casos, 13,4% eram fragmento de fêmur e o percentual restante distribuído entre fragmentos de clavícula, crânio, escápula, fêmur, manúbrio, osso longo, tíbia, vértebra, osso esterno, mandíbula e ulna, variando entre 1-2% para cada. Pode-se concluir que o perfil dos exames de DNA extraído de amostras de tecidos duros do Instituto pesquisado é composto por ossos e dentes, sendo em sua maioria por fragmentos ósseos de vários tipos, principalmente fêmur, sendo necessária a melhor qualificação dos tipos de amostra utilizados para extração

This study aimed to analyze the characteristics of questioned hard tissue samples sent for forensic DNA analysis, specifying the type and anatomical region targeted for collection, as well as the viability of the sample after processing. Characterized by being cross-sectional, with a quantitative and descriptive approach, it used secondary data extracted from the Institute's spreadsheets, with which it built a database, later analyzed. The results showed that bones and teeth are collected as samples for DNA testing, representing the percentage of 47.4% of all exams received in the year 2020, with 99.5% coming from crimes against life. Among the samples obtained from hard tissue, 42% had its processing completed (39.1% for teeth and 42.6% for bones), 10% were not completed (17.2% for teeth and 8.5% for bones), and 48% were listed as not informed. All tooth-composite samples didn´t specify the tooth classification. Bone samples corresponded to unspecified bone fragments in 81% of the cases, 13.4% were femur fragments, and the remaining percentage was distributed among fragments of clavicle, skull, scapula, femur, manubrium, long bone, tibia, vertebra, sternum bone, mandible, and ulna, ranging from 1-2% for each. Therefore, it can be concluded that the profile of DNA tests extracted from hard tissue samples at the researched institute is composed of bones and teeth, being mostly bone fragments of various types, especially femur, and a better qualification of the sample types used for extraction is needed

Guía para el diagnóstico, estudio y tratamiento de la infección urinaria: actualización 2022 / Clinical practice guideline for the diagnosis and management of urinary tract infections: 2022 update

En 2015 se publicaron en Archivos Argentinos de Pediatría las "Nuevas recomendaciones frente a las actuales controversias en infección urinaria". Dado que en estos años surgieron evidencias con respecto al diagnóstico, la forma de estudio y el tratamiento de la infección urinaria, el Comité de Nefrología Pediátrica de la Sociedad Argentina de Pediatría decidió actualizar dichas recomendaciones. El objetivo principal es brindar al pediatra las herramientas para realizar un correcto diagnóstico, definir el tratamiento más adecuado, seleccionar a los pacientes que se beneficiarán con la profilaxis antibiótica y decidir cuáles serán los estudios de imágenes necesarios, para evitar intervenciones costosas e invasivas. En estas guías se incluyen, además, los lineamientos para el manejo de niños con infecciones urinarias asociadas a situaciones especiales como la disfunción vesicointestinal, el recién nacido, los portadores de vejiga neurogénica, los receptores de trasplante renal y las infecciones urinarias micóticas.

In 2015, the "New recommendations regarding the current controversies in urinary infection" were published in the Archivos Argentinos de Pediatría. Given the fact that in these past years, new evidence has emerged regarding the diagnosis and treatment of urinary infection, the Pediatric Nephrology Committee of Sociedad Argentina de Pediatría has decided to update these recommendations. The main goal is to provide the pediatrician with the necessary tools to make a correct diagnosis, define the most appropriate treatment, select the patients who will benefit from antibiotic prophylaxis, and decide which imaging studies will be necessary, avoiding costly and invasive interventions. These guidelines also include the management of children with urinary tract infections associated with special situations such as: bladder bowel dysfunction, the newborn, children with neurogenic bladder, kidney transplant patients and fungal urinary tract infections.

Cirurgiões-dentistas diante de situações de assédio e importunação sexual: revisão integrativa / Dentists facing situations of sexual harassment: integrative review

Assédio e importunação sexual são tipos de violência configurados como crime pelo Código Penal Brasileiro. Situações como estas são frequentemente vivenciadas pela população, sendo as mulheres as principais vítimas. Na Odontologia, tais comportamentos tem trazido bastante preocupação, e promovido experiências negativas seja aos Cirurgiões-dentistas, Auxiliares de Saúde Bucal ou Técnicos de Saúde Bucal. Assim, por meio de uma revisão integrativa da literatura, este estudo objetivou analisar se o Cirurgião-dentista se sente preparado em lidar com este problema, as atitudes tomadas pelos Cirurgiões-Dentistas quando diante de situações em que se sinta assediado ou importunado sexualmente durante sua atividade profissional, bem como os sentimentos gerados pela experiência vivida. Para seleção dos artigos utilizou-se as bases de dados PubMed, Biblioteca Virtual de Saúde (BVS) e periódicos CAPES, e a amostra desta revisão constituiu-se em sete artigos. Após análise destas publicações, os resultados dos estudos apontaram prejuízos aos profissionais que vão desde o trabalho à vida pessoal. Foram relatados sentimentos de ansiedade, medo, perda de ânimo para realização das atividades profissionais, além de pesadelos e recordações angustiantes do momento vivido. Constatou-se que os Cirurgiões-dentistas de ambos os sexos não se sentem preparados profissionalmente para lidar com situações de assédio e importunação sexual, e que estes consideram de extrema relevância a inclusão da temática nos currículos dos cursos de graduação em Odontologia

Sexual harassment is a type of violence configured as a crime under the Brazilian Penal Code. Situations like these are frequently experienced by the population, with women being the main victims. In Dentistry, such behaviors have brought a lot of concern, and promoted negative experiences either for Dentist, Oral Dental Assistant or Dental Hygienists. Then, through an integrative literature review, this study aimed to analyze whether the dentist feels prepared to deal with this problem, the attitudes taken by dentists when faced with situations in which they feel sexually harassed during their professional activity, as well as the feelings generated by the lived experience. For selection of articles, the databases PubMed, Virtual Health Library (VHL) and CAPES periodicals were used, and the sample of this review consisted of seven articles. After evaluating these studies, the results pointed to several harms for professionals that happen from work to personal life. Feelings of anxiety, fear, and discouragement to do their job were reported, as well as nightmares and distressing memories of the lived moment. It was also found that Dentists do not feel professionally prepared to deal with situations of sexual harassment, and that they consider the inclusion of the subject in undergraduate dentistry curricula extremely relevant

Extracorporeal membrane oxygenation as a bridge to durable left ventricular assist device implantation in INTERMACS-1 patients.

Left ventricular assist devices (LVADs) are increasingly used as destination therapy or as a bridge to future cardiac transplant in patients with end-stage heart failure. Extracorporeal membrane oxygenation (ECMO) can be used to bridge patients in cardiogenic shock or with decompensated heart failure to durable mechanical circulatory support. We assessed outcomes in patients in critical cardiogenic shock (Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS] profile 1) who underwent implantation of a continuous-flow (CF)-LVAD, with or without preoperative ECMO bridging. For this retrospective study, we selected INTERMACS profile 1 patients who underwent CF-LVAD implantation at our institution between Sep 1, 2004 and Nov 30, 2018. Of 768 patients identified, 133 (17.3%) were INTERMACS profile 1; 26 (19.5%) received preoperative ECMO support, and 107 (80.5%) did not. Postimplantation outcomes were compared between the ECMO and no-ECMO groups. No significant differences were found in 30-day mortality (15.4 vs. 15.9%, P = 0.95) or survival at 1 year (53.8 vs. 60.9%, P = 0.51). Three patients who received ECMO before CF-LVAD implantation subsequently underwent cardiac transplant. In the ECMO group, the lactate level 1 day after ECMO initiation was lower in survivors than nonsurvivors (2.7 ± 2.2 vs. 7.4 ± 4.2 mmol/L, P = 0.02; area under the curve = 0.85, P = 0.01) after CF-LVAD implantation. Bridging with ECMO to CF-LVAD implantation in carefully selected INTERMACS profile 1 patients (those who are at the highest risk for critical cardiogenic shock and for whom palliation may be the only other option) produced acceptable postoperative outcomes.Field of research: Artificial lung/ECMO.

A Universidade Federal Fluminense promotora da saúde: um processo transformador / The Fluminense Federal University promoting health: a transforming process

Introdução: Estudo sobre ações de promoção da saúde desenvolvidas pelos projetos e programas cadastrados na Pró-Reitoria de Extensão da Universidade Federal Fluminense (PROEX-UFF), em 2019 e 2020. As universidades podem tornar-se ambientes de Promoção da Saúde e bem-estar para a comunidade universitária e seu entorno, mesmo em tempo de isolamento social. O objetivo geral: Analisar a consolidação das Políticas de Promoção da Saúde na UFF, tendo em vista sua afiliação à Rede Iberoamericana de Universidades Promotoras da Saúde (RIUPS). Objetivos específicos: 1) Descrever projetos e programas cadastrados na PROEX-UFF que desenvolveram ações de Promoção da Saúde com a comunidade universitária e seu entorno no período de 2019-2020. 2) Mapear políticas e ações de Promoção da Saúde desenvolvidas por instituições de ensino superior com a comunidade universitária e seu entorno no contexto da pandemia da COVID-19. 3) Discutir a visão de coordenadores de projetos e programas cadastrados na PROEX-UFF sobre a Promoção da Saúde na Universidade articulados a elementos conceituais freirianos. Metodologia: Estudo de natureza qualitativa, do tipo descritivo e documental. Inicialmente foi realizado um levantamento dos registros documentais das ações de extensão disponibilizadas no site da Pró-Reitoria de Extensão da UFF. Em seguida, foram realizados uma revisão de escopo e um estudo qualitativo com coordenadores dos projetos e programas com foco na Promoção da Saúde. A produção de dados do estudo documental se deu por meio do site da UFF utilizando tabela em planilha Excel. Os dados qualitativos foram obtidos por meio de formulário autopreenchível, contendo perguntas relativas à Promoção da Saúde na UFF. As técnicas de análise de dados utilizadas foram: Análise de Conteúdo e Análise do Discurso do Sujeito Coletivo. A aprovação no CEP/UFF recebeu o número 48714621.1.0000.5243. Tese de partida: Ações de Promoção da Saúde devem ser fomentadas pelas universidades, visando à saúde individual e coletiva, numa concepção ampliada. Tais ações devem reforçar parcerias com a comunidade e seu entorno. Resultados:Foram identificadas 244 ações com foco na Promoção da Saúde divididas em cinco categorias: "Reforço e visibilidade das ações comunitárias", "Aprimoramento de habilidades pessoais", "Criação de ambientes favoráveis no trabalho e estudo", "Reorientação dos serviços de saúde" e "Fortalecimento de políticas públicas saudáveis". A análise temática dos 38 estudos da revisão de escopo revelou três categorias: (1) Ações e estratégias de enfrentamento da COVID-19 nas universidades; (2) Ações e estratégias inclusivas e de Proteção social a grupos vulneráveis ao COVID-19 nas universidades; (3) Ações e estratégias de Educação em Saúde e Bem-Estar em face da COVID-19 nas universidades.Na análise do Discurso do Sujeito Coletivo emergiram três categorias: 1- Repercussão das ações de Promoção da Saúde na comunidade universitária e seu entorno, 2-Ações e serviços de Promoção da Saúde necessários na Universidade Federal Fluminense Promotora da Saúde, 3- A Universidade Federal Fluminense como Universidade Promotora da Saúde. Produtos da tese: certificação de afiliação da UFF na RIUPS, relatório aprovado e publicado no periódico Educapes e dois artigos científicos publicados.Considerações finais: Ações de Promoção da Saúde realizadas na UFF devem ser fortalecidas e ter maior visibilidade, reafirmando o compromisso social das universidades como centros de formação transformadora e participativa, fomentando políticas saudáveis e planejamento sustentável,mobilizando e envolvendo a comunidade acadêmica e seu entorno.

Introduction: Study on health promotion actions developed by projects and programs registered in the Dean of Extension of the Universidade Federal Fluminense (PROEX-UFF), in 2019 and 2020. Universities can become environments for Health Promotion and well-being to be for the university community and its surroundings, even in times of social isolation. The general objective: To analyze the consolidation of Health Promotion Policies at UFF, in view of its affiliation to the Iberoamerican Network of Health Promoting Universities (RIUPS). Specific Objectives: 1) To describe projects and programs registered at PROEX-UFF that developed Health Promotion actions with the university community and its surroundings in the period 2019-2020. 2) Map Health Promotion policies and actions developed by higher education institutions with the university community and its surroundings in the context of the COVID-19 pandemic. 3) Discuss the vision of project and program coordinators registered at PROEX-UFF on Health Promotion at the University articulated to Freirean conceptual elements. Methodology: This is a qualitative, descriptive and documentary study. Initially, a survey was carried out of the documentary records of the extension actions available on the website of the ProRectory of Extension of the UFF. Then, a scope review and a qualitative study were carried out with coordinators of projects and programs focused on Health Promotion. The production of data from the documentary study took place through the UFF website using a table in an Excel spreadsheet. Qualitative data were obtained through a self-completed form, containing questions related to Health Promotion at UFF. The data analysis techniques used were: Content Analysis and Collective Subject Discourse Analysis. The approval at CEP/UFF received the number 48714621.1.0000.5243. Starting thesis: Health Promotion Actions should be promoted by universities, aiming at individual and collective health, in an expanded concept. Such actions should reinforce partnerships with the community and its surroundings. Results: 244 actions focused on Health Promotion were identified, divided into five categories: "Reinforcement and visibility of community actions", "Improvement of personal skills", "Creation of favorable environments at work and study", "Reorientation of health services " and "Strengthening healthy public policies". The thematic analysis of the 38 studies of the scoping review revealed three categories: (1) Actions and strategies for coping with COVID-19 in universities; (2) Inclusive and Social Protection actions and strategies for groups vulnerable to COVID-19 in universities; (3) Health and Wellness Education actions and strategies in the face of COVID-19 in universities.In the analysis of the Discourse of the Collective Subject, three categories emerged: 1- Repercussion of Health Promotion actions in the university community and its surroundings, 2- Actions and services of Health Promotion necessary at the Universidade Federal Fluminense Health Promotion, 3- The Federal University Fluminense as a Health Promoting University. Thesis products: certification of UFF's affiliation with RIUPS, report approved and published in the journal Educapes and two published scientific articles. Final considerations: Health Promotion Actions carried out at UFF should be strengthened and have greater visibility, reaffirming the social commitment of universities as transforming and participatory training centers, promoting healthy policies and sustainable planning, mobilizing and involving the academic community and its surroundings.

Introduction : Étude sur les actions de promotion de la santé développées par les projets et programmes inscrits au Doyen de l'extension de l'Université fédérale Fluminense (PROEX-UFF), en 2019 et 2020. Les universités peuvent devenir des environnements de promotion de la santé et de bien-être pour l'université communauté et son environnement, même en période d'isolement social. L'objectif général: Analyser la consolidation des politiques de promotion de la santé à l'UFF, en vue de son affiliation au Réseau ibéro-américain des universités de promotion de la santé (RIUPS). Objectifs spécifiques : 1) Décrire les projets et programmes inscrits au PROEX-UFF qui ont développé des actions de promotion de la santé avec la communauté universitaire et ses environs au cours de la période 2019-2020. 2) Cartographier les politiques et actions de promotion de la santé développées par les établissements d'enseignement supérieur avec la communauté universitaire et son environnement dans le contexte de la pandémie COVID-19. 3) Discuter de la vision des coordonnateurs de projets et de programmes inscrits au PROEX-UFF sur la promotion de la santé à l'Université articulée aux éléments conceptuels freiriens. Méthodologie : Il s'agit d'une étude qualitative, descriptive et documentaire. Dans un premier temps, une enquête a été menée sur les fiches documentaires des actions d'extension disponibles sur le site internet du Pro-Rectorat d'Extension de l'UFF. Ensuite, un examen de la portée et une étude qualitative ont été réalisés auprès des coordonnateurs de projets et de programmes axés sur la promotion de la santé. La production des données de l'étude documentaire s'est faite via le site internet de l'UFF à partir d'un tableau dans un tableur Excel. Les données qualitatives ont été obtenues à l'aide d'un formulaire à remplir soi-même, contenant des questions liées à la promotion de la santé à l'UFF. Les techniques d'analyse de données utilisées étaient : l'analyse de contenu et l'analyse collective du discours du sujet. L'approbation au CEP/UFF a reçu le numéro 48714621.1.0000.5243. Thèse de départ : Les actions de promotion de la santé doivent être promues par les universités, visant la santé individuelle et collective, dans un concept élargi. De telles actions devraient renforcer les partenariats avec la communauté et son environnement. Résultats : 244 actions axées sur la promotion de la santé ont été identifiées, réparties en cinq catégories : « Renforcement et visibilité des actions communautaires ¼, « Amélioration des compétences personnelles ¼, « Création d'environnements favorables au travail et aux études ¼, « Réorientation des services de santé ¼ et « Renforcer les politiques publiques de santé ¼. L'analyse thématique des 38 études de l'examen de cadrage a révélé trois catégories : (1) Actions et stratégies pour faire face à la COVID-19 dans les universités ; (2) Actions et stratégies inclusives et de protection sociale pour les groupes vulnérables au COVID19 dans les universités ; (3) Actions et stratégies d'éducation à la santé et au bienêtre face à la COVID-19 dans les universités. Dans l'analyse du Discours du Sujet Collectif, trois catégories ont émergé : 1- Répercussion des actions de Promotion de la Santé dans la communauté universitaire et ses environs, 2- Actions et services de Promotion de la Santé nécessaires à l'Université Fédérale Fluminense Promotion de la Santé, 3- La Université fédérale Fluminense en tant qu'université de promotion de la santé. Produits de thèse : certification de l'affiliation de l'UFF au RIUPS, rapport approuvé et publié dans la revue Educapes et deux articles scientifiques publiés. Considérations finales : Les actions de promotion de la santé menées à l'UFF doivent être renforcées et avoir une plus grande visibilité, réaffirmant l'engagement social des universités comme et des centres de formation participatifs, promouvant des politiques saines et une planification durable, mobilisant et impliquant la communauté académique et son environnement.

Health promotion actions in universities in the face of the covid-19 pandemic: a scoping review / Acciones de promoción de la salud frente a la pandemia de covid-19: revisión de alcance / Ações de promoção da saúde nas universidades em face da pandemia do covid-19: scoping review

ABSTRACT Objective: to map in the literature the universities' health promotion actions and strategies in the context of the new coronavirus (COVID-19) pandemic. Method: a Scoping Review, based on the procedures recommended by the Joanna Briggs Institute. Based on these perspectives, the following guiding question was established: which health promotion actions and strategies were implemented in universities with the internal community and its surroundings in the COVID-19 pandemic? The searches were carried out in March 2021 in the databases of public, restricted and gray literature information portals. Results: a total of 38 studies were selected and three categories were elaborated based on them, namely: 1) Actions and strategies for coping with COVID-19 in universities; 2) Inclusive and Social protection actions and strategies for groups vulnerable to COVID-19 in universities; and 3) Health and Well-being Education actions and strategies in the face of COVID-19 in universities. Conclusions: the study evidenced that health promotion actions and strategies in universities become a reality when the proposals find institutional support, inter- and transdisciplinary mobilization and integration with governmental sectors and private initiative, in addition to engagement of the academic population. Several actions were observed in different scenarios, showing social commitment and a critical stance in the face of COVID-19, aiming at a fairer and more sustainable society through knowledge.

RESUMEN Objetivo: mapear en la literatura las acciones y estrategias de promoción de la salud de universidades en el contexto de la pandemia del nuevo coronavirus (COVID-19). Método: revisión de alcance, basada en procedimientos recomendados por el Instituto Joanna Briggs. A partir de estas perspectivas se estableció la pregunta orientadora: ¿Qué acciones y estrategias de promoción de la salud se realizaron en las universidades con la comunidad interna y su entorno durante la pandemia de COVID-19? Las búsquedas se realizaron en marzo de 2021 en las bases de datos de los portales de información públicos, restringidos y de literatura gris. Resultados: se seleccionaron 38 estudios y en base a estas tres categorías se construyeron: 1) Acciones y estrategias para afrontar el COVID-19 en las universidades; 2) Acciones y estrategias inclusivas y de protección social para grupos vulnerables al COVID-19 en las universidades; y 3) Acciones y estrategias de Educación para la Salud y el Bienestar frente al COVID-19 en las universidades. Conclusiones: el estudio mostró que las acciones y estrategias de promoción de la salud en las Universidades suceden cuando la propuesta encuentra apoyo institucional, movilización inter y transdisciplinaria, integración con los sectores gubernamentales e iniciativa privada, además del compromiso de la población académica. Se observaron diversas acciones en diferentes escenarios, en los que se demostró compromiso social y posicionamiento crítico frente al COVID-19, con miras a una sociedad más justa y sostenible a través del conocimiento.

RESUMO Objetivo: mapear na literatura as ações e estratégias de promoção da saúde das universidades no contexto da pandemia do novo coronavírus (COVID-19). Metodo: Scoping Review, baseado nos procedimentos recomendados pelo Instituto Joanna Briggs. Com base nestas perspectivas, ficou estabelecida a pergunta norteadora: quais ações e estratégias de promoção da saúde foram realizadas em universidades com a comunidade interna e seu entorno na pandemia do COVID-19? As buscas foram realizadas em março de 2021 nas bases de dados de portais de informação públicos, restritos e de literatura cinzenta. Resultados: foram selecionados 38 estudos e com base nesses foram construídas três categorias: 1) Ações e estratégias de enfrentamento do COVID-19 nas universidades 2) Ações e estratégias inclusivas e de Proteção social a grupos vulneráveis ao COVID-19 nas universidades 3) Ações e estratégias de Educação em saúde e bem-estar em face do COVID-19 nas universidades. Conclusões: o estudo evidenciou que ações e estratégias de promoção da saúde nas Universidades acontecem quando a proposta encontra apoio institucional, mobilização inter e transdisciplinar, integração com setores governamentais e iniciativa privada, além do engajamento da população acadêmica. Observaram-se diversas ações em diferentes cenários, demonstrando comprometimento social e posicionamento crítico em face do COVID-19, visando uma sociedade mais justa e sustentável pela via do conhecimento.

Estudo da espessura labial com finalidade pericial ­ comparação entre autoavaliação e avaliação técnica / Study of lip thickness for expert purposes-comparison between self-assessment and technical assessment

O exame da espessura labial pode se apresentar como uma útil ferramenta orientadora da identificação humana. Neste sentido, este estudo teve como objetivo a avaliação de 200 imagens dos lábios superior e inferior de estudantes da área de saúde da Universidade Federal de Pernambuco, por 02 examinadores, a fim de verificar a concordância entre a avaliação técnica, realizada por eles, e a autoavaliação, realizada pelos examinados, quanto à espessura dos lábios. Para isso, cada examinado inicialmente, após recebimento de instruções e assinatura do TCLE, olhando para um espelho, classificou, sem experiência prévia, seus lábios em finos, médios, grossos ou mistos, segundo sua autoavaliação, o que consideramos como avaliação empírica. Em seguida, o vermelhão dos lábios foi fotografado, associado a uma régua ABFO nº2, e mensurado pelos dois examinadores. Os resultados demonstraram que a concordância inter-examinadores técnicos, quanto a indicação do tipo de lábios foi alta, se apresentando com um percentual de 98,5%. Em relação à concordância entre a avaliação técnica com a avaliação empírica, foram obtidos valores baixos, ou seja, apresentaram uma concordância pequena, com percentual de 35%. Segundo a avaliação técnica, os lábios grossos se apresentaram com maior porcentagem, 49,5%, contra 54% da autoavaliação. Na autoavaliação, o tipo mais destacado foi lábios médios (54%). Pode-se concluir que a concordância entre a avaliação técnica e a autoavaliação realizada por pessoa sem experiência (avaliação empírica), neste estudo, quanto ao exame dos tipos de lábio, foi pouco exitosa, em face da pequena coincidência observada, destacando a importância de se considerar seriamente o fato de que tais divergências podem ser altas também em situações onde informações são obtidas a partir de pessoas comuns.

Effect of Laparoscopic Sleeve Gastrectomy on Heart Transplant Status in 4 Patients with Left Ventricular Assist Devices.

Bariatric surgery helps many morbidly obese patients lose substantial weight. However, few data exist on its long-term safety and effectiveness in patients who also have continuous-flow left ventricular assist devices and in whom heart transplantation is contemplated. We retrospectively identified patients at our institution who had undergone ventricular assist device implantation and subsequent laparoscopic sleeve gastrectomy from June 2015 through September 2017, and we evaluated their baseline demographic data, preoperative characteristics, and postoperative outcomes. Four patients (3 men), ranging in age from 32 to 44 years and in body mass index from 40 to 57, underwent sleeve gastrectomy from 858 to 1,849 days after left ventricular assist device implantation to treat nonischemic cardiomyopathy. All had multiple comorbidities. At a median follow-up duration of 42 months (range, 24-47 mo), median body mass index decreased to 31.9 (range, 28.3-44.3) at maximal weight loss, with a median percentage of excess body mass index lost of 72.5% (range, 38.7%-87.4%). After achieving target weight, one patient was listed for heart transplantation, another awaited listing, one was kept on destination therapy because of positive drug screens, and one regained weight and remained ineligible. On long-term follow-up, laparoscopic sleeve gastrectomy appears to be safe and feasible for morbidly obese patients with ventricular assist devices who must lose weight for transplantation consideration. Additional studies are warranted to evaluate this weight-loss strategy after transplantation and immunosuppression.

Device exchange from Heartmate II to HeartWare HVAD.

BACKGROUND: Despite technological advancements, pump durability and pump-related complications continue to affect and adversely impact the lives of patients with end-stage heart failure on left ventricular assist device (LVAD) support. In an attempt to avoid recurrent LVAD-related complications, there may be circumstances where it is clinically advantageous to exchange a patient's device from HeartMate II to HeartWare HVAD. However, there is a paucity of data that describes the safety and feasibility of such an approach. OBJECTIVE: We present the largest single-center series of HeartMate II (HMII) to HeartWare (HVAD) device exchanges. METHODS: A retrospective review of 11 patients who underwent HMII to HVAD exchange from 2012 to 2017 was conducted to evaluate patient characteristics, incidence of postoperative complications, and survival. RESULTS: Eleven male patients (mean age 55 ± 14.4 years) underwent HMII to HVAD device exchange. One patient expired on postoperative day 7 secondary to sepsis. One patient was lost-to-follow-up after 23 months. An additional three patients died at 5, 7, and 24 months. Mean follow-up after device exchange was 1555 ± 311 days for the remaining six patients. None of the 11 study patients underwent LVAD explant, further device exchange, or heart transplant. CONCLUSION: Exchange of an HMII LVAD to an HVAD can be performed safely with acceptable perioperative morbidity and mortality.

O significado da dor para mulheres em braquiterapia ginecológica: abordagem fenomenológica na consulta de enfermagem / El significado del dolor para las mujeres en la braquiterapia ginecológica: enfoque fenomenológico en la consulta de enfermería / The meaning of pain for women in gynecological brachytherapy: phenomenological approach in nursing consultation

Objetivo: Identificar a percepção da dor para mulheres em braquiterapia ginecológica na consulta de enfermagem. Método: Estudo qualitativo, realizado entre fevereiro a novembro de 2012, apoiado na abordagem da Fenomenologia Sociológica Compreensiva de Alfred Schutz. Treze mulheres participaram, maiores de dezoito anos, submetidas à braquiterapia ginecológica de dois serviços de radioterapia localizados no Rio de Janeiro e outro em São Paulo. Resultados: Uma característica que sobressaiu a partir dos depoimentos se referiu à dor na braquiterapia ginecológica, em que as mulheres revelaram o anseio por superá-la. Conclusão: Tal anseio independe da idade e do grau de instrução, é comum a todas e oriundo do vivido com o câncer. O que modifica é a maneira como se apresenta e a sua intensidade, que variam conforme a singularidade de cada sujeito

Objetivo: Identificar la percepción del dolor para las mujeres en braquiterapia ginecológica en la consulta de enfermería. Método: Estudio cualitativo, realizado de febrero a noviembre de 2012, a favor del enfoque de la fenomenología sociológica Integral de Alfred Schutz. Los participantes fueron trece las mujeres mayores de dieciocho años sometidos a la braquiterapia ginecológica dos servicios de radioterapia ubicadas en Río de Janeiro y otro en Sao Paulo. Resultados: Una característica que se destacó de los estados mencionados dolor en la braquiterapia ginecológica, en el que las mujeres revelan el deseo de superación. Conclusión: Este deseo es independiente de la edad y nivel de educación, es común a todos y procedentes de los vivos con el cáncer. Lo que cambia es la forma en que se presenta y su intensidad, que varían de acuerdo a la singularidad de cada sujeto

Objective: The study's goal has been to identify the perception of pain for women in gynecological brachytherapy in nursing consultation. Methods: It a qualitative study, carried out from February to November 2012, supported in the approach of the Sociological Phenomenology Comprehensive Alfred Schutz. Participants were thirteen women over eighteen years submitted to gynecological brachytherapy two radiotherapy services located in Rio de Janeiro and another in Sao Paulo. Results: One characteristic that emerged from the statements referred to pain in gynecological brachytherapy, in which women revealed the desire to overcoming it. Conclusion: This desire is independent of age and level of education; it is common to all and coming from the living with cancer. What changes is the way it is presented and its intensity, which vary according to the uniqueness of each subject

Pathogenic role of inflammatory response during Shiga toxin-associated hemolytic uremic syndrome (HUS).

Hemolytic uremic syndrome (HUS) is defined as a triad of noninmune microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. The most frequent presentation is secondary to Shiga toxin (Stx)-producing Escherichia coli (STEC) infections, which is termed postdiarrheal, epidemiologic or Stx-HUS, considering that Stx is the necessary etiological factor. After ingestion, STEC colonize the intestine and produce Stx, which translocates across the intestinal epithelium. Once Stx enters the bloodstream, it interacts with renal endothelial and epithelial cells, and leukocytes. This review summarizes the current evidence about the involvement of inflammatory components as central pathogenic factors that could determine outcome of STEC infections. Intestinal inflammation may favor epithelial leakage and subsequent passage of Stx to the systemic circulation. Vascular damage triggered by Stx promotes not only release of thrombin and increased fibrin concentration but also production of cytokines and chemokines by endothelial cells. Recent evidence from animal models and patients strongly indicate that several immune cells types may participate in HUS physiopathology: neutrophils, through release of proteases and reactive oxygen species (ROS); monocytes/macrophages through secretion of cytokines and chemokines. In addition, high levels of Bb factor and soluble C5b-9 (sC5b-9) in plasma as well as complement factors adhered to platelet-leukocyte complexes, microparticles and microvesicles, suggest activation of the alternative pathway of complement. Thus, acute immune response secondary to STEC infection, the Stx stimulatory effect on different immune cells, and inflammatory stimulus secondary to endothelial damage all together converge to define a strong inflammatory status that worsens Stx toxicity and disease.

Absceso renal neonatal: un desafío diagnóstico y terapéutico. Caso clínico / Neonatal renal abscess: a diagnostic and therapeutic challenge. A clinical case

El absceso renal representa una patología infrecuente en el recién nacido. Puede presentar consecuencias graves: sepsis con alta mortalidad, cicatrices renales y riesgo de enfermedad renal crónica. Se reporta sobre un recién nacido con absceso renal unilateral a Staphylococcus aureus, con cuadro de septicemia, sin otro foco supurativo ni malformación urinaria, que evolucionó adecuadamente con antibióticos endovenosos, sin tratamiento quirúrgico, aunque con cicatrices renales como secuela. A partir de este caso, se analizan las estrategias de diagnóstico, tratamiento y seguimiento del absceso renal en un neonato y se destaca el diagnóstico precoz para evitar cicatrices renales.

Renal abscess is a rare disease in newborn, but severe consequences can occur: sepsis with high mortality, renal scar formation and risk of chronic renal failure. A neonate with unilateral renal abscess due to Staphylococcus aureus is reported, with septicemia, with no other suppurative focus, nor with urinary malformation, with good clinical evolution with intravenous antibiotics and without surgical treatment, but with renal scars sequel. From this case, the strategies of diagnosis, treatment and followup of the renal abscess in a neonate are analyzed, emphasizing the early diagnosis to avoid renal scars.

Competências do docente do ensino clínico no curso de graduação em enfermagem: um estudo de caso / Skills of the clinical teaching teacher in nursing graduation course: a case study

Objetivo: identificar as competências requeridas pelo docente do ensino clínico no curso de Graduação em Enfermagem. Método: estudo qualitativo, descritivo e exploratório, tipo estudo de caso, cujos participantes foram 14 docentes do ensino clínico atuantes nos campos de estágio hospitalar. Utilizaram-se os documentos oficiais e entrevistas para coleta dos dados qualitativos, descritivos, e a análise se deu por Análise de Conteúdo na modalidade Análise temática. Resultados: os docentes identificaram competências requeridas durante o período de graduação, apresentadas a partir de duas unidades temáticas: “O aprender reflexivo na formação profissional de docentes” e “O movimento dos recursos cognitivos na prática do ensino clínico”. Conclusão: a EEAN estabelece como eixo basilar, em seu processo formativo, ações capitaneadas entre teoria e prática, geradoras de movimentos que resultam no desenvolvimento de competências.

[Neonatal renal abscess: a diagnostic and therapeutic challenge. A clinical case]. / Absceso renal neonatal: un desafío diagnóstico y terapéutico. Caso clínico.

Renal abscess is a rare disease in newborn, but severe consequences can occur: sepsis with high mortality, renal scar formation and risk of chronic renal failure. A neonate with unilateral renal abscess due to Staphylococcus aureus is reported, with septicemia, with no other suppurative focus, nor with urinary malformation, with good clinical evolution with intravenous antibiotics and without surgical treatment, but with renal scars sequel. From this case, the strategies of diagnosis, treatment and followup of the renal abscess in a neonate are analyzed, emphasizing the early diagnosis to avoid renal scars.

El absceso renal representa una patología infrecuente en el recién nacido. Puede presentar consecuencias graves: sepsis con alta mortalidad, cicatrices renales y riesgo de enfermedad renal crónica. Se reporta sobre un recién nacido con absceso renal unilateral a Staphylococcus aureus, con cuadro de septicemia, sin otro foco supurativo ni malformación urinaria, que evolucionó adecuadamente con antibióticos endovenosos, sin tratamiento quirúrgico, aunque con cicatrices renales como secuela. A partir de este caso, se analizan las estrategias de diagnóstico, tratamiento y seguimiento del absceso renal en un neonato y se destaca el diagnóstico precoz para evitar cicatrices renales.

Características sociodemográficas, clínicas e subjetivas de clientes com doença renal crônica atendidos na consulta de enfermagem / Sociodemographic, clinical and subjective characteristics of patients with chronic kidney disease taken in the nursing consultation

Objetivo: descrever as características sociodemográficas, clínicas e subjetivas de clientes com doença renal crônica em tratamento conservador. Método: estudo quantiqualitativo, com 35 clientes atendidos por meio da consulta de enfermagem no ambulatório de Nefrologia de um hospital universitário. O instrumento para coleta de dados consiste em um roteiro. Resultados: a maioria dos participantes era do sexo feminino, com baixa escolaridade e remuneração, sendo hipertensão e diabetes as principais comorbidades, com associação de doença coronariana. Após análise compreensiva, duas categorias emergiram: > e >.Conclusão: o enfermeiro deve viabilizar e se responsabilizar por intervenções que busquem entender a complexidade do ser, respeitando cada característica pessoal e se prontificando em associar cada informação para uma melhor transmissão dos aspectos do tratamento, aprofundando, assim, subsídios essenciais para o cuidado de enfermagem em nefrologia fundamentada para a saúde.

Induction of Neutrophil Extracellular Traps in Shiga Toxin-Associated Hemolytic Uremic Syndrome.

Hemolytic uremic syndrome (HUS), a vascular disease characterized by hemolytic anemia, thrombocytopenia, and acute renal failure, is caused by enterohemorrhagic Shiga toxin (Stx)-producing bacteria, which mainly affect children. Besides Stx, the inflammatory response mediated by neutrophils (PMN) is essential to HUS evolution. PMN can release neutrophil extracellular traps (NET) composed of DNA, histones, and other proteins. Since NET are involved in infectious and inflammatory diseases, the aim of this work was to investigate the contribution of NET to HUS. Plasma from HUS patients contained increased levels of circulating free-DNA and nucleosomes in comparison to plasma from healthy children. Neutrophils from HUS patients exhibited a greater capacity to undergo spontaneous NETosis. NET activated human glomerular endothelial cells, stimulating secretion of the proinflammatory cytokines IL-6 and IL-8. Stx induced PMN activation as judged by its ability to trigger reactive oxygen species production, increase CD11b and CD66b expression, and induce NETosis in PMN from healthy donors. During HUS, NET can contribute to the inflammatory response and thrombosis in the microvasculature and thus to renal failure. Intervention strategies to inhibit inflammatory mechanisms mediated by PMN, such as NETosis, could have a potential therapeutic impact towards amelioration of the severity of HUS.