Tecendo saberes: vivências interprofissionais na formação / Weaving Knowledge: Interprofessional Experiences in Education / Tejiendo Saberes: Vivencias Interprofesionales en la Formación

Objetivo: relatar a experiência do Grupo Tutorial III, no âmbito da gestão dos serviços, no que tange a interprofissionalidade e de como essa vivência pode contribuir para a tríade ensino-serviço-comunidade. Método: Trata-se de um relato de experiência, desenvolvido na Policlínica do George Américo e no Centro de Especialidades Odontológicas (CEO) Célia Pamponet, ao longo de doze meses, por bolsistas, preceptores e tutores, integrantes de um projeto de extensão desenvolvido pela Universidade Estadual de Feira de Santana. Resultados: Foi realizado um diagnóstico situacional das unidades que possibilitou intervenções como: oficinas para discussão de processos de trabalho, atuação com os diversos profissionais que compõem o quadro de servidores da Policlínica e CEO e montagem de melhorias operacionais em ambas unidades. Conclusão: Através das atividades desenvolvidas, o PET-Saúde contribuiu com a formação interprofissional de estudantes de saúde da Universidade Estadual de Feira de Santana, capacitando-os para enfrentar os desafios do SUS e fornecer uma assistência de qualidade

Objective: Reporting the experience of Tutorial Group III, in the scope of service management, regarding interprofessionalism and how this experience can contribute to the teaching-service-community triad. Method: This is an experience report, developed at Polyclínica do George Américo and at Centro de Especialidades Odontológicas (CEO) Célia Pamponet, over twelve months, by scholarship holders, preceptors and tutors, members of an extension project developed by State University of Feira de Santana. Results: a situational diagnosis of the units was carried out, which enabled interventions such as: workshops for the discussion of work processes, collaboration with the various professionals who make up the staff of the Polyclinic and CEO, and implementation of operational improvements in both units. Conclusion: Through the activities carried out, PET-Saúde contributed to the interprofessional training of health students at the State University of Feira de Santana, enabling them to face the challenges of the SUS and provide quality care.

Objetivo: Informar la experiencia del Grupo Tutorial III, en el ámbito de la gestión de servicios, en lo que respecta a la interprofesionalidad y cómo esta vivencia puede contribuir a la tríada enseñanza-servicio-comunidad. Método: Se trata de un relato de experiencia, desarrollado en la Policlínica do George Américo y en el Centro de Especialidades Odontológicas (CEO) Célia Pamponet, en un período de doce meses, por becarios, preceptores y tutores, integrantes de un proyecto de extensión desarrollado por la Universidad del Estado de Feria de Santana. Resultados: Se realizó un diagnóstico situacional de las unidades que permitió intervenciones como: talleres para discutir los procesos de trabajo, colaboración con los diversos profesionales que conforman el equipo de la Policlínica y el CEO, y implementación de mejoras operativas en ambas unidades. Conclusión: A través de las actividades realizadas, el PET-Saúde contribuyó para la formación interprofesional de los estudiantes de salud de la Universidad Estadual de Feira de Santana, capacitándonos para enfrentar los desafíos del SUS y brindar una atención de calidad.

Leaf morphoanatomy of an endemic massaranduba from Chapada Diamantina, Bahia, Brazil / Morfoanatomia foliar de uma massaranduba endêmica da Chapada Diamantina, Bahia, Brasil

Abstract: The Sapotaceae family is recognized for its economic importance, presenting food, medicinal and timber potential. Pouteria andarahiensis T.D.Penn., popularly known as "massaranduba", is endemic to Chapada Diamantina, Bahia, Brazil, and is currently classified on the IUCN red list as "endangered". Pouteria andarahiensis is little studied, highlighting this work as the first anatomical study for the species. Light microscopy and scanning electron microscopy techniques were used to perform anatomical studies. The species showed characters shared with the family (laticifers and malpiguiaceous trichomes), as well as diagnostic characters and associated with xeromorphy. The data obtained from the leaf architecture can assist in the identification of the species in a vegetative state, while the leaf surface provided unpublished data to the species, indicating the presence of a cuticle with complex ornamentation. Stand out as xeromorphic anatomical features, high stomatal density, high number of trichomes per area, sclerenchymatic columns in the mesophyll and a subepidermal sclerenchyma layer connecting the vascular bundles in the mesophyll.

Resumo: A família Sapotaceae é reconhecida pela sua importância econômica, apresentando potencial alimentício, medicinal e madeireiro. A espécie Pouteria andarahiensis T.D.Penn., conhecida popularmente como "massaranduba", é endêmica da Chapada Diamantina, Bahia, Brasil, e atualmente encontra-se classificada na lista vermelha da IUCN como "em perigo". Pouteria andarahiensis é pouco estudada, destacando este trabalho como o primeiro estudo anatômico para a espécie. Foram empregadas técnicas de microscopia de luz e de microscopia eletrônica de varredura para a realização dos estudos anatômicos. A espécie apresentou caracteres compartilhados com a família (laticíferos e tricomas malpiguiáceos), assim como, caracteres diagnósticos e associados a xeromorfia. Os dados obtidos da arquitetura foliar podem auxiliar na identificação da espécie em estado vegetativo, enquanto a superfície foliar forneceu dados inéditos a espécie, indicando a presença de uma cutícula com ornamentação complexa. Destacam-se como características anatômicas xeromórficas, alta densidade estomática, alto número de tricomas por área, colunas esclerenquimáticas no mesofilo e uma camada subepidérmica de esclerênquima conectando os feixes vasculares no mesofilo.

Perfil e percepção dos profissionais egressos de um curso de Odontologia / Profile and perception of graduated professionals from a dentistry course / Perfil y percepción de profesionales graduados de un curso de Odontologia

Objetivo: Avaliar o perfil e a percepção dos Cirurgiões-Dentistas formados na UEFS no período de 2013.1 a 2018.1 Método: Estudo de corte transversal de caráter descritivo, realizado por meio de um questionário com informações sobre dados pessoais, perfil socioeconômico e demográfico, campo de atuação e formação acadêmica. Resultados: Observou-se que a maioria dos egressos é do sexo feminino, na faixa etária de 22 a 26 anos e trabalha no setor privado. A maior parte cursou ou está cursando a pós-graduação devido à necessidade de aprimorar conhecimento, exigência do mercado de trabalho, seguir carreira acadêmica ou metas financeiras. Notou-se que serviço privado foi o principal local de atuação, seguido de serviço público ou mais de um local. Conclusão: Os profissionais entrevistados se mostraram satisfeitos ou muito satisfeitos sobre a maioria das variáveis relacionadas às atividades ambulatoriais, processo ensinoaprendizagem, atividades de estágio e corpo docente

Objective: To evaluate the profile and perception of Dental Surgeons trained at UEFS in the period 2013.1 to 2018.1 Method: Descriptive cross-sectional study, through a questionnaire containing information about personal data, socioeconomic and demographic profile, field of activity and academic background. Results: It was observed that the majority of graduates are female, aged between 22 and 26 years old and work in the private sector. Most have attended or are attending postgraduate courses due to the need to improve knowledge, demand in the labor market, pursue an academic career or financial goals. It was noted that private service was the main place of operation, followed by public service or more than one place. Conclusions: The professionals interviewed were satisfied / very satisfied about most variables related to outpatient activities, teaching-learning process, internship activity and teachers.

Objetivo: Evaluar el perfil y percepción de los Dentistas formados en UEFS en el periodo 2013.1 a 2018.1. Método: Estudio epidemiológico de corte transversal descriptivo, logrado a través de un cuestionario con informaciones sobre datos personales, perfil socioeconómico y demográfico, campo de actividad profesional y formación académica. Resultados: Se observó que la mayoría de los egresados son mujeres, tienen entre 22 y 26 años y trabajan en el sector privado. La mayoría ha cursado o está cursando estudios de posgrado por la necesidad de mejorar el conocimiento, la demanda en el mercado laboral, perseguir una carrera académica u objetivos económicos. Se señaló que el servicio privado era el principal lugar de operación, seguido del servicio público o más de un lugar. Conclusión: Los profesionales entrevistados se mostraron satisfechos o muy satisfechos con la mayoría de variables relacionadas con las actividades ambulatorias, el proceso de enseñanza-aprendizaje, las pasantía y el cuerpo docente.

Bacterial vaginosis: prevalence, risk profile and association with sexually transmitted infections / Vaginose bacteriana: prevalência, perfil de risco e associação com infecções sexualmente transmissíveis / Vaginosis bacteriana: prevalencia, perfil de riesgo y asociación con infecciones de transmisión sexual

Background and Objectives: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in the world. The study aimed to estimate the prevalence and to identify risk factors associated with bacterial vaginosis. Methods: A cross-sectional study was conducted in Ouro Preto, Brazil, between February and December 2017. Three hundred and forty-one women aged 18 years or older, users of the Brazilian Unified Health System, participated in this study. Women who used oral or topical antibiotics in the four weeks prior to the sample collection and women who had undergone a total hysterectomy were excluded from the study. After signing the Informed Consent Form and filling out a questionnaire containing sociodemographic, behavioral and sexual data, the participants were directed to the collection room, where the nurse collected the samples for the preventive examination of the cervix and also two vaginal swabs. Vaginal swabs and cervical samples were analyzed for cytological abnormalities and BV using Gram staining and cytology. Pathogens causing sexually transmitted infections (STIs) were identified by Polymerase Chain Reaction (PCR). For the analysis of the data, statistical package STATA version 10.0 was used. This study was approved by the Research Ethics Committee of the Federal University of Ouro Preto (UFOP). Results: During the study, 341 women were evaluated. The prevalence of BV using Gram staining (32.5% [CI95% 27.7-37.7%]) and cytology (27.7% [CI95% 23.032.8%]) was similar, however, the sensitivity of cytology was lower (77.8%). Risk factors associated with BV were smoking (IRR 1.5 [CI95%: 1.1  2.1]), use of an intrauterine device (IRR 2.8 [CI95%: 1.2 - 6.5]), and past medical history of BV (IRR 1.5 [CI95%: 1.1 - 2.1]). Correlation between the presence of BV and Trichomonas vaginalis (TV) infection (r=0.24) was observed. Conclusion: The prevalence of BV was affected by life habits and was prevalent in women with TV. Thus, behavioral and social prevention approaches to women with diverse risk profiles may help mitigate TV/BV prevalence and recurrence of BV.(AU)

Contexte et objectifs: La vaginose bactérienne (VB) est la cause la plus fréquente de pertes vaginales dans le monde. Le but de cette étude était d'évaluer la prévalence et les facteurs associés à la vaginose bactérienne. Méthodes: Il s'agit d'une approche descriptive, transversale et quantitative réalisée à Ouro Preto, Minas Gerais, Brésil, entre février et décembre 2017. 341 femmes ont participé à cette étude, âgées de 18 ans ou plus, utilisatrices du Système de santé unifié. Les femmes ayant utilisé des antibiotiques oraux ou topiques dans les quatre semaines précédant le prélèvement et les femmes ayant subi une hystérectomie totale ont été exclues de l'étude. Après avoir signé le formulaire de consentement éclairé et rempli un questionnaire contenant des données sociodémographiques, comportementales et sexuelles, les participants ont été dirigés vers la salle de collecte, où l'infirmière a prélevé les échantillons pour l'examen préventif du col de l'utérus. et aussi deux écouvillons vaginaux. Les échantillons de frottis vaginaux et cervicaux ont été analysés pour les anomalies cytologiques et VB en utilisant la coloration de Gram et la cytologie. Les agents pathogènes causant des infections sexuellement transmissibles (IST) ont été identifiés par réaction en chaîne par polymérase. Pour l'analyse des données, le progiciel statistique STATA version 10.0 a été utilisé. Cette étude a été approuvée par le Comité d'éthique de la recherche de l'Université fédérale d'Ouro Preto (UFOP). Résultats: Au cours de l'étude, 341 femmes ont été évaluées. La prévalence de la VB avec coloration de Gram (32,5% [IC 95% 27,7 - 37,7%]) et de la cytologie (27,7% [IC 95% 23,0 - 32,8%]) était similaire, cependant la sensibilité cytologique était plus faible (77,8%). Les facteurs de risque associés à la VB étaient le tabagisme (IRR 1,5 [IC 95%: 1,1 - 2,1]), l'utilisation d'un dispositif intra-utérin (IRR 2,8 [IC 95%: 1,2 - 6,5] ) et antécédents médicaux de VB (IRR 1,5 [IC 95%: 1,1 - 2,1]). Il y avait une corrélation entre la présence d'une infection à VB et Trichomonas vaginalis (TV) (r = 0,24). Conclusion: La prévalence de la VB était affectée par le mode de vie et l'infection TV. Ainsi, les approches de prévention comportementale et sociale pour les femmes présentant des profils de risque différents peuvent aider à atténuer la prévalence de la TV / VB et la récurrence de la VB.(AU)

Justificativa e Objetivos: A vaginose bacteriana (VB) é a causa mais comum de corrimento vaginal no mundo. O objetivo desse estudo foi avaliar a prevalência e os fatores associados à vaginose bacteriana. Métodos: Trata-se de um descritivo, de forma transversal e abordagem quantitativa realizado em Ouro Preto, Minas Gerais, Brasil, entre fevereiro a dezembro de 2017. Participaram desse estudo 341 mulheres com idade igual ou superior a 18 anos, usuárias do Sistema Único de Saúde (SUS). Mulheres que usaram antibióticos orais ou tópicos nas quatro semanas anteriores à coleta e mulheres que haviam sido submetidas a uma histerectomia total foram excluídas do estudo. Após a assinatura do Termo de Consentimento Livre e Esclarecido e preenchimento de questionário contendo dados sócio-demográfico, comportamental e sexual, as participantes foram encaminhadas para a sala de coleta, onde a enfermeira realizou a coleta das amostras para o exame preventivo do colo do útero e também de dois swabs vaginais. As amostras de esfregaço vaginal e cervical foram analisadas quanto às anormalidades citológicas e VB usando coloração de Gram e citologia. Patógenos causadores de infecções sexualmente transmissíveis (ISTs) foram identificados por Reação em Cadeia da Polimerase (PCR). Para a análise dos dados foi utilizado o pacote estatístico STATA versão 10.0. O presente estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Ouro Preto (UFOP). Resultados: Durante o estudo, 341 mulheres foram avaliadas. A prevalência de VB com coloração de Gram (32,5% [IC95% 27,7 - 37,7%]) e citologia (27,7% [IC95% 23,0 - 32,8%]) foi semelhante, porém a sensibilidade da citologia foi menor (77,8%). Os fatores de risco associados ao VB foram tabagismo (IRR 1,5 [IC95%: 1,1 - 2,1]), uso de dispositivo intrauterino (IRR 2,8 [IC 95%: 1,2 - 6,5]) e história médica pregressa de VB (IRR 1,5 [IC95%: 1,1 - 2.1]). Observou-se correlação entre a presença de infecção por VB e Trichomonas vaginalis (TV) (r = 0,24). Conclusão: A prevalência de VB foi afetada por hábitos de vida e infecção por TV. Assim, abordagens de prevenção comportamental e social para mulheres com diversos perfis de risco podem ajudar a mitigar a prevalência de TV / VB e recorrência de VB.(AU)

Auditory attention in individuals with tinnitus / Auditory attention in individuals with tinnitus

Abstract Introduction Tinnitus is characterized by the presence of a sound in the absence of external sound stimulus. In individuals with normal audiometry, it may be associated with auditory attention difficulty, especially in those who report high tinnitus annoyance. Objective To investigate auditory attention ability in individuals with tinnitus complaint. Methods Cross-sectional analytical observational study. We evaluated 30 volunteers with normal hearing (up to 25 dBHL): 15 with tinnitus (test group) and 15 with no complaints (control group), aged between 18-40 years. The volunteers answered the tinnitus handicap inventory questionnaire and a visual analogue scale. Subsequently, a basic audiological evaluation (meatoscopy, tonal and vocal audiometry, and imittanciometry) and psychoacoustic measures of tinnitus (loudness and pitch) were performed. To evaluate auditory attention, the following tests were performed: auditory cognitive evoked potential (P300), central auditory processing tests (dichotic digits test and speech-in-noise test) and sustained auditory attention ability test. Results In the tinnitus handicap inventory, individuals with tinnitus had a mean score of 37.78 (±27.05), characterized as moderate degree. In the dichotic digits test (binaural separation), a difference was observed between the groups in both ears. Moreover, there was a difference in the speech-in-noise test in both ears (RE: p = 0.044; LE: p = 0.019), in P300 (p = 0.049) and in total sustained auditory attention ability test (p = 0.032). Also, there is a negative correlation between sustained auditory attention ability test, decrease in attentiveness and binaural integration (RE: p = 0.044; LE: p = 0.048). Conclusions Individuals with tinnitus had a poorer performance compared to the control group regarding auditory attention ability. Therefore, it is inferred that tinnitus is associated with poor performance in selective and sustained auditory attention in the assessed volunteers. These aspects should be considered for the management of patients with tinnitus.

Resumo Introdução O zumbido caracteriza-se pela presença de som na ausência de estímulo sonoro externo. Em indivíduos com audiometria normal pode estar associado à dificuldade na atenção auditiva, principalmente naqueles que referem alto incômodo do zumbido. Objetivo Investigar a habilidade de atenção auditiva em indivíduos com queixa de zumbido. Método Pesquisa do tipo observacional analítica de caráter transversal. Foram avaliados 30 voluntários com audição normal (até 25 dBNA): 15 com zumbido (grupo teste) e 15 sem a queixa (grupo controle), entre 18 e 40 anos. Os voluntários responderam o questionário do handicap do zumbido - Tinnitus Handicap Inventory - e a escala visual analógica. Em seguida, fez-se a avaliação audiológica básica (meatoscopia, audiometria tonal, vocal e imitanciometria) e medidas psicoacústicas do zumbido (loudness e pitch). Para avaliar a atenção auditiva, foram usados os testes: potencial evocado auditivo cognitivo (P300), processamento auditivo central (dicótico de dígitos e de fala no ruído) e o de atenção auditiva sustentada. Resultados No Tinnitus Handicap Inventory, indivíduos com zumbido apresentaram escore médio de 37,78 (± 27,05); caracterizado por grau moderado. No teste dicótico de dígitos (separação binaural) percebeu-se diferença entre os grupos, nas duas orelhas. Além disso, houve diferença no teste de fala no ruído, em ambas as orelhas (OD: p = 0,044; OE: p = 0,019), no P300 (p = 0,049) e no teste de atenção auditiva sustentada total (p = 0,032). Além de correlação negativa entre o teste de atenção auditiva sustentada, decréscimo de vigilância e integração binaural (OD: p = 0,044; OE: p = 0,048). Conclusão Os indivíduos com zumbido apresentaram desempenho inferior ao grupo controle na habilidade de atenção auditiva. Portanto, infere-se que o zumbido está associado ao baixo desempenho na atenção auditiva seletiva e sustentada nos voluntários pesquisados. Tais aspectos devem ser considerados para o manejo do paciente com zumbido.

Acolher a diferença: a função da bissexualidade psíquica na construção da subjetividade / Accepting the difference: the function of psychic bisexuality in the construction of subjectivity / Acoger la diferencia: la función de la bisexualidad psíquica en la construcción de la subjetividad

Este artigo tem como objetivo explorar a relevância metapsicológica e a atualidade da noção de bissexualidade psíquica, presente na psicanálise desde sua origem e considerada por Freud fator decisivo da sexualidade humana. Pretende-se apresentar a bissexualidade psíquica como um conceito fundamental e ordenador dos processos de subjetivação e do reconhecimento da alteridade. Para tal, realizamos um percurso pelos textos de Freud e seus desdobramentos teóricos, seguindo a trilha de psicanalistas que procuraram novas leituras para o enigma da bissexualidade. Destacamos as ideias de Winnicott e Bion, autores que buscaram um diálogo entre a teoria pulsional e a das relações de objeto como solução para as ambiguidades teóricas deixadas por Freud. Resgatamos, desse modo, nossa aposta de que a bissexualidade, para além de uma disposição constitucional, inscreve-se no psiquismo originário através da relação do sujeito com seus objetos primários e tem função organizadora nos processos de subjetivação, na medida em que abre caminho para a coexistência desses objetos na vida psíquica.

This article aims to explore the metapsychological relevance and contemporaneity of the notion of psychic bisexuality, which has been present in psychoanalysis since its beginning and was considered by Freud as a decisive factor in human sexuality. We intend to present the psychic bisexuality as a fundamental and organizing concept of the subjective processes, as well as the recognition of otherness. For this, we go through the Freudian texts and his theoretical developments and follow researching the psychoanalysts who have been looking for new readings about bisexuality. We highlight the ideas of Winnicott and Bion, authors who sought a dialogue between the drive theory and that of object relations as a solution to Freud's theoretical ambiguities. Thus, we take our bet that bisexuality, besides a constitutional disposition, is inscribed in the original psyche through the relation between the subject and his primordial objects. Furthermore, it has an organizing function in the subjective processes, insofar that it paves the way to these objects coexist in psychic life.

Este artículo tiene como objetivo explorar la relevancia metapsicológica y la actualidad de la noción de bisexualidad psíquica, presente en el psicoanálisis desde su origen y considerada por Freud factor decisivo de la sexualidad humana. Se pretende en este estudio presentar la bisexualidad psíquica como un concepto fundamental y ordenador de los procesos de subjetivación y del reconocimiento de la alteridad. Para eso, hacemos un recorrido por los textos de Freud y sus desdoblamientos teóricos, siguiendo el sendero de psicoanalistas que buscaron nuevas lecturas para el enigma de la bisexualidad. Destacamos las ideas de Winnicott y Bion, autores que buscaron un diálogo entre teoría pulsional y teoría de las relaciones de objeto como solución a las ambigüedades teóricas legadas por Freud. De ese modo, rescatamos nuestra apuesta de que la bisexualidad, además de una disposición constitucional, se inscribe en el psiquismo originario a través de las relaciones del sujeto con sus objetos primarios y tiene función organizadora en los procesos de subjetivación, en la medida en que abre el camino para la coexistencia de esos objetos en la vida psíquica.

High-sugar diet leads to obesity and metabolic diseases in ad libitum -fed rats irrespective of caloric intake

ABSTRACT Objective Provide a comprehensive view of the events surrounding the sugar consumption, under conditions of energy equivalence; through the analysis of behavioral aspects of intake, and of biochemical, metabolic and physiological parameters, as well as the effect of this nutrient on the plasticity of adipose tissue. Materials and methods Newly weaned male Wistar rats were classified in two groups and subjected to the following normocaloric diets: standard chow diet or to high-sugar diet (HSD) ad libitum for 18 weeks. Results The animals submitted to the HSD were associated with a lower caloric intake during the 18 weeks of experimentation. However, the HSD induced a significant increase in body weight, white adipose tissue weight, adiposity index, Lee index, and the levels of triglycerides and very low-density lipoprotein in the serum. In addition, it induced glucose intolerance, insulin resistance and compensatory increase of insulin secretion by pancreatic β-cells. Also increased heart rate and induced hyperplasia, and hypertrophy of retroperitoneal visceral adipose tissue. In the liver, the HSD was associated with increased hepatic lipid content (i.e., triglycerides and cholesterol) and hepatomegaly. Conclusion The post-weaning consumption of HSD induces an adaptive response in metabolism; however, such an event is not enough to reverse the homeostatic imbalance triggered by the chronic consumption of this macronutrient, leading to the development of metabolic syndrome, irrespective of caloric intake. These findings corroborate recent evidence indicating that sugar is a direct contributor to metabolic diseases independent of a positive energy balance. Arch Endocrinol Metab. 2020;64(1):71-81

Hormones and Auditory Perception: Study of Dichotic Listening in Women during the Menstrual Cycle

Abstract Introduction Dichotic listening refers to the ability to hear different sounds presented to each ear simultaneously. Objective The aim of the present study was to assess dichotic listening in women throughout the menstrual cycle. Methods The volunteers who met the eligibility criteria participated in a dichotic listening assessment composed of three tests: 1) staggered spondaic word test; 2) dichotic digits test; and 3) consonant-vowel test. The female participants were tested during two different phases of the menstrual cycle: the follicular (days 11 to 13) and luteal (days 23 to 26) phases. The phases were confirmed by measuring serum levels of the hormone estradiol. Results A total of 20 volunteers aged 18 to 49 years participated in the study (9 females and 11 males). In test 1, only the right ear of females showed better performance during the follicular phase (high estrogen levels), compared with the luteal phase (low estrogen levels); in test 2, there were no significant differences for any of the groups; and in test 3, both males and females showed significantly better performance in their right ear compared with their left ear. Conclusion The better performance of females during the follicular phase of the cycle may indicate that estrogen levels might have an influence on dichotic listening in women. (AU)

Anti-serum validation for use in immunohistochemistry for Trypanosoma cruzi detection

Abstract INTRODUCTION: The detection of Trypanosoma cruzi in tissue samples is important in many situations, such as testing of the reactivation of the infection. The detection of T. cruzi nests in endomyocardial biopsies (EMB) may be useful to evaluate graft rejection. Given their scarcity, such nests are not routinely identified. To increase the diagnosis sensitivity, immunohistochemistry (IHC) may serve as a promising strategy. Here, we validate an antiserum for the detection of T. cruzi infection by IHC. METHODS: We used 1) positive controls (PCs) - 13 EMB, 12 skin biopsies, and 1 heart with T. cruzi nests as sections stained with hematoxylin and eosin (HE); 2) negative controls - a) 10 explant hearts and 10 EMB with no amastigote nests or clinical/laboratory signs of chagasic infection; and b) eight samples with leishmaniasis, toxoplasmosis, or histoplasmosis; and 3) Cases - 31 EMB of chagasic patients with no parasite nests in HE sections but detected positive for T. cruzi DNA by polymerase chain reaction. As a primary antibody, a hyperimmune serum from T. cruzi-infected rabbits was used. RESULTS: IHC results were positive for 21 of 26 PCs (80.8%) and one case of cutaneous leishmaniasis. In 4 of 31 cases, IHC revealed nests (12.9%), which were undetected by conventional histological examination. CONCLUSIONS: This study shows that IHC with the tested antiserum increases the sensitivity of the diagnosis and may be recommended for routine use in EMB analyses of cardiac transplant patients with Chagas disease.

A bissexualidade psíquica na constituição do sujeito: sobre suas origens e destinos identitários / Psychic bisexuality in the constitution of the subject: on its origins and identity destinies

O presente trabalho propõe uma compreensão da bissexualidade psíquica no curso do desenvolvimento psicossexual, objetivando investigar como esse fenômeno se inscreve nas origens da vida psíquica e modela os destinos identitários do sujeito. As autoras desenvolvem a ideia de que a bissexualidade se inscreve no psiquismo originário pela ação do objeto e participa tanto dos processos de subjetivação e de reconhecimento da diferença como também de seus impasses. Abordam o tema introduzindo aspectos teóricos da concepção freudiana do aparelho psíquico e dos modelos de Bion e Green sobre a formação dos primeiros traços do psiquismo, com destaque ao papel do objeto. Em seguida, tratam das formas da bissexualidade nos tempos do pré-genital, da travessia edípica e do genital adulto, conforme propostas por estudos contemporâneos. Resgatam a proposição de Green da figura do terceiro, que possibilita a inscrição de uma cena primitiva inaugural e abre caminho para a organização da bissexualidade. Ao final, apresentam argumentos teóricos para sustentar que a bissexualidade, em sua dupla referência ao masculino e ao feminino, não deve ser vista como uma confusão de sexos, mas como um ordenador dos processos subjetivos que possibilita a coexistência de dois no psiquismo, em suas configurações singulares e plurais

This paper proposes an understanding of psychic bisexuality throughout psychosexual development and aims at investigating how this phenomenon is inscribed in the origins of psychic life and shapes the subject's identity destinies. The authors develop the idea that bisexuality is inscribed in the original psyche by the action of the object and takes part both in the processes of subjectivation and recognition of difference and in its impasses. They address the theme by introducing some theoretical aspects regarding the freudian conception of the psychic apparatus as well as the models presented by Bion and Green on the constitution of early psychic traits, highlighting the role of the object. Next, they present the forms of bisexuality in the time of the pre-genital, the oedipal crossing, and the adult genital, as proposed by contemporary studies. They repropose Green's contributions about the third, who enables the inscription of an inaugural primitive scene and opens the way for the organization of bisexuality. Finally, they present theoretical arguments to sustain that bisexuality, in its dual reference to masculine and feminine, should not be seen as confusion of the sexes, but as an organizing factor of the subjective processes which allow the coexistence of two in the psyche, in their singular and plural configurations

El presente trabajo propone una comprensión de la bisexualidad psíquica en el curso del desarrollo psicosexual, con el objetivo de investigar cómo ese fenómeno se inscribe en los orígenes de la vida psíquica y modela los destinos identitarios del sujeto. Las autoras desarrollan la idea de que la bisexualidad se inscribe en el psiquismo originario por la acción del objeto y participa de los procesos de subjetivación y de reconocimiento de la diferencia, así como de sus impasses. Se introducen aspectos teóricos de la concepción freudiana del aparato psíquico y de los modelos de Bion y Green sobre la formación de los primeros rasgos del psiquismo, destacando el papel del objeto. En seguida se tratan de las formas de la bisexualidad en los tiempos del pre genital, de la travesía edípica y del genital adulto, propuestas por estudios contemporáneos. Rescatan la proposición de Green de la figura del tercero, que posibilita la inscripción de una escena primitiva inaugural y abre el camino para la organización de la bisexualidad. En fin, presentan argumentos teóricos para sostener que la bisexualidad, en su doble referencia al masculino y al femenino, no debe ser vista como una confusión de sexos, sino como un ordenador de los procesos subjetivos que posibilita la coexistencia de dos en el psiquismo, en sus configuraciones individuales y plurales

Avaliação da percepção auditiva em mulheres durante ciclo menstrual: revisão sistemática / Evaluation of auditory perception in women during menstrual cycle: a systematic review / Percepción de evaluación de audiencia sobre la mujer durante el ciclo menstrual: revisión sistemática

Introdução: As flutuações hormonais que ocorrem normalmente durante o ciclo menstrual podem interferir no sistema auditivo. A alteração mais encontrada neste período é a diminuição da acuidade auditiva, que parece estar mais associada à flutuação dos níveis de estrogênio, quando este se encontra reduzido na fase lútea final do período menstrual. Objetivo: Investigar por meio de uma revisão sistemática a percepção auditiva de mulheres durante as fases do ciclo menstrual. Método: Foi realizada uma busca nas bases de dados eletrônicas, nacionais e internacionais, LILACS, MEDLINE, PubMed e SciELO, através da consulta pelos seguintes descritores: "percepção auditiva" AND "ciclo menstrual", "percepção de fala" AND "ciclo menstrual", "percepção de fala" AND "hormônios" e seus correspondentes na língua inglesa. Resultados: Dos 293 artigos encontrados, foram selecionados apenas 7 artigos, após os critérios de inclusão e exclusão. A caracterização da amostra dos artigos selecionados variou entre 15 a 39 mulheres, com idade variando entre 17 e 46 anos. Na maioria dos artigos, nenhum tipo de procedimento clínico para estimar as fases do ciclo menstrual foi utilizado. Foi observada a realização de testes de percepção auditiva nos sete artigos selecionados, tendo destaque os testes dicóticos. Conclusão: Há necessidade da realização de mais pesquisas sobre o assunto, exigindo-se também maior rigor metodológico na elaboração desses estudos, através de procedimentos clínicos seguros e padronizados para mensuração dos níveis hormonais.

Introduction: Hormonal fluctuations that normally occur during the menstrual cycle can interfere with the audio system. The change most found in this period is the reduction of auditory acuity, which seems to be more related to fluctuating estrogen levels, when it is reduced in the luteal phase of the menstrual period end. Objective: Investigate through a systematic review hearing in women during the menstrual cycle phases. Method: A search was made in the electronic databases, national and international, LILACS, MEDLINE, PubMed and SciELO, by consulting the following descriptors: "auditory perception" and "menstrual cycle", "speech perception" and "menstrual cycle", "speech perception" and "hormones" and their corresponding in Portuguese. Results: Twenty-two articles were found, but only 7 articles were chosen after the criteria for inclusion and exclusion. The amount of the sample of selected articles ranged between 15 and 39 women, aged between 17 and 46 years old. In most articles, any type of medical procedure to estimate the phases of the menstrual cycle was used. The performance of auditory perception tests in the seven selected articles was observed, highlighted with the dichotic tests. Conclusion: There is a need of further research on the subject, demanding a greater methodological rigor in the preparation of these studies, through clinical safe and standardized to measure hormone levels procedures.

Introducción: Las fluctuaciones hormonales que ocurren normalmente durante el ciclo menstrual puede interferir con el sistema de audio. El hallazgo más frecuente en este periodo es la reducción de la agudeza auditiva, lo que parece estar más relacionado con la fluctuación de los niveles de estrógenos, cuando se reduce en la fase lútea del final del periodo menstrual. Objetivos: Investigar a través de una revisión sistemática de la percepción auditiva de la mujer durante las fases del ciclo menstrual. Métodos: Se realizó una búsqueda en bases de datos electrónicas, nacionales e internacionales, LILACS, MEDLINE, PubMed y SciELO, mediante la consulta de los siguientes descriptores: "la percepción auditiva" Y "ciclo menstrual", "la percepción del habla" Y "ciclo menstrual", "la percepción del habla" y "hormonas" y sus homólogos en el idioma Inglés. Resultados: De los 293 artículos encontrados, se seleccionaron sólo 7 artículos, después de que los criterios de inclusión y exclusión. La caracterización de la muestra de los artículos seleccionados osciló entre 15 y 39 mujeres, con edades comprendidas entre los 17 y 46 años. En la mayoría de los artículos, cualquier tipo de procedimiento médico para estimación se utilizan las fases del ciclo menstrual. el rendimiento de la prueba de percepción auditiva se observó en los siete elementos seleccionados, resalte que tiene dicóticos. Conclusión: Existe la necesidad de más investigación sobre el tema, lo que requiere también mayor rigor metodológico en la elaboración de estos estudios, através de procedimientos clínicos segura y estandarizada para medir los niveles hormonales.

Identification of the alcohol abuse in bankers / Identificação de uso de álcool em bancários / Identificación del uso de alcohol en bancarios

This study aimed to observe aspects related to the consumption of alcohol as a risk factor for occupational illness in workers at bank branches in the city of Alegrete - RS. In the period from May to August 2013 they were applied questionnaires in 94 bank workers who agreed to participate, of whom 58.5% were male and 41.5% female, with an average age of 41.54 years. Among the participants, 14.9% had risk consumption of alcohol, whereas 1% is considered high risk, and 1% had probable dependence. The results indicate considerable prevalence of hazardous alcohol consumption among workers of financial institutions in Alegrete and highlight the need for health promotion actions of these workers.

Este estudo tem como objetivo observar aspectos relacionados ao consumo de álcool enquanto fator de risco para o adoecimento laboral em trabalhadores de agências bancárias do município de Alegrete - RS. Foram aplicados questionários de maio a agosto de 2013 em 94 bancários que aceitaram participar da pesquisa, destes, 58,5% eram do sexo masculino e 41,5%, do feminino, com uma média de idade de 41,54 anos. Dentre os participantes, 14,9% realizavam consumo de risco de álcool, ao passo que 1% dos bancários fazem consumo de alto risco, e 1% apresentou provável dependência. Os resultados indicam prevalência um consumo de risco para bebidas alcoólicas entre os bancários deste município e apontam a necessidade de ações de promoção da saúde destes trabalhadores.

Este estudio tuvo como objetivo observar aspectos relacionados al consumo de alcohol, como factor de riesgo para el adoecimento laboral en bancarios en la ciudad de Alegrete - RS. Así, fueron aplicados cuestionarios de mayo a agosto del 2013 en 94 funcionarios que aceptaron participar de la investigación, y de éstos, 58,5% eran hombres y 41,5% mujeres, con la edad por medio de 41,54 años. Entre los participantes, 14,9% fueron considerados consumo de riesgo de bebidas alcohólicas, mientras que 1% de los bancarios alcanzaron el alto riesgo y 1 % fueran considerados probable dependencia. Los dados obtenidos en este estudio indican una alta prevalencia de consumo de riesgo de alcohol entre los trabajadores de las instituciones financieras de Alegrete y apuntan la necesidad de acciones de promoción de la salud de estos trabajadores.

Quality Indicators of Cervical Cytopathology Tests in the Public Service in Minas Gerais, Brazil / Indicadores de qualidade dos exames citopatológicos da rede pública em Minas Gerais, Brasil

Objective The objective of this study is to assess the performance of cytopathology laboratories providing services to the Brazilian Unified Health System (Sistema Único de Saúde - SUS) in the State of Minas Gerais, Brazil. Methods This descriptive study uses data obtained from the Cervical Cancer Information System from January to December 2012. Three quality indicators were analyzed to assess the quality of cervical cytopathology tests: positivity index, percentage of atypical squamous cells (ASCs) in abnormal tests, and percentage of tests compatiblewith high-grade squamous intraepithelial lesions (HSILs). Laboratories were classified according to their production scale in tests per year≤5,000; from 5,001 to 10,000; from 10,001 to 15,000; and 15,001. Based on the collection of variables and the classification of laboratories according to production scale, we created and analyzed a database using Microsoft Office Excel 97-2003. Results In the Brazilian state of Minas Gerais, 146 laboratories provided services to the SUS in 2012 by performing a total of 1,277,018 cervical cytopathology tests. Half of these laboratories had production scales≤5,000 tests/year and accounted for 13.1% of all tests performed in the entire state; in turn, 13.7% of these laboratories presented production scales of > 15,001 tests/year and accounted for 49.2% of the total of tests performed in the entire state. The positivity indexes of most laboratories providing services to the SUS in 2012, regardless of production scale, were below or well below recommended limits. Of the 20 laboratories that performed more than 15,001 tests per year, only three presented percentages of tests compatible with HSILs above the lower limit recommended by the Brazilian Ministry of Health. Conclusion The majority of laboratories providing services to the SUS in Minas Gerais presented quality indicators outside the range recommended by the Brazilian Ministry of Health.

Objetivo Avaliar o desempenho dos laboratórios de citopatologia prestadores de serviço para o Sistema Único de Saúde (SUS) no estado de Minas Gerais, Brasil. Métodos estudo descritivo combase nos dados obtidos do Sistema de Informação do Câncer do Colo do Útero no período de janeiro a dezembro de 2012. Para avaliação da qualidade dos exames citopatológicos do colo do útero, foram analisados três indicadores de qualidade: índice de positividade, percentual de ASC (células escamosas atípicas) entre os exames alterados e percentual de exames compatíveis com HSIL (Lesão intraepitelial escamosa de alto grau). Os laboratórios foram classificados conforme escala de produção em:≤5.000; entre 5.001 e 10.000; entre 10.001 e 15.000 e 15.001. Após a coleta das variáveis e classificação dos laboratórios conforme escala de produção foi elaborado um banco de dados, o qual foi analisado por meio do programa Microsoft Office Excel 97-2003. Resultados Em 2012, no estado de Minas Gerais, 146 laboratórios prestaram serviço para o SUS realizando um total de 1.277.018 exames citopatológicos do colo do útero. Metade desses laboratórios apresentou escala de produção≤5.000 exames/ano, e efetuaram 13,1% do total de exames do estado, por outro lado 13,7% dos laboratórios apresentaram escala de produção > 15.001 exames/ano e efetuaram 49,2% do total de exames do estado. O índice de positividade apresentado pela maioria dos laboratórios que prestaram serviço para o SUS no ano de 2012, independente de sua escala de produção, foi abaixo ou muito abaixo do recomendado. Dentre os 20 laboratórios que efetuaram mais de 15.001 exames por ano, somente três apresentaram o percentual de exames compatíveis com HSIL acima do recomendado pelo Ministério da Saúde. Conclusão Amaioria dos laboratórios prestadores de serviço para o SUS no estado de Minas Gerais apresentou indicadores de qualidade fora dos parâmetros recomendados pelo Ministério da Saúde.

Experimental benznidazole treatment of Trypanosoma cruzi II strains isolated from children of the Jequitinhonha Valley, Minas Gerais, Brazil, with Chagas disease

Trypanosoma cruzi strains from distinct geographic areas show differences in drug resistance and association between parasites genetic and treatment response has been observed. Considering that benznidazole (BZ) can reduce the parasite burden and tissues damage, even in not cured animals and individuals, the goal is to assess the drug response to BZ of T. cruzi II strains isolated from children of the Jequitinhonha Valley, state of Minas Gerais, Brazil, before treatment. Mice infected and treated with BZ in both phases of infection were compared with the untreated and evaluated by fresh blood examination, haemoculture, polymerase chain reaction, conventional (ELISA) and non-conventional (FC-ALTA) serologies. In mice treated in the acute phase, a significant decrease in parasitaemia was observed for all strains. Positive parasitological and/or serological tests in animals treated during the acute and chronic (95.1-100%) phases showed that most of the strains were BZ resistant. However, beneficial effect was demonstrated because significant reduction (p < 0.05%) and/or suppression of parasitaemia was observed in mice infected with all strains (acute phase), associated to reduction/elimination of inflammation and fibrosis for two/eight strains. BZ offered some benefit, even in not cured animals, what suggest that BZ use may be recommended at least for recent chronic infection of the studied region.

The TcI and TcII Trypanosoma cruzi experimental infections induce distinct immune responses and cardiac fibrosis in dogs

Trypanosoma cruzi infection may be caused by different strains with distinct discrete typing units (DTUs) that can result in variable clinical forms of chronic Chagas disease. The present study evaluates the immune response and cardiac lesions in dogs experimentally infected with different T. cruzi strains with distinct DTUs, namely, the Colombian (Col) and Y strains of TcI and TcII DTU, respectively. During infection with the Col strain, increased levels of alanine aminotransferase, erythrocytes, haematocrit and haemoglobin were observed. In addition, CD8+ T-lymphocytes isolated from the peripheral blood produced higher levels of interleukin (IL)-4. The latter suggests that during the acute phase, infection with the Col strain may remain unnoticed by circulating mononuclear cells. In the chronic phase, a significant increase in the number of inflammatory cells was detected in the right atrium. Conversely, infection with the Y strain led to leucopoenia, thrombopoenia, inversion of the ratio of CD4+/CD8+ T-lymphocytes and alterations in monocyte number. The Y strain stimulated the production of interferon-γ by CD4+ and CD8+ T-lymphocytes and IL-4 by CD8+ T-cells. In the chronic phase, significant heart inflammation and fibrosis were observed, demonstrating that strains of different DTUs interact differently with the host.

Assessment of acute toxicity of the ethanolic extract of Lychnophora pinaster (Brazilian arnica)

Species of the Lychnophora genus are plants native to Brazil, popularly known as "Brazilian arnica" and used in folk medicine as alcoholic and hydro-alcoholic preparations for the treatment of bruises, inflammation, pain, rheumatism and insect bites. The present study aimed to evaluate the safety of the use of Lychnophora pinaster Mart., Asteraceae. Acute toxicity of the crude ethanolic extract was evaluated by administration of the extract by oral route to male and female Swiss mice. A single extract dose of 125, 250 or 500 mg/kg was administered and the effects on spontaneous locomotor activity, exploratory behavior, muscle strength, body weight, food and water consumption, relative organ weight, histology, as well as hematological and biochemical parameters were evaluated. The three doses administered to the animals did not cause muscle tone alterations, but doses of 250 and 500 mg/kg induced a significant inhibition of the spontaneous locomotor activity and exploratory behavior of the animals in open-field test. There was no alteration to hematological parameters and consumption of water and food, body weight variation and organs relative weight. Changes were observed in AST and ALT during assessment of biochemical parameters. The histopathological evaluation showed that the extract provoked cellular alterations, such as vacuolar degeneration and inflammation in kidneys and liver at all doses. Liver morphometric analyses of male and female mice showed that the extract did not have dose-dependent effects. Although females showed a significant increase in inflammatory cells, the effect was not dose-dependent.

Myenteric plexus is differentially affected by infection with distinct Trypanosoma cruzi strains in Beagle dogs

Chagasic megaoesophagus and megacolon are characterised by motor abnormalities related to enteric nervous system lesions and their development seems to be related to geographic distribution of distinct Trypanosoma cruzi subpopulations. Beagle dogs were infected with Y or Berenice-78 (Be-78) T. cruzi strains and necropsied during the acute or chronic phase of experimental disease for post mortem histopathological evaluation of the oesophagus and colon. Both strains infected the oesophagus and colon and caused an inflammatory response during the acute phase. In the chronic phase, inflammatory process was observed exclusively in the Be-78 infected animals, possibly due to a parasitism persistent only in this group. Myenteric denervation occurred during the acute phase of infection for both strains, but persisted chronically only in Be-78 infected animals. Glial cell involvement occurred earlier in animals infected with the Y strain, while animals infected with the Be-78 strain showed reduced glial fibrillary acidic protein immunoreactive area of enteric glial cells in the chronic phase. These results suggest that although both strains cause lesions in the digestive tract, the Y strain is associated with early control of the lesion, while the Be-78 strain results in progressive gut lesions in this model.

Realidade sensorial e realidade psíquica: trânsito e turbulência / Sensory reality and psychic reality: transit and turbulence / Realidad sensorial y realidad psíquica: tránsito y turbulencia

Este trabalho clínico se propõe a examinar o trânsito de estados de mente da analista e de sua paciente, trânsito que se dá entre a percepção de impressões sensoriais e a apreensão da realidade psíquica, que só é possível por meio da experiência emocional vivenciada na relação analítica. Traz reflexões sobre a capacidade da dupla analítica de se mover entre o mundo sensorial e o não sensorial e de sofrer turbulência na situação de análise.

This paper examines the transit of states of mind of the analyst and her patient, transit that occurs between the perception of sensory impressions and the apprehension of psychic reality, which is only possible through the emotional experience that occurs in the analytic relationship. It presents reflections on the capacity of the analytic pair to move between the sensory and non-sensory worlds and to suffer turbulence in the situation of analysis.

En este trabajo se propone examinar el tránsito de los estados de la mente del analista y de su paciente, tránsito que tiene lugar entre la percepción de las impresiones sensoriales y la aprehensión de la realidad psíquica, que solo es posible a través de la experiencia emocional en la relación analítica. Reflexiona sobre la capacidad de la díada analítica para moverse entre el mundo sensorial y el mundo no sensorial y sufrir turbulencia en la situación del análisis.

Toxicological evaluation of ethanolic extract of Lychnophora trichocarpha, Brazilian arnica

The species of the genus Lychnophora, Asteraceae, are popularly known as "arnica" and are native from Brazilian savana (Cerrado). They are widely used in Brazilian folk medicine as anti-inflammatory, to treat bruise, pain, rheumatism and for insect bites. For evaluation of acute toxicity, the ethanolic extract was given to albino female and male mice. In open-field test, the extract of Lychnophora trichocarpha (Spreng.) Spreng. (0.750 g/kg) induced a significant inhibition of the spontaneous locomotor activity and exploratory behavior of the animals were observed 1 and 4 h after administration. In traction test, the same dose reduced the muscular force 1 h after administration. The exploratory behavior reduced significantly in the group that received 0.50 g/kg, 1 and 4 h after administration of the extract. The animals that received the doses of 0.25, 0.50 and 0.75 g/kg did not show any change of blood biochemical parameters comparing to control group and showed some histopathological changes such as congestion and inflammation of kidney and liver. The dose of 1.5 g/kg caused the most serious signs of toxicity. Histopathological changes observed was hemorrhage in 62.5% and pulmonary congestion in 100% of the animals. Brain and liver congestion was found in 62.5% of the animals.