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3.
Acta neurol. colomb ; 35(2): 103-110, abr.-jun. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1010944

ABSTRACT

RESUMEN El coriocarcinoma es una variante muy vascularizada, invasiva y poco común de la enfermedad trofoblástica gestacional. Es potencialmente fatal sin tratamiento adecuado y se caracteriza por la proliferación maligna de tejido trofoblástico con una alta tasa de metástasis. Se presenta el caso de una paciente joven con hemorragia intracerebral como primera manifestación de un coriocarcinoma metástasico. Se describen las características clínicas e imagenológicas y se hace una revisión de la literatura actual, con énfasis en los detalles más relevantes respecto al diagnóstico diferencial de la hemorragia intracerebral de presentación atípica y el tratamiento más apropiado.


SUMMARY Choriocarcinoma is an invasive, highly vascularized, rare gestational trophoblastic disease. It is potentially fatal without proper treatment and is characterized by malignant proliferation of trophoblastic tissue with a high rate of metastases. We present the case of a young patient with intracerebral hemorrhage as the first manifestation of metasta-tic choriocarcinoma. We describe the clinical and imaging characteristics and review current literature, with emphasis on the most relevant details regarding the differential diagnosis of intracerebral hemorrhage atypical presentation and the most appropriate treatment.

4.
Saúde Redes ; 4(2): 59-69, abr.- jun. 2018.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1016953

ABSTRACT

Investigar a formação docente é essencial à universidade com o intuito de alcançar melhorias. Neste sentido, a temática deste estudo está inserida no projeto "Os fatores de acesso e permanência que envolvem a formação docente na UFRGS e seus contrastes com as expectativas e demandas do mundo do trabalho em escolas públicas da rede básica no Estado do RS". O objetivo é contribuir para a compreensão dos fatores que levam à adaptação do estudante à universidade e o impacto deste processo no bem-estar do aluno de Licenciatura em Pedagogia a partir de cinco dimensões de adaptação (pessoal, interpessoal, carreira, estudo e institucional). Para verificar a adaptação do aluno ao curso utilizou-se o Questionário de Vivências Acadêmicas, com amostra estudantil dos alunos da Pedagogia, em versão adaptada ao contexto brasileiro. Os dados foram analisados a partir de estatística descritiva e relacionados com a fundamentação teórica apresentada, permitindo, assim, uma interpretação referencial apoiada desses dados. Em suma, poucos estudantes apresentaram sintomas relacionados à ansiedade, depressão ou estresse na pesquisa. A maioria dos alunos demonstrou-se satisfeitos com sua escolha pelo curso, seu desempenho acadêmico e os recursos oferecidos pela universidade. Além disso, apesar de demonstrarem algum nível de ansiedade e altas expectativas, isso não interfere de forma direta em seu desempenho acadêmico ou desejo de concluir o curso.


Investigating teacher education is essential to the university in order to design improvements and achieve challenges. The theme of this study is part of a larger project on the factors of access and permanence that involve teacher education and its contrasts with the expectations and demands of the working world in public schools of the basic network. The objective is to contribute to the understanding of the factors that lead to the adaptation of the student to the university and the impact of this process on the well-being of undergraduate student in Pedagogy from five dimensions of adaptation (personal, interpersonal, career, study and institutional). In order to verify the student's adaptation to the course, the Student Experience Questionnaire was used, with a student sample of Pedagogy students, in a version adapted to the Brazilian context. The data were analyzed from descriptive statistics and related to the theoretical basis presented, allowing, therefore, a supported reference interpretation of these data. In short, few students had symptoms related to anxiety, depression or stress in the research. Most students were satisfied with their choice of course, their academic performance, and the resources offered by the university. In addition, although they demonstrate some level of anxiety and high expectations, this does not seem to interfere directly with their academic performance or desire to complete the course.

6.
Pesqui. vet. bras ; 37(10): 1119-1124, out. 2017. tab, ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-895344

ABSTRACT

O objetivo do trabalho foi analisar os dados relacionados à transmissão da leishmaniose visceral (LV), no município de Fortaleza, e discutir a respeito da distribuição do vetor, reservatório doméstico e casos humanos ocorridos no período de 2009 a 2013. O presente estudo é do tipo descritivo realizado por meio de levantamento de dados secundários. A correlação entre casos humanos, caninos e número de flebotomíneos foi feita pelo teste de correlação de Spearman, com nível de significância de 5%. No período de 2009 a 2013 foram confirmados 941 casos e 55 óbitos. A letalidade média no período foi de 5,84%. Na distribuição por sexo, houve uma maior proporção de casos no sexo masculino em todos os anos analisados. A faixa etária de 1 a 4 anos apresentou a maior porcentagem de casos, destacando-se o ano de 2010 com 31,5% dos casos. A distribuição média de casos por regional demonstrou um predomínio nas regionais I, V e VI. Em relação aos flebotomíneos, a espécie encontrada em maior abundância foi Lutzomyia (Lutzomyia) longipalpis, seguido de Lutzomyia (Lutzomyia) migonei e Lutzomyia (Lutzomyia) lenti. Segundo os registros da Secretaria Municipal de Saúde de Fortaleza, 39.626 cães foram soro reagentes para LV nos anos de 2009 a 2013, destes 14.313 foram eutanasiados. O ano de 2013 destacou-se com 17.808 cães soro reagentes, sendo 1.273 da SER (Secretaria Executiva Regional) III, 2.572 da SER V e 1.909 da SER VI. Não foi observada correlação significativa entre o número de flebotomíneos capturados e o número de casos caninos de LV(p>0,05). Houve correlação negativa entre casos humanos e caninos (r=-0,0388) e correlação positiva entre casos humanos e número de flebotomíneos (r=0,7469). Os achados criam perspectivas para a identificação de outros fatores que podem influenciar a incidência de casos humanos e caninos, como a participação de outros possíveis reservatórios e vetores na cadeia de transmissão da leishmaniose visceral no município de Fortaleza.(AU)


The objective was to analyze the data relating to the transmission of visceral leishmaniasis (LV) in Fortaleza municipality, and discuss about the vector distribution, domestic reservoir and human cases from 2009 to 2013.This study is descriptive conducted through a survey of secondary data. The correlation between human and canine cases and sandflies number was taken by Spearman correlation test, with 5% significance level. In the period 2009 to 2013, 941 cases and 55 deaths were confirmed. The mortality rate for the period was 5.84%. There was a higher proportion of cases among men in all the years analyzed. The age group 1-4 years old had the highest percentage of cases, highlighting the year 2010 with 31.5% of the cases. The average distribution of cases by SER demonstrated a predominance in SER I, V and VI. With regard to the vector species found in greater abundance was Lutzomyia (Lutzomyia) longipalpis, followed by Lutzomyia (Lutzomyia) migonei and Lutzomyia (Lutzomyia) lenti. According to the records, 39,626 dogs were serum reagents for LV in the years 2009-2013, these 14,313 were killed. The year 2013 stood out with 17,808 dogs serum reagents, and 1,273 of SER III, 2572 of SER V and 1909 of SER VI. There was no significant correlation between the number of sand flies and the number of canine VL cases (p?γτ;0.05). There was a negative correlation between human and canine cases (r = -0.0388) and correlation was observed between human cases and number of sand flies (r= 0.7469).Our findings create prospects for the identification of other factors that may influence the incidence of human and canine cases, such as the participation of other possible reservoirs and vectors in the transmission of the visceral leishmaniasis in Fortaleza.(AU)


Subject(s)
Animals , Dogs , Leishmaniasis, Visceral/mortality , Leishmaniasis, Visceral/veterinary , Leishmaniasis, Visceral/epidemiology , Dogs
7.
Biomédica (Bogotá) ; 37(supl.1): 12-19, abr. 2017. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-888505

ABSTRACT

Resumen El síndrome de encefalopatía posterior reversible es una condición que responde a múltiples causas y presenta características clínicas o radiológicas distintivas; los intensivistas y los médicos de urgencias deben conocerlo con el fin de hacer el diagnóstico y ordenar el tratamiento oportuno. Se presenta un caso fatal de síndrome de encefalopatía posterior reversible, en el cual se determinaron los factores de riesgo relacionados con el resultado final. Un hombre de 60 años sin antecedentes médicos ingresó por urgencias con depresión de la conciencia, convulsiones y tensión arterial elevada. Las imágenes de la tomografía revelaron un hematoma cerebeloso posterior, y las de resonancia magnética mostraron zonas isquémicas, edema vasogénico que se extendía desde los tálamos hacia el tallo cerebral, los pedúnculos cerebelosos medios y la sustancia blanca profunda de los hemisferios cerebelosos, así como zonas de transformación hemorrágica. A pesar del tratamiento médico y quirúrgico recibido, el paciente falleció. Se determinaron los factores de riesgo que se han descrito como causa de muerte en este síndrome. Este caso demuestra que dicho síndrome puede ocurrir sin que se hayan detectado factores de riesgo desencadenantes y pone en evidencia la necesidad de su reconocimiento temprano para establecer una intervención adecuada y evitar daños o un desenlace fatal. Además, abre el camino a nuevos estudios sobre la propensión a desarrollarlo y las medidas preventivas que pueden adoptarse.


Abstract Posterior reversible encephalopathy syndrome is an illness with multiple causes and distinctive clinicalradiological characteristics that should be known by intensivists and emergency room physicians for a timely diagnosis and treatment. A fatal case of posterior reversible encephalopathy syndrome is presented, and the risk factors related to the outcome are identified. A 60-year-old man without a relevant medical history arrived at the emergency room presenting with depressed consciousness, seizures, and high blood pressure. Tomographic images revealed a posterior cerebellar hematoma. Resonance images showed ischemic zones, vasogenic edema from the thalamus to the brain stem, middle cerebellar peduncles, deep white matter of the cerebral hemispheres, and zones of hemorrhagic transformation. Despite medical-surgical management, the patient died. The risk factors described as the cause of the fatal outcome were identified. This case demonstrates that posterior reversible encephalopathy syndrome can occur without triggering risk factors and highlights the need for early recognition to establish an appropriate intervention to avoid injury or a fatal outcome. Cases of posterior reversible encephalopathy syndrome provide opportunities to investigate the susceptibility for the development of this condition and to establish appropriate preventive measures.

8.
Motriz (Online) ; 23(3): e101785, 2017. tab, graf
Article in English | LILACS | ID: biblio-894987

ABSTRACT

Aim: The study aimed to verify the effect of carbohydrate (CHO) mouth rinse on time to exhaustion, energy systems contribution and rating of perceived exertion (RPE) during a high-intensity exercise. Methods Fourteen men performed an incremental exercise test to determine their maximal oxygen uptake and peak power output (PPO) and two time-to-exhaustion tests at 110% of PPO. Participants rinsed their mouth with 25ml of 6.4% of CHO or placebo (PLA) solution immediately before the time-to-exhaustion test, using a crossover design. The contribution of the energy systems was calculated using the free software GEDAE-LaB®. Results: Time to exhaustion was similar between the conditions (CHO:174.3±42.8s; PLA:166.7±26.3s; p=0.33). In addition, there was no difference between the CHO and PLA condition for aerobic (CHO:135.1±41.2kJ and PLA:129.8±35.3kJ, p=0.34), anaerobic lactic (CHO:57.6±17.1kJ and PLA:53.4±15.1kJ, p=0.10), and anaerobic alactic (CHO:10.4±8.4kJ and PLA:13.2±9.2kJ, p=0.37) contribution. Consequently, total energy expenditure was similar between conditions (CHO:203.2±46.4kJ and PLA:196.5±45.2kJ, p=0.15). However, CHO mouth rinse reduced the RPE at the moment of exhaustion (CHO:18.2±1.0units and PLA:19.1±1.1units; p=0.02). Conclusion: CHO mouth rinse neither increased time to exhaustion nor altered energy systems contribution during a high-intensity exercise, but reduced the perceived effort at the exhaustion.(AU)


Subject(s)
Humans , Male , Oxygen Consumption/physiology , Exercise/physiology , Mouthwashes/administration & dosage
9.
Rev. colomb. cardiol ; 21(1): 52-57, ene.-feb. 2014. graf, tab
Article in Spanish | LILACS, COLNAL | ID: lil-709011

ABSTRACT

Objetivo: describir las características epidemiológicas y los resultados del tratamiento quirúrgico temprano de los pacientes con diagnóstico de endocarditis infecciosa intervenidos en el Departamento de Cirugía Cardiovascular de la Clínica Medellín, Colombia. Métodos: estudio observacional, descriptivo, retrospectivo, de todos los pacientes con diagnóstico de endocarditis infecciosa tratados mediante cirugía en la Clínica Medellín, entre enero de 2003 y enero de 2010. Resultados: se incluyeron en total 54 pacientes, 37 (68,5%) de ellos de género masculino. La mediana de la edad fue 57,5 años (9 - 76 años). El 77,7% tenía algún factor de riesgo para desarrollar endocarditis infecciosa; entre los más destacados insuficiencia renal crónica (IRC) en hemodiálisis (18,5%) y prótesis valvulares cardiacas (18,5%). El 66,7% de los hemocultivos fue positivo. Staphylococcus aureus fue el principal germen aislado en el 40,7% del total de pacientes. El 81,4% de las válvulas comprometidas eran nativas con predominio de la válvula mitral (44,5%) y el 7,5% presentaba compromiso de dos válvulas. En el 68,5% el motivo de consulta fue falla cardiaca y 35,3% presentaron fenómenos embólicos como manifestación inicial o asociada (cerebral 16,7%, pulmonar 13%, esplénica 5,6%). En el 83,3% de los casos se realizó cirugía temprana; 66% recibieron válvulas mecánicas. La mortalidad total a tres meses fue del 13% (muerte intraoperatoria 3,7%, mortalidad a 30 días, 9%). La mediana en el tiempo de estancia hospitalaria fue de 36 días (7 a 130 días). En este estudio se reporta una mortalidad total que se encuentra en el límite inferior de lo reportado en el mundo. Una de las razones atribuibles a este hallazgo es el manejo quirúrgico temprano que se protocoliza en el servicio.


Objective: to describe the epidemiological characteristics and the results of early surgical treatment of patients diagnosed with infectious endocarditis who underwent surgery in the Department of Cardiovascular Surgery in the Medellin Clinic, Colombia. Methods: observational, descriptive, retrospective study of all the patients diagnosed with infective endocarditis treated by surgery in the Medellin Clinic between January 2003 and January 2010. Results: a total of 54 patients were included. 37 (68.5%) were male. Mean age was 57.5 years (9-76 years). 77.7% had a risk factor for developing infective endocarditis; among the most prominent risk factors were chronic renal failure (CRF), patients on hemodialysis (18.5%) and heart valve prostheses (18.5%). 66.7% of the blood cultures were positive. Staphylococcus aureus was the main germ isolated in 40.7% of patients. 81.4% of the involved valves were native, with mitral valve predominance (44.5%) and 7.5% had involvement of two valves. In 68.5% the reason for the consultation was heart failure and 35.3% had embolic phenomena as the initial manifestation or associated (16.7% cerebral, pulmonary 13%, spleen 5.6%). In 83.3 % of cases early surgery was performed: 66% received mechanical valves. The three-month total mortality was 13% (3.7% intraoperative death, mortality at 30 days 9%). The median length of hospital stay was 36 days (7-130 days). In this study the total mortality reported is at the lower limit of the reported in the world. One of the reasons attributed to this finding is the early surgical management that is the protocol in the service.


Subject(s)
Humans , Male , Female , Middle Aged , Thoracic Surgery , Endocarditis , Echocardiography , Embolization, Therapeutic
10.
Rev. colomb. cardiol ; 20(4): 246-251, jul.-ago. 2013. ilus, tab
Article in Spanish | LILACS, COLNAL | ID: lil-696616

ABSTRACT

Objetivo: describir las características epidemiológicas y los resultados del tratamiento quirúrgico de los defectos septales atriales en los pacientes intervenidos por esta patología en un centro de alta complejidad en Colombia. Métodos: estudio observacional de tipo descriptivo, retrospectivo, de una cohorte que incluye todos los pacientes intervenidos mediante cirugía por defectos septales atriales en el periodo comprendido entre octubre de 1996 y julio de 2012. Resultados: se incluyeron en total 329 pacientes, de los cuales 216 (65,6%) pertenecía al género femenino. La mediana de la edad fue de 34 años (RIC 15-49). El 77,8% de los defectos fueron tipo ostium secundum. En 80% se realizó reparo del defecto mediante parche de pericardio autólogo. En 7,6% de los casos se utilizó técnica de cirugía cardiaca mínimamente invasiva. Se realizaron cuatro cirugías de rescate (1,21%) por complicaciones relacionadas con la colocación de dispositivos percutáneos. Se documentó una sola muerte intraoperatoria (tasa de mortalidad del 0,3%) y una morbilidad global asociada de 7,6%, sin ninguna secuela y representada por: reintervención por sangrado en ocho casos (2,4%), infección profunda de la herida esternal en tres pacientes (0,9%), empiema en tres pacientes (0,9%), colecciones pleurales residuales en cuatro pacientes (1,2%), infecciones superficiales en cinco pacientes (1,5%), disección arterial femoral secundaria a canulación arterial en un paciente (0,3%) y bloqueo cardiaco completo con necesidad de marcapaso permanente en un paciente (0,3%). La mediana del tiempo de estancia en UCI fue de 24 horas (RIC 20 – 25). La mediana del tiempo de ventilación mecánica fue de 3 horas (RIC 0-5). La mediana del tiempo de estancia hospitalaria fue de 4 días (RIC 3-5). Conclusiones: los resultados obtenidos reflejan que en nuestro medio la corrección quirúrgica de los defectos septales atriales es segura y efectiva, con una tasa de mortalidad con tendencia al 0% y una muy baja morbilidad asociada, acorde con los estándares internacionales. De igual forma, la cirugía cardiaca mínimamente invasiva ha permitido mejorar los resultados del procedimiento y ha tenido gran aceptación por parte de los pacientes, por lo que constituye el abordaje de elección actual para el manejo quirúrgico de esta patología en el servicio de Cardiología de la institución.


Objective: to describe the epidemiological characteristics and outcomes of surgical treatment of atrial septal defects in patients operated for this condition on a tertiary care center in Colombia. Methods: an observational, descriptive, retrospective study of a cohort including all patients undergoing surgery for atrial septal defects in the period between October 1996 and July 2012. Results: we included a total of 329 patients, were 216 (65.6%) were female. The mean age was 34 years (IQR 15-49). 77.8% of the defects were ostium secundum type. In 80% the defect repair was performed using autologous pericardial patch. In 7.6% of cases we used minimally invasive cardiac surgery technique. Four rescue surgeries (1.21%) were performed due to complications related to the placement of percutaneous devices. We documented only one operative death (mortality rate 0.3%) and an associated overall morbidity of 7.6% without any sequelae and represented by re-operation for bleeding in eight cases (2.4%), deep sternal wound infection in three patients (0.9%), empyema in three patients (0.9%), residual pleural collections in four patients (1.2%), superficial infections in five patients (1.5%), femoral arterial dissection secondary to arterial cannulation in one patient (0.3%) and complete heart block requiring permanent pacemaker in one patient (0.3%). The median length of stay in ICU was 24 hours (IQR 20-25). The median duration of mechanical ventilation was 3 hours (IQR 0-5). The median hospital stay was 4 days (IQR 3-5). Conclusions: the results obtained show that in our environment, surgical correction of atrial septal defects is safe and effective, with a mortality rate tending to 0% and a very low associated morbidity, in line with international standards. Similarly, minimally invasive cardiac surgery has improved the results of the procedure and has been widely accepted by the patients, thus constituting the current preferred approach in the Cardiology service of the institution for the surgical management of this pathology.


Subject(s)
Atrial Septum , Thoracic Surgery , Morbidity , Mortality
11.
Rev. latinoam. psicopatol. fundam ; 16(1): 17-27, mar. 2013.
Article in Portuguese | LILACS-Express | LILACS | ID: lil-671000
12.
Medicina (B.Aires) ; 72(2): 128-130, abr. 2012. ilus
Article in Spanish | LILACS | ID: lil-639664

ABSTRACT

La alta mortalidad de los pacientes con tromboembolismo pulmonar masivo de alto riesgo amerita un enfoque terapéutico enérgico e invasivo que incluya la embolectomía pulmonar quirúrgica en aquellos pacientes con contraindicación para trombolisis o trombolisis fallida. Describimos un caso de tromboembolismo pulmonar masivo de alto riesgo que recibió tratamiento quirúrgico en vez de trombolisis debido a que al momento del diagnóstico presentaba un trombo móvil a través de un foramen oval permeable con altísima posibilidad de embolismo paradójico arterial.


High mortality rate associated with massive pulmonary embolism requires an aggressive invasive approach including surgical pulmonary embolectomy when thrombolytic therapy has failed or is contraindicated. We describe a case of high-risk massive pulmonary embolism who underwent surgical treatment due to the presence of a mobile intracardiac clot in a patent foramen ovale, and the possible risk of paradoxical arterial embolism.


Subject(s)
Female , Humans , Middle Aged , Foramen Ovale, Patent/complications , Pulmonary Embolism/etiology , Echocardiography, Transesophageal , Embolectomy , Foramen Ovale, Patent , Foramen Ovale, Patent/surgery , Pulmonary Artery/surgery , Pulmonary Embolism , Tomography, X-Ray Computed
14.
Rev. colomb. cardiol ; 18(5): 282-287, sept.-oct. 2011.
Article in Spanish | LILACS | ID: lil-647252

ABSTRACT

La pericarditis constrictiva crónica es un síndrome clínico causado por la compresión cardíaca ejercida por un pericardio engrosado o rígido. La tuberculosis es una causa rara de pericarditis constrictiva en los países desarrollados. Sin embargo, ésta es una importante condición a considerar en países en desarrollo y en pacientes con infección por VIH. La pericarditis tuberculosa es una forma de tuberculosis extra-pulmonar que puede conducir a la muerte. La dificultad en su diagnóstico y las serias consecuencias de la infección no tratada hacen de esta condición un importante problema de salud tanto en países industrializados como en aquellos en vía de desarrollo. Ayudas diagnósticas como la ecocardiografía son esenciales en el diagnóstico, y ante la sospecha de afección tuberculosa del pericardio se indica la realización de estudios del líquido o del tejido pericárdico. El tratamiento antituberculoso se realiza durante seis meses y se considera la pericardiectomía en pacientes con pericarditis constrictiva calcificada o en quienes la constricción empeora después de seis a ocho semanas de tratamiento.


Constrictive pericarditis is a clinical syndrome caused by the cardiac compression of a thickened or rigid pericardium. Tuberculosis is a rare cause of constrictive pericarditis in developed countries. However, this is an important condition to consider in developing countries and in patients with HVI infection. Tuberculous pericarditis is a form of extra-pulmonary tuberculosis that may lead to death. The difficulty in its diagnosis and the serious consequences of this non-treated infection make this condition an important health problem both in industrialized and developing countries. Diagnostic aids such as echography are essential in the diagnosis, and in front of the suspicion of tuberculous infection of the pericardium, the performance of pericardial fluid or pericardial tissue studies is indicated. Anti TB treatment is carried out for six months and pericardiectomy is considered in patients with calcified constrictive pericarditis or in those in whom the constriction worsens after six to eight weeks of treatment.


Subject(s)
Diagnosis , Infections , Pericarditis
15.
Rev. bras. educ. méd ; 34(4): 554-564, out.-dez. 2010. graf, tab
Article in Portuguese | LILACS | ID: lil-576194

ABSTRACT

As exigências sociopolíticas atuais quanto à formação e ao perfil do profissional de saúde se ampliam para além da capacitação técnico-científica, requerendo profissionais capazes de um atendimento integral em equipe interdisciplinar/multiprofissional. Nesse contexto, o objetivo deste estudo foi, através da Educação a Distância, baseada em método fundamentado na teoria construtivista, promover cenários de interação visando à construção de uma prática/pensamento integral em saúde, com a participação de seis graduandos de Medicina e nove profissionais da saúde. Foi utilizado o Teleduc, um ambiente de aprendizagem a distância. O modelo de estudo foi definido como um estudo de caso, e a análise se baseou nas interações dos alunos, na participação nos fóruns de discussão, nas edições dos exercícios individuais e dos portfólios de grupo. O procedimento mostrou-se um valioso promotor de interação em saúde, possibilitando desequilíbrios, reflexões, postura cooperativa e mudanças de conduta, com geração de conhecimento integral em saúde. A análise evidenciou que, para construir relações de cooperação no virtual, são necessários elementos que otimizem as interações, conferindo qualidade pedagógica e proporcionando um contexto favorável, a fim de prolongar o aprendizado rumo a uma prática transformadora.


Current social and political demands on health professionals' training and profile have expanded beyond technical and scientific training, requiring professionals capable of providing comprehensive care in an interdisciplinary and multiprofissional team. In this context, this study's aim was to focus on Distance Education, based on a method with its foundations in constructivist theory, to promote interaction scenarios to construct comprehensive practice and thought in health. Six undergraduate medical students and nine health professionals participated. The study used Teleduc, a distance learning environment. The study model was defined as a case study, and the analysis was based on students' interactions, participation in the discussion forums, editions of individual exercises, and group portfolios. The procedure proved to be a valuable promoter of health interaction, allowing imbalances, reflections, a cooperative stance, and changes of conduct, with the generation of comprehensive health knowledge. The analysis further allowed demonstrating that in order to build cooperative relations in the virtual environment, elements are needed that optimize interaction, providing a pedagogical quality and a favorable context in order to prolong learning towards a transformative practice.


Subject(s)
Comprehensive Health Care , Education, Distance , Health Education , Learning
16.
Article in Portuguese | LILACS-Express | LILACS | ID: lil-499900

ABSTRACT

O trabalho apresenta a crise epistemológica em que se insere a psicanálise em particular e as ciências humanas em geral. Mostra como a psicanálise não está em condições de ser aprovada se os critérios de ciência forem os critérios positivistas. Aponta tentativas fracassadas de reformulação da psicanálise. Indica a radicalização necessária, que rompe com estes critérios positivos de ciência. O trabalho aproxima também a disciplina de Freud da fenomenologia de Husserl e mostra os limites desta aproximação. Por fim, coloca a psicanálise no contexto interdisciplinar da psicopatologia fundamental, onde a tensão e o conflito de posições são tolerados.


This article discusses the epistemological crisis in course today, which encompasses not only psychoanalysis in particular, but the humanities in general. The article shows how psychoanalysis cannot be approved according to positivist criteria of science. Failed attempts at reformulating psychoanalysis are recalled and the author suggests that there is need for more radical approaches that will allow a break with these positive criteria of science. The text shows similarities between psychoanalysis with Husserl's phenomenology but also points out the limits of this approximation. Finally, psychoanalysis is placed in the interdisciplinary context of fundamental psychopathology, where tension and conflict among positions are tolerated.


Ce travail décrit la crise épistémologique dans laquelle se trouvent la psychanalyse en particulier et les sciences humaines en général. Il expose pourquoi la psychanalyse ne peut pas être acceptée tant que les critères de la science sont positivistes, décrit les essais fracassés de reformulation de la psychanalyse et définit la radicalisation nécessaire qui rompt avec les critères positivistes de la science. Ce travail rapproche encore la discipline de Freud à la phénoménologie de Husserl et montre les limites de ce rapprochement. Pour finir, il place la psychanalyse dans le contexte interdisciplinaire de la psychopathologie fondamentale, où la tension et le conflit des positions sont tolérés.


El trabajo presenta la crisis epistemológica que afecta al psicoanálisis, en particular, y a las ciencias humanas en general. Muestra cómo el psicoanálisis no está en condiciones de ser aprobado si los criterios de ciencia fuesen los criterios positivistas. Apunta para tentativas fracasadas de reformulación del psicoanálisis. Indica la radicalización necesaria que rompe con esos criterios positivistas de ciencia. Aproxima también la disciplina de Freud de la fenomenología de Husserl y muestra los límites de esa aproximación. Por último, coloca el psicoanálisis en el contexto interdisciplinario de la psicopatología fundamental donde la tensión y el conflicto de posiciones son tolerados.

17.
Cad. saúde pública ; 24(supl.4): s569-s580, 2008.
Article in English | LILACS | ID: lil-492099

ABSTRACT

Polycyclic aromatic hydrocarbons (PAH) are widely distributed in the environment, and some are carcinogenic to human beings. The study of biomarkers has helped clarify the nature and magnitude of the human health risks posed by such substances. This article provides a review of the state-of-the-art on PAH biomarkers for human health risk assessment and also discusses their applicability within the context of environmental management in Brazil. The article discusses the methodologies for determination of some biomarkers such as 1-hydroxypyrene and PAH-DNA adducts. Cytogenetic markers, frequency of chromosomal aberrations, and micronucleus induction were considered for the evaluation of cancer risk. The current stage of studies on validation of such biomarkers was also approached.


Os hidrocarbonetos policíclicos aromáticos (HPAs) estão amplamente distribuídos no ambiente e alguns são carcinogênicos para humanos. O estudo dos biomarcadores tem contribuído para a compreensão da natureza e magnitude dos riscos que estas substâncias representam à saúde humana. Este trabalho apresenta uma revisão do estado da arte dos biomarcadores de HPAs para avaliação de risco à saúde humana e analisa criticamente sua aplicabilidade, no contexto da gestão ambiental brasileira. Destaca as metodologias para a determinação de alguns biomarcadores como 1-hidroxipireno e adutos HPA-DNA. Para avaliação do risco de câncer destacam-se marcadores citogenéticos, freqüência de aberrações cromossômicas e indução de micronúcleo. Também é abordado o estágio atual dos estudos de validação desses biomarcadores.


Subject(s)
Humans , Biomarkers/analysis , Environmental Exposure/adverse effects , Environmental Pollutants/adverse effects , Environmental Pollutants/toxicity , Neoplasms/chemically induced , Polycyclic Aromatic Hydrocarbons/toxicity , Brazil , DNA Damage , Environmental Monitoring , Occupational Exposure/adverse effects , Risk Assessment
18.
Rev. latinoam. psicopatol. fundam ; 10(4): 591-613, dez. 2007.
Article in Portuguese | LILACS | ID: lil-498083

ABSTRACT

O artigo recupera um desconhecido caso de Freud, do qual a correspondência Freud & Pfister dá fragmentárias notícias. As cartas trocadas entre 1924 e 1927 fornecem informações sobre o encaminhamento, a difícil evolução do tratamento de AB e o sofrimento de Freud ao atendê-lo. Os avanços e recuos do problemático caso estão relacionados com as vicissitudes da vida de Freud, com os avanços da psicanálise e com os acontecimentos sociais e políticos à época. Pacientes como AB, com problemáticas narcísicas e esquizóides, afirma o artigo, continuam chegando aos consultórios dos analistas hoje.


This article describes a little-known case treated by Freud, known as the AB Case, about which the correspondence between him and Pfister gives us some fragmentary information. The letters these friends exchanged between 1924 and 1927 discuss Pfister’s referral of the young patient to Freud, the difficult treatment involved and Freud’s suffering during the process. The article associates the advances and setbacks in this complex case, related to Freud’s personal difficulties at the time as well as with advances in psychoanalysis and with the social and political events of the period. Patients like Ab who show narcissistic and schizoid traits, still continue to arrive at analyst’s offices today.


Subject(s)
Narcissism , Psychoanalysis
19.
Rev. colomb. cardiol ; 14(4): 232-237, jul.-ago. 2007. tab
Article in Spanish | LILACS | ID: lil-469043

ABSTRACT

Objetivo: describir y evaluar la técnica de perfusión subclavia para protección cerebral selectiva con hipotermia moderada.Métodos: estudio descriptivo de 19 pacientes, a quienes se les practicó corrección de disección o aneurisma del arco aórtico mediante la utilización de esta técnica...


Objective: describe and evaluate the subclavian perfusion technique for selective cerebral protection with moderate hypothermia. Methods: descriptive study of 19 patients to whom correction of the dissection or aneurysm of the aortic arch through the utilization of this technique was practiced. Results: between September 2002 and September 2005, 19 patients were operated. 68.4% were men with mean age 54.05 ± 13.53 years. 57.8% corresponded to aortic dissection type A; the remaining 42.2% had aneurysms in some portion of the aorta, with arch involvement. 73.7% had aortic valve insufficiency. 47.3% were in functional class I, 31.5% in class II and 21% in class III. 36.8% required coronary revascularization. Mean time of selective cerebral perfusion was 28.95 ± 8.73 minutes; systemic perfusion was 163.31 ± 32.15 minutes; aortic clamping was 135.36 ± 34.48 minutes and mean temperature was 27.66° ± 0.94°C. There were 3 deaths. No definitive neurological complications were found.Conclusions: this technique may be standardized for elective or emergent surgeries. It is a simple reproducible technique that allows more prolonged periods of time for the reconstruction of the aortic arch without producing cerebral ischemia; the extracorporeal circulation times are shorter, there are few bleeding complications, there is a decrease of cerebral anterograde embolism, and an excellent neurological result.


Subject(s)
Aorta, Thoracic , Catheterization , Perfusion
20.
Rev. colomb. cardiol ; 14(1): 43-55, ene.-feb. 2007. ilus, graf
Article in Spanish | LILACS | ID: lil-469020

ABSTRACT

No existe una publicación colombiana con seguimiento a mediano plazo acerca del uso de esta técnica.Objetivo: evaluar el tratamiento quirúrgico de la fibrilación auricular a través de radiofrecuencia monopolar irrigada, mediante el seguimiento clínico, electrocardiográfico y ecocardiográfico a corto y mediano plazo. Métodos: entre septiembre de 2003 y octubre de 2005, se evaluaron de manera prospectiva, 70 pacientes con diagnóstico de fibrilación atrial y otra patología cardiaca que requería intervención quirúrgica. Se utilizó el sistema de ablación por radiofrecuencia monopolar Cardioblate (marca registrada) (Medtronic, Inc.). Los resultados se analizaron en un paquete estadístico SPSS versión 1...


There is not any publication about the use of this technique with midterm follow-up in Colombia.bjective: to evaluate the surgical treatment of atrial fibrillation with the use of irrigated monopolar radiofrequency to short and midterm, through clinical follow-up, electrocardiogram and echocardiogram.Methods: 70 patients with diagnosis of atrial fibrillation and some other heart pathology that required surgery were evaluated between September 2003 and October 2005, in a prospective way. An ablation though monopolar radiofrequency (Cardioblate® Medtronic, Inc) was performed. Results were analyzed with the SPSS version 11, 0 statistical package. Results: 70 patients, 52% females and 48% males with mean age 54 years and preoperatory ejection fraction of 47% had mitral insufficiency (49%) and mitral stenosis (26%) as their main cause for primary heart surgery. 87% patients were evaluated at 18 months (3 to 25 months). Sinus rhythm was achieved in 88%. Residual arrhythmias in this group were atrial fibrillation (6%) and atrial flutter (6%). 80% of post-operatory arrhythmias were found in the first 15 days after surgery, being atrial fibrillation and atrial flutter the most common ones. Anticoagulation and anti-arrhythmic medication was suspended in 89% and 90% of the patients, respectively. The surgical technique had no inherent complications. Conclusions: this investigation demonstrated that the surgical ablation of atrial fibrillation with irrigated monopolar radiofrequency is easily reproducible, highly effective and safe for the patient.


Subject(s)
Atrial Fibrillation , Atrial Flutter , Mitral Valve Stenosis
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