Por uma decolonização do HIV e interseccionalização das respostas à aids / For an HIV Decolonization and intersectionalization of AIDS responses

Resumo Com o advento da aids, uma articulação discursiva jornalística-biomédica-midiática contribuiu para acentuar a estigmatização sobre determinadas populações implicando uma colonização do HIV em que o vírus atingiria algumas pessoas enquanto outras estariam livres. Através de uma Análise do Discurso Crítica (ADC) realizou-se uma análise de retórica de algumas rupturas e continuidades discursivas nas áreas acadêmica-jurídica-midiática a partir de uma revisão narrativa de literatura (RNL). Os referenciais teóricos, éticos e políticos dos estudos decoloniais foram utilizados para a presente análise por entenderem que a colonialidade se reproduz em uma tripla dimensão: a do poder, do saber e do ser. Estes estudos foram articulados à uma crítica interseccional em que múltiplas formas de discriminação podem se sobrepor e serem experimentadas em intersecção tendo a contextualização sobre o que representou a aids, no Haiti, como eixo central comparativa para análise. Interessou-nos pensar a contribuição dessas perspectivas para lançar algumas provocações às respostas ao HIV/aids numa tentativa de superação de uma visão reducionista propagada por discursos morais e criminalizantes que, ao se posicionarem através de uma suposta neutralidade, dissimulam a interseccionalidade de gênero, classe, raça e sexualidade, levantando barreiras para as políticas e estratégias de promoção da saúde e prevenção ao HIV/aids.

Abstract With the advent of AIDS, a discursive journalistic-biomedical-mediatic articulation contributed to accentuate stigmatization on certain populations, implying a colonization of HIV in which the virus would reach some people while others would be free. Through a Critical Discourse Analysis (CDA), a critical literature review was carried out in some academic-legal-media areas from a narrative literature review (NLR). The theoretical, ethical and political references of decolonial studies were used for the present analysis because they understand that coloniality is reproduced in a triple dimension: that of power, knowledge and being. These studies were linked to an intersectional criticism in which multiple forms of discrimination can overlap and be experienced in intersection having the contextualization about what aids represented, in Haiti, as a comparative central axis for analysis. We were interested in thinking about the contribution of these perspectives to launch some provocations to the responses to HIV/AIDS in an attempt to overcome a reductionist view propagated by moral and criminalizing discourses that, by positioning themselves through supposed neutrality, conceal the intersectionality of gender, class, race and sexuality, raising barriers to health promotion and HIV/AIDS prevention policies and strategies.

Principais características demográficas e nosológicas das doenças da cavidade oral de cães atendidos em um serviço de odontologia veterinária / Main demographic and nosological characteristics of diseases of the oral cavity of dogs treated at a veterinary dentistry service

Afecções da cavidade oral como o cálculo dentário (CD) e a doença periodontal (DP) são frequentes na clínica de cães e têm grande impacto na saúde e qualidade de vida dos pacientes acometidos. No entanto, a adoção de medidas preventivas ainda é difícil, uma vez que a frequência das doenças da cavidade oral em cães ainda é pouco compreendida no Brasil. O objetivo deste estudo foi avaliar características demográficas e nosológicas, como os hábitos alimentares e de manejo de escovação, dos distúrbios da cavidade oral de 198 cães atendidos no período compreendido entre 2013 e 2019, em um serviço de odontologia veterinária, na cidade do Rio de Janeiro. A maioria dos cães atendidos não tinha raça definida. Entre os de raça pura, Yorkshire Terrie foi a mais prevalente, não havendo distinção significativa entre o gênero, em todos os casos. Quanto à idade, observou-se uma predominância de animais de meia idade a idosos, com faixa etária acima dos sete anos. Dentre as afecções mais prevalentes, o destaque se deve ao cálculo dentário e à doença periodontal, seguidos por gengivite e halitose. Quanto aos hábitos dos tutores, notou-se baixa adesão à realização de escovação rotineira, e um alto percentual no fornecimento de petiscos. Avaliando-se os resultados e relacionando-os aos hábitos alimentares dos pacientes, surge a hipótese de que a alimentação à base de ração comercial, de alguma forma possa contribuir para evolução do cálculo dentário, necessitando estudos com maior amostragem para elucidação.

Diseases of the oral cavity, such as Dental Calculus (DC) and Periodontal Disease (PD), are frequent in the dog clinic and have a great impact on the health and quality of life of affected patients. However, the adoption of preventive measures is still difficult, since the epidemiology of diseases of the oral cavity is still poorly understood in Brazil. The aim of this study was to evaluate demographic and nosological aspects ­ such as feeding and brushing habits ­ of disorders of the oral cavity of 198 dogs treated in the period between 2013 and 2019, in a veterinary dentistry service, in the city of Rio de Janeiro. The most prevalent breeds were mixed breed dogs, followed by Yorkshire Terries, with no significant distinction between the gender. As for age, there was a predominance of animals from middle age to the elderly, with ages above seven years old. Among the most prevalent conditions, the highlight is due to dental calculus and periodontal disease followed by gingivitis and halitosis. Regarding the tutors' habits, there was a low level of routine brushing, and a high percentage in the supply of snacks. Evaluating the results and relating them to the eating habits of the patients, the hypothesis that comercial dog food feeding may somehow contribute to dental calculus evolution, urging studies with bigger samples for a deeper investigation.

Estudo retrospectivo das doenças da cavidade oral de cães em um serviço de odontologia veterinária / Main demographic and nosological characteristics of diseases of the oral cavity of dogs treated at a veterinary dentistry service

Afecções da cavidade oral como o Cálculo Dentário (CD) e a Doença Periodontal (DP) são frequentes na clínica de cães e têm grande impacto na saúde e qualidade de vida dos pacientes acometidos. No entanto, a adoção de medidas preventivas ainda é difícil, uma vez que a epidemiologia das doenças da cavidade oral ainda é pouco compreendida no Brasil. O objetivo deste estudo foi avaliar aspectos epidemiológicos dos distúrbios da cavidade oral de 198 cães atendidos no período compreendido entre 2013 e 2019, em um serviço de odontologia veterinária, na cidade do Rio de Janeiro. As raças mais prevalentes foram cães sem raça definida, seguidos do Yorkshire, não havendo distinção significativa entre o gênero. Quanto a idade, observou-se uma predominância de animais de meia idade a idosos, com faixa etária acima dos 7 anos. Dentre as afecções mais prevalentes, o destaque se deve ao cálculo dentário e a doença periodontal seguidos de gengivite e halitose. Quanto aos hábitos dos tutores, notou-se baixa realização de escovação rotineira, e um alto percentual no fornecimento de petiscos. Avaliando-se os resultados e os relacionando aos hábitos alimentares dos pacientes, conclui-se que a alimentação com ração canina industrializada teve maior impacto e associação a CD do que a alimentação natural.

Diseases of the oral cavity, such as Dental Calculus (DC) and Periodontal Disease (PD), are frequent in the dog clinic and have a great impact on the health and quality of life of affected patients. However, the adoption of preventive measures is still difficult, since the epidemiology of diseases of the oral cavity is still poorly understood in Brazil. The aim of this study was to evaluate demographic and nosological aspects – such as feeding and brushing habits – of disorders of the oral cavity of 198 dogs treated in the period between 2013 and 2019, in a veterinary dentistry service, in the city of Rio de Janeiro. The most prevalent breeds were mixed breed dogs, followed by Yorkshire Terries, with no significant distinction between the gender. As for age, there was a predominance of animals from middle age to the elderly, with ages above seven years old. Among the most prevalent conditions, the highlight is due to dental calculus and periodontal disease followed by gingivitis and halitosis. Regarding the tutors’ habits, there was a low level of routine brushing, and a high percentage in the supply of snacks. Evaluating the results and relating them to the eating habits of the patients, the hypothesis that comercial dog food feeding may somehow contribute to dental calculus evolution, urging studies with bigger samples for a deeper investigation.

Using formal methods for content validation of medical procedure documents.

OBJECTIVE: We propose the use of a formal approach to support content validation of a standard operating procedure (SOP) for a therapeutic intervention. Such an approach provides a useful tool to identify ambiguities, omissions and inconsistencies, and improves the applicability and efficacy of documents in the health settings. MATERIALS AND METHODS: We apply and evaluate a methodology originally proposed for the verification of software specification documents to a specific SOP. The verification methodology uses the graph formalism to model the document. Semi-automatic analysis identifies possible problems in the model and in the original document. The verification is an iterative process that identifies possible faults in the original text that should be revised by its authors and/or specialists. RESULTS: The proposed method was able to identify 23 possible issues in the original document (ambiguities, omissions, redundant information, and inaccuracies, among others). The formal verification process aided the specialists to consider a wider range of usage scenarios and to identify which instructions form the kernel of the proposed SOP and which ones represent additional or required knowledge that are mandatory for the correct application of the medical document. CONCLUSION: By using the proposed verification process, a simpler and yet more complete SOP could be produced. As consequence, during the validation process the experts received a more mature document and could focus on the technical aspects of the procedure itself.

Estudo da técnica da sindesmoplastia extra-articular com fascia lata autógena: modelo em cães / Study of the extra articulate syndesmoplasty technique with autogenous fascia lata: a model in dogs

OBJETIVO: Avaliar a eficácia da técnica extra-capsular para o tratamento de ruptura do ligamento cruzado anterior em cães. MÉTODOS: Foi realizada a reparação cirúrgica extra-articular, sem artrotomia do ligamento cruzado anterior, com a utilização da fáscia lata autógena para estabilização da articulação do joelho em seis animais que apresentaram claudicação grave e movimento de gaveta positivo. RESULTADOS: A técnica cirúrgica extra-articular foi eficaz com boa estabilização articular e evolução satisfatória. CONCLUSÃO: A via extra capsular com uso da fáscia lata para correção da ruptura do ligamento cruzado anterior mostrou-se útil haja vista tratar-se de um procedimento simples e de rápida execução, causando o mínimo dano tecidual e recuperação pós-operatória eficiente.

OBJETIVE: To evaluate extra-capsular technique for the treatment of the anterior cruciate ligament rupture, in dogs. METHODS: It was performed an extra-articulate surgery without arthrotomy of the anterior cruciate ligament by using a strip of the autogenous fascia lata for stabilization of the knee joint in six animals which had severe claudication and drawer movement sign positive. RESULTS: The extra articulate technique was effective with good knee stabilization and satisfactory outcome. CONCLUSION: The use of the fascia lata with an extra capsular technique to fix the rupture of the anterior cruciate ligament seems to be useful once it is a simple and rapid procedure with minimum tissue damage and efficient postoperative recovery.

Modelo cirúrgico de insuficiência renal crônica: estudo em coelhos / Surgical model of chronic renal failure: study in rabbits

OBJETIVO: Estabelecer um modelo de insuficiência renal crônica (IRC) em coelhos, com perspectivas de seu uso para ações terapêuticas e reparadoras. MÉTODO: Foram utilizados 19 coelhos da linhagem Nova Zelândia, machos, adultos, aleatoriamente distribuídos em três Grupos: Grupo 1 - Controle (n =5), Grupo 2- Simulação (n =7), Grupo 3 - Experimental (n =7). Os animais foram anestesiados com Cetamina e Diazepam e Fentanil por via intramuscular e Sevorane, através de vaporizador. No Grupo 3 realizou-se uma nefrectomia bipolar esquerda e após quatro semanas, uma nefrectomia direita. Todas as amostras do parênquima renal foram pesadas. O Grupo 2 foi submetido a duas laparotomias, sem nefrectomia.. Em todos os grupos foram realizadas avaliações: bioquímicas com dosagens de uréia, creatinina, sódio e potássio; ultra-sonográficas abdominais; cintigráficas e histológicas. RESULTADOS: No Grupo 3 houve aumento progressivo da uréia (p=0.0001), creatinina (p=0,0001), sódio (p= 0,0002) e potássio (p=0,0003). A comparação destes resultados com os dos Grupos 1 e 2, nos diversos intervalos, também revelou elevação sérica, com significância estatística (p < 0,05). A ultra-sonografia identificou aumento do rim esquerdo no grupo 3, após 16 semanas. A cintigrafia comprovou, na 4ª semana, perda de 75 por centoda massa renal esquerda. No Grupo 3, a avaliação histológica evidenciou fibrose subcapsular e intersticial e regeneração tubular. CONCLUSÃO: O modelo experimental de IRC é exeqüível, com sobrevida dos animais, em médio prazo, o que permite o uso deste intervalo como janela terapêutica para testar diferentes ações reparadoras ao parênquima renal comprometido.

OBJECTIVES: To establish a model of chronic renal failure in rabbits, with perspectives of its use for therapeutic and repairing actions. METHODS: Nineteen males, adults rabbits (New Zealand) randomly distributed into three groups were used: Group 1 - Control (n =5); Group 2-Sham (n =7); and Group 3 - Experimental (n =7). They were anaesthetized by using intramuscular Cetamine, Diazepam and Fentanyl followed by Sevorane with vaporizer device. In Group 3, a bipolar left nephrectomy was carried out and after four weeks, it was also done a right nephrectomy. All the samples of the renal tissue were weighed. The Group 2 was only submitted to both abdominal laparotomies, without nephrectomy. Biochemical evaluations, with urea, creatinina, sodium and potassium measurement; abdominal ultrasound scan; scintigraphy and histological analysis were performed in all animals. RESULTS: In group 3 there was a progressive increase of urea (p=0.0001), creatinine (p=0.0001), sodium (p = 0,0002) and potassium (p=0,0003). The comparison of these results with those one of the Groups 1 and 2, in all intervals, revealed blood rising with statistical significant level (p < 0,05). In Group 3, the ultrasound scan identified an increasing of the left kidney size, after 16 weeks and at the 4th week the scintigraphy confirmed the loss of 75 percent of the left renal mass. In the same group, the histological evaluation showed subcapsular and intersticial fibrosis and also tubular regeneration. CONCLUSION: The experimental model of IRC is feasible, with animal's survival in middle term which allows the use of this interval like a therapeutic window for testing different approaches in order to repair the kidney damages.

[Surgical model of chronic renal failure: study in rabbits]. / Modelo cirúrgico de insuficiência renal crônica: estudo em coelhos.

OBJECTIVES: To establish a model of chronic renal failure in rabbits, with perspectives of its use for therapeutic and repairing actions. METHODS: Nineteen males, adults rabbits (New Zealand) randomly distributed into three groups were used: Group 1 - Control (n =5); Group 2-Sham (n =7); and Group 3 - Experimental (n =7). They were anaesthetized by using intramuscular Cetamine, Diazepam and Fentanyl followed by Sevorane with vaporizer device. In Group 3, a bipolar left nephrectomy was carried out and after four weeks, it was also done a right nephrectomy. All the samples of the renal tissue were weighed. The Group 2 was only submitted to both abdominal laparotomies, without nephrectomy. Biochemical evaluations, with urea, creatinina, sodium and potassium measurement; abdominal ultrasound scan; scintigraphy and histological analysis were performed in all animals. RESULTS: In group 3 there was a progressive increase of urea (p=0.0001), creatinine (p=0.0001), sodium (p = 0,0002) and potassium (p=0,0003). The comparison of these results with those one of the Groups 1 and 2, in all intervals, revealed blood rising with statistical significant level (p < 0,05). In Group 3, the ultrasound scan identified an increasing of the left kidney size, after 16 weeks and at the 4th week the scintigraphy confirmed the loss of 75% of the left renal mass. In the same group, the histological evaluation showed subcapsular and intersticial fibrosis and also tubular regeneration. CONCLUSION: The experimental model of IRC is feasible, with animal's survival in middle term which allows the use of this interval like a therapeutic window for testing different approaches in order to repair the kidney damages.

[Study of the extra articulate syndesmoplasty technique with autogenous fascia lata. A model in dogs]. / Estudo da técnica da sindesmoplastia extra-articular com fascia lata autógena. Modelo em cães.

OBJECTIVE: To evaluate extra-capsular technique for the treatment of the anterior cruciate ligament rupture, in dogs. METHODS: It was performed an extra-articulate surgery without arthrotomy of the anterior cruciate ligament by using a strip of the autogenous fascia lata for stabilization of the knee joint in six animals which had severe claudication and drawer movement sign positive. RESULTS: The extra articulate technique was effective with good knee stabilization and satisfactory outcome. CONCLUSION: The use of the fascia lata with an extra capsular technique to fix the rupture of the anterior cruciate ligament seems to be useful once it is a simple and rapid procedure with minimum tissue damage and efficient postoperative recovery.