Characterization of microsatellite markers in the coding regions of the Penaeus vannamei genome.

In this study, an extensive analysis of microsatellite markers (Single Tandem Repeats-STRs) in Penaeus vannamei was conducted at an advanced level. The markers were thoroughly examined, characterized, and specific markers located within coding regions were identified. Out of a total of 306 STRs, 117 were classified as perfect markers based on their single repeat motif. Among these perfect markers, 62 were found to be associated with predicted coding genes (mRNA), which were involved in various functions such as binding, catalytic activity, ATP-dependent activity, transcription, structural and molecular regulation. To validate the accuracy of the findings, a sample of nine markers was subjected to in vitro testing, which confirmed the presence of polymorphisms within the population. These results suggest the existence of different protein isoforms within the population, indicating the potential of these markers for application in both population and phenotype-genotype association studies. This innovative approach opens up new possibilities for investigating the impact of genomic plasticity in populations of P. vannamei.

Mapping the tuberculosis scientific landscape among BRICS countries: a bibliometric and network analysis.

BACKGROUND: The five BRICS (Brazil, Russian, Indian, China, and South Africa) countries bear 49% of the world's tuberculosis (TB) burden and they are committed to ending tuberculosis. OBJECTIVES: The aim of this paper is to map the scientific landscape related to TB research in BRICS countries. METHODS: Were combined bibliometrics and social network analysis techniques to map the scientific publications related to TB produced by the BRICS. Was made a descriptive statistical data covering the full period of analysis (1993-2016) and the research networks were made for 2007-2016 (8,366 records). The bubble charts were generated by VantagePoint and the networks by the Gephi 0.9.1 software (Gephi Consortium 2010) from co-occurrence matrices produced in VantagePoint. The Fruchterman-Reingold algorithm provided the networks' layout. FINDINGS: During the period 1993-2016, there were 38,315 peer-reviewed, among them, there were 11,018 (28.7%) articles related by one or more authors in a BRICS: India 38.7%; China 23.8%; South Africa 21.1%; Brazil 13.0%; and Russia 4.5% (The total was greater than 100% because our criterion was all papers with at least one author in a BRICS). Among the BRICS, there was greater interaction between India and South Africa and organisations in India and China had the highest productivity; however, South African organisations had more interaction with countries outside the BRICS. Publications by and about BRICS generally covered all research areas, especially those in India and China covered all research areas, although Brazil and South Africa prioritised infectious diseases, microbiology, and the respiratory system. MAIN CONCLUSIONS: An overview of BRICS scientific publications and interactions highlighted the necessity to develop a BRICS TB research plan to increase efforts and funding to ensure that basic science research successfully translates into products and policies to help end the TB epidemic.

As implicações da COVID-19 no sistema cardiovascular: prognóstico e intercorrências / Implications of COVID-19 on the cardiovascular system: prognosis and intercurrences

Objetivo: descrever as implicações da COVID-19 no sistema cardiovascular: prognósticos e intercorrências. Método: trata-se de uma revisão integrativa da literatura, realizada nas bases de dados, Science Direct, National Library of Medicine National Institutes of Health dos EUA (PUBMED), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cochrane Collaboration e Medical Literature Analysis and Retrieval System Online (MEDLINE) com os descritores, Cardiovascular System; Cardiovascular Diseases; Coronary Disease, e a palavra-chave Covid-19. Incluíram-se estudos originais, relatos de casos, revisões sistemáticas na série temporal 2019-2020. Resultados: a busca resultou em 13 artigos, todos na língua inglesa, emergindo os pontos-chave: potencialização das complicações cardiovasculares pela infecção por COVID-19; aumento da mortalidade de origens cardiovasculares influenciadas pela infecção por COVID-19. Conclusão: o envolvimento do sistema cardiovascular no COVID-19 pode determinar a gravidade da doença, potencializado na presença de fatores de riscos cardiovasculares, repercutindo em complicações que necessitam de tratamento intensivo e morte. De maneira geral, todos os pacientes com COVID-19 são passíveis de ter comprometimento cardiológico, fato que pode depender de antecedentes mórbidos pessoais, resposta inflamatória e liberadores bioquímicos.

Objective: to describe the implications of COVID-19 in the cardiovascular system: prognosis and intercurrences. Method: This is an Integrative Literature Review, performed in the databases, Science direct, National Library of Medicine National Institutes of Health (PUBMED), Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Collaboration and Medical Literature Analysis and Retrieval System Online (MEDLINE) with the descriptors, Cardiovascular system; Cardiovascular Diseases; Coronary Disease, and the keyword Covid-19. It included original studies, case reports, systematic reviews in the time series 2019-2020. Results: The search resulted in 13 articles, all in English language, emerging the key points, Potentiation of cardiovascular complications by COVID-19 infection; Increased mortality of cardiovascular origin influenced by COVID-19 infection. Conclusion: The involvement of the cardiovascular system in COVID-19 may determine the severity of the disease, potentiated in the presence of cardiovascular risk factors, resulting in complications that require intensive treatment and death. In general, all patients with COVID-19 are likely to have cardiological impairment, which may depend on personal morbid antecedents, inflammatory response and biochemical liberators.

Mapping the tuberculosis scientific landscape among BRICS countries: a bibliometric and network analysis

BACKGROUND The five BRICS (Brazil, Russian, Indian, China, and South Africa) countries bear 49% of the world's tuberculosis (TB) burden and they are committed to ending tuberculosis. OBJECTIVES The aim of this paper is to map the scientific landscape related to TB research in BRICS countries. METHODS Were combined bibliometrics and social network analysis techniques to map the scientific publications related to TB produced by the BRICS. Was made a descriptive statistical data covering the full period of analysis (1993-2016) and the research networks were made for 2007-2016 (8,366 records). The bubble charts were generated by VantagePoint and the networks by the Gephi 0.9.1 software (Gephi Consortium 2010) from co-occurrence matrices produced in VantagePoint. The Fruchterman-Reingold algorithm provided the networks' layout. FINDINGS During the period 1993-2016, there were 38,315 peer-reviewed, among them, there were 11,018 (28.7%) articles related by one or more authors in a BRICS: India 38.7%; China 23.8%; South Africa 21.1%; Brazil 13.0%; and Russia 4.5% (The total was greater than 100% because our criterion was all papers with at least one author in a BRICS). Among the BRICS, there was greater interaction between India and South Africa and organisations in India and China had the highest productivity; however, South African organisations had more interaction with countries outside the BRICS. Publications by and about BRICS generally covered all research areas, especially those in India and China covered all research areas, although Brazil and South Africa prioritised infectious diseases, microbiology, and the respiratory system. MAIN CONCLUSIONS An overview of BRICS scientific publications and interactions highlighted the necessity to develop a BRICS TB research plan to increase efforts and funding to ensure that basic science research successfully translates into products and policies to help end the TB epidemic.

OTX1 and OTX2 Genes in Medulloblastoma.

OBJECTIVE: To study the prevalence of OTX1 and OTX2 gene expression in 60 medulloblastoma specimen samples and to establish correlations between gene expression and clinical and histopathological aspects. METHODS: We performed a retrospective analysis of 60 patients with a diagnosis of medulloblastoma at the Clinicas Hospital of the School of Medicine, University of São Paulo, and the Cancer Hospital of Barretos. We created a database of the 60 patients containing information on the gene expression of OTX1 and OTX2 (obtained using real-time polymerase chain reaction) and clinical and epidemiological data. Statistical tests were performed to verify potential correlations of clinicopathological data and follow-up aspects with gene expression. RESULTS: The OTX1 gene was expressed in 52% of the study population. Expression varied with age (higher in adults), location (predominantly by hemisphere), and histological type (desmoplastic). The OTX2 gene was expressed in 62% of the study population. Expression varied with age (higher in younger age groups), location (predominantly vermis), and histological type (classic and anaplastic). A statistical correlation between OTX2 gene expression and the development of leptomeningeal metastases was observed. CONCLUSIONS: The relative expression of OTX1 and OTX2 was dependent on patient age, tumor location, and histological variant. In addition, OTX2 expression might be a predictive factor for leptomeningeal metastases of medulloblastoma. The OTX pathway should be consider as an important venue for medulloblastomas development.

Diretrizes curriculares nacionais das profissões da Saúde 2001-2004: análise à luz das teorias de desenvolvimento curricular / Directrices curriculares nacionales de las profesiones de la Salud 2001-2004: análisis a la luz de las teorías de desarrollo curricular / National curriculum guidelines for health professions 2001-2004: an analysis according to curriculum development theories

O objetivo desta pesquisa foi analisar as Diretrizes Curriculares Nacionais (DCNs) do período de 2001 a 2004 para 14 carreiras da Saúde. Foi conduzido um estudo descritivo exploratório entre 2015 e 2016, mediante a análise documental das DCNs conforme a Resolução nº 287/1998. A coleta dos dados foi por consulta ao site do MEC/Portal. Para análise dos dados, utilizou-se uma matriz analítica com dois eixos/categorias: Currículo (processo de avaliação; processo de ensino-aprendizagem; e organização curricular) e Perfil Profissional (Perfil Profissional; Cuidado com a Saúde; Educação na Saúde; e Gestão em Saúde). Os resultados mostram que as DCNs mantiveram aspectos do modelo tradicional de ensino, com pouca qualificação nas orientações pedagógicas inovadoras. A associação desses achados com a presença de lacunas na articulação entre formação, necessidades de saúde e demandas do Sistema Único de Saúde (SUS) apontam o desafio de uma maior produção desse tipo de análise e da revisão das DCNs.(AU)

El objetivo de esta investigación fue analizar las Directrices Curriculares Nacionales (DCNs) del período de 2001 a 2004 para 14 carreras de Salud. Se realizó un estudio descriptivo exploratorio entre 2015 y 2016, mediante el análisis documental de las DCNs conforme la Resolución nº 287/1998. La colecta de los datos se realizó mediante consulta a la página web del MEC/Portal. Para análisis de los datos, se utilizó una matriz analítica con dos ejes/categorías: Currículo (proceso de evaluación, proceso de enseñanza-aprendizaje y organización curricular) y Perfil Profesional (perfil profesional, cuidado con la salud, educación en salud y gestión en salud). Los resultados muestran que las DCNs mantuvieron aspectos del modelo tradicional de enseñanza con poca calificación en las orientaciones pedagógicas innovadoras. La asociación de esos hallazgos con la presencia de lagunas en la articulación entre formación, necesidades de salud y demandas del Sistema Brasileño de Salud (SUS) señalan el desafío de una mayor producción de ese tipo de análisis y de la revisión de las DCNs.(AU)

This study aimed to analyze the National Curriculum Guidelines (DCNs) published from 2001 to 2004 for fourteen careers in the area of Health. A descriptive exploratory study was conducted in 2015 and 2016 through a documental analysis of the DCNs according to Resolution no. 287/1998. Data were collected from the website of the Ministry of Education. To analyze the data, an analytical matrix with two axes was used: Curriculum (evaluation process; teaching-learning process; curriculum organization) and Professional Profile (professional profile; healthcare; health education; health management). The results showed that the DCNs maintained aspects of the traditional model of teaching, and the innovative pedagogical orientations were not qualified in a clear way in these documents. The association of these findings with the presence of gaps in the articulation among education, health needs and the demands of the Brazilian National Health System (SUS) reveal that further analyses of this type should be carried out and that the DCNs should be reviewed.(AU)

Qualidade de Vida de Estudantes de Medicina em um Curso que Adota Metodologias Ativas de Ensino-Aprendizagem / Quality of Life of Medical Students on a Course that Adopts Active Teaching-Learning Methods

RESUMO A qualidade de vida (QV) de estudantes de Medicina tem sido alvo de estudos, mas não encontramos na literatura trabalhos que avaliem a QV de estudantes de escolas médicas que adotam exclusivamente metodologias ativas de ensino-aprendizagem. O presente estudo avaliou a qualidade de vida dos estudantes do primeiro ao quarto ano do curso de Medicina da Universidade Federal de São Carlos. Como instrumento de coleta de dados, foi utilizado o questionário WHOQoL-100, em sua versão completa, traduzida e validada em português, que avalia seis domínios, além da QV global. Foram participantes todos os 182 estudantes matriculados do primeiro ao quarto ano do curso. Quatro estudantes foram excluídos da amostra por preenchimento incompleto do questionário, resultando em cinco grupos: grupo controle com 32 alunos recém-ingressos no curso de Medicina; grupo primeiro ano com 38 alunos concluintes; grupo segundo ano com 35 concluintes; grupo terceiro ano com 35 concluintes; e grupo quarto ano com 38 concluintes. A análise descritiva dos resultados foi apresentada como média ± erro padrão da média. A significância das diferenças foi determinada por análise de variância, seguida pelo teste de comparações múltiplas de Newman-Keuls. Para a análise de correlação, foi utilizado o método de correlação de Spearman. O nível de significância adotado foi de 5%. A QV global apresentou melhor pontuação no grupo controle (77,54 ± 2,153); seguida, em ordem decrescente, pelos grupos segundo ano (65,71 ± 3,923), quarto ano (65,63 ± 3,306), primeiro ano (65,46 ± 3,289) e terceiro ano (52,86 ± 2,776). Houve diferença significativa na QV global do grupo terceiro ano em relação aos demais (p < 0,05). Entre todos os domínios avaliados, o psicológico influenciou significativamente a QV, apresentando forte correlação com a QV nos grupos do primeiro ao quarto ano.

ABSTRACT The quality of life (QoL) of medical students has been the subject of studies, but we did not find any works in the literature that assess the QoL of students of medical schools that exclusively adopt active teaching methods. This study therefore evaluates quality of life in students from the 1st to 4th year of medical school at the Universidade Federal de São Carlos. The complete version WHOQoL-100 questionnaire was used as the data collection instrument, translated and validated for Portuguese. This questionnaire evaluates six domains, in addition to global QoL. All 182 students enrolled from the 1st to 4th year were interviewed. Four students were excluded from the sample due to incomplete filling out of the questionnaire, resulting in five groups: a control group with 32 students recently admitted to medical college; 1st year group with 38 students who had just completed the 1st year; a 2nd year group with 35 students who had just completed the 2nd year; a 3rd year group with 35 students who had just completed the 3rd year; and a 4th year group with 38 students who had just completed the 4th year. Descriptive analysis of the results was presented as means ± SEM. The significance of the differences was determined by analysis of variance followed by the Newman-Keuls multiple comparison test. For the correlation analysis, the Spearman correlation method was used. The level of significance was set at 5%. Global QoL showed a better score in the control group (77.54 ± 2.153) followed, in descending order, by the 2nd year (65.71 ± 3.923), 4th year (65.63 ± 3.306), 1st year (65.46 ± 3.289) and 3rd year (52.86 ± 2.766). There was a significant difference in the Global QoL for the 3rd year group in relation to the others (p <0.05). Among all the evaluated domains, the psychological domain had a significant influence on QoL, presenting strong correlation in the 1st to the 4th year groups.

Cuidado à Saúde e a Formação do Profissional Médico / Healthcare and Professional Medical Training

RESUMO O curso de Medicina da Universidade Federal de São Carlos (UFSCar) apresenta um currículo inovador, com processos metodológicos e pedagógicos inovadores, adequados às novas Diretrizes Curriculares Nacionais. Das Unidades Educacionais que compõem seu currículo, merece destaque a Unidade Educacional de Prática Profissional (UEPP), que simboliza os ideais de transposição dos muros da universidade pela graduação, proporcionando aos alunos a aprendizagem em cenários reais da prática profissional, com o envolvimento de docentes e estudantes no cuidado à saúde das populações. O objetivo deste estudo foi analisar o cuidado à saúde prestado pelos estudantes no contexto da UEPP nas Unidades de Saúde da Família (USF). Os sujeitos da pesquisa foram os pacientes acompanhados pelos estudantes da segunda série do curso de Medicina da UFSCar em 2014. A coleta de dados foi realizada por meio de entrevistas, e os dados foram analisados pela técnica de análise de conteúdo temática. Na análise, foram construídas duas categorias temáticas: "uma relação estudante-paciente cuidadosa" e "abordagem dialógica na elaboração da história clínica". Na primeira categoria, os pacientes destacam: a atenção e dedicação dispensadas a eles como importantes no processo longitudinal de cuidado, com sensível diferença na percepção do serviço ofertado pela USF nos períodos de ausência dos estudantes; a facilidade no acesso aos acadêmicos e as ações destes em relação aos pacientes cuidados, as quais se refletiram numa aproximação maior entre o usuário e o sistema de saúde, bem como na melhora da percepção individual de autocuidado. A aprovação dos usuários é demonstrada, entre outras formas, na sugestão de que o modelo de visita dos acadêmicos fosse adotado em outras unidades de saúde. Na segunda categoria, o estabelecimento de uma relação dialógica entre o estudante e os pacientes possibilitou construir histórias clínicas de conteúdo ampliado, que refletiam um acompanhamento regular e acessível. Em sua abordagem, os estudantes realizavam ações de promoção e prevenção de saúde direcionadas a cada faixa do ciclo de vida e, em troca, dispunham de um cenário prático rico e satisfatório para a aquisição de habilidades previstas academicamente para a expertise de um estudante de Medicina em seus dois primeiros anos de graduação. Com os resultados apurados e a discussão realizada, verificou-se que esta Unidade Educacional proporcionou a construção de um aprendizado sobre a clínica desde os primeiros anos da graduação. Inferem-se as múltiplas possibilidades que a atenção básica fornece à formação do profissional médico e os valores positivos destacados a partir de uma relação de atenção continuada do estudante em relação ao paciente. Além disso, destaca-se que a experiência dos estudantes de Medicina permite a construção de relações interpessoais no processo de cuidado em saúde, servindo como base para toda a graduação e vida profissional, e como modelo para outras instituições.

ABSTRACT The Medicine course of the Federal University of São Carlos (UFSCar) presents an innovative curriculum, with pioneering methodological and pedagogical processes, adapted to the new National Curricular Guidelines. Of the educational modules that compose the syllabus, the Educational Professional Practice Unit (UEPP) can be highlighted. This unit symbolizes the ideals of an undergraduate training that transposes the University walls, providing apprenticeship to students in real practical settings, with teacher and student participation in public healthcare actions. The objective of the study was to analyze the care provided by the students at Family Health Centers (USF) in the context of the UEPP. The research subjects were the patients attended to by UFSCar student medics in 2014. The data was collected through individual interviews and analyzed using thematic content analysis. The analysis involved the formation of two major thematic categories: "a caring student-patient relationship" and "dialogical approach to preparing the patient's medical history". In the first category, patients highlighted the following topics: the attention and dedication afforded them as important aspects of the longitudinal care process, with a significant difference in how they perceived the service offered by the center when the students were not present; the students' accessibility and their actions in relation to the patients under their care, which resulted in the user feeling closer to the health system, as well as in an improved individual perception of self-care. One way in which the users' approval is demonstrated is in the suggestion that the academics' visiting model be adopted in other centers. In the second category, the establishment of a dialogical relationship between the student and the patients allowed for an expanded construction of the patients' medical histories, reflected in regular and accessible follow-ups. In their approach, the students carried out health promotion and prevention actions directed at each stage of the life cycle; in exchange, they were able to make use of a rich and fulfilling practical setting in order to acquire skills foreseen as part of the skillset to be taught in the first two years of undergraduate medical training. Having checked and discussed the results, the researchers ascertained that this Educational Unit provided a learning opportunity in relation to clinical care from the first years of undergraduate training onwards. Multiple possibilities for the provision of professional medical training through basic care are inferred, in addition to the positive values highlighted and derived from an ongoing care relationship between student and patient. It should also be noted that this experience allows the student medics to build interpersonal relationships within the healthcare process, serving as a foundation for their entire undergraduate and professional life, as well as a model for other institutions.

Mapping the dengue scientific landscape worldwide: a bibliometric and network analysis

BACKGROUND Despite the current global trend of reduction in the morbidity and mortality of neglected diseases, dengue’s incidence has increased and occurrence areas have expanded. Dengue also persists as a scientific and technological challenge since there is no effective treatment, vaccine, vector control or public health intervention. Combining bibliometrics and social network analysis methods can support the mapping of dengue research and development (R&D) activities worldwide. OBJECTIVES The aim of this paper is to map the scientific scenario related to dengue research worldwide. METHODS We use scientific publication data from Web of Science Core Collection - articles indexed in Science Citation Index Expanded (SCI-EXPANDED) - and combine bibliometrics and social network analysis techniques to identify the most relevant journals, scientific references, research areas, countries and research organisations in the dengue scientific landscape. FINDINGS Our results show a significant increase of dengue publications over time; tropical medicine and virology as the most frequent research areas and biochemistry and molecular biology as the most central area in the network; USA and Brazil as the most productive countries; and Mahidol University and Fundação Oswaldo Cruz as the main research organisations and the Centres for Disease Control and Prevention as the most central organisation in the collaboration network. MAIN CONCLUSIONS Our findings can be used to strengthen a global knowledge platform guiding policy, planning and funding decisions as well as to providing directions to researchers and institutions. So that, by offering to the scientific community, policy makers and public health practitioners a mapping of the dengue scientific landscape, this paper has aimed to contribute to upcoming debates, decision-making and planning on dengue R&D and public health strategies worldwide.

Mapping the dengue scientific landscape worldwide: a bibliometric and network analysis.

BACKGROUND: Despite the current global trend of reduction in the morbidity and mortality of neglected diseases, dengue's incidence has increased and occurrence areas have expanded. Dengue also persists as a scientific and technological challenge since there is no effective treatment, vaccine, vector control or public health intervention. Combining bibliometrics and social network analysis methods can support the mapping of dengue research and development (R&D) activities worldwide. OBJECTIVES: The aim of this paper is to map the scientific scenario related to dengue research worldwide. METHODS: We use scientific publication data from Web of Science Core Collection - articles indexed in Science Citation Index Expanded (SCI-EXPANDED) - and combine bibliometrics and social network analysis techniques to identify the most relevant journals, scientific references, research areas, countries and research organisations in the dengue scientific landscape. FINDINGS: Our results show a significant increase of dengue publications over time; tropical medicine and virology as the most frequent research areas and biochemistry and molecular biology as the most central area in the network; USA and Brazil as the most productive countries; and Mahidol University and Fundação Oswaldo Cruz as the main research organisations and the Centres for Disease Control and Prevention as the most central organisation in the collaboration network. MAIN CONCLUSIONS: Our findings can be used to strengthen a global knowledge platform guiding policy, planning and funding decisions as well as to providing directions to researchers and institutions. So that, by offering to the scientific community, policy makers and public health practitioners a mapping of the dengue scientific landscape, this paper has aimed to contribute to upcoming debates, decision-making and planning on dengue R&D and public health strategies worldwide.

Desafios e potencialidades do processo de educação permanente em saúde / Challenges and opportunities of the continuing education in health process / Desafíos y potencialidades del proceso de educación permanente en salud

Resumo Este artigo se propõe a apresentar uma análise sobre o processo de implementação da educação permanente em saúde no município de São Carlos, no estado de São Paulo, ponderando os impasses que dificultam o desenvolvimento desse processo e suas condições de realização. A discussão está subsidiada na técnica qualitativa de pesquisa, e os dados foram produzidos por meio de entrevistas semiestruturadas submetidas aos sujeitos ligados à educação permanente em saúde no município. Os resultados evidenciaram que esta modalidade de educação se encontrava fragilizada principalmente pela ruptura de políticas municipais em razão da alternância de governos. Apesar disso, a pesquisa demonstrou que o município dispunha também de potenciais para a efetivação da educação permanente em saúde, como representatividade nos colegiados de discussão. Sugere-se a retomada da ideia de criação de um núcleo, já que, como visto na literatura, a formação desses núcleos se mostrou efetiva para a implementação da educação permanente em saúde em várias outras localidades.

Abstract This article aims to present an analysis of the process of implementing continuing education in health in São Carlos, São Paulo, Brazil, considering the impasses that hinder the development and feasibility of this process. The discussion is based on the qualitative research technique, and the data were produced through semi-structured interviews submitted to the subjects connected to continuing education in health in the city. The results showed that education mode was weakened mainly on account of the breakdown of municipal policies because of alternating governments. Nevertheless, the research showed that the city also had potential to implement the continuing education in health, such as representativeness in the joint discussion committees. It is suggested that the idea of creating a center be resumed, since, as seen in the literature, forming such centers was an effective tool to implement permanent health education in several other locations.

Resumen Este artículo se propone presentar un análisis sobre el proceso de implementación de la educación permanente en salud (EPS) en el municipio de São Carlos, en el estado de San Pablo, Brasil, ponderando los impasses que dificultan el desarrollo de este proceso y sus condiciones de realización. La discusión está apoyada en la técnica cualitativa de investigación y los datos se produjeron mediante entrevistas semiestructuradas aplicadas a los sujetos vinculados a la EPS en el municipio. Los resultados mostraron que la EPS se encontraba debilitada principalmente por la ruptura de políticas municipales en razón de la alternancia de gobiernos. A pesar de ello, la investigación demostró que el municipio disponía también de potenciales para hacer efectiva la EPS, como representatividad en los colegiados de discusión. Se sugiere retomar la idea de creación de un núcleo de EPS, ya que, como se observó en la literatura, la formación de esos núcleos se mostró efectiva para implementar la educación permanente en salud, en otras localidades.

The expression of the aminoacid transporters ASCT2 (SLC1A5) and LAT1 (SLC7A5) in astrocytomas / Expressão dos transportadores de aminoácidos ASCT2 (SLC1A5) e LAT1 (SLC7A5) em astrocitomas

OBJECTIVE: ASCT2 and LAT1 are aminoacid transporters involved in glutamine transport and play a role in tumor growth. Previous studies have shown an association of ASCT2 to cell proliferation through the mechanistic Target of Rapamycin (mTOR) translational machinery; LAT1 has been shown as a prognostic marker due to its relation to tumor invasion, microscopic vascular invasion and metastasis. This study analyzed the gene expression of ASCT2 and LAT1 in astrocytomas of different grades and how this correlates to clinical outcome in glioblastoma patients. METHOD: This is an observational study with ASCT2 and LAT1 mRNA expression analysis in 153 samples of human astrocytomas, distributed in different World Health Organization (WHO) grades of malignancy (23 at grade I or pilocytic astrocytoma, 26 at grade II or low-grade astrocytoma, 18 at grade III or anaplastic astrocytoma, 86 at grade IV astrocytoma or glioblastoma (AGIV or GBM)); these were compared to 22 non-neoplastic brain samples. RESULTS: Significant hyperexpression of both genes was observed particularly in malignant astrocytomas (GIII & GBM). Moreover, LAT1 hyperexpression impacted negatively in the overall survival in a subset of GBM patients. CONCLUSION: LAT1 is more expressed in higher grade astrocytomas. It leads to a poorer prognosis among GBM patients and may be a potential therapeutical target.

OBJETIVO: ASCT2 e LAT1 são transportadores de aminoácidos envolvidos no transporte de glutamina e desempenham um papel no crescimento tumoral. Estudos prévios mostraram uma associação de ASCT2 com proliferação celular através da maquinaria de tradução do mTOR; tem sido mostrado que o LAT1 é um marcador prognóstico devido à sua relação com invasão tumoral, invasão vascular microscópica e metástase. Este estudo analisou a expressão gênica de ASCT2 e LAT1 em astrocitomas de diferentes graus e sua correlação com desfecho clínico em pacientes com glioblastoma. METODO: Este é um estudo observacional com análise de expressão de RNAm de ASCT2 e LAT1 em 153 amostras de astrocitomas humanos, distribuídas em diferentes graus de malignidade segundo a OMS (23 astrocitomas de grau I ou astrocitoma pilocítico, 26 de astrocitoma de grau II ou astrocitoma de baixo grau, 18 de astrocitoma de grau III ou astrocitoma anaplásico, 86 de astrocitoma de grau IV ou glioblastoma (AGIV ou GBM); estes foram comparados com 22 amostras cerebrais não neoplásicas. RESULTADOS: Foi observada uma hiperexpressão de ambos os genes, particularmente nos astrocitomas malignos (GIII & GBM). Além disso, a hiperexpressão LAT1 impactou negativamente na sobrevida global em um grupo de pacientes com GBM. CONCLUSÃO: LAT1 é mais expresso em astrocitomas de grau maior. Isso leva a um pior prognóstico entre os pacientes com GBM e pode ser um potencial alvo terapêutico.

Residência multiprofissional em saúde e o mundo do trabalho do fisioterapeuta / Multiprofessional residency in health and the world's physiotherapist job / Residencia multiprofesional en salud y el mundo del trabajo fisioterapeuta

This study analyzed the physiotherapists' experiences that attended a multiprofessional residency program in family and community health- MRPFCH, intending to verify the repercussions of the professional practice. In the current qualitative case study, by means of the Oral Story technique (HO). The interviews had been transcribed and transcreated and subjected of the analysis by the use of the sense interpretation method. Through the analysis and articulation of the themes, it has been observed that the residency had an important role in the professional formation of those physiotherapists, mostly in in the consolidation of principles aimed at humanization and comprehensiveness of health care. Nevertheless, the residency cannot become the savior of the fragmented educational process of graduation. It is necessary to continue investing in this health formation, as well in changes concerning the professional profile according to the Curriculum National Guidelines.

Esto estudio ha analizado las experiencias de los fisioterapeutas graduados del programa de residencia multiprofesional en salud de la familia - RMSFC, con el objetivo de echarle un vistazo a las repercusiones de esta residencia en la práctica profesional. Se realizó un estudio cualitativo con la técnica de la Historia Oral (HO). Hubo una transcripción de las entrevistas y estas se analizaron con el método de interpretación de los sentidos. A través del análisis y de la articulación de las temáticas, se pudo verificar que la residencia tiene un rol importante en la formación profesional de los fisioterapeutas, especialmente en la consolidación de los principios involucrados a la humanización y la integralidad del cuidado en la salud. El estudio señala la necesidad de más inversiones en esta modalidad de formación, así como la necesidad de cambios en la graduación en base al perfil profesiona, según las directrices del currículo nacional.

Portfólio Reflexivo Eletrônico: Resultados de um Projeto Piloto / Reflective e-Portfolio: Results of a Pilot Project

RESUMO Este estudo investigou a implantação de um Portfólio Reflexivo Eletrônico (PRE) nas atividades de Prática Profissional (PP), que ocorrem em ambientes internos e externos ao campus. Para avaliação, um protótipo foi instalado em netbooks e usado durante cinco meses por um grupo de estudantes e um facilitador do primeiro ciclo da Unidade Educacional de Prática Profissional (Uepp) do curso de Medicina da Universidade Federal de São Carlos (UFSCar). O estudo percorreu as seguintes etapas: levantamento dos requisitos, design e implementação do protótipo e avaliação do protótipo. Na avaliação foi feito um inquérito com aplicação de dois questionários e a realização de observações locais durante esse período. Os resultados demonstraram que a maioria dos estudantes prefere usar o PRE nas atividades internas e em grupo, mas prefere usar papel durante o atendimento aos pacientes, e que características de hardware e software do dispositivo de acesso e os diferentes ambientes de uso influenciam essa preferência.

ABSTRACT This study investigated the deployment of a Reflective e-Portfolio (REP) for Professional Practice (PP) activities, which activities occur on and off the campus. For the prototype evaluation, the e-Portfolio was installed on netbooks and used for five months by a group of students and a facilitator of the first cycle of the Educational Unit of Professional Practice (EUPP) of the UFSCar Medicine Course. The study involved the following steps: survey to establish the requirements, design and implementation of the prototype, and evaluation of the prototype. The evaluation consisted of an investigation with the application of two questionnaires and local observations conducted during that period. The results showed that most students prefer to use the REP in the internal and group activities, but prefer to use paper for patient care, and that hardware and software characteristics of the access device as well as the different environments of use influence this preference.

Stathmin involvement in the maternal embryonic leucine zipper kinase pathway in glioblastoma.

BACKGROUND: Maternal Embryonic Leucine Zipper Kinase (MELK) is a serine/threonine kinase involved in cell cycle, differentiation, proliferation, and apoptosis. These multiple features are consistent with it being a potential anticancer target. Nevertheless, the MELK pathway in tumorigenesis is not yet completely understood. This study aims to identify proteins associated with MELK pathway in astrocytomas. To this end, proteomic data of the human glioma cell line U87MG transfected with siRNA for MELK were compared with non-target transfected control cells and compared with oligonucleotide microarray data. RESULTS: In both assays, we identified stathmin/oncoprotein 18 (STMN1), involved in cell cycle. STMN1 gene expression was further assessed in a series of 154 astrocytomas and 22 non-neoplastic brain samples by qRT-PCR. STMN1 expression was significantly increased in malignant diffusely infiltrative astrocytomas compared with pilocytic astrocytoma (p < 0.0001). A strong correlation between MELK and STMN1 expressions was observed (r = 0.741, p < 0.0001) in glioblastoma (GBM) samples. However, no difference on survival times was found when compared GBM cases with upregulated and downregulated STMN1 (Breslow = 0.092, median survival time: 11 and 13 months, respectively). Functional assays knocking down MELK by siRNA in GBM cell line showed that gene and protein expression of both MELK and stathmin were diminished. On the other hand, when the same analysis was performed for STMN1, only stathmin gene and protein was silenced. CONCLUSIONS: The results presented herein point stahtmin as a downstream target in the MELK pathway that plays a role in malignant progression of astrocytomas.

The impact of interleukin-13 receptor expressions in cell migration of astrocytomas / O impacto da expressão dos receptores de interleucina-13 na migração celular em astrocitomas

INTRODUCTION: Astrocytomas are common brain tumors. Increased expression levels of Interleukin-13 Receptor α2 (IL-13RA2) have been reported in astrocytomas. The Interleukin-13 signaling pathway may be associated with cell migration when binding to Interleukin-13 Receptor α1. OBJECTIVE: To investigate Interleukin-13 Receptor α1 (IL-13RA1) and IL13RA2 expression levels in human diffusely infiltrative astrocytomas and test the involvement of Interleukin-13 levels in cell migration in two glioblastoma cell lines. METHODS: IL13RA expression levels were accessed by quantitative real time PCR in 128 samples of astrocytomas and 18 samples of non-neoplastic brain tissues from temporal lobe epilepsy surgery. The impact of IL-13 levels (10 and 20 ng/mL) on cell migration was analyzed by the wound assay in U87MG and A172 cells. RESULTS: Glioblastoma presented higher IL13RA1 and IL13RA2 expression levels compared to lower grades astrocytomas and to non-neoplastic cases. U87MG and A172 cells presented higher expression levels of IL-13RA1 vs. IL-13RA2. A significant difference in migration rate was observed in A172 cells treated with 10 ng/mL of IL-13 vs. control: treated cells presented slower migration than non-treated cells. U87MG cells treated with IL-13 20ng/mL presented slower migration than non-treated cells. This indicates that the IL13Rα1 signaling pathway was not activated, indeed inhibited by the decoy IL-13Rα2, slowing cell migration. This impact occurred with a lesser concentration of IL-13 on the A172 than on the U87MG cell line, because A172 cells have a higher IL-13RA2/A1 ratio. CONCLUSION: The present results suggest IL-13 receptors as possible targets to decrease tumor cell migration.

INTRODUÇÃO Astrocitomas são os tumores cerebrais mais frequentes. Nestes tumores foi observada maior expressão do receptor de Interleucina-13 α2 (IL13RA2). A cascata de sinalização da Interleucina-13 pode estar associada com a migração celular, após sua ligação com o receptor de Interleucina-13 α1 (IL13Rα1). OBJETIVO: Investigar os níveis de expressão dos receptores de Interleucina-13 (IL13RA1 e IL13RA2) em astrocitomas difusamente infiltrativos e avaliar o envolvimento da Interleucina-13 na migração celular de duas linhagens de glioblastoma. MÉTODOS: A expressão dos receptores IL13RA foi analisada por PCR em tempo real, em 128 amostras de astrocitomas e 18 amostras de tecido cerebral não neoplásico, provenientes de cirurgia de epilepsia do lobo temporal. E o impacto da quantidade de IL-13 (10ng/ml e 20ng/ml) em ensaio de migração celular. RESULTADOS: As amostras de Glioblastoma apresentaram maior expressão de IL13RA1 and IL13RA2 comparados com astrocitomas de baixo grau e os casos não-neoplásicos. Nas células U87MG e A172 foi observado maior nível de expressão de IL-13RA1 do que IL-13RA2. Uma diferença significativa na taxa de migração foi obtida em células A172 tratadas com 10 ng/mL comparadas com o controle: as células tratadas apresentaram menor migração que as células não tratadas. As células U87MG tratadas com 20ng/mL de IL-13 apresentaram menor migração celular que as células não tratadas. A diferença na migração celular indica que o caminho de sinalização de IL13Rα1 não foi ativado e foi inibido pelo IL-13Rα2, diminuindo a migração celular. Esse impacto ocorreu com uma concentração menor de IL-13 nas células A172 ao contrário da U87MG, porque as células A172 possuem uma razão IL-13RA2/A1 maior. CONCLUSÃO: os resultados sugerem que os receptores de IL-13 podem ser utilizados como possíveis alvos para a diminuição da migração celular tumoral.

Challenges of matrix support as educational practice: mental health in primary healthcare / Desafios do apoio matricial como prática educacional: a saúde mental na atenção básica / Desafíos del apoyo matricial como práctica educativa: la salud mental en la atención básica

This study investigated the educational dimension of matrix support practices for mental health within primary care. Using an interpretative-explanatory qualitative approach, professionals involved in matrix support for mental health in a municipality in the state of São Paulo, Brazil, were interviewed. The data were compared with matrix support frameworks with two pedagogical trends: directive and constructivist. The analysis on this content was incorporated with the interviews and two themes could be identified: “matrix supporter’s profile”, and “challenges for construction of matrix supporter’s practice.” The subjects’ perceptions regarding supporters’ competence profiles were coherent with matrix support assumptions, whereas their educational practices related mainly to the directive trend. The challenge of implementing constructivist practice was only partially recognized, since this requires a critical and transformative stance regarding the hegemonic educational practices within healthcare.

Trata-se de investigação sobre a dimensão educacional das práticas de apoio matricial (AM) em saúde mental na atenção básica. A partir de uma abordagem qualitativa, do tipo interpretativo-explicativo, foram entrevistados profissionais envolvidos com AM em saúde mental de um município do interior de São Paulo, Brasil. Esses dados foram confrontados com os referenciais de AM em duas tendências pedagógicas: diretiva e construtivista. A análise deste conteúdo foi incorporada às entrevistas e permitiu a identificação de duas temáticas: “perfil do apoiador matricial”; e “desafios para a construção da prática do apoiador matricial”. A percepção sobre o perfil de competência do apoiador mostrou-se coerente com os pressupostos do AM, ao passo que suas práticas educacionais apresentaram-se predominantemente vinculadas à tendência diretiva. O desafio para uma prática construtivista foi parcialmente constatado, uma vez que requer uma posição crítica e transformadora frente às práticas educacionais hegemônicas presentes na saúde.

Se trata de una investigación sobre la dimensión educativa de las prácticas de apoyo matricial (AM) en salud mental en la atención básica. A partir de un abordaje cualitativo, se entrevistaron profesionales envueltos en AM en salud mental de un municipio del interior de São Paulo, Brasil. Esos datos se confrontaron con los datos referenciales de AM en dos tendencias pedagógicas: directiva y constructivista. El análisis de este contenido se incorporó a las entrevistas y permitió la identificación de dos temáticas: “perfil del apoyador matricial” y “desafíos para la construcción de la práctica del apoyador matricial”. La percepción sobre el perfil de competencia del apoyador se mostró coherente con las presuposiciones del AM, sus prácticas educativas se presentaron predominantemente vinculadas a la tendencia directiva. El desafío para una práctica constructivista se constató parcialmente, puesto que requiere una posición crítica y transformadora ante las prácticas educativas hegemónicas presentes en la salud.

LOX expression and functional analysis in astrocytomas and impact of IDH1 mutation.

Lysyl oxidase (LOX) is involved in vital biological processes such as cell motility, cell signaling and gene regulation. Deregulation of this protein can contribute to tumor formation and progression. Although it is known that LOX is involved in invasion, proliferation and tumor migration in other types of tumors, studies of LOX in astrocytomas of different grades are scarce. The purpose of our study was to characterize LOX, BMP1 and HIF1A expression by real-time PCR in astrocytomas with WHO grades I to IV compared to non-neoplastic brain tissue. IDH1 mutational status was determined by PCR and sequencing. LOX protein expression was also analyzed by immunohistochemistry. LOX functional analyses were performed using siRNA knockdown and the specific inhibitor BAPN in two glioblastoma cell lines. The expression levels of LOX, BMP1 and HIF1A were correlated and analyzed according to IDH1 mutation status and to the clinical end-point of overall survival of glioblastoma patients. The results demonstrate that increased expression and activity of LOX, BMP1 and HIF1A were positively correlated with the malignant grade of astrocytomas. LOX protein expression also increased according to the degree of malignancy, with localization in the cytoplasm and nucleus and staining observed in endothelial cells. Glioblastoma with a mutation in IDH1 expressed lower levels of LOX in the nucleus, and IDH1-mutated cases showed lower LOX expression levels when compared to wild-type IDH1 cases. LOX knockdown and inhibition by BAPN in U87MG and A172 cell lines affected migration, invasion and soft agar colony formation. Taken together, these results corroborate the role of LOX in the migration, invasion and angiogenesis of astrocytomas. Furthermore, LOX expression is influenced by IDH1 mutational status. This work provides new insights for researchers aiming to design targeted therapies to control astrocytomas.