Erythropoietin effects on cryopreserved/transplanted cat ovarian tissue: A comparison of two incubation methods.

Many feline species are currently threatened with extinction. Therefore, germplasm bank establishment has become imperative. However, cryoinjury and ischemia-reperfusion injury pose significant obstacles to both cryopreservation and xenotransplantation. In this regard, erythropoietin (Epo) represents a potential alternative strategy due to its properties. This study aimed to assess the incubation of domestic cat ovarian tissue in Epo, both before and after cryopreservation, and investigate its effectiveness in promoting revascularization following xenotransplantation. Sixteen ovaries from 8 healthy cats were sliced following elective bilateral ovariohysterectomy (OHE). Subsequently, 8 fragments measuring 3 mm³ each were obtained from the cortical region of each ovary. The fragments were allocated into 3 treatment groups: Cryo group, fragments were cryopreserved, thawed and immediately transplanted; Cryo + Epo group, fragments were first cryopreserved in nitrogen, thawed, incubated in Epo (100 IU) for 2h and transplanted; and the Epo + Cryo group, in which fragments were first incubated in Epo (100 IU) for 2h, cryopreserved, thawed and immediately transplanted. The fragments were then xenotransplanted into the dorsal subcutaneous region of ovariectomized female nude mice and retrieved at 7, 14, 21, and 28 days post-transplantation. The results indicated that Epo effectively enhanced follicular survival, preservation of viability, and tissue revascularization. The Epo + Cryo group displayed better revascularization rates on D14 and D21 post-transplantation and an increase in primordial and growing follicles on D28, the Cryo + Epo group exhibited significantly more follicles on D14 and D21, with fewer degenerated follicles.

Elaboração e validação de cenários de simulação clínica em hanseníase: comunicação em saúde / Elaboración y validación de escenarios de simulación clínica en lepra: comunicación en salud / Development and validation of clinical simulation scenarios in leprosy: health communication

RESUMO Objetivo: construir e validar cenários de simulação clínica para desenvolvimento da habilidade de comunicação em saúde de estudantes/profissionais no atendimento aos pacientes com hanseníase e seus contactantes. Método: desenvolveu-se pesquisa metodológica de novembro de 2020 a dezembro de 2021 em três etapas: construção dos cenários, validação e realização do teste piloto. A construção dos cenários se deu com base na literatura. Participaram da validação dez juízes com expertise em hanseníase e/ou simulação clínica, avaliando os cenários de forma remota por meio de formulários do Google Forms, pelo Índice de Validação de Conteúdo (IVC), no qual um cenário é validado se seu IVC for ≥ 0,80. Os dados foram analisados no software SPSS. O teste piloto foi dividido em: exposição de aula teórica, participação do cenário e debriefing. Participaram cinco estudantes e um profissional da área da saúde. Resultados: Foram elaborados três cenários: suspeição diagnóstica e classificação em hanseníase; vigilância dos contatos e informações sobre aplicação da vacina BCG; consulta na alta por cura, contendo, respectivamente, nove, oito e nove itens, todos com concordância satisfatória (IVC ≥ 0,90). Conclusão: considerou-se validados os cenários da pesquisa, estando disponíveis como novo material didático para fomentar o ensino na área da saúde.

RESUMEN Objetivo: construir y validar escenarios de simulación clínica para el desarrollo de la habilidad de comunicación en salud de estudiantes/profesionales en la atención a los pacientes con lepra y sus contactantes. Método: se desarrolló investigación metodológica de noviembre de 2020 a diciembre de 2021 en tres etapas: construcción de los escenarios, validación y realización de la prueba piloto. La construcción de los escenarios se dio con base en la literatura. En la validación participaron diez jueces con experiencia en lepra y/o simulación clínica, evaluando los escenarios de forma remota por medio de formularios de Google Forms, por el Índice de Validación de Contenido (IVC), en el cual un escenario es validado si su IVC es ≥ 0,80. Los datos fueron analizados en el software SPSS. La prueba piloto se dividió en: exposición de clase teórica, participación del escenario y debriefing. Participaron cinco estudiantes y un profesional de área de la salud. Resultados: fueron elaborados tres escenarios: sospecha diagnóstica y clasificación en lepra; vigilancia de los contactos e información sobre aplicación de la vacuna BCG; consulta en el alta por cura, conteniendo, respectivamente, nueve, ocho y nueve ítems, todos con concordancia satisfactoria (IVC ≥ 0,90). Conclusión: los escenarios de la investigación fueron considerados validados, estando disponibles como nuevo material didáctico para fomentar la enseñanza en el área de la salud.

ABSTRACT Objective: To construct and validate clinical simulation scenarios for the development of health communication skills of students/professionals in the care of leprosy patients and their contacts. Method: Methodological research carried out from November 2020 to December 2021 in three stages: construction of scenarios, validation and carrying out the pilot testing. The construction of the scenarios was based on the literature. A total of ten judges with expertise in leprosy and/or clinical simulation participated in the validation, evaluating the scenarios remotely through Google Forms, using the Content Validation Index (CVI), in which a scenario is validated if its CVI is ≥ 0.80. Data were analyzed using SPSS software. The pilot test was divided into: exposition of theoretical class, participation in the scenario and debriefing. Five students and one health professional participated in the study. Results: Three scenarios were elaborated: diagnostic suspicion and leprosy classification; surveillance of contacts and information on the application of the BCG vaccine; consultation at discharge due to cure containing, respectively, nine, eight and nine items, all with satisfactory agreement (CVI ≥ 0.90). Conclusion: the research scenarios were considered validated, being available as new didactic material to promote teaching in the health area.

Violência recorrente contra mulheres: análise dos casos notificados / Violencia recurrente contra mujeres: análisis de los casos notificados / Recurrent violence against women: analysis of reported cases

Resumo Objetivo Identificar a frequência de recorrência da violência contra mulheres nos diferentes ciclos de vida e verificar os fatores associados. Métodos Estudo transversal realizado com dados de notificação de violência contra o sexo feminino do estado do Espírito Santo no período de 2011 a 2018. Utilizaram-se dados do Sistema de Informação de Agravos de Notificação, por meio da Ficha de Notificação/Investigação de Violência Interpessoal e Autoprovocada. Foram realizadas análises estatísticas por meio da regressão de Poisson e do teste do qui-quadrado. Resultados A frequência de recorrência de violência no sexo feminino foi de 58,9% (IC95% 58,2-59,5). A violência de repetição foi 1,26 vez mais prevalente nas idosas e 32% mais frequente entre aquelas com deficiência; as notificações em área urbana foram 8% maiores. Quanto ao agressor, o sexo masculino prevaleceu (razão de prevalência de 1,37; IC95% 1,28-1,46), e faixa etária mais frequente foi mais de 25 anos (razão de prevalência de 1,07; IC95% 1,03-1,11). A violência recorrente foi 3,28 vezes mais cometida por conhecidos e por um agressor único (razão de prevalência de 1,24). As notificações de violência recorrente foram 55% mais prevalentes na residência. Conclusão A alta frequência da violência de repetição e as associações com as características estudadas refletem a necessidade de atenção a esse público, bem como a importância de ações que visem à detecção precoce da violência e à adequada assistência às vítimas e aos agressores familiares, a fim de evitar a perpetuação das agressões no cotidiano das mulheres.

Resumen Objetivo Identificar la frecuencia de recurrencia de la violencia contra mujeres en los diferentes ciclos de la vida y verificar los factores asociados. Métodos Estudio transversal realizado con datos de notificación de violencia contra el sexo femenino del estado de Espírito Santo, en el período de 2011 a 2018. Se utilizaron datos del Sistema de Información de Agravios de Notificación, por medio de la Ficha de Notificación/Investigación de Violencia Interpersonal y Autoprovocada. Se realizaron análisis estadísticos mediante la regresión de Poisson y la prueba χ2 de Pearson. Resultados La frecuencia de recurrencia de violencia en personas de sexo femenino fue de 58,9 % (IC95 % 58,2-59,5). La violencia de repetición fue 1,26 veces más prevalente en mujeres mayores y 32 % más frecuente entre aquellas con discapacidad. Hubo un 8 % más de notificaciones en área urbana. Respecto al agresor, el sexo masculino prevaleció (razón de prevalencia de 1,37; IC95 % 1,28-1,46), y el grupo de edad más frecuente fue más de 25 años (razón de prevalencia de 1,07; IC95 % 1,03-1,11). La violencia recurrente fue 3,28 veces más cometida por conocidos y por un único agresor (razón de prevalencia de 1,24). Las notificaciones de violencia recurrente fueron un 55 % más prevalentes en la residencia. Conclusión La alta frecuencia de violencia de repetición y las asociaciones con las características estudiadas reflejan la necesidad de atención a este público, así como la importancia de acciones que busquen la detección temprana de la violencia y la atención adecuada a las víctimas y a los agresores familiares, a fin de evitar la perpetuación de las agresiones en la vida cotidiana de las mujeres.

Abstract Objective To identify the frequency of recurrence of violence against women in different life cycles and to verify associated factors. Methods This is a cross-sectional study carried out with data on report of violence against women in the state of Espírito Santo from 2011 to 2018. Data from the Notifiable Diseases Information System were used, through the Interpersonal and Self-Inflicted Violence Reporting/Investigation Form. Statistical analyzes were performed using Poisson regression and the chi-square test. Results The frequency of recurrence of violence in females was 58.9% (95%CI 58.2-59.5). Repeated violence was 1.26 times more prevalent among elderly women and 32% more frequent among those with disabilities, and reports in urban areas were 8% higher. As for the aggressor, males prevailed (Prevalence Ratio of 1.37; 95%CI 1.28-1.46), and the most frequent age group was over 25 years (Prevalence Ratio of 1.07; 95%CI 1 03-1.11). Recurrent violence was 3.28 times more committed by acquaintances and by a single perpetrator (Prevalence Ratio of 1.24). Reports of recurrent violence were 55% more prevalent in the household. Conclusion The high frequency of recurrent violence and the associations with the characteristics studied reflect the need for attention to this public as well as the importance of actions aimed at the early detection of violence and adequate assistance to victims and family aggressors, in order to avoid the perpetuation of aggression in women's daily lives.

Management strategies for implementing a multicenter cross-sectional study: lessons from the ADHERE Brazil study

ABSTRACT BACKGROUND: Epidemiological studies involving large samples usually face financial and operational challenges. OBJECTIVES: To describe the planning and execution of ADHERE Brazil, an epidemiological study on 1,105 kidney transplant patients, and report on how the study was structured, difficulties faced and solutions found. DESIGN AND SETTING: Cross-sectional multicenter study in 20 Brazilian kidney transplantation centers. METHODS: Actions developed in each phase of implementation were described, with emphasis on innovations used within the logistics of this study, aimed at estimating the prevalence of nonadherence to treatment. RESULTS: Coordination of activities was divided into four areas: general, regulatory, data collection and statistics. Weekly meetings were held for action planning. The general coordination team was in charge of project elaboration, choice of participating centers, definition of publication policy and monitoring other coordination teams. The regulatory team provided support to centers for submitting the project to ethics committees. The data collection team prepared a manual on the electronic collection system, scheduled web meetings and was available to respond to queries. It also monitored the data quality and reported any inadequacies found. Communication with the centers was through monthly reports via e-mail and distribution of exclusive material. The statistical team acted in all phases of the study, especially in creating the data analysis plan and data bank, generation of randomization lists and data extraction. CONCLUSIONS: Through these logistics, we collected high-quality data and built a local research infrastructure for further studies. We present supporting alternatives for conducting similar studies. CLINICAL TRIAL ANNOTATION: http://clinicaltrials.gov/ on October 10, 2013; NCT02066935.

Management strategies for implementing a multicenter cross-sectional study: lessons from the ADHERE Brazil study.

BACKGROUND: Epidemiological studies involving large samples usually face financial and operational challenges. OBJECTIVES: To describe the planning and execution of ADHERE Brazil, an epidemiological study on 1,105 kidney transplant patients, and report on how the study was structured, difficulties faced and solutions found. DESIGN AND SETTING: Cross-sectional multicenter study in 20 Brazilian kidney transplantation centers. METHODS: Actions developed in each phase of implementation were described, with emphasis on innovations used within the logistics of this study, aimed at estimating the prevalence of nonadherence to treatment. RESULTS: Coordination of activities was divided into four areas: general, regulatory, data collection and statistics. Weekly meetings were held for action planning. The general coordination team was in charge of project elaboration, choice of participating centers, definition of publication policy and monitoring other coordination teams. The regulatory team provided support to centers for submitting the project to ethics committees. The data collection team prepared a manual on the electronic collection system, scheduled web meetings and was available to respond to queries. It also monitored the data quality and reported any inadequacies found. Communication with the centers was through monthly reports via e-mail and distribution of exclusive material. The statistical team acted in all phases of the study, especially in creating the data analysis plan and data bank, generation of randomization lists and data extraction. CONCLUSIONS: Through these logistics, we collected high-quality data and built a local research infrastructure for further studies. We present supporting alternatives for conducting similar studies. CLINICAL TRIAL ANNOTATION: http://clinicaltrials.gov/ on October 10, 2013; NCT02066935.

Functionality assessment in patients with rheumatic diseases undergoing treatment in the Public Health System.

OBJECTIVE: To evaluate the therapeutic response (functionality) and its associated factors in patients on biological drugs on the Public Health System for treatment of rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. METHODS: An open prospective cohort was carried out from 2011 to 2019, in Belo Horizonte (MG). Functionality was assessed using the Health Assessment Questionnaire Disability-Index at baseline, and after 6 and 12 months of follow-up. Factors associated with poor functionality were identified through logistic regression. RESULTS: The median Health Assessment Questionnaire Disability-Index at baseline was 1.5 (interquartile range of 0.8-1.9), with poor functionality observed in patients with rheumatoid arthritis. Improved functionality was seen at 6 months of treatment for the three diseases. The predictors of poor functionality at 6 months for psoriatic arthritis and ankylosing spondylitis were female sex, low education levels, and high disease activity; and for rheumatoid arthritis and psoriatic arthritis were female sex, advanced age, and high disease activity. In 12 months, the three diseases had predictors of worse functionality: female sex, low education, and high disease activity. CONCLUSION: There was a significant improvement in functionality during the follow-up, with better response at 6 months of treatment. Poor functionality was observed in older, female patients, with low education and high disease activity.

South Brazil pre-colonial sharks: Insights into biodiversity and species distributions.

South Brazil's archaeological coastal sites (shellmounds and middens) show a diverse collection of shark faunal remains, some of which belong to species considered rare nowadays for the region. However, shark archaeological remains identification in this region has been historically insufficient and prone to mistakes. This study identified shark fauna and estimated body size (total length) present at two archaeological sites: Rio do Meio (1220-977 Cal B.P.) and Enseada II (4286-3783 Cal B.P.), located in Santa Catarina, South of Brazil. Here, 1600 teeth and 3588 vertebrae were analysed and identified. We showed higher historical shark species richness than previously reported for South Brazil in historical and archaeological studies. In total, we identified at least 15 species of sharks (11 species and four identifications at the genus level). The presence of juvenile shark remains adds to the evidence of pre-colonial fishing impacts in local shark populations. The consistent recovery of adults and juveniles of Carcharias taurus points to a possible nursery area on the mouth of Babitonga bay. The high teeth frequency (43%) of C. taurus suggests the South Brazil coastline was once home to abundant populations of this critically endangered species. Furthermore, we discuss the presence of rare species nowadays, suggesting a possible historical residency for adult populations of Carcharodon carcharias based on the presence of juveniles and young-of-the-year on archaeological sites. The occurrence of Negaprion brevirostris, a tropical species, might have been facilitated by ocean current variations.

Nonadherence to immunosuppressives and treatment in kidney transplant: ADHERE BRAZIL Study.

OBJECTIVE: To estimate the prevalence and variability of nonadherence to immunosuppressives and nonpharmacological treatment across kidney transplantation centers and two health access-disparate regions in Brazil. METHODS: In a cross-sectional design, a random multistage sample of 1,105 patients was included, based on center transplantation activity (low/moderate/high) and region (R1: North/Northeast/Mid-West; and R2: South/Southeast). Nonadherence to immunosuppressives (implementation phase) was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)©. Self-report questionnaires assessed nonadherence to physical activity, smoking cessation, alcohol intake, and appointment keeping. We compared regions using the adjusted-χ2 or t-test. RESULTS: Most patients were men (58.5%), white (51.4%), and had a mean age of 47.5 (SD = 12.6) years. Regarding kidney transplantation centers, 75.9% were from R2 and 38.2% had low activity. The patients in R2 were older, white-majority, had more frequently steady partners, and received peritoneal dialysis. Nonadherence to immunosuppressives ranged from 11-65.2%; 44.5-90% to physical activity; 0-23.7% to appointment keeping; and 0-14% to smoking cessation. The total prevalence of nonadherence and by region (R1 versus R2) were: for immunosuppressives, 39.7% (44.9% versus 38.1%, p = 0.18); for smoking, 3.9% (1% versus 5%, p < 0.001); for physical activity, 69.1% (71% versus 69%, p = 0.48); for appointment keeping, 13% (12.7% versus 12%, p = 0.77); and for alcohol consumption, 0%. CONCLUSION: Despite differences among centers and high variability, only the nonadherence to smoking cessation was higher in the region with greater access to kidney transplantation. We suppose that differences in healthcare access may have been overcome by other positive aspects of the post kidney transplantation treatment.

Nonadherence to immunosuppressives and treatment in kidney transplant: Adhere Brazil Study

ABSTRACT OBJECTIVE To estimate the prevalence and variability of nonadherence to immunosuppressives and nonpharmacological treatment across kidney transplantation centers and two health access-disparate regions in Brazil. METHODS In a cross-sectional design, a random multistage sample of 1,105 patients was included, based on center transplantation activity (low/moderate/high) and region (R1: North/Northeast/Mid-West; and R2: South/Southeast). Nonadherence to immunosuppressives (implementation phase) was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS)©. Self-report questionnaires assessed nonadherence to physical activity, smoking cessation, alcohol intake, and appointment keeping. We compared regions using the adjusted-χ2 or t-test. RESULTS Most patients were men (58.5%), white (51.4%), and had a mean age of 47.5 (SD = 12.6) years. Regarding kidney transplantation centers, 75.9% were from R2 and 38.2% had low activity. The patients in R2 were older, white-majority, had more frequently steady partners, and received peritoneal dialysis. Nonadherence to immunosuppressives ranged from 11-65.2%; 44.5-90% to physical activity; 0-23.7% to appointment keeping; and 0-14% to smoking cessation. The total prevalence of nonadherence and by region (R1 versus R2) were: for immunosuppressives, 39.7% (44.9% versus 38.1%, p = 0.18); for smoking, 3.9% (1% versus 5%, p < 0.001); for physical activity, 69.1% (71% versus 69%, p = 0.48); for appointment keeping, 13% (12.7% versus 12%, p = 0.77); and for alcohol consumption, 0%. CONCLUSION Despite differences among centers and high variability, only the nonadherence to smoking cessation was higher in the region with greater access to kidney transplantation. We suppose that differences in healthcare access may have been overcome by other positive aspects of the post kidney transplantation treatment.

DNA from wood - A simple approach facing a challenging matrix - A preliminary study.

Plant DNA barcoding has proven to be a handy tool for identifying botanical species. However, extracting DNA from woody materials is often a challenging task. Forensic applications, therefore, must be able to overcome the technical difficulties of this nature. A simple and successful adaptation, through a widely used method in forensic laboratories, using chemistry based on magnetic DNA isolation technology and a robotic platform, is presented here. The model case was the application of this adapted DNA extraction method for the identification of Aspidosperma spp., a genus comprising several species in all biomes of Brazil, including Cerrado and Rain Forest. Such technology adaptation can aid in the identification of seized material and help in investigations involving illegal logging and deforestation, ultimately contributing to environmental protection.

Retinal alterations in a pre-clinical model of an autism spectrum disorder.

Background: Autism spectrum disorders (ASD) affect around 1.5% of people worldwide. Symptoms start around age 2, when children fail to maintain eye contact and to develop speech and other forms of communication. Disturbances in glutamatergic and GABAergic signaling that lead to synaptic changes and alter the balance between excitation and inhibition in the developing brain are consistently found in ASD. One of the hallmarks of these disorders is hypersensitivity to sensory stimuli; however, little is known about its underlying causes. Since the retina is the part of the CNS that converts light into a neuronal signal, we set out to study how it is affected in adolescent mice prenatally exposed to valproic acid (VPA), a useful tool to study ASD endophenotypes. Methods: Pregnant female mice received VPA (600 mg/kg, ip) or saline at gestational day 11. Their male adolescent pups (P29-35) were behaviorally tested for anxiety and social interaction. Proteins known to be related with ASD were quantified and visualized in their retinas by immunoassays, and retinal function was assessed by full-field scotopic electroretinograms (ERGs). Results: Early adolescent mice prenatally exposed to VPA displayed impaired social interest and increased anxiety-like behaviors consistent with an ASD phenotype. The expression of GABA, GAD, synapsin-1, and FMRP proteins were reduced in their retinas, while mGluR5 was increased. The a-wave amplitudes of VPA-exposed were smaller than those of CTR animals, whereas the b-wave and oscillatory potentials were normal. Conclusions: This study establishes that adolescent male mice of the VPA-induced ASD model have alterations in retinal function and protein expression compatible with those found in several brain areas of other autism models. These results support the view that synaptic disturbances with excitatory/inhibitory imbalance early in life are associated with ASD and point to the retina as a window to understand their subjacent mechanisms.

Risk factors for neurocognitive impairment in HIV-infected patients and comparison of different screening tools / Fatores de risco para alterações neurocognitvas em pacientes infectados pelo HIV e comparação de diferentes ferramentas de triagem

HIV-associated neurocognitive disorder (HAND) is relatively frequent among HIV-infected patients and is often underdiagnosed. Assessment of HAND in daily clinical practice is challenging and different tools have been proposed. Objective : To evaluate risk factors and compare different screening tools for neurocognitive impairment in HIV-infected patients. Methods : HIV-infected patients were evaluated using the International HIV-Dementia Scale (IHDS), Mini-Mental State Examination (MMSE) and a neurocognitive self-perception questionnaire recommended by the European AIDS Clinical Society. Sociodemographic, clinical and laboratory data were obtained through chart review and patient interview. Results : Among the 63 patients included, low performance on the IHDS was observed in 54.0% and IHDS score was inversely associated with age (OR 0.13; 95%CI [0.02-0.67]). Regarding cognitive self-perception, 63.5% of patients reported no impairment on the three domains covered by the questionnaire. Among those patients self-reporting no problems, 42.1% had low performance on the IHDS. None of the patients scored below the education-adjusted cut-off on the MMSE. Conclusion : IHDS scores suggestive of HAND were observed in more than half of the patients and lower scores were found among older patients. There was low agreement between the different tools, suggesting that the MMSE may be inadequate for assessing HAND. The self-assessment questionnaire had low sensitivity and might not be useful as a screening tool.

As alterações neurocognitivas associadas ao HIV (HAND) são relativamente frequentes entre pacientes infectados pelo HIV, porém são subdiagnosticadas. Avaliação de HAND na prática clínica diária é desafiador e diferentes ferramentas têm sido propostas. Objetivo : Avaliar fatores de risco e comparar diferentes ferramentas de rastreamento de alterações neurocognitivas em pacientes infectados pelo HIV. Métodos : Pacientes infectados pelo HIV foram avaliados usando a Escala Internacional de Demência pelo HIV (IHDS), Mini Exame do Estado Mental (MEEM) e um questionário de autopercepção neurocognitiva recomendado pela Sociedade Clínica Europeia de AIDS. Dados sociodemográficos, clínicos e laboratoriais foram obtidos por revisão de prontuário e entrevista com o paciente. Resultados : Entre os 63 pacientes incluídos no estudo, um baixo desempenho no IHDS foi observado em 54,0% e o escore no IHDS esteve inversamente associado à idade (OR 0,13; IC95% [0,02-0,67]). Em relação à autopercepção cognitiva, 63,5% dos pacientes não relataram nenhum prejuízo nos três domínios avaliados pelo instrumento. Nenhum paciente apresentou escore no MEEM abaixo do ponto de corte ajustado para escolaridade. Conclusão : Escores no IHDS sugestivos de HAND foram observados em mais da metade dos pacientes e valores mais baixos foram encontrados entre pacientes mais velhos. Houve pouca concordância entre os diferentes métodos de avaliação, sugerindo que o MEEM é inadequado para avaliação de HAND e o questionário de auto-avaliação tem uma baixa sensibilidade, não parecendo ser útil como ferramenta de triagem.

Risk factors for neurocognitive impairment in HIV-infected patients and comparison of different screening tools.

HIV-associated neurocognitive disorder (HAND) is relatively frequent among HIV-infected patients and is often underdiagnosed. Assessment of HAND in daily clinical practice is challenging and different tools have been proposed. OBJECTIVE: To evaluate risk factors and compare different screening tools for neurocognitive impairment in HIV-infected patients. METHODS: HIV-infected patients were evaluated using the International HIV-Dementia Scale (IHDS), Mini-Mental State Examination (MMSE) and a neurocognitive self-perception questionnaire recommended by the European AIDS Clinical Society. Sociodemographic, clinical and laboratory data were obtained through chart review and patient interview. RESULTS: Among the 63 patients included, low performance on the IHDS was observed in 54.0% and IHDS score was inversely associated with age (OR 0.13; 95%CI [0.02-0.67]). Regarding cognitive self-perception, 63.5% of patients reported no impairment on the three domains covered by the questionnaire. Among those patients self-reporting no problems, 42.1% had low performance on the IHDS. None of the patients scored below the education-adjusted cut-off on the MMSE. CONCLUSION: IHDS scores suggestive of HAND were observed in more than half of the patients and lower scores were found among older patients. There was low agreement between the different tools, suggesting that the MMSE may be inadequate for assessing HAND. The self-assessment questionnaire had low sensitivity and might not be useful as a screening tool.

As alterações neurocognitivas associadas ao HIV (HAND) são relativamente frequentes entre pacientes infectados pelo HIV, porém são subdiagnosticadas. Avaliação de HAND na prática clínica diária é desafiador e diferentes ferramentas têm sido propostas. OBJETIVO: Avaliar fatores de risco e comparar diferentes ferramentas de rastreamento de alterações neurocognitivas em pacientes infectados pelo HIV. MÉTODOS: Pacientes infectados pelo HIV foram avaliados usando a Escala Internacional de Demência pelo HIV (IHDS), Mini Exame do Estado Mental (MEEM) e um questionário de autopercepção neurocognitiva recomendado pela Sociedade Clínica Europeia de AIDS. Dados sociodemográficos, clínicos e laboratoriais foram obtidos por revisão de prontuário e entrevista com o paciente. RESULTADOS: Entre os 63 pacientes incluídos no estudo, um baixo desempenho no IHDS foi observado em 54,0% e o escore no IHDS esteve inversamente associado à idade (OR 0,13; IC95% [0,02-0,67]). Em relação à autopercepção cognitiva, 63,5% dos pacientes não relataram nenhum prejuízo nos três domínios avaliados pelo instrumento. Nenhum paciente apresentou escore no MEEM abaixo do ponto de corte ajustado para escolaridade. CONCLUSÃO: Escores no IHDS sugestivos de HAND foram observados em mais da metade dos pacientes e valores mais baixos foram encontrados entre pacientes mais velhos. Houve pouca concordância entre os diferentes métodos de avaliação, sugerindo que o MEEM é inadequado para avaliação de HAND e o questionário de auto-avaliação tem uma baixa sensibilidade, não parecendo ser útil como ferramenta de triagem.

Does ethnic ancestry play a role in smoking?

The higher proportion of smokers among Black people in Brazil has been attributed to socioeconomic disparities, but genetic factors could also contribute for this finding. This study aimed at investigating associations between smoking status with genetically defined ethnic ancestry and socioeconomic features in Brazilians. Blood samples were collected from 448 volunteers (66.7% male; age: 37.1 ± 11.4 years) classified as current smokers (CS: 60.9%), former smokers (FS: 8.9%) and never smokers (NS: 30.1%). Individual interethnic admixtures were determined using a 48 insertion-deletion polymorphisms ancestry-informative-marker panel. CS showed a lower amount of European ancestry than NS (0.837 ± 0.243 X 0.883 ± 0.194, p ≤ 0.05) and FS (0.837 ± 0.243 X 0.864 ± 0.230, p ≤ 0.05), and a higher proportion of African Sub-Saharan ancestry than FS (0.128 ± 0.222 X 0.07 ± 0.174, p ≤ 0.05) and NS (0.128 ± 0.222 X 0.085 ± 0.178, p ≤ 0.05). NS reported a higher number of years in school than CS (11.2 ± 3.7 X 8.9 ± 3.8, p ≤ 0.001). CS were less common in economic Class A (30%) and more common in Class B (56.8%). In multivariate analysis, only lower number of school years and lower economic class were associated with higher chances for CS. The use of genetic molecular markers for characterizing ethnic background confirmed that socioeconomic disparities are the main determinants of higher smoking rates among Blacks in Brazil.

O olhar dos profissionais de uma Unidade Básica de Saúde sobre a implantação do Programa Saúde na Escola / The professional look of a Basic Health Unit about the implementation of the Health at School Program

Introdução: o Programa Saúde na Escola (PSE) é uma iniciativa do Ministério da Saúde e da Educação, que visa a contribuir para a formação integral dos estudantes da rede pública de educação básica, por meio de ações de prevenção de doenças e agravos, promoção e atenção à saúde. Portanto, torna-se imprescindível a parceria das equipes de saúde juntoà escola. Objetivo: verificar o perfil sociodemográfico e a percepção dos profissionais de uma Unidade Básica de Saúde (UBS) sobre o PSE, com o intuito de subsidiar estratégias para aprimorar o programa. Métodos: trata-se de um estudo transversal descritivo, realizado por meio de entrevistas, com 45 (65%) profissionais que trabalham na UBS ? Serra Verde em Belo Horizonte, Minas Gerais. Resultados: o grupo entrevistado é caracterizado por maioria feminina (n=39, 88,6%), formação superior (n=20, 45,5%) e idade média de 42 anos. Quanto à percepção do PSE no que concerne à avaliação, os percentuais mais frequentes de respostas foram avaliando o PSE de forma positiva (n=16, 36,4%) e relatando não saber avaliá-lo (36,4%). Já em relação aos pontos positivos e negativos, boa parte não soube identificá-los (n=15, 34,1% e n=17, 38,6%, respectivamente). Houve também argumentações diversas quanto à importância do PSE para a comunidade local. Conclusão: verifica-se desconhecimento expressivo sobre o PSE por parte dos profissionais entrevistados, assim como reduzida capacidade de argumentação na avaliação do programa. Contudo, a maioria julga-o importante para a comunidade local. Dessa forma, visualiza-se a necessidade de estratégias voltadas para esses profissionais, concernentes à efetivação do PSE.

Introduction: the Health at School Program (PSE) is an initiative of the Ministry of Health and Education, which aims to contribute to the integral formation of public school students at basic education through actions of illnesses and diseases prevention and promotion and attention to health. Therefore, the partnership between health teams and school becomes imperative. Objective: to verify the demographic profile and the perception of professionals, from a Basic Health Unit (UBS), about the PSE to subsidize strategies to enhance the program. Methods: this was a descriptive cross-sectional study, conducted through interviews with 45 (65%) professionals who work at a UBS ? Serra Verde in Belo Horizonte, Minas Gerais. Results: the interviewed group was characterized by a majority of females (n = 39, 88.6%), higher education (n = 20, 45.5%), and an average age of 42 years. The PSE perceptions showed that the mostfrequent responses were positive (n = 16, 36.4%) and not knowing how to evaluate (36.4%). Most of the interviewees could not identify positive and negative points (n = 15, 34.1% and n = 17, 38.6%, respectively). Moreover, diverse arguments regarding the importance of PSE for the local community were presented. Conclusion: an expressive lack of knowledge about the PSE was observed on the part of the interviewed professionals and reduced ability of argumentation in the evaluation of the program. However, the majority deems it important to the local community. Therefore, the need for strategies to these professionals, concerning the effectiveness of the PSE, is fundamental.

Rapid preparation of rodent testicular cell suspensions and spermatogenic stages purification by flow cytometry using a novel blue-laser-excitable vital dye.

Availability of purified or highly enriched fractions representing the various spermatogenic stages is a usual requirement to study mammalian spermatogenesis at the molecular level. Fast preparation of high quality testicular cell suspensions is crucial when flow cytometry (FCM) is chosen to accomplish the stage/s purification. Formerly, we reported a method to rapidly obtain good quality rodent testicular cell suspensions for FCM analysis and sorting. Using that method we could distinguish and purify early meiocytes (leptotene/zygotene stages, L/Z) from more advanced ones (pachytene, P) in guinea pig, which presents an unusually high content of early stages. Here we present an upgrade of that method with improvements that enabled the obtainment of high-purity meiotic substages also from mouse testis, namely:•Shortening of the mechanical disaggregation time to optimize the integrity of the suspension.•Elimination of the 25 µm-filtration step to ensure the presence of large P cells.•Inclusion of a non-cytotoxic, DNA-specific, 488 nm-excitable vital fluorochrome (Vybrant DyeCycle Green [VDG], Invitrogen) instead of Hoechst 33342 (requires UV laser, which can damage nucleic acids) or propidium iodide (usually related to dead/damaged cells). As far as we know, this is the first report on the use of this fluorochrome for the discrimination and purification of meiotic prophase I substages.

A motivational profile for smoking among adolescents.

OBJECTIVES: To characterize a motivational profile of reasons for smoking among teenagers. To investigate the influence of clinical and social elements on observed scores. METHODS: High school students who smoked in the past month (n = 226; age, 16.4 ± 10 years; 46.5% male) answered a questionnaire during school time. The instrument included the University of São Paulo Reasons for Smoking Scale (USP-RSS), the Fagerström Test for Nicotine Dependence, and clinical and social information. The USP-RSS scores from 307 healthy adult smokers (67.5% male; age, 37.9 ± 11.2 years) were also used for comparisons. RESULTS: Most of the adolescents (90.2%) exhibited low or very low levels of nicotine addiction (median Fagerström Test for Nicotine Dependence score 0, range 0 to 8). The mean scores of the USP-RSS subscales were as follows: Addiction, 1.9 ± 1.1; Pleasure From Smoking, 3.0 ± 1.3; Tension Reduction, 2.4 ± 1.3; Stimulation, 1.9 ± 0.9; Automatism, 1.3 ± 0.6; Handling, 2.3 ± 1.1; Social Smoking, 1.9 ± 1.0; Weight Control, 1.4 ± 1.0; and Affiliative Attachment, 1.6 ± 0.9. In comparison with adults, teenagers exhibited lower scores for Addiction, Pleasure From Smoking, Tension Reduction, Automatism, Weight Control, and Affiliative Attachment and higher scores for Social Smoking (P < 0.05). Older age, past school failure, illicit drugs use, alcohol abuse, high levels of perceived stress, and the death of at least one parent were associated with high scores for all subscales. CONCLUSIONS: The USP-RSS subscales Addiction, Pleasure From Smoking, and Social Smoking were important factors for adolescent smoking. Comparisons with adult smokers stressed the importance of the component of Social Smoking. The identification of distinctive factors that drive teenagers to smoke might help in making decisions dealing with interventions aimed at smoking cessation and control.

Contribuições das atividades complementares na formação profissional em odontologia / Contributions of complementary activities in professional dental training

Objetivo: Caracterizar a inserção de atividades complementares em um curso de graduação em Odontologia, bem como sua contribuição para a formação profissional. Métodos: Trata-se de uma pesquisa transversal, exploratória, com abordagem quanti-qualitativa. O levantamento de dados deu-se a partir da aplicação de um questionário a todos os discentes do último ano do curso de graduação em Odontologia da Universidade Federal de Santa Catarina, durante três semestres (2011.2, 2012.1, 2012.2). Os dados quantitativos foram tabulados e analisados por meio de análise estatística descritiva com o auxílio do aplicativo Googledocs para formulários de pesquisa. Realizaram-se, também, entrevistas em profundidade com 10 discentes que responderam ao questionário, cujos dados qualitativos foram analisados segundo os pressupostos da Análise de Conteúdo. Resultados: Participaram da pesquisa 70 discentes; destes, 93% haviam participado de alguma atividade complementar durante a graduação. As atividades foram realizadas principalmente na área de Odontologia em Saúde Coletiva (67%) e se relacionavam com mais frequência a estágios e atividades de extensão. Destas atividades, 33% estavam relacionadas ao trabalho de conclusão de curso do discente, enquanto apenas 9% estavam vinculadas à pós-graduação; 65% dos discentes consideraram que a participação nestas atividades contribuiu muito para a sua formação. Os resultados obtidos através dos dados qualitativos foram agrupados em 03 categorias relativas aos Fatores que influenciam na participação dos alunos nas atividades complementares, a Importância da participação em atividades complementares e às Limitações na realização de atividades complementares. Conclusão: Grande parte dos discentes participou de alguma atividade complementar durante a sua formação e considerou essa participação posi tiva, indicando que o curso em questão tem disponibilizado esse tipo de oportunidade. Uma boa adequação didático-pedagógica das atividades complementares parece influenciar no modo como o aluno percebe a importância e valoriza a participação nessas atividades, como auxiliar no seu processo de ensino-aprendizagem na formação profissional em Odontologia (AU).

Objective: Characterize the inclusion of complementary activities in an undergraduate dental course, and their contribution to professional training. Methods: This was an exploratory cross-sectional study with a quantitative and qualitative approach. During 2011 (2nd sem.) and 2012 (1st and 2nd sem.), all undergraduate students in their final year at the Federal University of Santa Catarina Dental School were asked to answer a questionnaire. The quantitative data were tabulated and analyzed using descriptive statistics, with the help of Google Docs® software for research forms. There were also in-depth interviews with 10 students who completed the questionnaire. The qualitative data were analyzed according to the content analysis framework. Results: There were 70 participants; 93% had been involved in complementary activities during their undergraduate studies. The activities were carried out mainly in the area of public health dentistry (67%) and were most often related to internships and outreach activities; 33% were related to the student's final term paper for the course, whereas only 9% were related to graduate research; 65% of the students felt that participating in these activities contributed greatly to their education. The results obtained from the qualitative data were grouped into three categories related to the factors that influence student participation in complementary activities, to the importance of participating in complementary activities and to limitations while performing complementary activities. Conclusion: Most of the students participated in complementary activities during their university training and considered them a positive experience, indicating that the course in question provided this type of opportunity. The didactic and pedagogic organization of the complementary activities appears to influence how students perceive the importance and value of their participation in these activities, as an aid in the teaching-learning process of professional dentistry training (AU).

Violência urbana e cultura escolar: estudos das percepções dos atores sociais em uma escola pública em Ananideua - PA / Urban violence and school culture: study of the perceptions of social actors in a public school in Ananindeua - PA

Atualmente, torna-se difícil diferenciar o que é violência escolar da não-escolar. O objeto aqui estudado foi a violência urbana e sua (inter) relação com a escola. Os sujeitos do estudo foram os professores, de uma escola pública de Ananindeua (Pará), cidade essa que apresenta elevada taxa de violência urbana envolvendo o público juvenil. O aporte teóricometodológico foi qualitativo, do tipo Estudo de Caso, onde se buscou analisar as percepções dos atores escolares acerca da violência urbana e sua mútua relação com a escola. Os resultados foram percepções que concebem a escola de modo isolado à realidade social do entorno. Logo, revelou-se uma visão fragmentada sobre a escola e sociedade.(AU)

Currently, it is difficult to identify what is school violence from non-school. The object here was to study urban violence and their (inter) relationship with the school. The target of this study were teachers, technicians and employees of a public school in Ananindeua (Pará), this city that has a high rate of urban violence involving young audience. The theoretical and methodological approach was qualitative, adopting a case study, which sought to examine the perceptions of school actors about urban violence and their (mutual) relationship with the school. The results were perceptions that view the school in isolation from the surrounding social reality. Soon, it was revealed a fragmented view of the school and society.(AU)

En la actualidad, es difícil identificar lo que la violencia escolar no es la escuela. El objetivo aquí fue el estudio de la violencia urbana y la (inter) relación con la escuela. El público objetivo de este estudio fueron los profesores, técnicos y empleados de una escuela pública en Ananindeua (Pará), esta ciudad que tiene una alta tasa de violencia urbana que implica público joven. La calidad teórica y metodológica fue, como estudio de caso, que investiga las percepciones de los actores de la escuela sobre la violencia urbana y su (mutuo) relación con la escuela. Los resultados fueron la percepción de que la escuela de diseño de manera aislada a la realidad social del entorno. Pronto se puso de manifiesto una visión fragmentada de la escuela y la sociedad.(AU)