Migração, trabalho e violência: interfaces com a Saúde / Migration labor and violence: interfaces with healthcare / Migración trabajo y violencia: interfaces con la salud

A cartilha é um material educativo fruto da pesquisa "Migração, saúde e violências: experiências de trabalhadoras(es) migrantes e refugiadas(os) no Rio de Janeiro", durante a qual foram escutadas(os) migrantes e refugiadas(os) residentes no Brasil, especificamente no estado do Rio de Janeiro. Os deslocamentos humanos são uma realidade de dimensões globais e garantir o acesso e a permanência de migrantes e refugiadas(os) em postos de trabalho seguros, saudáveis e não violentos deve ser uma das finalidades de sociedades que prezam pela justiça social. A migração e o refúgio podem trazer mudanças na forma de organização familiar e a necessidade de buscar emprego, casa, estudo, relações de amizade e redes de apoio. Ao mesmo tempo em que a migração e o refúgio podem ser experiências que tragam novos recomeços, os sentimentos de incerteza, insegurança, medo, saudades e preocupação estão presentes no cotidiano de migrantes e refugiadas(os) e se expressam também na esfera do trabalho. Associado a isso, o mundo do trabalho tem passado por profundas transformações, principalmente nas últimas cinco décadas, que vêm impactando a vida de trabalhadoras(es), como o aumento do desemprego, contratações temporárias, baixos salários e a permanência de trabalho escravizado e forçado. Portanto, é preciso reconhecê-las para enfrentá-las, de modo a garantir um ambiente de trabalho seguro e saudável para todas(os). (AU)

Therapeutic or lifelong training effects on pancreatic morphological and functional parameters in an animal model of aging and obesity.

AIMS: Obesity, aging, and physical training are factors influencing pancreatic functional and morphological parameters. Aiming to clarify the impact of the interaction of these factors, we analyzed the effect of therapeutic or lifelong physical training on body adiposity and pancreatic functional and morphological parameters of aged and obese rats. METHODS: 24 male Wistar rats were (initial age = 4 months and final age = 14 months) randomly divided into three aged and obese experimental groups (n = 8/group): untrained, therapeutic trained, and lifelong trained. Body adiposity, plasmatic concentration and pancreatic immunostaining of insulin, markers of tissue inflammation, lipid peroxidation, activity and immunostaining of antioxidant enzymes, and parameters of pancreatic morphology were evaluated. RESULTS: Lifelong physical training improved the body adiposity, plasmatic insulin concentration, and macrophage immunostaining in the pancreas. The animals submitted to therapeutic and lifelong training showed an increase in the density of the pancreatic islets; lower insulin, Nuclear Factor Kappa B (NF-κB), and Transforming Growth Factor beta (TGF-ß) immunostaining in the pancreatic parenchyma, as well as lower pancreatic tissue lipid peroxidation, lower fibrosis area, increased catalase and glutathione peroxidase (GPx) activity and increased heme oxygenase-1 (HO-1) immunostaining, with the greatest effect in the lifelong training group. CONCLUSION: Lifelong training promoted greater beneficial effects on the pancreatic functional and morphological parameters of aged and obese animals compared to therapeutic exercise.

Postmenopausal Hyperandrogenism due to Ovarian Hyperthecosis.

Ovarian hyperthecosis or ovarian stromal hyperplasia is a non-neoplastic functional disorder resulting from the presence of luteinized thecal cells within a hyperplastic ovarian stroma. The condition is more common in postmenopausal women than in those of reproductive age and leads to substantial clinical and laboratory alterations, principally androgenetic alopecia, progressive hirsutism, and elevated testosterone levels. Investigation should include clinical evaluation, laboratory tests, and imaging tests to differentiate between the principal diagnostic hypotheses. The gold standard for diagnosis is histopathology of the ovarian tissue. The present case report describes a woman being followed up as an outpatient at the Santa Casa de Misericórdia Hospital in Vitória, Brazil. The objective in publishing this case report is to add to available data on ovarian hyperthecosis, thus contributing towards improving timely diagnosis and treatment. Early diagnosis and treatment would ensure better quality of life for patients with this condition and better physical and mental health. Moreover, these data should be useful both for the medical community and for future research into this disease.

The quality and inflammatory index of the diet of patients with migraine.

BACKGROUND: The association between diet and migraine has been reported in the literature, but only a few studies have evaluated whether the diet consumed by patients with migraine differs from individuals without migraine. OBJECTIVE: Herein, we aimed to investigate whether the quality and the Dietary Inflammatory Index (DII) of diet consumed by migraine patients differ from that consumed by healthy controls. We also evaluated whether the severity of migraine and headache frequency were associated with these parameters. METHODS: Patients of both sexes, aged between 18 and 65, with episodic migraine and healthy controls were enrolled in this cross-sectional study. Disability and impact caused by migraine and depressive symptoms were evaluated. Dietary intake was assessed using a 24-hour dietary recall and a three-day non-consecutive food record. The quality of the diet was calculated using the Healthy Eating Index (HEI)-2015 adapted to the Brazilian population, and DII was calculated based on the method developed by Shivappa et al. (2014). RESULTS: Ninety patients with migraine and 62 individuals without migraine were included in this study. The groups did not differ regarding age, sex, marital status, years of schooling, anthropometric characteristics, and depressive symptoms. Patients with migraine had lower HEI total score than controls, indicating that these patients have a lower quality of the diet. Patients with migraine also had higher DII than controls. Nevertheless, HEI and DII scores did not correlate with migraine frequency and severity. CONCLUSION: This study corroborates the view that the characteristics of the diet might be involved in migraine pathophysiology.

Older Adults' Perceptions of Frailty Language: A Scoping Review.

There is growing interest in conceptualizing and diagnosing frailty. Less is understood, however, about older adults' perceptions of the term "frail", and the implications of being classified as "frail". The purpose of this scoping review was to map the breadth of primary studies; and describe the meaning, perceptions, and perceived implications of frailty language amongst community-dwelling older adults. Eight studies were included in the review and three core themes were identified: (1) understanding frailty as inevitable age-related decline in multiple domains, (2) perceiving frailty as a generalizing label, and (3) perceiving impacts of language on health and health care utilization. Clinical practice recommendations for health care professionals working with individuals with frailty include: (1) maintaining a holistic view of frailty that extends beyond physical function to include psychosocial and environmental constructs, (2) using person-first language, and (3) using a strengths-based approach to discuss aspects of frailty.

Spiders in Brazil: from arachnidism to potential therapeutic use of their venom part 1 of 2

Spider envenomation, generically known as arachnidism, is described in many places around the world. In terms of medical importance, the following genera of animals stand out as the main origin of the morbid condition: Atrax (Sidney funnel web spider), Steatoda (false black widow), Latrodectus (black widow), Loxosceles (brown spider) and Phoneutria (armed spider), the last three causing accidents involving spiders in Brazil. This article, part 1 of 2, aims to present the main aspects of arachnidism in the country, with an emphasis on the biology and geographical distribution of spiders, biochemistry of the venom, pathogenesis and epidemiology of arachnidism, as well as prevention of the morbid condition.

Spiders in Brazil: from arachnidism to potential therapeutic use of their venom part 2 of 2

Arachnidism, spider envenomation, is an important public health issue in different parts of the world. Its clinical evolution depends on the genus involved. Symptoms and signs range from skin alterations to systemic manifestations. The success of treatment, consisting of serotherapy and other measures, depends on the patient's immediate care. In addition to the potential injury to human hosts, spider venom has been investigated for the therapy of various diseases. Based on these considerations, this article, part 2 of 2, aims to present the main aspects of spider accidents, focusing on clinical findings, diagnosis, differential diagnosis and treatment, as well as highlighting the potential of the venom of these arachnids.

SARSCOVIDB-A New Platform for the Analysis of the Molecular Impact of SARS-CoV-2 Viral Infection.

The COVID-19 pandemic caused by the new coronavirus (SARS-CoV-2) has become a global emergency issue for public health. This threat has led to an acceleration in related research and, consequently, an unprecedented volume of clinical and experimental data that include changes in gene expression resulting from infection. The SARS-CoV-2 infection database (SARSCOVIDB: https://sarscovidb.org/) was created to mitigate the difficulties related to this scenario. The SARSCOVIDB is an online platform that aims to integrate all differential gene expression data, at messenger RNA and protein levels, helping to speed up analysis and research on the molecular impact of COVID-19. The database can be searched from different experimental perspectives and presents all related information from published data, such as viral strains, hosts, methodological approaches (proteomics or transcriptomics), genes/proteins, and samples (clinical or experimental). All information was taken from 24 articles related to analyses of differential gene expression out of 5,554 COVID-19/SARS-CoV-2-related articles published so far. The database features 12,535 genes whose expression has been identified as altered due to SARS-CoV-2 infection. Thus, the SARSCOVIDB is a new resource to support the health workers and the scientific community in understanding the pathogenesis and molecular impact caused by SARS-CoV-2.

Adaptations in GLUT4 Expression in Response to Exercise Detraining Linked to Downregulation of Insulin-Dependent Pathways in Cardiac but not in Skeletal Muscle Tissue.

Insulin resistance is associated with cardiometabolic risk factors, and exercise training can improve insulin-mediated glucose uptake. However, few studies have demonstrated the reversibility of exercise-induced benefits. Thus, the authors examine the time-response effects of exercise training and detraining on glucose transporter 4 (GLUT4) content, insulin-dependent and insulin-independent pathways in cardiac and gastrocnemius muscle tissues of spontaneously hypertensive rats. Thirty-two male spontaneously hypertensive rats, 4 months old, were assigned to (n = 8/group): T (exercise training: 10-week treadmill exercise, 50-70% maximum effort capacity, 1 hr/day, 5 days/week); D2 (exercise training + 2-day detraining), D4 (exercise training + 4-day detraining); and S (no exercise). The authors evaluated insulin resistance, maximum effort capacity, GLUT4 content, p-IRS-1Tyr1179, p-AS160Ser588, p-AMPKα1Thr172, and p-CaMKIIThr286 in cardiac and gastrocnemius muscle tissues (Western blot). In response to exercise training, there were improvements in insulin resistance (15.4%; p = .010), increased GLUT4 content (microsomal, 29.4%; p = .012; plasma membrane, 27.1%; p < .001), p-IRS-1 (42.2%; p < .001), p-AS160 (60.0%; p < .001) in cardiac tissue, and increased GLUT4 content (microsomal, 29.4%; p = .009; plasma membrane, 55.5%; p < .001), p-IRS-1 (28.1%; p = .018), p-AS160 (76.0%; p < .001), p-AMPK-α1 (37.5%; p = .026), and p-CaMKII (30.0%; p = .040) in the gastrocnemius tissue. In D4 group, the exercise-induced increase in GLUT4 was reversed (plasma membrane, -21.3%; p = .027), p-IRS1 (-37.1%; p = .008), and p-AS160 (-82.6%; p < .001) in the cardiac tissue; p-AS160 expression (-35.7%; p = .034) was reduced in the gastrocnemius. In conclusion, the cardiac tissue is more susceptible to exercise adaptations in the GLUT4 content and signaling pathways than the gastrocnemius muscle. This finding may be explained by particular characteristics of insulin-dependent and insulin-independent pathways in the muscle tissues studied.

Short-Term Detraining does not Change Insulin Sensitivity and RBP4 in Rodents Previously Submitted to Aerobic Exercise.

Elevated serum retinol binding protein 4 (RBP4) levels were previously described in insulin-resistance states. Exercise training can improve insulin sensitivity and RBP4, but the time-response effect of exercise detraining on RBP4 has not been studied. Thus, we examined the effects of exercise training and short-term detraining on insulin resistance, serum RBP4 levels, and GLUT4 expression in spontaneously hypertensive rats (SHR). Thirty-two male SHR, 4 months old, were submitted to 10-week treadmill training, 5 times/week or kept sedentary, followed by a 2- and 4-day detraining period. Body weight, insulin tolerance test, maximum speed in a maximal exercise test, serum RBP4 (ELISA), and epididymal fat GLUT4 expression (Western blot) were measured. Although all rats gained weight (43%, p=0.004) only the trained group showed a reduction (p<0.001) of epididymal fat weight. Detraining did not change these parameters. Exercise training increased insulin sensitivity (26%, p=0.001) and maximum exercise capacity (80%, p<0.001), benefits not lost after detraining. RBP4 levels were reduced in response to exercise training (45%, p<0.001); detraining did not change these benefits. Trained rats had increased GLUT4 expression (microsomal, ~226%; p<0.001 and plasma membrane, ~55%; p=0.011). A slight reduction in GLUT4 expression in the plasma membrane (~28%, p=0.041), but not in the microsomal fraction, was observed after 4 days of detraining. Exercise training is associated with reduced RBP4 levels, increased insulin sensitivity, and epididymal fat GLUT4 expression. Even short periods of detraining (4 days) were shown to be associated with reversal of higher plasma membrane GLUT4.

Um estudo descritivo das brincadeiras em uma comunidade Ribeirinha Amazônica / A descriptive study of child's play in an Amazonian Riverside community / Un estudio descriptivo de juego en una comunidad Ribereño Amazonas

A brincadeira é um fenômeno universal que apresenta aspectos peculiares os quais são influenciados por elementos dos ambientes físico, social, cultural e pelas características das crianças. Esses aspectos permitem compreender a brincadeira como produto e produtor do desenvolvimento humano, pois é por meio dela que o indivíduo experimenta, de uma forma segura, comportamentos que, em situações normais, isto é, fora do contexto lúdico, poderiam ter consequências sociais aversivas. O objetivo do trabalho foi o de descrever as brincadeiras ribeirinhas amazônicas. Participaram da pesquisa 66 crianças e adolescentes, moradores da comunidade do rio Araraiana, cuja faixa etária está entre 0 e 18 anos, dos quais 32 meninos e 34 meninas. Utilizou-se o Inventário Sociodemográfico (ISD) e o Inventário Espontâneo das Brincadeiras (IEB). Os dados revelaram uma diversidade de brincadeiras: a brincadeira simbólica, jogos com regras, brincadeira locomotora, brincadeiras com objetos e com animais e brincadeira de construção. Os resultados demonstram que as brincadeiras expressam, em sua maioria, o dia a dia da comunidade como: a construção de brinquedos de barco e espingarda, situações com temas domésticos (cozinha, boneca) e ligados ao meio de subsistência como pescar, conduzir canoa, construir gaiola. Portanto, as brincadeiras de maneira geral retratam aspectos peculiares do ambiente físico, social e cultural do universo infantil da comunidade ribeirinha estudada.

El juego es un fenómeno universal que tiene aspectos peculiares que son influenciados por elementos de los ambientes físicos, sociales y culturales por parte de las características de los niños. Estos aspectos nos permiten entender la broma como un producto y productor del desarrollo humano, ya que es a través de él que las experiencias individuales en una forma segura y comportamientos que, en situaciones normales, es decir, fuera del contexto del juego, podría tener consecuencias sociales aversivas. El objetivo de este estudio fue describir los juegos fluviales amazónicas. Participaron en el estudio 66 niños, niñas y adolescentes que viven en el río Araraiana comunidad, cuya edad está comprendida entre 0 y 18 años, entre ellos 32 niños y 34 niñas. Se utilizó el programa sociodemográfica (ISD) y el Inventario de Juego Espontáneo (IEB). Los datos revelaron una diversidad de juegos: juego simbólico, juegos con reglas, juego locomotor, jugar con objetos y animales y la construcción de broma. Los resultados demuestran que las bromas expresan, sobre todo los días para la comunidad día como barco juguetes de construcción y de escopeta situaciones con cuestiones domésticas (cocina, muñeca) y vinculados a los medios de subsistencia, como la pesca, el piragüismo plomo, construir jaula. Por lo tanto, los juegos generalmente retratan aspectos específicos del entorno físico, social y cultural de la niñez en la comunidad ribereña de estudio.

Play is a universal phenomenon which has peculiar aspects which are influenced by elements of the physical, social, and cultural environments by the characteristics of children. These aspects allow us to understand the joke as a product and producer of human development, because it is through it that the individual experiences in a safe way, behaviors that, in normal situations, ie, outside the play context, could have aversive social consequences. The objective of this study was to describe the Amazonian riverine games. Participated in the study 66 children and adolescents living in the community Araraiana river, whose age is between 0 and 18 years, including 32 boys and 34 girls. We used the sociodemographic schedule (ISD) and the Inventory of Spontaneous Play (IEB). The data revealed a diversity of games: a symbolic play, turbulent/agonistic play, games with rules, locomotor play, play with objects and animals and joke construction. The results demonstrate that the jokes express, mostly day to day community as building toys boat and shotgun situations with domestic issues (kitchen, doll) and linked to livelihood such as fishing, canoeing lead, build cage. Therefore, the games generally portray specific aspects of the physical, social and cultural environment of childhood in the riverside community studied.

Um estudo descritivo das brincadeiras em uma comunidade Ribeirinha Amazônica / A descriptive study of child's play in an Amazonian Riverside community / Un estudio descriptivo de juego en una comunidad Ribereño Amazonas

A brincadeira é um fenômeno universal que apresenta aspectos peculiares os quais são influenciados por elementos dos ambientes físico, social, cultural e pelas características das crianças. Esses aspectos permitem compreender a brincadeira como produto e produtor do desenvolvimento humano, pois é por meio dela que o indivíduo experimenta, de uma forma segura, comportamentos que, em situações normais, isto é, fora do contexto lúdico, poderiam ter consequências sociais aversivas. O objetivo do trabalho foi o de descrever as brincadeiras ribeirinhas amazônicas. Participaram da pesquisa 66 crianças e adolescentes, moradores da comunidade do rio Araraiana, cuja faixa etária está entre 0 e 18 anos, dos quais 32 meninos e 34 meninas. Utilizou-se o Inventário Sociodemográfico (ISD) e o Inventário Espontâneo das Brincadeiras (IEB). Os dados revelaram uma diversidade de brincadeiras: a brincadeira simbólica, jogos com regras, brincadeira locomotora, brincadeiras com objetos e com animais e brincadeira de construção. Os resultados demonstram que as brincadeiras expressam, em sua maioria, o dia a dia da comunidade como: a construção de brinquedos de barco e espingarda, situações com temas domésticos (cozinha, boneca) e ligados ao meio de subsistência como pescar, conduzir canoa, construir gaiola. Portanto, as brincadeiras de maneira geral retratam aspectos peculiares do ambiente físico, social e cultural do universo infantil da comunidade ribeirinha estudada.(AU).

El juego es un fenómeno universal que tiene aspectos peculiares que son influenciados por elementos de los ambientes físicos, sociales y culturales por parte de las características de los niños. Estos aspectos nos permiten entender la broma como un producto y productor del desarrollo humano, ya que es a través de él que las experiencias individuales en una forma segura y comportamientos que, en situaciones normales, es decir, fuera del contexto del juego, podría tener consecuencias sociales aversivas. El objetivo de este estudio fue describir los juegos fluviales amazónicas. Participaron en el estudio 66 niños, niñas y adolescentes que viven en el río Araraiana comunidad, cuya edad está comprendida entre 0 y 18 años, entre ellos 32 niños y 34 niñas. Se utilizó el programa sociodemográfica (ISD) y el Inventario de Juego Espontáneo (IEB). Los datos revelaron una diversidad de juegos: juego simbólico, juegos con reglas, juego locomotor, jugar con objetos y animales y la construcción de broma. Los resultados demuestran que las bromas expresan, sobre todo los días para la comunidad día como barco juguetes de construcción y de escopeta situaciones con cuestiones domésticas (cocina, muñeca) y vinculados a los medios de subsistencia, como la pesca, el piragüismo plomo, construir jaula. Por lo tanto, los juegos generalmente retratan aspectos específicos del entorno físico, social y cultural de la niñez en la comunidad ribereña de estudio.(AU).

Play is a universal phenomenon which has peculiar aspects which are influenced by elements of the physical, social, and cultural environments by the characteristics of children. These aspects allow us to understand the joke as a product and producer of human development, because it is through it that the individual experiences in a safe way, behaviors that, in normal situations, ie, outside the play context, could have aversive social consequences. The objective of this study was to describe the Amazonian riverine games. Participated in the study 66 children and adolescents living in the community Araraiana river, whose age is between 0 and 18 years, including 32 boys and 34 girls. We used the sociodemographic schedule (ISD) and the Inventory of Spontaneous Play (IEB). The data revealed a diversity of games: a symbolic play, turbulent/agonistic play, games with rules, locomotor play, play with objects and animals and joke construction. The results demonstrate that the jokes express, mostly day to day community as building toys boat and shotgun situations with domestic issues (kitchen, doll) and linked to livelihood such as fishing, canoeing lead, build cage. Therefore, the games generally portray specific aspects of the physical, social and cultural environment of childhood in the riverside community studied.(AU).

Aerobic exercise training induces metabolic benefits in rats with metabolic syndrome independent of dietary changes.

OBJECTIVES: We evaluated the effects of aerobic exercise training without dietary changes on cardiovascular and metabolic variables and on the expression of glucose transporter Type 4 in rats with metabolic syndrome. METHODS: Twenty male spontaneously hypertensive rats received monosodium glutamate during the neonatal period. The animals were allocated to the following groups: MS (sedentary metabolic syndrome), MS-T (trained on a treadmill for 1 hour/day, 5 days/week for 10 weeks), H (sedentary spontaneously hypertensive rats) and H-T (trained spontaneously hypertensive rats). The Lee index, blood pressure (tail-cuff system), insulin sensitivity (insulin tolerance test) and functional capacity were evaluated before and after 10 weeks of training. Glucose transporter Type 4 expression was analyzed using Western blotting. The data were compared using analysis of variance (ANOVA) (p<0.05). RESULTS: At baseline, the MS rats exhibited lower insulin sensitivity and increased Lee index compared with the H rats. Training decreased the body weight and Lee index of the MS rats (MS-T vs. MS), but not of the H rats (H-T vs. H). There were no differences in food intake between the groups. At the end of the experiments, the systolic blood pressure was lower in the two trained groups than in their sedentary controls. Whole-body insulin sensitivity increased in the trained groups. Glucose transporter Type 4 content increased in the heart, white adipose tissue and gastrocnemius muscle of the trained groups relative to their respective untrained groups. CONCLUSION: In conclusion, the present study shows that an isolated aerobic exercise training intervention is an efficient means of improving several components of metabolic syndrome, that is, training reduces obesity and hypertension and increases insulin sensitivity.

Aerobic exercise training induces metabolic benefits in rats with metabolic syndrome independent of dietary changes

OBJECTIVES: We evaluated the effects of aerobic exercise training without dietary changes on cardiovascular and metabolic variables and on the expression of glucose transporter Type 4 in rats with metabolic syndrome. METHODS: Twenty male spontaneously hypertensive rats received monosodium glutamate during the neonatal period. The animals were allocated to the following groups: MS (sedentary metabolic syndrome), MS-T (trained on a treadmill for 1 hour/day, 5 days/week for 10 weeks), H (sedentary spontaneously hypertensive rats) and H-T (trained spontaneously hypertensive rats). The Lee index, blood pressure (tail-cuff system), insulin sensitivity (insulin tolerance test) and functional capacity were evaluated before and after 10 weeks of training. Glucose transporter Type 4 expression was analyzed using Western blotting. The data were compared using analysis of variance (ANOVA) (p<0.05). RESULTS: At baseline, the MS rats exhibited lower insulin sensitivity and increased Lee index compared with the H rats. Training decreased the body weight and Lee index of the MS rats (MS-T vs. MS), but not of the H rats (H-T vs. H). There were no differences in food intake between the groups. At the end of the experiments, the systolic blood pressure was lower in the two trained groups than in their sedentary controls. Whole-body insulin sensitivity increased in the trained groups. Glucose transporter Type 4 content increased in the heart, white adipose tissue and gastrocnemius muscle of the trained groups relative to their respective untrained groups. CONCLUSION: In conclusion, the present study shows that an isolated aerobic exercise training intervention is an efficient means of improving several components of metabolic syndrome, that is, training reduces obesity and hypertension and increases insulin sensitivity. .

Atividades acadêmicas na rotina de crianças ribeirinhas participantes do Programa Bolsa Família / Academic activities in the routine of riverine children who participate in the Bolsa Família Program

Este artigo objetiva descrever a rotina referente à vida acadêmica de crianças atendidas pelo Programa Bolsa Família em uma comunidade ribeirinha amazônica. Participaram do estudo 30 crianças: 16 meninas e 14 meninos. Foram utilizados os Inventários Sociodemográfico e o de Rotina. Os principais resultados indicaram que a atividade de ir para a escola ocupa 16% de um dia de semana, o dever de casa atinge 3% e não há leituras fora do ambiente escolar. No fim de semana, as crianças não realizam dever de casa ou leituras. A participação parental na rotina dos filhos e filhas é restrita. Ações de envolvimento e capacitação das famílias ribeirinhas são necessárias para que estas participem e estruturem atividades acadêmicas nas rotinas das crianças.(AU)

This article aims to describe the routine related to academic life of children who participate in the Bolsa Família Program in an Amazon riverside community. A Sociodemographic and a Routine Inventory were administered to 30 children: 16 girls and 14 boys. The main results indicate attending school occupies 16% of their weekday, homework 3% and no reading activities take place outside the school. In the weekend, children do not make homework or develop reading activities. Parental participation in the routine of their sons and daughters is restricted. Actions to stimulate involvement and qualification of those riverside community families are necessary so they can participate and organize academic activities in the routine of their children.(AU)

Atividades acadêmicas na rotina de crianças ribeirinhas participantes do Programa Bolsa Família / Academic activities in the routine of riverine children who participate in the Bolsa Família Program

Este artigo objetiva descrever a rotina referente à vida acadêmica de crianças atendidas pelo Programa Bolsa Família em uma comunidade ribeirinha amazônica. Participaram do estudo 30 crianças: 16 meninas e 14 meninos. Foram utilizados os Inventários Sociodemográfico e o de Rotina. Os principais resultados indicaram que a atividade de ir para a escola ocupa 16% de um dia de semana, o dever de casa atinge 3% e não há leituras fora do ambiente escolar. No fim de semana, as crianças não realizam dever de casa ou leituras. A participação parental na rotina dos filhos e filhas é restrita. Ações de envolvimento e capacitação das famílias ribeirinhas são necessárias para que estas participem e estruturem atividades acadêmicas nas rotinas das crianças.

This article aims to describe the routine related to academic life of children who participate in the Bolsa Família Program in an Amazon riverside community. A Sociodemographic and a Routine Inventory were administered to 30 children: 16 girls and 14 boys. The main results indicate attending school occupies 16% of their weekday, homework 3% and no reading activities take place outside the school. In the weekend, children do not make homework or develop reading activities. Parental participation in the routine of their sons and daughters is restricted. Actions to stimulate involvement and qualification of those riverside community families are necessary so they can participate and organize academic activities in the routine of their children.

Renal GLUT1 reduction depends on angiotensin-converting enzyme inhibition in diabetic hypertensive rats.

AIMS: Angiotensin-converting enzyme (ACE) inhibitors are used in diabetic kidney disease to reduce systemic/intra-glomerular pressure. The objective of this study was to investigate whether reducing blood pressure (BP) could modulate renal glucose transporter expression, and urinary markers of diabetic nephropathy in diabetic hypertensive rats treated with ramipril or amlodipine. MAIN METHODS: Diabetes was induced in spontaneously-hypertensive rats (~210 g) by streptozotocin (50mg/kg). Thirty days later, animals received ramipril 15 µg/kg/day (R, n=10), or amlodipine 10mg/kg/day (A, n=8,) or water (C, n=10) by gavage. After 30-day treatment, body weight, glycaemia, urinary albumin and TGF-ß1 (enzyme-linked immunosorbent assay) and BP (tail-cuff pressure method) were evaluated. Kidneys were removed for evaluation of renal cortex glucose transporters (Western blotting) and renal tissue ACE activity (fluorometric assay). KEY FINDINGS: After treatments, body weight (p=0.77) and glycaemia (p=0.22) were similar among the groups. Systolic BP was similarly reduced (p<0.001) in A and R vs. C (172.4 ± 3.2; 1867 ± 3.7 and 202.2 ± 4.3 mmHg; respectively). ACE activity (C: 0.903 ± 0.086; A: 0.654 ± 0.025, and R: 0.389 ± 0.057 mU/mg), albuminuria (C: 264.8 ± 15.4; A: 140.8 ± 13.5 and R: 102.8 ± 6.7 mg/24h), and renal cortex GLUT1 content (C: 46.81 ± 4.54; A: 40.30 ± 5.39 and R: 26.89 ± 0.79 AU) decreased only in R (p<0.001, p<0.05 and p<0.001; respectively). SIGNIFICANCE: We concluded that the blockade of the renin-angiotensin system with ramipril reduced early markers of diabetic nephropathy, a phenomenon that cannot be specifically related to decreased BP levels.

A iatrogenia como desdobramento da relação médico-paciente: [revisão] / Iatrogenesis as an implication of patient-physician relationship: [review]

JUSTIFICATIVA E OBJETIVOS: Entende-se por iatrogenia qualquer intervenção da equipe de saúde, seja ela correta ou equivocada, justificada ou não, que resulte em alguma lesão para ao bem estar do paciente. Nesse sentido, a própria relação médico-paciente seria uma possível fonte de desdobramentos caracteristicamente iatrogênicos no nível emocional, plenos em consequências. No presente estudo, busca-se entender esses desdobramentos observando a relação entre alguém que necessita de cuidados com o outro que se propõe a cuidar, utilizando-se para tanto os conceitos de regressão e transferência, a partir das teorias do psicanalista Donald W. Winnicott referentes às funções da mãe quanto ao cuidado primário dedicadas ao bebê. CONTEÚDO: Destacam-se aspectos da relação primitiva de dependência presentificados no vínculo entre médico e paciente, bem como algumas implicações dos desencontros nas expectativas de um em relação ao outro. CONCLUSÃO: A transferência que o paciente estabelece em relação ao médico contribui para as possibilidades iatrogênicas já inerentes ao vínculo entre os dois. É necessário, portanto, que o profissional atente para a intromissão dessas demandas regressivas, sem negar, tampouco, a possível intromissão de suas próprias questões pessoais. Reconhecer uma e outra interferência a partirde seus sinais é o que o permitirá evitar ou contornar seus piores efeitos iatrogênicos.

BACKGROUND AND OBJECTIVES: Iatrogenesis can be defined as any intervention of the healthcare team, either is itcorrect or misguided, justified or not, resulting in patient's health damage. In this sense, the patient-physician relationship itself would be a possible source of characteristically iatrogenic implications on emotional level, full of consequences. The present study aims to understand these implications by observing the relationship between someone who needs care with another that purports to take care, using the regression and transference concepts, and Donald W. Winnicott's theories concerning themother's role in provide baby's primary care. CONTENTS: It highlights some elements of the primitive dependence relationship between mother and child, which reappears inside the patient-physician bond, as well as some implications of disagreements on the expectations regarding each other. CONCLUSION: The patient-physician relationship is endowed with an iatrogenic potential derived from its transferencial elements. Therefore, the professional must be aware of the regressive demands that meddle in the therapeutic relationship, and recognize them from their signals without denying also the interference resulting from their own personal issues, allowing, in avoiding interference from both sources, prevent its worst iatrogenic effects.

Avaliação econômica das associações fixas de prostaglandina/prostamida e timolol no tratamento do glaucoma e da hipertensão ocular / Economic evaluation of prostaglandin/prostamide and timolol fixed combinations in the treatment of glaucoma and ocular hypertension

OBJETIVO: Avaliar o custo ao final de 5 anos, a efetividade e a relação custo-efetividade das associações fixas de prostaglandina ou prostamida com timolol 0,5 por cento para o tratamento do glaucoma e da hipertensão ocular no Estado de Minas Gerais, Brasil. MÉTODOS: Este estudo transversal avaliou as seguintes associações fixas: bimatoprosta/timolol 0,5 por cento (BT), latanoprosta/timolol 0,5 por cento (LT) e travoprosta/timolol 0,5 por cento (TT). O custo foi calculado a partir do número médio de gotas de 5 frascos de cada associação, da duração (dias) e do preço máximo ao consumidor (PMC). A efetividade na redução da pressão intraocular (PIO) foi obtida na literatura. Para cada uma das associações, calculou-se o custo diário, mensal, anual e em 5 anos. A relação custo-efetividade foi definida como o custo em 5 anos de cada percentual de redução da PIO. RESULTADOS: O PMC, número médio de gotas por frasco e a duração média (dias) foram, respectivamente: R$ 83,07; 109,4 e 54,7 para BT; R$ 126,03; 97,0 e 48,5 para LT e R$ 97,47; 96 e 48,0 para TT. A capacidade de redução percentual da PIO encontrada na literatura foi 35,10 por cento para BT, 35,00 por cento para LT e 34,70 por cento para TT. O custo em 5 anos para cada percentual de redução da PIO foi de R$ 61,02 para BT, R$ 104,71 para LT e R$ 82,53 para TT. A associação BT é dominante sobre as demais. CONCLUSÕES: BT apresentou em 5 anos menor custo e maior efetividade que LT e TT.

PURPOSE:To assess the 5-year cost, effectiveness and costeffectiveness of fixed combinations of prostaglandin or prostamide and timolol 0. 5 percent on glaucoma and/or ocular hypertension in the state of Minas Gerais, Brazil. METHODS: This cross-sectional study evaluated the following fixed combinations: bimatoprost/timolol 0. 5 percent (BT), latanoprost/timolol 0. 5 percent (LT) and travoprost/ timolol 0. 5 percent (TT). Cost was obtained through mean number of drops in a sample of 5 containers of each medication, duration (days) and the average wholesale price (AWP). Effectiveness in reducing intraocular pressure IOP was derived from the literature. Daily, monthly, annually and 5-year cost was calculated. Costeffectiveness was defined as cost by each percentage of IOP reduction over 5 years. RESULTS: AWP, mean number of drops and mean duration (days) were: R$ 83. 07; 109. 4 and 54. 7 for BT; R$ 126. 03; 97. 0 and 48. 5 for LT and R$ 97. 47; 96. 0 and 48. 0 for TT. Mean percentage of IOP reduction, obtained from literature, was: 35. 10 percent for BT, 35. 00 percent for LT and 34. 70 percent for TT. Cost-effetiveness ratio (R$/ percent) was: 61. 02 for BT, 104. 71 for LT and 82. 53 for TT. BT was dominant over LT and TT. CONCLUSION: BT presented lower costs and better effectiveness when compared to LT and TT. The most cost-effective fixed combination was BT.