Fatigue in Post-COVID-19 Syndrome: Clinical Phenomenology, Comorbidities and Association With Initial Course of COVID-19.

Introduction: Post-COVID-19 syndrome affects approximately 10-25% of people suffering from COVID-19 infection, irrespective of initial COVID-19 severity. Fatigue is one of the major symptoms, occurring in 30-90% of people with post-COVID-19 syndrome. This study aims at describing factors associated with fatigue in people with Post-COVID-19 seen in our newly established Post-Covid clinic. Methods: This retrospective single center study included 42 consecutive patients suffering from Post-COVID-19 syndrome treated at the Department of Neurology, University Hospital Bern, between 11/2020 and05/2021. Clinical phenomenology of Post-COVID-19 syndrome with a special focus on fatigue and risk factor identification was performed using Mann-Whitney U Test, Pearson Correlation, and Chi-Quadrat-Test. Results: Fatigue (90.5%) was the most prevalent Post-COVID-19 symptom followed by depressive mood (52.4%) and sleep disturbance (47.6%). Fatigue was in mean severe (Fatigue severity scale (FSS) mean 5.5 points (95% Confidence interval (95CI) 5.1 - 5.9, range .9 - 6.9, n = 40), and it was unrelated to age, COVID-19 severity or sex. The only related factors with fatigue severity were daytime sleepiness and depressed mood. Conclusion: Fatigue is the main symptom of the Post-COVID-19 syndrome in our cohort. Further studies describing this syndrome are needed to prepare the healthcare systems for the challenge of treating patients with Post-COVID-19 syndrome.

Dental Pulp Autotransplantation: A New Modality of Endodontic Regenerative Therapy-Follow-Up of 3 Clinical Cases.

The aim of this study was to develop a novel method of endodontic therapy, which we refer to as dental pulp autotransplantation. Three patients (2 males and 1 female) were selected for endodontic treatment of a uniradicular premolar and extraction of a third molar (without odontosection). Electric assessment of pulp vitality and computed tomographic imaging were undertaken followed by endodontic access and instrumentation using triantibiotic solution for irrigation in the host tooth. A few minutes before the transplant procedure, the third molar was extracted, the tooth was sectioned with a diamond blade in a low-speed handpiece, and the pulp was carefully removed. After premolar instrumentation, the harvested and preserved pulp tissue was reinserted into the root canal followed by direct pulp capping performed using Biodentine (Septodont, Saint-Maur-des-Fossés, France), a liner of resin-modified glass ionomer cement and composite resin restoration. The teeth were followed up for at least 12 months after the procedures and were analyzed using computed tomographic imaging, electric pulp vitality testing, and Doppler ultrasound examination. At the 3- and 6-month follow-ups, positive pulp vitality and regression of periapical lesions were verified. After 9-12 months, all teeth were revascularized as determined by Doppler imaging, and the tooth vitality was reestablished with no signs of endodontic/periodontal radiolucency or complications. Within the limitations of the study, considering that it was a case series with only 3 patients, we described a highly innovative procedure of pulp autotransplantation, which appears to be feasible, highlighting the potential for clinical application of pulp regeneration using this new modality of endodontic therapy.

Hormone therapy after risk-reducing surgery in patients with BRCA1/BRCA2 mutation: evaluation of potential benefits and safety.

Women with mutations in the BRCA 1 and 2 genes are at increased risk for ovarian and breast cancer and therefore candidates for risk-reducing surgery, including salpingo-oophorectomy and mastectomy. Risk-reducing salpingo-oophorectomy (RRSO) is considered the most effective prophylactic measure for ovarian cancer prevention in this group of patients. This procedure involves loss of ovarian function and induced menopause. Estrogen therapy is the most effective treatment for controlling vasomotor symptoms and improving the quality of life of climacteric women. However, the potential hormonal stimulation of these tumors and the risk of breast cancer are a concern regarding the safety of hormone replacement therapy (HRT) in this population. This article aims to review the current evidence regarding the potential benefits and safety of HRT after RRSO.

Hormone therapy after risk-reducing surgery in patients with BRCA1/BRCA2 mutation: evaluation of potential benefits and safety

SUMMARY Women with mutations in the BRCA 1 and 2 genes are at increased risk for ovarian and breast cancer and therefore candidates for risk-reducing surgery, including salpingo-oophorectomy and mastectomy. Risk-reducing salpingo-oophorectomy (RRSO) is considered the most effective prophylactic measure for ovarian cancer prevention in this group of patients. This procedure involves loss of ovarian function and induced menopause. Estrogen therapy is the most effective treatment for controlling vasomotor symptoms and improving the quality of life of climacteric women. However, the potential hormonal stimulation of these tumors and the risk of breast cancer are a concern regarding the safety of hormone replacement therapy (HRT) in this population. This article aims to review the current evidence regarding the potential benefits and safety of HRT after RRSO.

RESUMO Mulheres portadoras de mutações nos genes BRCA 1 e 2 possuem risco aumentado para cânceres de ovário e mama e, portanto, são candidatas às cirurgias redutoras de risco, incluindo a salpingo-ooforectomia e a mastectomia. A salpingo-ooforectomia redutora de risco (SORR) é considerada a medida profilática mais efetiva para prevenção do câncer de ovário nesse grupo de pacientes. Esse procedimento implica a perda da função ovariana e menopausa induzida. A estrogenioterapia é o tratamento mais efetivo para o controle de sintomas vasomotores e melhora da qualidade de vida de mulheres no climatério. No entanto, a potencial estimulação hormonal desses tumores e o risco de câncer de mama constituem uma preocupação com a segurança da terapia hormonal (TH) nesta população. Este artigo tem como objetivo uma revisão das evidências atuais quanto aos benefícios potenciais e segurança da TH após SORR.

Effects of effortful swallowing on cardiac autonomic control in individuals with neurogenic dysphagia: a prospective observational analytical study.

Considering that neurogenic oropharyngeal dysphagia is a prevalent condition with or without cardiac disease we should contemplate issues surrounding cardiovascular difficulties during rehabilitation. This study aims to evaluate the effects of effortful swallowing maneuver (ESM) on heart rate variability (HRV) in subjects with neurogenic oropharyngeal dysphagia. We studied 22 individuals [8 Stroke and 14 Parkinson Disease (PD) subjects aged between 41 and 75 years old] with neurogenic oropharyngeal dysphagia regardless of gender. HRV was assessed under two circumstances: spontaneous swallowing versus ESM. Surface electromyography of the suprahyoid muscles was undertaken to measure the swallowing muscle excitation, which then confirmed higher muscle activity during ESM. We attained no changes in HRV between the two swallowing events [HR: spontaneous swallowing 78.68 ± 13.91 bpm vs. ESM 102.57 ± 107.81 bpm, p = 0.201; RMSSD (root-mean square of differences between adjacent normal RR intervals in a time interval): spontaneous swallowing 16.99 ± 15.65 ms vs. ESM 44.74 ± 138.85 ms, p = 0.312; HF (high frequency): spontaneous swallowing 119.35 ± 273 ms2 vs. ESM 99.83 ± 194.58 ms2, p = 0.301; SD1 (standard deviation of the instantaneous variability of the beat-to-beat heart rate): spontaneous swallowing 12.02 ± 1.07 ms vs. ESM 31.66 ± 98.25 ms, p = 0.301]. The effortful swallowing maneuver did not cause clinically significant changes in autonomic control of HR in this group of subjects with oropharyngeal dysphagia.

Risk factors for oropharyngeal dysphagia in cardiovascular diseases.

Some conditions consolidated as risk factors for oropharyngeal dysphagia have already been identified in other diseases, such as neurological. Studies on cardiovascular diseases concentrate in individuals in the postoperative period; thus, it is unknown if these same factors occur in individuals hospitalized for clinical or surgical treatment of these diseases. Objective to correlate predictive risk factors for oropharyngeal dysphagia in individuals with cardiovascular disease admitted at a reference cardiology hospital. Methodology This is a retrospective clinical study. Medical records of 175 individuals hospitalized for clinical and/or surgical treatment at a reference cardiology hospital from January to June 2017, attendants of the Speech-Language Pathology and Nutrition team, were analyzed. Of these, 100 records were included in the study: 41 females and 59 males (mean age 67.56 years). Deaths and individuals from 0 to 18 years were excluded. Stroke, malnutrition, age and prolonged orotracheal intubation were considered predictive risk factors for oropharyngeal dysphagia. Mann-Whitney test and Fisher's test were used for statistical analysis. Results Stroke (OR=2.93 p=0.02), malnutrition (OR=2.89 p=0.02) and prolonged orotracheal intubation (OR=3.94 p=0.02) were statistically significant predictors for oropharyngeal dysphagia within this population. Age below 80 years was not significant (p=0.06), but within octogenarians, significance was found (p=0.033). Conclusion Stroke, malnutrition, prolonged orotracheal intubation and age > 80 years are predictive risk factors for oropharyngeal dysphagia in adult population with cardiovascular diseases.

Risk factors for oropharyngeal dysphagia in cardiovascular diseases

ABSTRACT: Some conditions consolidated as risk factors for oropharyngeal dysphagia have already been identified in other diseases, such as neurological. Studies on cardiovascular diseases concentrate in individuals in the postoperative period; thus, it is unknown if these same factors occur in individuals hospitalized for clinical or surgical treatment of these diseases. OBJECTIVE: to correlate predictive risk factors for oropharyngeal dysphagia in individuals with cardiovascular disease admitted at a reference cardiology hospital. METHODOLOGY: This is a retrospective clinical study. Medical records of 175 individuals hospitalized for clinical and/or surgical treatment at a reference cardiology hospital from January to June 2017, attendants of the Speech-Language Pathology and Nutrition team, were analyzed. Of these, 100 records were included in the study: 41 females and 59 males (mean age 67.56 years). Deaths and individuals from 0 to 18 years were excluded. Stroke, malnutrition, age and prolonged orotracheal intubation were considered predictive risk factors for oropharyngeal dysphagia. Mann-Whitney test and Fisher's test were used for statistical analysis. RESULTS: Stroke (OR=2.93 p=0.02), malnutrition (OR=2.89 p=0.02) and prolonged orotracheal intubation (OR=3.94 p=0.02) were statistically significant predictors for oropharyngeal dysphagia within this population. Age below 80 years was not significant (p=0.06), but within octogenarians, significance was found (p=0.033). CONCLUSION: Stroke, malnutrition, prolonged orotracheal intubation and age > 80 years are predictive risk factors for oropharyngeal dysphagia in adult population with cardiovascular diseases.

Effects of manual chest compression on expiratory flow bias during the positive end-expiratory pressure-zero end-expiratory pressure maneuver in patients on mechanical ventilation.

OBJECTIVE: To investigate the effects of manual chest compression (MCC) on the expiratory flow bias during the positive end-expiratory pressure-zero end-expiratory pressure (PEEP-ZEEP) airway clearance maneuver applied in patients on mechanical ventilation. The flow bias, which influences pulmonary secretion removal, is evaluated by the ratio and difference between the peak expiratory flow (PEF) and the peak inspiratory flow (PIF). METHODS: This was a crossover randomized study involving 10 patients. The PEEP-ZEEP maneuver was applied at four time points, one without MCC and the other three with MCC, which were performed by three different respiratory therapists. Respiratory mechanics data were obtained with a specific monitor. RESULTS: The PEEP-ZEEP maneuver without MCC was enough to exceed the threshold that is considered necessary to move secretion toward the glottis (PEF - PIF difference > 33 L/min): a mean PEF - PIF difference of 49.1 ± 9.4 L/min was achieved. The mean PEF/PIF ratio achieved was 3.3 ± 0.7. Using MCC with PEEP-ZEEP increased the mean PEF - PIF difference by 6.7 ± 3.4 L/min. We found a moderate correlation between respiratory therapist hand grip strength and the flow bias generated with MCC. No adverse hemodynamic or respiratory effects were found. CONCLUSIONS: The PEEP-ZEEP maneuver, without MCC, resulted in an expiratory flow bias superior to that necessary to facilitate pulmonary secretion removal. Combining MCC with the PEEP-ZEEP maneuver increased the expiratory flow bias, which increases the potential of the maneuver to remove secretions.

Effects of manual chest compression on expiratory flow bias during the positive end-expiratory pressure-zero end-expiratory pressure maneuver in patients on mechanical ventilation / Efeitos da compressão torácica manual sobre o flow bias expiratório durante a manobra positive end-expiratory pressure-zero end-expiratory pressure em pacientes sob ventilação mecânica invasiva

ABSTRACT Objective: To investigate the effects of manual chest compression (MCC) on the expiratory flow bias during the positive end-expiratory pressure-zero end-expiratory pressure (PEEP-ZEEP) airway clearance maneuver applied in patients on mechanical ventilation. The flow bias, which influences pulmonary secretion removal, is evaluated by the ratio and difference between the peak expiratory flow (PEF) and the peak inspiratory flow (PIF). Methods: This was a crossover randomized study involving 10 patients. The PEEP-ZEEP maneuver was applied at four time points, one without MCC and the other three with MCC, which were performed by three different respiratory therapists. Respiratory mechanics data were obtained with a specific monitor. Results: The PEEP-ZEEP maneuver without MCC was enough to exceed the threshold that is considered necessary to move secretion toward the glottis (PEF − PIF difference > 33 L/min): a mean PEF − PIF difference of 49.1 ± 9.4 L/min was achieved. The mean PEF/PIF ratio achieved was 3.3 ± 0.7. Using MCC with PEEP-ZEEP increased the mean PEF − PIF difference by 6.7 ± 3.4 L/min. We found a moderate correlation between respiratory therapist hand grip strength and the flow bias generated with MCC. No adverse hemodynamic or respiratory effects were found. Conclusions: The PEEP-ZEEP maneuver, without MCC, resulted in an expiratory flow bias superior to that necessary to facilitate pulmonary secretion removal. Combining MCC with the PEEP-ZEEP maneuver increased the expiratory flow bias, which increases the potential of the maneuver to remove secretions.

RESUMO Objetivo: Avaliar os efeitos da compressão torácica manual (CTM) sobre o flow bias expiratório durante a manobra positive end-expiratory pressure-zero end-expiratory pressure (PEEP-ZEEP) para a remoção de secreção em pacientes sob ventilação mecânica invasiva. O flow bias, que influencia na remoção de secreção pulmonar, foi avaliado pela razão e diferença entre pico de fluxo expiratório (PFE) e pico de fluxo inspiratório (PFI). Métodos: Estudo cruzado e randomizado no qual participaram 10 pacientes. A manobra PEEP-ZEEP foi aplicada em quatro momentos, sendo um sem CTM e os outros três em associação com a CTM, que foram aplicadas por três fisioterapeutas distintos. Um monitor específico foi utilizado para o registro dos dados de mecânica respiratória. Resultados: A manobra PEEP-ZEEP sem a CTM foi suficiente para ultrapassar o limiar do flow bias expiratório (diferença PFE − PFI > 33 l/min), considerado necessário para deslocar a secreção em direção à glote; a média da diferença PFE − PFI encontrada foi de 49,1 ± 9,4 l/min. A média da razão PFE/PFI alcançada foi de 3,3 ± 0,7. A associação da CTM à PEEP-ZEEP aumentou a média da diferença PFE − PFI em 6,7 ± 3,4 l/min. Foi observada correlação moderada entre a força de preensão manual dos fisioterapeutas e o flow bias gerado durante a CTM. Não foram encontradas alterações hemodinâmicas ou respiratórias adversas ao longo do estudo. Conclusões: A manobra PEEP-ZEEP sem a CTM resultou em um flow bias expiratório superior ao considerado efetivo para auxiliar na remoção de secreção pulmonar. A associação com a CTM aumentou o flow bias expiratório, o que aumenta o potencial da manobra para remover secreções.

Avaliação da biocompatibilidade e atividade antimicrobiana in vitro da matriz de Hidrogel associada ao extrato glicólico do Punica granatum L. (romã) / Evaluation of biocompatibility and antimicrobial action in vitro of a hydrogel scaffolds Hydromatrix associated to glycolic extract of Punica granatum (pomegranate)

A matriz de hidrogel é um biomaterial de nanofibra peptídica tridimensional que induz o crescimento, migração e proliferação celular, assim favorecendo a regeneração tecidual. O objetivo deste trabalho foi avaliar a biocompatibilidade e a atividade antimicrobiana da matriz de hidrogel associado ao extrato romã e ao antimicrobiano ciprofloxacino. Para isso, foram realizadas análises microbiológicas sobre Enterococcus faecalis (ATCC 4083) em cultura planctônica, por meio d ensaio de microdiluição em caldo e em biofilme pelo teste de MTT. Para os ensaios da biocompatibilidade, foi utilizada cultura de macrófagos (RAW 264.7). A citotoxicidade foi avaliada pelo ensaio de MTT e a genotoxicidade foi realizado pelo teste de micronúcleo. A análise estatística foi realizada pelos testes ANOVA e Tukey, adotando o nível de significância 5%. Os resultados demonstraram que a matriz de hidrogel associado ao extrato de romã não apresentou atividade antimicrobiana para a cultura planctônica como para o biofilme de E. faecalis. Porém, não foi citotóxico e genotóxico para RAW 264.7. Por outro lado, o antimicrobiano ciprofloxacino apresentou atividade antimicrobiana sobre E. faecalis,além de ter apresentado efeitos citotóxico e genotóxico para os macrófagos. Com isso, foi possível concluir que o extrato de romã associado ou não a matriz de hidrogel apresenta ausência de citotóxico, genotóxico e efeito antimicrobiano

The hydrogel matrix is a three-dimensional peptide nanofiber biomaterial that induces cell growth, migration and proliferation, thus favoring tissue regeneration. The objective of this work was to evaluate the biocompatibility and antimicrobial activity of the hydrogel matrix associated with the pomegranate extract and the antimicrobial ciprofloxacin. For this, microbiological analyzes on Enterococcus faecalis (ATCC 4083) were carried out in planktonic culture, by means of the microdilution test in broth and in biofilm by the MTT test. For the biocompatibility assays, macrophage culture (RAW 264.7) was used. Cytotoxicity was assessed by the MTT assay and genotoxicity was performed by the micronucleus test. Statistical analysis was performed by the ANOVA and Tukey tests, adopting the significance level 5%. The results showed that the hydrogel matrix associated with the pomegranate extract did not show antimicrobial activity for the planktonic culture as for the E. faecalis biofilm. However, it was not cytotoxic and genotoxic for RAW 264.7. On the other hand, the antimicrobial ciprofloxacin showed antimicrobial activity on E. faecalis, besides having cytotoxic and genotoxic effects for the macrophages. With this, it was possible to conclude that the pomegranate extract associated or not with the hydrogel matrix shows absence of cytotoxic, genotoxic and antimicrobial effect

Punica granatum L. (Pomegranate) Extract: In Vivo Study of Antimicrobial Activity against Porphyromonas gingivalis in Galleria mellonella Model.

Due to the increase of bacterial resistance, medicinal alternatives are being explored. Punica granatum L. is an effective herbal extract with broad spectrum of action and bactericidal, antifungal, anthelmintic potential and being able to modulate the immune response. The aim was to evaluate the antimicrobial activity of pomegranate glycolic extract (PGE) against the periodontal pathogen Porphyromonas gingivalis by using Galleria mellonella as in vivo model. Fifteen larvae were used per group. Injection of high concentration (200, 100, and 25 mg/mL) of PGE showed a toxic effect, leading them to death. A suspension of P. gingivalis (106 cells/mL) was inoculated in the left last proleg and PGE (12.5, 6.25, 3.1, and 2.5 mg/mL) were injected into the right proleg. The larvae were then kept at 37°C under the dark. Injection of PGE at any dose statistically improved larvae survival rates. The data were analysed (log-rank test, Mantel-Cox, P < 0.05) and showed that all concentrations of PGE (12.5, 6.25, 3.1, and 2.5 mg/mL) presented higher larval survival rates, with significant statistical difference in relation to control group (P. gingivalis). In conclusion, the PGE had antimicrobial action against P. gingivalis in vivo model using G. mellonella.

Effects of Effortful Swallow on Cardiac Autonomic Regulation.

Swallowing-induced changes in heart rate have been recently reported. However, it is not apparent the responses of heart rate variability (HRV) elicited by effortful swallow maneuver. We investigated the acute effects of effortful swallowing maneuver on HRV. This study was performed on 34 healthy women between 18 and 35 years old. We assessed heart rate variability in the time (SDNN, RMSSD, and pNN50) and frequency (HF, LF, and LF/HF ratio) domains and, visual analysis through the Poincaré plot. The subjects remained at rest for 5 min during spontaneous swallowing and then performed effortful swallowing for 5 min. HRV was analyzed during spontaneous and effortful swallowing. We found no significant differences for SDNN, pNN50, RMSSD, HF in absolute units (ms(2)). There is a trend for increase of LF in absolute (p = 0.05) and normalized (p = 0.08) units during effortful swallowing. HF in normalized units reduced (p = 0.02) during effortful swallowing and LF/HF ratio (p = 0.03) increased during effortful swallowing. In conclusion effortful swallow maneuver in healthy women increased sympathetic cardiac modulation, indicating a cardiac overload.

Educação em saúde para mulheres no climatério: impactos na qualidade de vida / Health education for climacteric women: impacts on quality of life

Objetivo: Avaliar os efeitos de um processo multidisciplinar de educação em saúde (ES) na qualidade de vida (QV) de mulheres climatéricas. Métodos: Fez‐se uma pesquisa quase experimental com 14 mulheres entre 40 e 65 anos. Sete compuseram o grupo controle (GC) e as restantes formaram o grupo experimental (GE), submetidas à ES. Fizeram‐se seis encontros semanais de 90 minutos cada, um total de nove horas. A fim de analisar a QV das participantes, usou‐se o WHOQOL‐bref – medida elaborada pela Organização Mundial de Saúde – para pré e pós‐testes. Esse instrumento avalia quatro domínios (físico, psicológico, relações sociais e meio ambiente) e a QV global. Resultados: Verificou‐se diferença significativa entre os grupos no domínio relações sociais, ocorreu aumento desse fator no GE e diminuição no GC. Conclusões: Apesar de positivo, esse resultado revela a importância de avaliar se processos de ES promovem QV em seus vários domínios. Devido ao caráter preventivo e de promoção de saúde, a ES deve ser alvo constante de pesquisas para que tecnologias educacionais capazes de promover a saúde da mulher climatérica, sobretudo a QV, sejam desenvolvidas e aprimoradas.

Aims: Evaluate the effects of a multidisciplinary process of health education (HE) on quality of life (QoL) of climacteric women. Methods: A quasi‐experimental research with 14 women between 40 and 65 years old was carried out. Seven comprised the control group (CG) and the others formed the experimental group (EG), subjected to the HE. Six weekly sessions of 90 minutes each were performed, with a total of nine hours. To assess the QoL of the participants, it has been used the WHOQOL‐bref ‐ elaborated by the World Health Organization ‐ for pre and post‐tests. This instrument assesses four domains (Physical, Psychological, Social Relationships and Environment) and global QoL. Results: There was a significant difference between groups in the Social Relationships domain, causing an increase of this factor in the EG and decrease in the CG. Conclusions: Although positive, this result reveals the importance of assessing whether the HE processes promote QoL in their various domains. Due to its preventive and health promotion character, the HE should be the subject of constant research in order to develop and improve educational technologies to promote health of the climacteric women, especially QoL.

Experimentação política da amizade na internet / Experimentación política de la amistad en internet / Political experiment of friendship on the internet

A experimentação política da amizade na internet é lida à luz da teoria dos afetos de Baruch Espinosa: o corpo é essencialmente relacional e é na relação com seus outros, na maneira como afeta e é afetado por eles, que se dá a condição de possibilidade da resistência à tristeza e afirmação da alegria - compreendida como aumento da potência de pensar e agir. Este artigo tem como objetivo investigar a experimentação política da amizade na internet. Para isso, adultos foram entrevistados sobre suas histórias de amizades mediadas pela internet. Os resultados revelaram que os vínculos entre amigos na internet não só se expressaram como viabilizadores da experimentação da qualidade política da amizade naquilo que concerne à possibilidade de relativização do pensamento, mas também porque engendraram gestos com o vigor da solidariedade que mobilizam os corpos a agir em defesa da afirmação de sua potência.(AU)

La experimentación política de la amistad en internet es leída a la luz de la teoría de los afectos de Baruch Espinosa: el cuerpo es esencialmente relacional y es en la relación con sus otros, de la manera cómo afecta y es afectado por ellos que se da la condición de la posibilidad de resistencia a la tristeza y a la afirmación de la alegría - comprendida como aumento de la potencia de pensar y actuar. Este artículo tiene como objetivo investigar la experimentación política de la amistad en internet. Para lo cual, personas adultas fueron entrevistadas sobre sus historias de amistad mediadas por internet. Los resultados revelaron que los vínculos entre amigos en internet no sólo se expresan como impulsores de experimentación de calidad política de la amistad en lo que se refiere a la posibilidad de relativización del pensamiento sino también porque engendraron gestos con el vigor de la solidaridad que movilizan los cuerpos para actuar en defensa de la afirmación de su potencia.(AU)

The political experiment of friendship by the internet is read trough the light of Baruch Spinoza's theory of affections: the body is essentially relational and it is in its relationship to others, and also through how it affects and is affected by them, that it gives the condition of possibility of resistance against sorrow and affirmation of joy - which are both understood as a decreasing and an increasing power to think and act. We interviewed adults regarding their internet-mediated stories of friendships. The results have shown that the bonds between friends by the internet not only express a way of experiencing a political quality of friendship, regarded as a possibility of relativization of thinking, but also engendered vigorous gestures of solidarity that mobilize bodies to act in defense and in affirmation of its power.(AU)

Experimentação política da amizade na internet / Experimentación política de la amistad en internet / Political experiment of friendship on the internet

A experimentação política da amizade na internet é lida à luz da teoria dos afetos de Baruch Espinosa: o corpo é essencialmente relacional e é na relação com seus outros, na maneira como afeta e é afetado por eles, que se dá a condição de possibilidade da resistência à tristeza e afirmação da alegria - compreendida como aumento da potência de pensar e agir. Este artigo tem como objetivo investigar a experimentação política da amizade na internet. Para isso, adultos foram entrevistados sobre suas histórias de amizades mediadas pela internet. Os resultados revelaram que os vínculos entre amigos na internet não só se expressaram como viabilizadores da experimentação da qualidade política da amizade naquilo que concerne à possibilidade de relativização do pensamento, mas também porque engendraram gestos com o vigor da solidariedade que mobilizam os corpos a agir em defesa da afirmação de sua potência.

La experimentación política de la amistad en internet es leída a la luz de la teoría de los afectos de Baruch Espinosa: el cuerpo es esencialmente relacional y es en la relación con sus otros, de la manera cómo afecta y es afectado por ellos que se da la condición de la posibilidad de resistencia a la tristeza y a la afirmación de la alegría - comprendida como aumento de la potencia de pensar y actuar. Este artículo tiene como objetivo investigar la experimentación política de la amistad en internet. Para lo cual, personas adultas fueron entrevistadas sobre sus historias de amistad mediadas por internet. Los resultados revelaron que los vínculos entre amigos en internet no sólo se expresan como impulsores de experimentación de calidad política de la amistad en lo que se refiere a la posibilidad de relativización del pensamiento sino también porque engendraron gestos con el vigor de la solidaridad que movilizan los cuerpos para actuar en defensa de la afirmación de su potencia.

The political experiment of friendship by the internet is read trough the light of Baruch Spinoza's theory of affections: the body is essentially relational and it is in its relationship to others, and also through how it affects and is affected by them, that it gives the condition of possibility of resistance against sorrow and affirmation of joy - which are both understood as a decreasing and an increasing power to think and act. We interviewed adults regarding their internet-mediated stories of friendships. The results have shown that the bonds between friends by the internet not only express a way of experiencing a political quality of friendship, regarded as a possibility of relativization of thinking, but also engendered vigorous gestures of solidarity that mobilize bodies to act in defense and in affirmation of its power.

O desafio da intersetorialidade: a experiência do Programa Saúde na Escola (PSE) em Manguinhos, no Município do Rio de Janeiro / The challenge of intersectionality: the experience of the School Health Program (ESP) in Manguinhos, in the Municipality of Rio de Janeiro

O Programa Saúde na Escola (PSE), instituído no Brasil em 2007, busca fortalecer as experiências desenvolvidas no ambiente escolar e promover a articulação das ações vinculadas ao Sistema Único de Saúde (SUS) com a rede pública de ensino. Este estudo teve como objetivo acompanhar o processo de implementação do PSE no contexto de Manguinhos, zona norte do Município do Rio de Janeiro, no que se refere à articulação entre saúde e educação, identificando os desafios e possibilidades para a ação intersetorial, no âmbito do programa. A abordagem metodológica adotada privilegiou a análise de implementação, a partir do estudo de caso, com a realização de entrevistas semiestruturadas com gestores e profissionais das áreas da saúde, educação e assistência social; acompanhamento de reuniões e levantamento documental, no período de março de 2010 a dezembro de 2011. A pesquisa identificou fatores facilitadores e impeditivos na trajetória de implementação do PSE, identificando os atores envolvidos, suas concepções, os papéis que desempenham e as interações entre eles. Os resultados apontam que o PSE desenvolvido no município, a partir de investimentos federais e municipais, ganha uma nova característica: a expansão e o estímulo das ações de saúde na escola para todo o território, com ações descentralizadas, a partir dos Núcleos de Saúde na Escola e Creche (NSEC’s), e ações de assistência à saúde, por meio de equipes de saúde contratadas. Em Manguinhos foi possível observar que a comunicação e a articulação entre os atores locais apresentaram-se frágeis e descontínuas, principalmente após a entrada das equipes contratadas, levando à sobreposição de algumas ações no território e à sua interrupção. Em contrapartida a atuação de atores chave representou a expectativa de viabilizar parcerias e interlocuções para a construção de iniciativas envolvendo saúde e educação. O estudo aponta para a necessidade de se repensar dinâmicas e processos para o fortalecimento dessas ações locais, de forma mais articulada e sustentável; a viabilização da capacitação de técnicos, a partir de metodologias participativas; e o estímulo à participação comunitária na construção das ações e atividades voltadas para as reais necessidades da comunidade escolar.

Amizade e experimentação política: solidariedade e resistência entre amigos nas classes populares / Friendship and experimentation politics: solidarity and resistance between friendas in the popular classrooms

Este artigo pretende descrever e discutir alguns resultados de uma pesquisa que investigou a possibilidade da amizade se configurar como espaço de experimentação política. A relação de amizade mostrou-se um importante vínculo de escuta e acolhimento, de troca de conhecimentos e aprendizagens. A solidariedade entre amigos revelou modos criativos, solidários e astuciosos de enfrentamento de condições espoliantes, fundamentais para a resistência e organização política, contribuindo para reverter situações de extrema dificuldade e penúria.(AU)

This paper aims to describe and discuss some results of a research that investigated the possibility of friendship is set up as an area of political experimentation. The relationship of friendship shown to be an important link of listening and reception, exchange of knowledge and learning. The solidarity among friends showed creative ways, fundamental to the strength and political organization, helping to reverse situations of extreme difficulty and destitute.(AU)