Abordagem de organização facilitada para otimização de testes rápidos de detecção de infecções sexualmente transmissíveis: um relato de experiência / Facilitated organization approach for optimization of rapid tests for detecting sexually transmitted infections: experience report

Ao confrontar a elevação dos números de casos de infecções sexualmente transmissíveis, em especial a AIDS, a sífilis e as hepatites virais do tipo B e C; constatamos a necessidade de uma testagem mais expressiva da população por meio da facilitação do acesso aos insumos e demais materiais necessários para os procedimentos, visando à otimização do tempo dos usuários do serviço público de saúde e gerando uma maior adesão aos mecanismos de testagem. A facilitação do acesso aos materiais para testagem gerou umadiferença de seis vezes no número de testes quando comparados o primeiro mês do experimento e o último. A maior modificação, no entanto, não se concentrou no aparecimento da bancada com seu protocolo guia, mas sim na participação conjunta de todos os profissionais da equipe de saúde, buscando compreender e se envolver nos processos de testagem, de modo que todos estivessem aptos a realizar adequadamente os procedimentos assim que se fizesse necessário. Evidenciou-se o potencial beneficiador que a facilitação do acesso aos testes rápidos, com a devida capacitação conjunta da equipe disponível, produz efeitos notórios no rastreio e no diagnóstico precoce de infecções sexualmente transmissíveis de elevadas prevalências.

When confronting the increase in the number of cases of sexually transmitted infections, especially AIDS, syphilis, and viral hepatitis B and C, we found the need for more expressive testing of the population through facilitated access to supplies and other materials needed for the procedures aiming at optimizing the time users spend in public health services and generating greater adherence to the testing mechanisms. Facilitating access to testing materialsgenerated a sixfold difference in the number of tests when comparing the first month of the experiment and the last month. The biggest change, however, did not focus on the appearance of a protocol guide, but on the joint participation of all health team professionals seeking to understand and get involved in the testing processes so that everyone would be able to adequately perform the procedures as soon as they become necessary. Thus, it was evidenced that the potential benefits of facilitating access torapid tests along with the proper joint training of the team available produce notorious effects on screening and early diagnosis of sexually transmitted infections of high prevalence.

"Café com Ciência": trabalhando a educação permanente no âmbito de uma estratégia saúde da família / Coffee with Science: working permanent education within the framework of a family health strategy

O processo de educação permanente em saúde é uma estratégia político-pedagógica voltada à incorporação dos problemas e necessidades do ambiente de trabalho e que visa potencializar a formação dos profissionais e reorientar os saberes e fazeresno cuidado em saúde. Este trabalho tem por objetivo relatar a experiência de implantação do Café com Ciência em uma Estratégia Saúde da Família(ESF)do município de Atalaia, Alagoas, Brasil. O Café com Ciência é formado pelas seguintes etapas: 1.Alongamento; 2.Dinâmica/apresentação de vídeo; 3.Querofalar! 4.Pré-teste/fala sério ou com certeza; 5.Estudodo tema; 7.Pós-teste/fala sério ou com certeza. As atividades são desenvolvidas de forma democrática, participativa e provocativa da autonomia dos sujeitos envolvidos. Tais momentos são essenciais para a aprendizagem teórico-científica, oportunizando a ampliação da interação entre a equipe e a construção de vínculos solidários através do diálogo.

The process of continuing education in health is a political-pedagogical strategy aimed at incorporating the problems and needs of the work environment to enhance the training of professionals and reorient knowledge and practices in health care. This paper aims to report the experience of implementing Coffee with Science in a Family Health Strategy in the city of Atalaia, Alagoas (Brazil). Coffee with Science consists of the following stages: 1. Stretching; 2. Warmups/video presentation; 3. "I want to talk!"4. Pre-test/"no way" or "that's right"; 5. Theme study; 6. Post-test/"no way" or "that's right". The activities developed are democratic, participatory, and stimulate the autonomy of the subjects involved. Such moments were essential for theoretical-scientific learning, providing opportunities for the expansion of interaction between the team and the construction of solidary bonds through dialogue.

A neuronal disruption in redox homeostasis elicited by ammonia alters the glycine/glutamate (GABA) cycle and contributes to MMA-induced excitability.

Hyperammonemia is a common finding in children with methylmalonic acidemia. However, its contribution to methylmalonate-induced excitotoxicty is poorly understood. The aim of this study was to evaluate the mechanisms by which ammonia influences in the neurotoxicity induced by methylmalonate (MMA) in mice. The effects of ammonium chloride (NH4Cl 3, 6, and 12 mmol/kg; s.c.) on electroencephalographic (EEG) and behavioral convulsions induced by MMA (0.3, 0.66, and 1 µmol/2 µL, i.c.v.) were observed in mice. After, ammonia, TNF-α, IL1ß, IL-6, nitrite/nitrate (NOx) levels, mitochondrial potential (ΔΨ), reactive oxygen species (ROS) generation, Methyl-Tetrazolium (MTT) reduction, succinate dehydrogenase (SDH), and Na(+), K(+)-ATPase activity levels were measured in the cerebral cortex. The binding of [(3)H]flunitrazepam, release of glutamate-GABA; glutamate decarboxylase (GAD) and glutamine synthetase (GS) activity and neuronal damage [opening of blood brain barrier (BBB) permeability and cellular death volume] were also measured. EEG recordings showed that an intermediate dose of NH4Cl (6 mmol/kg) increased the duration of convulsive episodes induced by MMA (0.66 µmol/2 µL i.c.v). NH4Cl (6 mmol/kg) administration also induced neuronal ammonia and NOx increase, as well as mitochondrial ROS generation throughout oxidation of 2,7-dichlorofluorescein diacetate (DCFH-DA) to DCF-RS, followed by GS and GAD inhibition. The NH4Cl plus MMA administration did not alter cytokine levels, plasma fluorescein extravasation, or neuronal damage. However, it potentiated DCF-RS levels, decreased the ΔΨ potential, reduced MTT, inhibited SDH activity, and increased Na(+), K(+)-ATPase activity. NH4Cl also altered the GABA cycle characterized by GS and GAD activity inhibition, [(3)H]flunitrazepam binding, and GABA release after MMA injection. On the basis of our findings, the changes in ROS and reactive nitrogen species (RNS) levels elicited by ammonia alter the glycine/glutamate (GABA) cycle and contribute to MMA-induced excitability.