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Objetivo: Relatar a experiência de prescrição de leite de vaca para uma criança que não poderia ser amamentada. Método: Relato de experiência, seguindo o protocolo Squire 2.0, de atendimento realizado em uma UBS de João Pessoa-PB, em setembro de 2022. Resultados: Em consulta com criança de 32 dias de vida e inadequado ganho de peso para a idade, foi identificada, como queixa oculta, dificuldade de amamentação devido a depressão pós-parto, e ausência de recursos para fórmula infantil. Em bases de dados, foi encontrada a sugestão de diluir o leite integral de vaca em água fervida, até os 4 meses, na proporção 2/3 + 1/3, respectivamente, acrescendo 1 colher de chá de óleo para cada 100 ml. Após 12 dias, verificou-se que a criança ganha peso adequadamente, estando, clinicamente, estável. Conclusão: Tornar as condutas e protocolos compatíveis com a realidade familiar e socioeconômica dos pacientes é fundamental. A vivência relatada expõe o quão complexo é ponderar essas questões, reduzindo danos e ofertando saúde de qualidade.

A relevância e a abordagem consistente dos temas reunidos no Guia Prático em Osteometabolismo asseguraram a publicação dessa nova edição. Preparada pelos membros do Departamento de Metabolismo Ósseo e Mineral da Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) e por seus colaboradores, oferece uma visão ainda mais detalhada sobre condições enfrentadas diariamente por clínicos e especialistas, como diabetes mellitus, osteoporose, hipertireoidismo e hipoparatireoidismo. Com isso, o guia mantém a sua condição como material de consulta e referência para profissionais da Endocrinologia e áreas relacionadas.

The present work aims to present two national exhibitions promoted by the Brazilian New State (1937-45): The National Exhibition of the New State (RJ-1938) and the Great National Exhibition of Pernambuco (PE-1939). Guided by the first edition of the Mostra della Rivoluzione Fascista (1932), the article craves to show how the getulist national exhibitions presented discursive and programmatic similarities to the fascist exposition and how these events were planned and executed to create a space of political and ideological consensus. O presente trabalho tem por meta apresentar duas exposições nacionais promovidas pelo Estado Novo Brasileiro (1937-45): A Exposição Nacional do Estado Novo (RJ-1938) e a Grande Exposição Nacional de Pernambuco (PE-1939). Tomando por base a primeira edição da Mostra della Rivoluzione Fascista (1932), o artigo almeja evidenciar como as mostras nacionais getulistas O presente trabalho tem por meta apresentar duas exposições nacionais promovidas pelo Estado Novo Brasileiro (1937-45): A Exposição Nacional do Estado Novo (RJ-1938) e a Grande Exposição Nacional de Pernambuco (PE-1939). Tomando por base a primeira edição da Mostra della Rivoluzione Fascista (1932), o artigo almeja evidenciar como as mostras nacionais getulistas apresentavam similaridades discursivas e programáticas com a exposição fascista e como esses eventos foram planejados e executados para a criação de espaço de consenso político e ideológico.

A novel coronavirus emerged in China in late 2019 as a disease named coronavirus disease 2019. This pathogen was initially identified as causing a respiratory syndrome, but later, it was found that COVID-19 could also affect other body systems, such as the neurological and cardiovascular systems. For didactic purposes, cardiovascular and neurological manifestations of SARS-CoV-2 have been classified in three different groups: acute complications, late complications, and post-vaccine complications. Therefore, the following study has the goal to summarize and disseminate the present knowledge about the cardiovascular and neurological manifestations of COVID-19 based on the latest and most up-to-date data available and, thus, promote more prepared medical care for these conditions as the medical team is updated. Based on what is brought on this revision and its understanding, the medical service becomes more aware of the causal relationship between some conditions and COVID-19 and can better prepare for the most prevalent conditions to associate and, consequently, to treat patients earlier. Therefore, there is a chance of better prognoses in this context and the need to increase the number of studies about complications related to SARS-CoV-2 infection for a better understanding of other associated conditions.

Nitric oxide (NO) is an important endogenously produced molecule. Ruthenium–NO tetraamine complexes appear as model structures to investigate the control of nitric oxide bioavailability. NO release typically occurs through the trans-[RuII(NH3)4Ltrans(NO+)]3+/2+ + e− → trans-[RuII(NH3)4Ltrans(NO0)]2+/+ reduction reaction, followed by the trans-[RuII(NH3)4Ltrans(NO0)]2+/+ + H2O → trans-[RuII(NH3)4Ltrans(H2O)]2+/+ + NO0 hydrolysis reaction. The choice of the NO trans ligand, Ltrans, is fundamental to control the Ru–NO bond stability. Here, the nature and charge influences of Ltrans were evaluated considering the following ligands Ltrans = σ-donors (NH3 and H−), π-donors (H2O and NH2−), and π-donors and π-acceptors (CO and CN−) through the ZORA-BP86/TZ2P computational model. Energy Decomposition Analysis in conjunction with the Natural Orbitals for Chemical Valence methodology (EDA-NOCV) showed that molecules with Ltrans = H2O and NH2− promoted larger Ru–NO stabilization than complexes with Ltrans = NH3 and H−, respectively, mainly due to the interaction orbital energy (ΔEoi). The opposite trend was observed in compounds with Ltrans = CO and CN− compared to structures with Ltrans = H2O and NH2−. The study of the charge distribution, performed using the Voronoi Deformation Density (VDD) method, and the topological analysis of the electron density, realized using the Quantum Theory of Atoms in Molecules (QTAIM), on the investigated complexes indicated that Ltrans with negative charge promoted, in general, predominantly a decrease of the electron flux in the Ltrans(σ) → Ru(dσ*) ← NO(σ) process.

Anais do Instituto de Higiene e Medicina Tropical, v. 20 (2021): Suplemento n�� 1 - Perspetivas sobre a educa����o m��dica em Angola

Acute mesenteric ischemia, caused by an abrupt interruption of blood flow in the mesenteric vessels, is associated with high mortality. When treated with surgical interventions or drugs to re-open the vascular lumen, the reperfusion process itself can inflict damage to the intestinal wall. Ischemia and reperfusion injury comprise complex mechanisms involving disarrangement of the splanchnic microcirculatory flow and impairment of the mitochondrial respiratory chain due to initial hypoxemia and subsequent oxidative stress during the reperfusion phase. This pathophysiologic process results in the production of large amounts of reactive oxygen (ROS) and nitrogen (RNS) species, which damage deoxyribonucleic acid, protein, lipids, and carbohydrates by autophagy, mitoptosis, necrosis, necroptosis, and apoptosis. Fluorescence-based systems using molecular probes have emerged as highly effective tools to monitor the concentrations and locations of these often short-lived ROS and RNS. The timely and accurate detection of both ROS and RNS by such an approach would help to identify early injury events associated with ischemia and reperfusion and increase overall clinical diagnostic sensitivity. This abstract describes the pathophysiology of intestinal ischemia and reperfusion and the early biological laboratory diagnosis using fluorescent molecular probes anticipating clinical decisions in the face of an extremely morbid disease.

Background: Neural tuberculosis is an infection of the central nervous system caused by the bacterium Mycobacterium tuberculosis. Bearing in mind that neural tuberculosis is the most severe form of extrapulmonary tuberculosis and results in significant morbidity and mortality rates, it is important to analyze its sociodemographic characteristics in Brazil. Objectives: To describe the sociodemographic characteristics of neural tuberculosis cases in Brazil in the period from 2010 to 2020. Design and Setting: Cross-sectional, retrospective, and descriptive study, carried out using data collected from the Notifiable Diseases Information System (SINAN) and the Hospital Information System (SIH / SUS) of confirmed cases and hospitalizations for neural tuberculosis. Methods: Variables used: region, sex, age group, color/race and year of service. Results: In the period from 2010 to 2020, the number of notified cases of meningoencephalic tuberculosis was 7.451, with mean cases per year of 677.36. The Southeast region was the most affected with 43.8% of the total cases, followed by the South and Northeast regions, with 24.1% and 20.1%, respectively. There was a wide predominance in individuals aged 30-39 years (42.8%) and in the age group 40-59 years (35.9%). The male sex was the most affected with 63.3% of the total. Conclusions: The study shows a predominance of cases in the South and Southeast regions, with a significant prevalence of males and age groups of 20- 59. This could be an alert for new prevention and health promotion strategies for the most affected groups.

Background: Stroke is an important cause of death and is a major cause of serious disability in Brazil and in the world. Therefore, it is fundamental to analyze its treatment in the hospital setting in Brazil. Objectives: To describe the progression of the stroke treatment in the hospital setting in Brazil between the years 2010 and 2019 and the outcomes associated to the disease. Design and Setting: Transversal, retrospective and quantitative study, with secondary data collected in the Hospital Information System of SUS (SIH / SUS) between 2010 and 2019, in Brazil. Methods: Data from number of hospitalizations for stroke treatment, mortality rate and average length of hospital stay were collected and analyzed. A comparison has been made between these data over the selected years. Results: The number of hospitalizations for stroke treatment had a 16,83% growth between 2010 and 2019. In comparison, the average length of hospital stay was 7,7 days in 2010 and 7,6 days in 2019. The mortality rate had a reduction of 10,52% between these years. Conclusions: Despite the growth of hospitalization to stroke treatment, there was a reduction in the average length of hospital stay and in the mortality rate associated to the procedure. It is possible to infer an optimization in the stroke lead in intensive care units in Brazil.

The role of art education on the unveiling and construction of personal and social cultural identities is the topic. The chapter starts with an account on the rise of a critical pedagogy project in Brazil and its implications on art education. Following this is a report on the experience on the art-teaching program at the Faculdade Paulista de Artes – FPA, based on three examples as they appear in the graduation work of my students.

Background: Stroke is rare in pediatric patients, but it is of paramount importance due to its serious complications. The study of the incidence of strokes in these patients is important for us to be able to adequate public health policies. Objectives: To evaluate the incidence of strokes in pediatric patients in Brazil. Design and setting: Descriptive, retrospective study, carried out using data from the Hospital Information System (SIH/SUS), from 2011 to 2020. Methods: Variables: brain stroke not specific for the hemorrhagic or ischemic type, mortality, hospitalizations, sex, ethnicity and age group from 0 to 19 years of age. Results: During the period from 2011 from 2020, there were a total of 6912 cases of stroke in the age group from 0 to 19 years; the highest incidence in 2019 (10.59%) and the lowest incidence in 2020 (8.65%.) The age group from 15 to 19 accumulated the greatest number of cases (60.40%). The total mortality rate was 8.12% (561 cases). The highest mortality rate was observed between 15 and 19 years of age (62.03%), and the lowest between 5 and 9 years of age(4.63%). The incidence was slightly higher in males (50.41%). Conclusions: Similar annual stroke rates were identified during the analyzed period, demonstrating the need for interventional actions to reduce its incidence. The non-specification of the hemorrhagic or ischemic types is a limiting factor, since the prevention management is different in each case. There was a higher prevalence, as well as a higher mortality rate, from 15 to 19 years.

Background: Spina bifida is the second leading cause of motor disability in childhood. Therefore, it’s important to know if the therapeutic offer for spina bifida is fulfilling its demand. Objectives: To evaluate the relationship between the number of treatments and the incidence of spina bifida in Brazil, between 2016 and 2019. Design and Setting: Descriptive, retrospective study, with secondary data collected in the Hospital Information System of SUS (SIH / SUS) and the Information System of Live Births (SINASC), between 2016 and 2019, in Brazil. Methods: Variables used: frequency of spina bifida by live births and quantity of treatments. Results: In 2016, the frequency of spina bifida by live births was 746 and the number of procedures for treating the disease was 360, resulting in a 0.48 ratio between the treatment quantity and the affected live births. In 2017, the frequency was 711 and the procedure quantity was 337, with a 0.47 proportion. In 2018, the frequency was 726, the procedure quantity 294, with a 0.4 proportion. In 2019, the frequency decreased to 694, with 288 procedures, and a 0.41 proportion. In total, there were 2,877 live births with spina bifida and 1,300 hospital procedures, with a proportion of 0.45. Conclusions: The study shows a clear disparity between the frequency of spina bifida and the procedure quantity for this condition. In addition, the number of procedures was decreased, without a proportional declination in the disease incidence, indicating a need for greater public investment for such treatments.

Intestinal ischemia-reperfusion (I/R) injury constitutes a severe disorder, in great part resulting from oxidative stress. Because sulforaphane and albumin were shown to increase antioxidant defenses, we evaluated the therapeutic potential of these agents in an experimental model of I/R injury.Wistar rats were used to establish a model of intestinal I/R (35 min of ischemia, followed by 45 min of reperfusion) and were treated with albumin (5 mL/kg), sulforaphane (500 μg/kg), or saline intravenously before reperfusion. Animals that were not subjected to I/R served as the sham (laparotomy only) and control groups. Blood samples were analyzed for arterial gas, reactive oxygen species, and reactive nitrogen species using different molecular fluorescent probes. After euthanasia, ileal samples were collected for analysis, including histopathology, immunohistochemistry, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling assays, and lactic dehydrogenase measurement.Oxygenation status and hemodynamic parameters were uniform during the experiment. The sulforaphane- or albumin-treated groups showed reduced concentrations of reactive oxygen species (P 0.04), nitric oxide (P 0.001), and peroxynitrite (P = 0.001), compared with I/R injury untreated animals. Treatment with sulforaphane or albumin resulted in the preservation of goblet cells (P 0.03), reductions in histopathologic scores (P 0.01), macrophage density (P 0.01), iNOS expression (P 0.004), NF-kappa B activation (P 0.05), and apoptotic rates (P 0.04) in the mucosa and a reduction in the concentration of lactic dehydrogenase (P 0.04), more pronounced with sulforaphane.Attenuation of intestinal I/R injury in this model probably reflects the antioxidative effects of systemic administration of both sulforaphane and albumin and reinforces their use in future translational research.

Several methods have been discussed to assess and quantify proprioceptive deficits. Most clinical assessments are based on categorical or ordinal results which are not sensitive to subtle changes or subtle deficits observed in different patients. In this paper, we propose a quantitative protocol for post-stroke proprioceptive assessment based on three-dimensional inertial tracking. The system is based on a network of five inertial sensors that are attached to the subjects’ upper limbs. Validation of our approach was based on a set of upper-limb experiments performed by thirty healthy subjects and six stroke patients.

Orientador: Profa. Dra. Barbara Trzaskos Coorientador: Prof Dr. rer. nat. Germán Vinueza Dissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Terra, Programa de Pós-Graduação em Geologia. Defesa : Curitiba, 18/12/2020 Inclui referências: p. 44-49 Resumo: A estabilidade do talude é uma das maiores preocupações para as práticas de mineração hoje e considerar a resposta do maciço rochoso à detonação de cargas explosivas é fundamental para obter a geometria da cava planejada. O desafio é determinar um desenho de desmonte, que alcance a fragmentação da rocha sem prejudicar os taludes Assim, correlacionar as vibrações induzidas pelo desmonte aos danos e construir um modelo representativo para determinar o plano de fogo é fundamental para ultrapassar este desafio. Este estudo consiste no desenvolvimento de uma metodologia que conecta o comportamento dinâmico do maciço rochoso às vibrações induzidas pela detonação com o objetivo de determinar a melhor configuração da malha de perfuração, configuração de carga, temporização e sequenciamento dos desenhos de detonação aplicados em uma mina de cobre neste particular maciço rochoso. O elemento central deste estudo foi a construção do modelo de atenuação de vibrações e onda elementar que, em conjunto com propriedades geomecânicas, permitiu a caracterização deste maciço rochoso e dos fenômenos de atenuação de vibração O novo plano de fogo foi desenvolvido a partir das simulações do modelo, uma vez que foi possível reconhecer quais parâmetros do projeto afetam a maior parte dos danos induzidos pela detonação. Para garantir a representatividade do modelo, foram realizados dois desmontes teste: um com o plano de fogo usual e outro com o novo Além disso, furos foram feitos a jusante dos desmontes e foram inspecionados antes e depois de cada desmonte para comparar o fraturamento produzido com o fraturamento esperado pelo modelo. Os resultados obtidos nestes testes mostram uma forte correlação entre o modelado e o real. A modelagem provou ser uma ferramenta útil para a previsão de danos induzidas pela detonação e para gerar um plano de fogo, que gere paredes estáveis. Palavras-chave: VPP crítica, estabilidade de taludes, dano induzido, vibrações induzidas por explosivos Abstract: Slope stability is one of the biggest concerns for mining practices today and to consider the rock mass response over blasting is fundamental to achieve pit geometry as planned. The challenge is to determine a blast design, which address the rock fragmentation without harm, the slopes. Thus, correlate blasting induced vibrations to damage and build a representative model to determine the blast design is fundamental to overlap this challenge This study consists in developing a methodology which connects the dynamic behavior of one lithological domain to the blasting-induced vibrations aiming to determine the best configuration of drilling pattern, charge configuration, timing and sequencing of the blast designs applied at a copper mine in this particular rock. The central element of this study was the construction of vibration attenuation and seed wave model which, in conjunction with geomechanical properties, has allowed the characterization of this particular rock mass and the vibration attenuation phenomena. The new blast design was developed from the model simulations, once it was possible to recognize which parameters of the blast design affect most of the damage induced by blasting To guarantee model representativeness, two blast tests were conducted: one with the usual blast design and another using the new one. Furthermore, holes were drilled behind the blasts, which were inspected before and after each blast to compare the produced fracturing with the fracturing expected by the model The results obtained in these blast tests show a strong correlation between the modeled and the real. The modeling proved to be a useful tool for prediction of blasting-induced providing manners to stablish a blast design, which generates stable walls. Keywords: Critical PPV, slope stability, induced damage, blasting-induced vibrations