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This paper aims to evaluate nursing students’ academic motivation, using as methodology descriptive research with quantitative approach. The result indicates a significant statistic of students already working in the nursing technical area (p 0.001). The results show self-determined motivational profile in regard to motivations and academic perspectives, with higher level of motivation autonomy, featuring students committed to satisfying their personal and professional need for development. It was verified the absence of motivation in small groups of students. The conclusion indicates that learning about the students’ academic motivational profile highlights the importance of examining the continuous process of self-determination, following paths for growth and quality of human relatedness, and giving us a glance into effective and significant learning toward excellence in the professional training and efficient and humanized professional practice.

Objectives This study surveys medical education literature published over the last 25 years (1993–2018) to identify the factors scholars consider deleterious to outpatient teaching for medical students. Methods This study conducts a review of medical education literature published between 1993 and 2018 using Medline, Lilacs, Ibecs, Cochrane Library, and Scielo databases. The following search terms were utilized: “Education, Medical, Undergraduate” AND “Ambulatory Care” AND “Teaching/methods” OR “Clinical Clerkship” OR “Preceptorship.” This study focuses on papers describing deleterious factors for outpatient teaching with medical students and analyzes their results, discussions, and conclusions sections. Results Of the 363 articles obtained, this study selected 33 for analysis. These papers identify numerous factors as barriers to outpatient education. For didactic purposes, these factors are categorized into four barrier groups: environment-institution, academic staff, students, and patients. Academic staff-related teaching barrier was the most frequently mentioned obstacle. Intense care schedule with little teaching time was considered the most common and relevant barrier to outpatient medical education, followed by inappropriate teaching environment and inadequate supervision model. Conclusions There is a lack of recent literature on studies focusing on barriers to effective outpatient medical education. Factors identified as harmful to outpatient education have been pointed out by course directors, academic staff, and students in the literature. However, many of these factors remain overlooked by educators, who can use these factors to modify their academic activities for more effective results.

A new perspective for health completeness, for different knowledges and practices and the development of new dimensions of care needed to work inside multidisciplinary teams in the Sistema unico de Saude (SUS) led to the search for new forms of training, with the support of Brazilian National Curriculum Guidelines (Brasil. Ministerio da Educacao-MS, 2001). This study evaluates aspects of the interprofessional way of teaching and integration of students from the medical school at Sao Paulo City University, employing a weekly qualitative analysis evaluation (cards) of students and the half-yearly narratives on practices (2008-2012). The speeches of the students showed positive feelings (95%) related to practice. The core ideas were “motivation” (50.84%), “teamwork” and “interprofessional relations” (74%). The analysis of the narratives identified the “community people” as the most affecting the students, followed by the physician figure (due to their own professional option). The medical care was the activity that mostly involved the students.

This research presents an analysis of the University City of Sao Paulo (UNICID) medical school teaching and learning environment, a school in Brazyl which employs active methodologies. A total of three hundred and ninety one students participated voluntarily in the research, being one hundred and fifty five students on its first phase, in the year of 2006, and two hundred and thirty six students in 2009. The Dundee Ready Education Environment Measure (DREEM) has been employed for accessing an evaluation of UNICID medical school academic environment. The DREEM questionnaire consists on 50 items assessing the school’s educational environment in five dimensions, to which scores have been attributed. A maximum of 200 points have been ascribed according to each dimension: Perception of Learning (with 12 items and maximum score of 48 points), Perception of Teaching (with 11 items and maximum score of 44 points), Academic Self-perception (with 8 items and maximum score of 32 points), Perception of the Environment (with 12 items and maximum score of 48 points) and Social Self-perception (with 7 items and maximum score of 28 points). The higher the score reaches, the more positively can be regarded the results. As the results show, the score increases in the second phase of the research. Each dimension will be analyzed separately and the differences in scores between them will be explained.

PURPOSE: To analyze the effects of application of 1% and 3% insulin-like growth factor I (IGF-1) cream on the process of wound healing in induced skin lesions in diabetic and non-diabetic rats and evaluate its effect on expression of myofibroblasts.METHODS: Ninety-six Wistar adult male rats were divided into six groups, with 16 rats in each group, as follows: group 1: non-diabetic, untreated; group 2: non-diabetic, treated with 1% IGF-1 cream; group 3: non-diabetic, treated with 3% IGF-1 cream; group 4: diabetic, untreated; group 5: diabetic, treated with 1% IGF-1 cream; and group 6: diabetic, treated with 3% IGF-1 cream. In groups 4, 5, and 6, diabetes was induced by intravenous injection of alloxan. After diabetes had been induced, animals were mantained for 3 months. The experimental procedure consisted of the creation of a circular incision of 0.9 mm in diameter using a metal punch. Following this, wounds were treated daily according to the assigned treatment regimen. Groups 2 and 5 were treated with 1% IGF-1 cream, groups 3 and 6 with 3% IGF-1 cream, and groups 1 and 4 and the untreated groups with 0.9% saline solution. From each group, samples from 4 rats were taken at three, seven, 14, and 21 days after the injury. Samples were fixed in 10% formalin to prepare slides for histological analysis. Slides stained with hematoxylin-eosin (H&E) and Masson were observed vascular proliferation, mononuclear cells, polymorphonuclear cells, fibroblast proliferation, re-epithelialization, and collagen fibers. This study analyzed the expression of α-smooth muscle actin using specific antibodies to correlate the temporal expression of α-smooth muscle-specific actin (α-SM actin), a molecular marker for myofibroblast transformation.RESULTS:Macroscopic observation of wounds showed a more rapid re-epithelialization of wounds treated with IGF. Regarding acute inflammatory reactions, the results of the analysis of vascular proliferation and polymorphonuclear and mononuclear cells showed no statistically significant differences in any of the periods studied (according to the results of a Mann-Whitney test). The initial immunohistochemical analysis of tissue samples conducted to compare the expression of α-smooth muscle actin between groups showed a relevant response in the expression of myofibroblasts. Data were analyzed using ANOVA and were found to be statistically significant.CONCLUSION: The topical application of 1% and 3% IGF-1 creams increases the expression of myofibroblasts in the process of wound healing in rats.

Introduction: This study focused on the effectiveness of municipal Sanitary Surveillance actions carried out in the context of clinical laboratories under the jurisdiction of the Regional Health Superintendence of Patos de Minas, state of Minas Gerais, Brazil. Objective: To verify if the Sanitary Surveillance followed eleven regulations set forth by Resolution No. 302/2015 of the Collegiate Board of Directors of the Brazilian Health Surveillance Agency when issuing sanitary permits to such laboratories. Methods: Data were collected from 181 annual health inspection reports from 2006 to 2013. Simple frequency and cross-checking analyses were carried out to treat data. Results: Sanitary Surveillance actions were still incipient in years 2006 and 2007. From 2008 on, however, there has been a significant increase in such actions, although they have shown to be less effective when it comes to compliance with items that are closely related to accuracy of laboratory tests and to the safety of patients and staff. Conclusion: the lack of effectiveness concerning Sanitary Surveillance actions is serious and brings out problems experienced by its team. Such problems ought to be investigated and resolved in order to improve the quality of the services provided by clinical laboratories.

Introduction: The human papillomavirus (HPV) is associated with sexually transmitted diseases (STD) and the lower genital tract carcinogenesis. Objective: To evaluate the previous knowledge and the function of educational action towards the reaction regarding the vaccine for Human Papilomavirus (HPV). Methods: Intervention study, like randomized clinical trial, considering 200 18-30 year-old women, divided in two groups submitted to a questionnaire to evaluate the previous knowledge about HPV and its vaccine, and the attitude for the vaccination, with one of the groups receiving intervention through educational action. Results: The attitude towards the vaccine against HPV was different in the group that received the educational action, with 37% of proper personal attitude (p=0,044) and 49% in the transference to a likely daughter (p=0,021). Conclusion: The previous knowledge about HPV and its vaccine is scarce, insufficient and sometimes mistaken. Through the comparison of attitude between different groups it was confirmed that the educational action does a determinant role to the correct women’s attitude to the vaccine against HPV and modifies the conditions of its accession.

To demonstrate the importance of using the family genogram in pediatric consultation, as an analysis tool to evaluate the degradation of parental bonding and also violence against children.A qualitative study was conducted in 2011 wherein 63 children, aged between 2 and 6 years, enrolled in a slum nursery, was studied. In order to construct the genogram, data were collected in four stages: pediatric evaluation at nursery; interview with caregivers; interview with teachers; and interview with the nursery coordinator. The data about the families were used to construct the genograms with the aid of GenoPro®-2016 software. In order to evaluate the quality of bonding, the following items were included in the genograms: violence against children, drug addiction, neglect, mental disorder, type of relationship among family members.The evaluated children and their families generated 55 genograms. In 38 of them, functional family arrangements, and close or very close emotional ties were observed. In 17 cases, situations involving physical, emotional, or sexual violence against children were perceived. Among these, four represented extreme cases, with fraying parental bonding, and dysfunctional family arrangements. In these families, chemical addiction was prevalent among multiple members, as well as severe mental disorder, persistent physical and verbal abuse, and sexual abuse.The use of the genogram helps to identify at an early stage the degradation of parental bonding and violence against children, and when it is incorporated into the pediatric practice routine, it may contribute to the promotion of the comprehensive health care of the child, regardless of the presence of social vulnerability.Demonstrar a importância da utilização do genograma familiar na consulta pediátrica como ferramenta de análise da presença de degradação do vínculo parental e da violência contra a criança.Estudo qualitativo, conduzido em 2011. A população compreendeu 63 crianças, com idades entre 2 e 6 anos, matriculadas em creche. Para a construção do genograma, a coleta dos dados se deu em quatro momentos: avaliação pediátrica na creche; entrevista dos cuidadores; entrevista dos professores; e entrevista da coordenadora da creche. Foram utilizados os dados sobre as famílias para a construção dos genogramas, com auxilio do programa GenoPro®-2016. Na avaliação da qualidade de vínculo, foram incluídos na representação do genograma: violência contra a criança, dependência química, negligência, transtorno mental, tipo de relação entre os membros da família.As crianças e respectivas famílias avaliadas deram origem a 55 genogramas. Em 38 deles, observaram-se arranjos familiares funcionais e com vínculos afetivos próximos ou muito próximos. Em 17 dos casos, evidenciaram-se situações que envolviam violência física, emocional ou sexual contra as crianças. Dentre esses, quatro representavam casos mais extremos, com esgarçamento do vinculo parental e arranjos familiares disfuncionais. Nessas famílias predominava a dependência química de múltiplos membros, transtorno mental grave, agressões física e verbal persistentes e abuso sexual.A utilização do genograma auxilia na identificação precoce da degradação do vínculo parental e da violência praticada contra a criança e, quando incorporada à prática pediátrica rotineira, pode contribuir para a promoção de uma assistência integral à saúde da criança, independentemente da presença de vulnerabilidades social.

CONTEXT AND OBJECTIVE: Epidemiology may help educators to face the challenge of establishing content guidelines for the curricula in medical schools. The aim was to develop learning objectives for a medical curriculum from an epidemiology database. DESIGN AND SETTING: Descriptive study assessing morbidity and mortality data, conducted in a private university in São Paulo. METHODS: An epidemiology database was used, with mortality and morbidity recorded as summaries of deaths and the World Health Organization's Disability-Adjusted Life Year (DALY). The scoring took into consideration probabilities for mortality and morbidity. RESULTS: The scoring presented a classification of health conditions to be used by a curriculum design committee, taking into consideration its highest and lowest quartiles, which corresponded respectively to the highest and lowest impact on morbidity and mortality. Data from three countries were used for international comparison and showed distinct results. The resulting scores indicated topics to be developed through educational taxonomy. CONCLUSION: The frequencies of the health conditions and their statistical treatment made it possible to identify topics that should be fully developed within medical education. The classification also suggested limits between topics that should be developed in depth, including knowledge and development of skills and attitudes, regarding topics that can be concisely presented at the level of knowledge. CONTEXTO E OBJETIVO: A epidemiologia pode auxiliar os educadores a enfrentar o desafio de estabelecer diretrizes para o conteúdo dos currículos em escolas médicas. O objetivo foi desenvolver objetivos de aprendizagem para um currículo médico por meio de um banco de dados epidemiológicos. TIPO DE ESTUDO E LOCAL: Estudo descritivo avaliando dados de morbidade e mortalidade, realizado por universidade particular em São Paulo. MÉTODOS: O banco de dados epidemiológicos com morbidade e mortalidade registrados como resumo de causas de morte e o Disability-Adjusted Life Year (DALY) da Organização Mundial de Saúde foi utilizado. A pontuação desenvolvida considerou probabilidades de mortalidade e morbidade. RESULTADOS: A pontuação apresenta uma classificação dessas condições de saúde para ser utilizada por uma comissão responsável pelo desenho curricular, considerando seus quartis superior e inferior, designando, respectivamente, maior e menor impacto na morbidade e mortalidade. Dados de três países foram utilizados para comparação internacional, mostrando resultados distintos. As pontuações resultantes indicaram temas a serem desenvolvidos pela taxonomia educacional. CONCLUSÃO: A frequência das condições de saúde e seu tratamento estatístico possibilitaram a identificação de temas que devem ser plenamente desenvolvidos em educação médica. A classificação sugere também limites entre tópicos que devem ser desenvolvidos em profundidade, incluindo o conhecimento e o desenvolvimento de habilidades e atitudes, a respeito de tópicos que podem ser concisamente apresentados ao nível de conhecimento.

In the context of medical school instruction, the segmented approach of a focus on specialties and excessive use of technology seem to hamper the development of the professional–patient relationship and an understanding of the ethics of this relationship. The real world presents complexities that require multiple approaches. Engagement in the community where health competence is developed allows extending the usefulness of what is learned. Health services are spaces where the relationship between theory and practice in health care are real and where the social role of the university can be revealed. Yet some competencies are still lacking and may require an explicit agenda to enact. Ten topics are presented for focus here: environmental awareness, involvement of students in medical school, social networks, interprofessional learning, new technologies for the management of care, virtual reality, working with errors, training in management for results, concept of leadership, and internationalization of schools. Potential barriers to this agenda are an underinvestment in ambulatory care infrastructure and community-based health care facilities, as well as in information technology offered at these facilities; an inflexible departmental culture; and an environment centered on a discipline-based medical curriculum.

A expansão do número de vagas no ensino superior, especialmente na área da saúde, deu-se principalmente às custas do setor privado e sob as recomendações das Diretrizes Curriculares Nacionais. A formação de profissionais de saúde demanda um novo perfil de competências para a docência no ensino superior. O objetivo deste estudo foi avaliar os Projetos Político-Pedagógicos (PPPs) dos novos cursos de graduação na área da saúde que incorporam metodologias ativas de ensino-aprendizagem e observar a coerência entre a proposta pedagógica e a forma de recrutamento, contratação e capacitação do corpo docente. O estudo é descritivo. Foram analisados os processos de recrutamento e capacitação de professores em novos cursos da área da saúde que expressam uma concepção inovadora no período de 2000 a 2008. Foram observadas sete instituições públicas e sete particulares. Apenas dois cursos entre os 19 analisados organizam os currículos por disciplinas e não por módulos integrados. As instituições privadas realizaram o mesmo processo de recrutamento e capacitação de docentes, com a seleção ocorrendo em meio à capacitação. As públicas realizaram capacitação após a definição do concurso público, com os docentes já contratados. Este estudo propõe a necessidade de redimensionar a formação docente na universidade, resgatando o papel da competência pedagógica como construção contínua de saberes. The expansion in university enrollment in Brazil, especially in the health fields, has occurred mainly in the private sector and in compliance with the National Curriculum Guidelines. Training Brazilian health professionals requires a new set of teaching skills in higher education. The aim of this study was to evaluate the teaching policy plans in new undergraduate courses in health that incorporate active teaching-learning processes, and to observe the consistency between the pedagogical approach and the policies for faculty recruiting, hiring, and training. This descriptive study analyzed the recruitment and training of professors in recently inaugurated courses (2000 to 2008) in the health field that express an innovative design. The study sample included seven public (government) and seven private institutions of higher learning, with a total of 19 courses. Only two of the 19 courses organize the curriculum by disciplines and not within integrated modules. The private institutions used the same faculty recruiting and training approach, with selection occurring during the training process. Public institutions provided their training after the public admissions and hiring process. The article concludes by emphasizing the need to reevaluate faculty training by reclaiming the role of teaching skills for knowledge-building.

Made available in DSpace on 2021-07-14T10:20:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-09. Added 1 bitstream(s) on 2021-07-14T11:27:45Z : No. of bitstreams: 1 S0100-55022008000300012.pdf: 141844 bytes, checksum: f025434b25e15dd6e7da50760cc22a75 (MD5) Este trabalho registra o processo de concepção, implantação e implementação do Programa Interinstitucional de Interação de Ensino, Serviço, Comunidade (Pinesc), uma parceria entre a universidade e a Prefeitura Municipal de Campo Grande, visando à realização de módulos curriculares longitudinais de ensino baseado na comunidade, desenvolvidos em oito semestres letivos do curso de medicina da Universidade para o Desenvolvimento do Estado e da Região do Pantanal (Uniderp, Anhanguera, MS). O relato inlcui o histórico, com seus pontos fortes e dificuldades, além de desdobramentos ão previstos, bem como aspectos operacionais do programa. This paper relates the planning, implantation and implementation process of the Inter-institutional Program for University-Health Service-Community Interaction (Pinesc), a partnership between the university, the city council of Campo Grande and the Local Health System aimed at producing a longitudinal curriculum module of community based education (CBE and Come), developed over eight semesters of the medical course of the Universidade para o Desenvolvimento do Estado e da Região do Pantanal (Uniderp, Anhanguera, MS, Brazil). This report tells the history of the implementation of the program, its strengths, difficulties and unforeseen developments besides approaching some operational aspects. Universidade para o Desenvolvimento do Estado e da Região do Pantanal Universidade Estadual Paulista Universidade Cidade de São Paulo Universidade Estadual Paulista

The purpose of this study was to investigate if experimental alloxanic diabetes could cause qualitative changes in intestinal anastomoses of the terminal ileum and distal colon in rats, as compared to controls. 192 male Wistar rats, weighing +/-300 g were split into four experimental groups of 48 animals each, after 3 months of follow-up: a control group with ileum anastomoses (G1), a control group with colon anastomoses (G2), a diabetic group with ileum anastomoses (G3) and a diabetic group with colon anastomoses (G4). Animals were evaluated and sacrificed on days 4, 14, 21 and 30 after surgery, and fragments of the small and large intestine where the anastomoses were performed were removed. Samples from 6 animals from each sacrifice moment were submitted to ultrastructural analysis of the collagen fibers using a scanning electron microscope and samples from another 6 animals were submitted to histopathology and optical microscopy studies using picrosirius red-staining. Histopathological analysis of picrosirius red-stained anastomosis slides using an optical microscope at 40x magnification showed that the distribution of collagen fibers was disarranged and also revealed a delay in scar tissue retraction. The morphometric study revealed differences in the collagen filled area for the ileum anastomoses 14 days post surgery whereas, in the case of colon anastomoses, differences were observed at days 4 and 30 post surgery, with higher values in the diabetic animals. Ultrastructure analysis of the ileum and colon anastomoses using a scanning electron microscope revealed fewer wide collagen fibers, the presence of narrower fibers and a disarranged distribution of the collagen fibers. We conclude that diabetes caused qualitative changes in scar tissue as well as in the structural arrangement of collagen fibers, what could explain the reduced wound strength in the anastomosis of diabetic animals.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:57:39Z No. of bitstreams: 1 S0102-67202007000100009.pdf: 404462 bytes, checksum: aa2d8e00725122f40ee2c261b93f6c13 (MD5) Made available in DSpace on 2013-08-22T18:57:39Z (GMT). No. of bitstreams: 1 S0102-67202007000100009.pdf: 404462 bytes, checksum: aa2d8e00725122f40ee2c261b93f6c13 (MD5) Previous issue date: 2007-03-01 Made available in DSpace on 2013-09-30T19:52:38Z (GMT). No. of bitstreams: 2 S0102-67202007000100009.pdf: 404462 bytes, checksum: aa2d8e00725122f40ee2c261b93f6c13 (MD5) S0102-67202007000100009.pdf.txt: 26776 bytes, checksum: 2ebb075d9d7a319f86547859410875d8 (MD5) Previous issue date: 2007-03-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:13:41Z No. of bitstreams: 2 S0102-67202007000100009.pdf: 404462 bytes, checksum: aa2d8e00725122f40ee2c261b93f6c13 (MD5) S0102-67202007000100009.pdf.txt: 26776 bytes, checksum: 2ebb075d9d7a319f86547859410875d8 (MD5) Made available in DSpace on 2014-05-20T15:13:41Z (GMT). No. of bitstreams: 2 S0102-67202007000100009.pdf: 404462 bytes, checksum: aa2d8e00725122f40ee2c261b93f6c13 (MD5) S0102-67202007000100009.pdf.txt: 26776 bytes, checksum: 2ebb075d9d7a319f86547859410875d8 (MD5) Previous issue date: 2007-03-01 RACIONAL: Crianças portadoras de distúrbios neurológicos têm maior incidência de refluxo e, em geral, não apresentam melhora da sintomatologia com tratamento clínico, necessitando de intervenção cirúrgica. OBJETIVO: Comparar os resultados da operação antirefluxo em crianças normais e com comprometimento neurológico, identificando as principais complicações e causas de reoperação. MÉTODOS: Cento e vinte crianças portadores de refluxo foram distribuídas em dois grupos de estudo: Grupo I - 60 crianças normais; Grupo II - 60 crianças com comprometimento neurológico. Exame contrastado do esôfago, estômago e duodeno, endoscopia digestiva alta com biópsia, pHmetria esofágica de 24 horas e cintilografia foram os exames utilizados no diagnóstico e na avaliação da eficácia da operação antirefluxo. Todos os pacientes operados eram refratários ao tratamento clínico. O procedimento cirúrgico antirefluxo realizado foi predominantemente a fundoplicatura de Lind, sendo associada à gastrostomia em 55% dos pacientes do Grupo II. RESULTADOS: No Grupo II a indicação cirúrgica foi significantemente mais precoce que no Grupo I. A principal causa de indicação cirúrgica entre neuropatas foi o alto comprometimento do desenvolvimento neuropsíquico-motor e as pneumonias de repetição. O tempo de internação, as reoperações e a necessidade de dilatações esofágicas no pós-operatório foi maior no Grupo II (p

The article aims to explore the concept of clinical management, with a view towards understanding the diverse meanings that could be attributed to that expression. This discussion can contribute to the planning and organization of health services geared to the management of clinical practices, as well as to set forth principles to draft actions in that field. Methodologically, the study consists of a qualitative literature review, using keywords of the Virtual Health Library (VHL). In terms of results, seven topics stand out that synthesize the analysis of sources: management, quality promotion, clinical monitoring or auditing, education, responsibility or accountability, safety in care and a systemic dimension. The conclusion is that the variation of meanings relates to the way in which the authors of the studies reviewed express or unfold the structuring conceptual components broadly accepted as clinical governance. What we observe is a lack of a greater focus on discussions regarding planning and policies relating to clinical governance.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:58:13Z No. of bitstreams: 1 S0102-86502009000100012.pdf: 183856 bytes, checksum: 0653eb05e30a1cb1f9a4b23747e72a2e (MD5) Made available in DSpace on 2013-08-22T18:58:13Z (GMT). No. of bitstreams: 1 S0102-86502009000100012.pdf: 183856 bytes, checksum: 0653eb05e30a1cb1f9a4b23747e72a2e (MD5) Previous issue date: 2009-02-01 Made available in DSpace on 2013-09-30T19:53:44Z (GMT). No. of bitstreams: 2 S0102-86502009000100012.pdf: 183856 bytes, checksum: 0653eb05e30a1cb1f9a4b23747e72a2e (MD5) S0102-86502009000100012.pdf.txt: 23393 bytes, checksum: ce42b5451518e919b819a94dc76047a3 (MD5) Previous issue date: 2009-02-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:32:20Z No. of bitstreams: 2 S0102-86502009000100012.pdf: 183856 bytes, checksum: 0653eb05e30a1cb1f9a4b23747e72a2e (MD5) S0102-86502009000100012.pdf.txt: 23393 bytes, checksum: ce42b5451518e919b819a94dc76047a3 (MD5) Made available in DSpace on 2014-05-20T13:32:20Z (GMT). No. of bitstreams: 2 S0102-86502009000100012.pdf: 183856 bytes, checksum: 0653eb05e30a1cb1f9a4b23747e72a2e (MD5) S0102-86502009000100012.pdf.txt: 23393 bytes, checksum: ce42b5451518e919b819a94dc76047a3 (MD5) Previous issue date: 2009-02-01 OBJETIVO: Investigar se o diabetes mellitus pode alterar a força de ruptura (FR) e o conteúdo de colágeno em anastomoses realizadas no íleo e cólon de ratos. MÉTODOS: 300 ratos Wistar foram distribuídos por sorteio em 5 grupos experimentais com 60 animais cada: controle normal manipulado cirurgicamente (G1); normais controles submetidos a anastomoses no íleo (G2) e cólon (G3); ratos diabéticos submetidos a anastomoses no íleo (G4) e cólon (G5). Cada grupo foi dividido em 6 subgrupos com 10 ratos cada para sacrifícios com 0, 4, 7, 14, 21 e 30 dias após as operações. Os procedimentos cirúrgicos foram realizados 3 meses após a indução do diabetes com aloxana. A FR foi medida em todas anastomoses intestinais. Fragmentos de anastomoses do íleo e cólon foram retirados para dosagens de hidroxiprolina (HP) e proteína tecidual total (PT). RESULTADOS: A FR teve significante redução (P

Purpose The impact of pancreas transplantation (PT) on the progression of eye disease is still controversial. This study evaluated the course of retinopathy in transplanted rats in two different diabetic stages. Methods Sixty inbred male Lewis rats were assigned to four experimental groups: NC—15 nondiabetic control rats; DC—15 untreated diabetic control rats; PT 1 —15 diabetic rats that received syngeneic pancreas transplants 2 weeks after alloxan diabetes induction; PT 2 —15 diabetic rats that received pancreas transplants 12 weeks after diabetes onset. Clinical and laboratory parameters and lens opacity were examined in all rats prior to treatment and at 1-, 6-, and 12-months follow-up. Nucleated eyes from five rats in each group processed for ultrastructural study of the retinal at 6 and 12 months after PT or at follow-up. Results Cataracts were observed in 20%, 60%, and 100% of DC rats at 1-, 6-, and 12-months follow-up, respectively. Early PT (2 weeks) significantly reduced the prevalence of this complication but not late (12 weeks) PT. PT 1 rats also showed improved ultrastructure of the superficial and deep capillary plexuses of the retina, and of Muller cells, compared with DC and PT 2 . In the last group, retinopathy continued to evolve despite successful PT. Conclusion Our results suggested that prevention of diabetic ocular lesions by PT was closely dependent on earlier performance of the procedure.

Purpose. Oxidative stress is one of the most important mechanisms to explain genesis of the complications in the chronic progression of diabetes. In this investigation we studied the effects of pancreas transplantation (PT) on the imbalance caused by excessive production of free oxygen radicals by antioxidant defenses of rats with serious chronic hyperglycemia induced by alloxan. Methods. Ninety inbred male Lewis rats were randomly distributed into three groups: NC-30 nondiabetic controls; DC-30 diabetic controls without any treatment; PT-30 diabetic rats undergoing syngeneic PT from normal donor Lewis rats. Each experimental group was then split into three subgroups of 10 animals for sacrifice after 1, 3, or 6 months. Clinical and laboratory parameters from all rats as well as lipid hydroperoxide (LPO) concentrations and renal tissue enzyme activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) were recorded for all rats. Results. Successful PT corrected clinical and laboratory alterations in diabetic rats with sustained normoglycemia throughout the study. A significant increase in LPO concentration and a marked reduction in SOD and CAT enzyme activity were observed in DC rats; there was no significant variation in renal tissue GSH-Px in this group. However, alterations in DC rats were completely restored from 1st month after PT; all evaluated enzyme levels did not significantly differ (P

The long-term effects of five different treatments of diabetes were evaluated in alloxan-induced diabetic rats.Seven experimental groups, with 50 rats each (GN--normal control; GD--untreated diabetic control; GI, GA, GIA--treated groups with insulin, acarbose, and insulin plus acarbose, respectively; GTIL, GTPD--treated groups with islet of Langerhans and pancreas transplantation) were studied. Clinical (body weight, water intake, food intake and urine output) and laboratory (blood and urinary glucose, and plasma insulin) parameters were analyzed at the beginning of the study, and after 1, 3, 6, 9 and 12 months of follow-up.Mortality was observed in all groups, except GN, during 12 months (GD = 50%; GI = 20%; GA = 26%; GIA = 18%; GTIL = 4%; GTPD = 20%). Rats from the GD, GI, and GIA groups died due to metabolic or hydrossaline disbalance, and/or pneumonia, diarrhoea, and cachexy. All deaths observed in GTIL and GTPD groups were in decorrence of technical failure at the immediate postoperative, until 72h. Animals from the GI, GA and GIA had significative improving of the clinical and laboratory parameters (p0,05) observed in diabetic rats, being the efficacy of theses treatments equal. However, rats from the GTIL and GTPD groups had better control of these parameters than GI, GA, and GIA groups. Transplanted rats had complete restoration, at the normal levels, of all analyzed variables (p0.01).Conventional treatments with insulin, acarbose, and insulin plus acarbose improved the severe diabetic state of the alloxan-diabetic rats, but pancreas and islet transplantation have a better performance for treatment of diabetes.

Made available in DSpace on 2016-07-19T13:51:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-02-01. Added 1 bitstream(s) on 2016-07-19T14:08:05Z : No. of bitstreams: 1 S0102-86502005000100008.pdf: 233981 bytes, checksum: 933661bd2aa22c10178ab7c88e7a70e8 (MD5) OBJETIVOS: Este estudo visa a analisar os efeitos, a longo prazo, de cinco diferentes tratamentos sobre o controle metabólico de ratos diabéticos aloxânicos. MÉTODOS: Foram analisados 7 grupos experimentais, com 50 ratos cada um, sendo: GN o grupo controle normal; GD o grupo controle diabético, sem tratamento; GI, GA e GIA os grupos tratados, respectivamente, com insulina, acarbose e associação insulina + acarbose; GTIL o grupo tratado com transplante de ilhotas de Langerhans; e o GTPD o grupo tratado com transplante pancreatoduodenal heterotópico. Parâmetros clínicos (peso, ingestão hídrica, ingestão alimentar e diurese) e laboratoriais (glicemia, glicose urinária e insulina plasmática) foram avaliados em todos os animais, no início do experimento, e após 1, 3, 6, 9 e 12 meses de seguimento. RESULTADOS: À exceção do GN, mortalidade foi observada em todos os grupos experimentais no seguimento de 12 meses (GD= 50%; GI= 20%; GA= 26%; GIA= 18%; GTIL= 4%; GTPD= 20%). em GD, GI, GA e GIA os óbitos ocorreram por distúrbios metabólicos ou hidroeletrolíticos e/ou pneumonia, diarréia e caquexia; em GTIL e GTPD todos os óbitos ocorreram por falhas técnicas no pós-operatório até 72h. Animais dos grupos GI, GA e GIA tiveram melhora significativa (p < 0,05) de todos os parâmetros clínicos e laboratoriais observados em ratos diabéticos, sem diferença de efetividade entre os tratamentos. Porém, os resultados observados nestes grupos, biologicamente não foram comparáveis aos observados em GTIL e GTPD, onde observou-se correção completa, aos níveis normais, de todas as variáveis analisadas (p

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:58:04Z No. of bitstreams: 1 S0102-86502003000200010.pdf: 815486 bytes, checksum: 523745c821f2ce88aa1de4e62561d0a4 (MD5) Made available in DSpace on 2013-08-22T18:58:04Z (GMT). No. of bitstreams: 1 S0102-86502003000200010.pdf: 815486 bytes, checksum: 523745c821f2ce88aa1de4e62561d0a4 (MD5) Previous issue date: 2003-03-01 Made available in DSpace on 2013-09-30T18:16:29Z (GMT). No. of bitstreams: 2 S0102-86502003000200010.pdf: 815486 bytes, checksum: 523745c821f2ce88aa1de4e62561d0a4 (MD5) S0102-86502003000200010.pdf.txt: 42790 bytes, checksum: 2aa30a46fabb4237b868b9dcba10d3e5 (MD5) Previous issue date: 2003-03-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:32:46Z No. of bitstreams: 2 S0102-86502003000200010.pdf: 815486 bytes, checksum: 523745c821f2ce88aa1de4e62561d0a4 (MD5) S0102-86502003000200010.pdf.txt: 42790 bytes, checksum: 2aa30a46fabb4237b868b9dcba10d3e5 (MD5) Made available in DSpace on 2014-05-20T13:32:46Z (GMT). No. of bitstreams: 2 S0102-86502003000200010.pdf: 815486 bytes, checksum: 523745c821f2ce88aa1de4e62561d0a4 (MD5) S0102-86502003000200010.pdf.txt: 42790 bytes, checksum: 2aa30a46fabb4237b868b9dcba10d3e5 (MD5) Previous issue date: 2003-03-01 OBJETIVO: O presente estudo teve por objetivo caracterizar as alterações clínicas e laboratoriais do rato portador de Diabetes Mellitus induzido pela administração endovenosa de aloxana. MÉTODOS: Os animais foram distribuídos, por sorteio, em dois grupos experimentais: Grupo Controle Normal (G1), constituído de 25 animais sadios, e Grupo Diabético (G2), formado por 25 animais diabéticos graves, que foram avaliados em cinco momentos (1, 3, 6, 9 e 12 meses) de seguimento, tendo sido estudados os seguintes parâmetros: evolução clínica (peso, ingestão hídrica, ingestão alimentar e diurese) e exames bioquímicos (glicemia de jejum, glicose urinária, glicosúria, cetonúria, colesterol total, colesterol HDL, triglicérides e lipídios). RESULTADOS: A injeção de aloxana 2% na via endovenosa do rato acompanhou-se de um índice de mortalidade de 39%, tendo produzido diabetes grave também em 39% dos animais. O diabetes foi caracterizado por queda progressiva do peso corporal, elevação substancial da ingestão hídrica, ingestão alimentar e da diurese, com valores glicêmicos acima de 300 mg/dl, glicosúria 3+ e, eventualmente, cetonúria. O diabetes não altera o perfil de colesterol e lípides de ratos a longo prazo. CONCLUSÃO: Nossos estudos revelam que a aloxana produz, no rato, alterações clínicas e laboratoriais características de diabetes grave, as quais possibilitam estudos a longo prazo do diabetes. PURPOSE: This work aimed to determine the clinical and laboratory alterations of rat with Diabetes mellitus using alloxan endovenously. METHODS: The animals were randomly assigned to two experimental groups: Normal Control Group (G1) with 25 healty animals and Diabetic Group (G2) with 25 severe diabetic animals. They were evaluated in 5 moments (1, 3, 6, 9 and 12 months) during which the following parameters were studied: clinical evolution (body weight, water intake, food intake, and diuresis) and biochemical exams (fast glycemia, urinary glucose, glucosuria, ketonury, total cholesterol, HDL cholesterol, triglycerides and lipids). RESULTS: Alloxan 2% injection intravenously in the rat was followed by 39% death rate and also caused severe diabetes in 39% of the animals. Diabetes was characterized by progressive body weight loss, significative water intake, food intake and diuresis with blood glucose levels above 300 mg/dl, glucosuria 3+ and eventually ketonury. Diabetes doesn`t change profile a long-term of cholesterol and lipids levels. CONCLUSION: Our studies showed that alloxan causes clinical and laboratory alterations in the rat, what is typical of severe diabetes. They allow the long-term studies of diabetic. UNESP Faculdade de Medicina de Botucatu Departamento de Cirurgia e Ortopedia UNESP Faculdade de Medicina de Botucatu Departamento de Oftalmologia UNESP Instituto de Biociências Departamento de Bioestatística UNESP Faculdade de Medicina de Botucatu Departamento de Cirurgia e Ortopedia UNESP Faculdade de Medicina de Botucatu Departamento de Oftalmologia UNESP Instituto de Biociências Departamento de Bioestatística

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:58:02Z No. of bitstreams: 0 Made available in DSpace on 2013-08-22T18:58:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-06-01 Made available in DSpace on 2013-09-30T19:53:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-06-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:13:52Z No. of bitstreams: 0 Made available in DSpace on 2014-05-20T15:13:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-06-01 Cem ratos norvégicus, machos, com aproximadamente 3 meses de idade foram distribuídos por sorteio em 2 grupos experimentais: Grupo Controle (GC): com 50 ratos sadios, não diabéticos e Grupo Diabético (GD): com 50 ratos diabéticos, induzidos pela aloxana, sem qualquer tratamento. Cada grupo foi dividido em 5 subgrupos com 10 ratos cada e sacrificados com 1, 3, 6, 9 e 12 meses de seguimento, respectivamente. Parâmetros clínicos (peso, ingestão hídrica e alimentar, e diurese) e laboratoriais (glicemia, glicose urinária e insulina) foram documentados em todos os momentos de avaliação. Um segmento do nervo ciático foi obtido de cada animal, em ambos os grupos, para estudo à MO. e ME. Alterações clínicas e laboratoriais significativas (P

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:58:01Z No. of bitstreams: 0 Made available in DSpace on 2013-08-22T18:58:01Z (GMT). No. of bitstreams: 0 Previous issue date: 1997-09-01 Made available in DSpace on 2013-09-30T19:53:20Z (GMT). No. of bitstreams: 0 Previous issue date: 1997-09-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:36:30Z No. of bitstreams: 0 Made available in DSpace on 2014-05-20T13:36:30Z (GMT). No. of bitstreams: 0 Previous issue date: 1997-09-01 A proposição foi realizada, no período pós-operatório imediato, em 40 ratos Wistar, distribuídos por sorteio em doi grupos: grupo NC, vinte ratos correspondentes ao grupo controle, não diabético, submetidos a operação simulada e o grupo PT, 20 ratos correspondentes ao grupo diabético que recebeu transplante de pâncreas heterotópico de ratos Wistar normais. Durante sete dias, antes do transplante, e 1, 3, 6, 12, 24, 48, 72, 96 horas após, determinava-se a glicose sanguínea, a insulina plasnática e o glucagon. Estes parâmetros eram obtidos também do grupo NC. Diabetes mellitus experimental era induzida pela administração intravenosa de aloxana. O grupo PT era imunosuprimido com ciclosporina A. O grupo NC apresentou níveis normais de glicose sanguínea, de insulina plásmica e de glucagon, durante todo o experimento. Foi encontrada nítida hiperinsulinemia no sangue venoso periférico do grupo PT. A insulina plasmática era significantemente maior no grupo PT comparada ao grupo NC começando 72 horas após o transplante. O glucagon plasmático, elevado no período pré-transplante, não se alterou após o transplante. Apesar de hiperinsulinemia e hiperglucagonemia, os níveis de glicose sanguínea eram elevados 6 horas após o transplante e mantiveram-se normais após este período. Considerando-se os níveis de glicose sanguínea 12 horas pós-transplante, não houve diferença estatisticamente significante entre os grupos PT e NC, até o sacrifício. The consequences of the bypass of the portal venous effluent into the systemic circulation on the blood glucose, plasma insulin, and glucagon in immediate postoperative period of rats submitted to pancreas transplantation were studied. Forty outbred male Wistar rats were randomly assigned to two experimental groups: group NC included 20 non-diabetic control rats, submitted to simulated operating (sham-operated), and group PT included 20 diabetic rats that received heterotopic pancreas transplantation from normal donor Wistar rats. For 7 days prior and 1, 3, 6, 12, 24, 48, 72 and 96 hours after transplantation blood glucose, plasma insulin, and glucagon were recorded. These parameters were also concurrently recorded for NC rats. Diabetes was induced by i.v. alloxan administration; PT rats were immunosuppressed with cyclosporin A. NC rats presented normal values of blood glucose, plasma insulin, and glucagon over the course of experiment. A marked hyperinsulinemia was found in peripheral venous blood of PT rats, being plasma insulin significantly higher than that for NC rats (P

RESUMO A medicina atua com a prevenção e a cura das doenças humanas num sentido amplo. Uma formação com enfoque em problemas permite ao estudante um poder de análise dos componentes das situações de saúde. O Programa de Integração em Saúde da Comunidade (Pisco) prevê levar estudantes e professores para a vivência da prática voltada à integralidade das ações, valorizando a prevenção e a promoção à saúde. O objetivo deste estudo foi analisar as vivências dos estudantes de Medicina no processo de avaliação das atividades do Pisco do primeiro ao quarto ano do curso e a sua relação com o projeto pedagógico do curso. Foi realizado um estudo descritivo quali-quantitativo. Foram produzidos registros escritos pelos estudantes ao final de cada encontro, de março de 2008 a dezembro de 2011, posteriormente analisados por meio do Discurso do Sujeito e pelo software QualiQuantiSoft®. Os resultados mostram diminuição do número de registros a partir da quinta etapa, pois a partir dela os alunos iniciam vivências em ambientes diferentes de prática médica e, assim, passam a desvalorizar as atividades no Programa de Saúde da Família. ABSTRACT Broadly speaking, medicine engages the prevention and cure of human diseases. Problem-based training allows the student to analyze the components of health situations. The Community Health Integration Program (Pisco) aims to enable students and teachers to experience the practice directed at comprehensive actions, highlighting health prevention and promotion. The objective of this study was to analyze first to fourth-year student experiences during the evaluation process of Pisco activities and their relationship with the pedagogical design of the course. A qualitative-quantitative descriptive study was conducted. The students produced written records at the end of each meeting, from March 2008 to December 2011. The records were analyzed using Discourse of the Subject and the software QualiQuantiSoft®. The results showed a reduced number of records made from the fifth stage onwards, from which time the students begin to experience different medical practice environments and start to pay less attention to Family Health Program activities.

RESUMO Objetivo: Demonstrar a importância da utilização do genograma familiar na consulta pediátrica como ferramenta de análise da presença de degradação do vínculo parental e da violência contra a criança. Métodos: Estudo qualitativo, conduzido em 2011. A população compreendeu 63 crianças, com idades entre 2 e 6 anos, matriculadas em creche. Para a construção do genograma, a coleta dos dados se deu em quatro momentos: avaliação pediátrica na creche; entrevista dos cuidadores; entrevista dos professores; e entrevista da coordenadora da creche. Foram utilizados os dados sobre as famílias para a construção dos genogramas, com auxilio do programa GenoPro®-2016. Na avaliação da qualidade de vínculo, foram incluídos na representação do genograma: violência contra a criança, dependência química, negligência, transtorno mental, tipo de relação entre os membros da família. Resultados: As crianças e respectivas famílias avaliadas deram origem a 55 genogramas. Em 38 deles, observaram-se arranjos familiares funcionais e com vínculos afetivos próximos ou muito próximos. Em 17 dos casos, evidenciaram-se situações que envolviam violência física, emocional ou sexual contra as crianças. Dentre esses, quatro representavam casos mais extremos, com esgarçamento do vinculo parental e arranjos familiares disfuncionais. Nessas famílias predominava a dependência química de múltiplos membros, transtorno mental grave, agressões física e verbal persistentes e abuso sexual. Conclusões: A utilização do genograma auxilia na identificação precoce da degradação do vínculo parental e da violência praticada contra a criança e, quando incorporada à prática pediátrica rotineira, pode contribuir para a promoção de uma assistência integral à saúde da criança, independentemente da presença de vulnerabilidades social.

PURPOSE: To assess ischemic preconditioning (IPC) effects in pulmonary lesion in intestinal and hepatic ischemia-reperfusion (IR) injury models using diabetic rats. METHODS: Diabetes (DM) was induced in 28 male Wistar rats by alloxan (42 mg/kg, IV). After 28 days, severe DM rats were submitted to intestinal or hepatic IR injury with or without IPC. Intestinal IR (30 min of mesenteric artery occlusion and 30 min of reperfusion; n=6) and IPC groups (10 min ischemia, 10 min reperfusion, followed by intestinal IR; n=6), and Hepatic IR (30 min of hepatic pedicle occlusion and 30 min of reperfusion; n=5) and IPC groups (10 min ischemia, 10 min reperfusion, followed by hepatic IR; n=5), were compared to DM rats group (n=6). Plasmatic lactate, glycemia were measured before and after IR injury. Histomorphology of lung was performed counting inflammatory cells. Data was expressed in mean± SE. P

Background Universidade Cidade de São Paulo adopted a problem-based learning (PBL) strategy as the predominant method for teaching and learning medicine. Self-, peer- and tutor marks of the educational process are taken into account as part of the final grade, which also includes assessment of content. This study compared the different perspectives (and grades) of evaluators during tutorials with first year medical students, from 2004 to 2007 (n = 349), from seven semesters. Methods The tutorial evaluation method was comprised of the students' self assessment (SA) (10%), tutor assessment (TA) (80%) and peer assessment (PA) (10%) to calculate a final educational process grade for each tutorial. We compared these three grades from each tutorial for seven semesters using ANOVA and a post hoc test. Results A total of 349 students participated with 199 (57%) women and 150 (42%) men. The SA and PA scores were consistently greater than the TA scores. Moreover, the SA and PA groups did not show statistical difference in any semester evaluated, while both differed from tutor assessment in all semesters (Kruskal-Wallis, Dunn's test). The Spearman rank order showed significant (p < 0.0001) and positive correlation for the SA and PA groups (r = 0.806); this was not observed when we compared TA with PA (r = 0.456) or TA with SA (r = 0.376). Conclusion Peer- and self-assessment marks might be reliable but not valid for PBL tutorial process, especially if these assessments are used for summative assessment, composing the final grade. This article suggests reconsideration of the use of summative assessment for self-evaluation in PBL tutorials.

O projeto UNI é uma iniciativa da Fundação W. K. Kellogg que começou a ser implantada em Botucatu em 1993, pressupondo um esforço de cooperação entre a Universidade, serviços locais de saúde e organizações comunitárias. O principal objetivo do UNI é apoiar o desenvolvimento integrado de modelos inovadores de ensino, dos sistemas locais de saúde e da ação comunitária. Em Botucatu, o Projeto UNI toma forma numa parceria entre a Faculdade de Medicina de Botucatu (FMB), a Secretaria de Saúde e Meio Ambiente da Prefeitura e a União das Associações e Sociedade de Amigos de Bairro do Município, a Unasab’s. A gestão partilhada é a marca registrada do Projeto, que se encontra agora em sua segunda fase de execução e já está sendo transformado na Fundação UNI. Por meio dessa iniciativa, o UNI vem delineando uma nova maneira de integrar parceiros e desenvolver modelos. Abre, assim, caminhos para a formação de profissionais de Saúde que articulem os avanços científicos e tecnológicos à necessidade de nossa gente. The UNI Project is an initiative of the W.K.Kellogg Foundation, which started in Botucatu in 1993 and presupposes an effort toward cooperation among the university, local health services and community organizations. The main purpose of the UNI Program is to support the integrated development of innovative models of teaching, local health services and community participation. In Botucatu, the UNI Project is a partnership which includes the Botucatu Medical School (FMB), the Municipal Health and Environment Office and the Union of Associations and Societies of Municipal Communities, the Unasabs. Shared management is the project’s trademark. The project is now going through its second phase of operation and is being transformed into the UNI Foundation. The foundation is a UNI initiative that allows the outlining of a new way to integrate partners and develop models. It favors the training of health professionals so that they adapt scientific and technological advances to our people’s needs.