Reflexiones sobre el aprendizaje de la histología en biología y en ciencias de la salud

El conocimiento de la estructura, composición y función del organismo es fundamental en la formación de los graduados de Ciencias Biomédicas y de Ciencias de la Salud. Las células y los tejidos son los componentes básicos para comprender el normal funcionamiento del organismo y sus procesos patológicos. Por otra parte, la Histología es una de las disciplinas básicas con mayor cantidad de publicaciones sobre temas relacionados con su docencia. Sin embargo, a pesar de la abrumadora literatura existente, todavía no hay criterios claros sobre la pertinencia de los contenidos, los métodos en el aprendizaje y la evaluación de esta materia. En este trabajo; tras una revisión bibliográfica y a partir de la información aportada por profesores de Histología, se lo analizan las principales cuestiones que plantea el proceso de enseñanza aprendizaje de la Histología en el ámbito de Biomedicina (Biología, Medicina, Veterinaria, Enfermería, Nutrición, Fisioterapia, Biotecnología, etc.), a saber: su pertinencia, los contenidos a impartir, las estrategias y los medios didácticos a emplear y los métodos de evaluación. A partir de todos estos datos se describen los principales puntos fuertes y débiles de la Histología con las correspondientes sugerencias de cambio y adaptación al entorno actual.

Nosotros, los bioéticos. Estrategias de producción identitarias de grupos católicos reunidos en torno a la bioética

Para 1994, las preocupaciones sobre los avances científicos en términos de biomedicina como la reproducción asistida, la anticoncepción y el aborto llevaron al Papa Juan Pablo II a instituir formalmente a la Pontificia Academia para la Vida con el objetivo de defender y promover la vida mediante el estudio y monitoreo de los avances médicos y el derecho. Desde esta institución se promovió la bioética, personalista, como la disciplina propicia para establecer concepciones filosóficas y antropológicas sobre los conceptos de inicio y finalización de la vida y del ser humano en general. En nuestro país, recién para 1998, algunos movimientos católicos empezaron a dar sus primeros pasos en la formación de laicos en estas cuestiones, apoyando la idea de que son ellos, especialmente los profesionales de la salud, quienes deben difundir los postulados doctrinarios en el territorio, allí donde se encuentran los bautizados. La defensa de la vida como valor máximo, universal, trascendental y a la vez secular es el objetivo máximo de los promulgadores de la bioética ya que aúna criterios con otras religiones en el movimiento de la defensa de la vida y la planificación natural de la fertilidad, que estos grupos católicos pretenden dominar. Este trabajo intentará dar cuenta de las estrategias de producción identitarias por parte de los líderes católicos bioéticos, de un grupo católico secular, destinadas al conjunto de los laicos, durante el año 2008, en el cual el movimiento bioético, luego de diez años de vida, se encuentra afianzado y logra la movilización de centenares de laicos militantes de la defensa de la vida, a lo largo de la Argentina

Médicos acupuntores : Su visión de la alopatía y del potencial de la medicina integrativa

Basándonos en 18 entrevistas en profundidad con médicos que han incorporado en su práctica clínica la acupuntura, en este trabajo analizamos cómo ellos definen la medicina que practican y de qué modo la diferencian de la práctica biomédica convencional o alopática. El trabajo de campo se realizó en las ciudades de Buenos Aires y Tucumán durante los años 2005 y 2006. El estudio se centra en los significados y estilos terapéuticos desarrollados por los médicos, y más específicamente en sus perspectivas de cómo el ejercicio de la acupuntura en la atención primaria de la salud les ha permitido mantenerse próximos a la "esencia" de lo que debería ser la medicina. Los médicos construyen dicha esencia a partir de la crítica de la biomedicina actual hiper especializada y altamente tecnologizada, y de la recuperación de valores y prácticas perdidas de la medicina occidental moderna (el enfoque holístico y centrado en el paciente) así como de la posibilidades que abren las medicinas no convencionales de brindar tratamientos que no producen iatrogenia y de facilitar una relación terapéutica menos paternalista

Otras cosas en juego en la 'Fraternidad de Exactas'. Trayectorias y ejercicio de la profesión entre embriólogos

Este trabajo articula aspectos de la construcción de conocimiento en embriología humana, a partir de una etnografía en laboratorios de reproducción asistida realizado en la ciudad y provincia de Buenos Aires. Médicos y embriólogos conformaron los sujetos de estudio de esta investigación que focaliza en la construcción material y simbólica de embriones. Ambas profesiones involucran experiencias divergentes que serán analizadas y recuperadas a partir del punto de vista de los actores. Con trayectorias profesionales heterogéneas, los relatos profesionales en torno al 'inicio' en la FIV (Fertilización in Vitro) se organizan, para los embriólogos en torno a diferencias entre la 'ciencia' y el 'trabajo'. Los embriólogos proceden en su mayor parte de la investigación en ciencias básicas, con mayor o menor inserción en los organismos públicos (Conicet y Universidad en su mayor parte), de tal forma que la 'vida anterior' de un embriólogo puede tener poco que ver con el ámbito de la salud e incluso con los humanos. Mientras tanto, los médicos encuentran en el espacio de la actividad una continuidad con las prácticas 'aprendidas' en el ejercicio de la profesión. Esta disparidad de experiencias, da cuenta de la ausencia de espacios formales de especialización o entrenamiento profesional en embriología y de las prácticas de standarización formal y jerárquica de la intervención en biomedicina. Las tensiones que atraviesan las relaciones al interior de estos equipos revelan aspectos no resueltos de los procesos de estabilización tecnológica imprescindibles para el ejercicio profesional

Nosotros, los bioéticos. Estrategias de producción identitarias de grupos católicos reunidos en torno a la bioética

Para 1994, las preocupaciones sobre los avances científicos en términos de biomedicina como la reproducción asistida, la anticoncepción y el aborto llevaron al Papa Juan Pablo II a instituir formalmente a la Pontificia Academia para la Vida con el objetivo de defender y promover la vida mediante el estudio y monitoreo de los avances médicos y el derecho. Desde esta institución se promovió la bioética, personalista, como la disciplina propicia para establecer concepciones filosóficas y antropológicas sobre los conceptos de inicio y finalización de la vida y del ser humano en general. En nuestro país, recién para 1998, algunos movimientos católicos empezaron a dar sus primeros pasos en la formación de laicos en estas cuestiones, apoyando la idea de que son ellos, especialmente los profesionales de la salud, quienes deben difundir los postulados doctrinarios en el territorio, allí donde se encuentran los bautizados. La defensa de la vida como valor máximo, universal, trascendental y a la vez secular es el objetivo máximo de los promulgadores de la bioética ya que aúna criterios con otras religiones en el movimiento de la defensa de la vida y la planificación natural de la fertilidad, que estos grupos católicos pretenden dominar. Este trabajo intentará dar cuenta de las estrategias de producción identitarias por parte de los líderes católicos bioéticos, de un grupo católico secular, destinadas al conjunto de los laicos, durante el año 2008, en el cual el movimiento bioético, luego de diez años de vida, se encuentra afianzado y logra la movilización de centenares de laicos militantes de la defensa de la vida, a lo largo de la Argentina

En torno a la problemática de la interculturalidad en los saberes y prácticas bio-médicas

En el contexto de las profundas transformaciones que se dieron en toda América Latina con las aplicaciones de las políticas neo-liberales un nuevo concepto aparece en las agendas de Salud: "interculturalidad". A dicho concepto se apela tanto en la elaboración de la estrategia de APS como en la producción de programas de salud más ambiciosos, al menos en los discursos. En este trabajo intentamos reflexionar, desde la perspectiva de la Antropología Crítica de la Salud, las modalidades en que las estrategias políticas y programas de salud y "la interculturalidad en acción", condicionan los saberes y prácticas de los profesionales de la biomedicina sobre el proceso de salud/enfermedad/atención de grupos migrantes tobas asentados en la ciudad de Rosario

Dificultades en la conceptualización y en el registro de la utilización de Medicinas Alternativas y Complementarias

Estudios internacionales y locales dan cuenta de la utilización de medicinas alternativas y complementarias (MACs), aunque en nuestro país los estudios empíricos sobre la temática han sido abordados mayoritariamente desde una metodología cualitativa. Existen sólo unos pocos relevamientos por encuesta con pequeñas muestras no probabilísticas sobre utilización de dichas medicinas, aunque cabe destacar que los mismos no se han realizado con la población general sino con usuarios de establecimientos de salud públicos y privados con el objetivo de relevar su utilización de MACs, y hasta la fecha no contamos con encuestas nacionales ni estadísticas oficiales sobre el tema. En nuestra ponencia discutimos las dificultades de definir a las MACs como categoría global y residual frente a la biomedicina o medicina oficial, teniendo en cuenta la heterogeneidad de las medicinas y terapias que engloba el término, así como los límites cambiantes entre lo que se entiende por medicina convencional y no convencional, e identificamos algunos problemas que se presentan para medir su utilización. Para ello primero revisamos la literatura internacional (norteamericana) que en gran medida ha servido de modelo para los relevamientos cuantitativos locales, y en segundo lugar, discutimos algunos inconvenientes que observamos entre estos últimos estudios, a lo que agregamos propuestas para futuros relevamientos

Concepção de ser humano subjacente à discussão sobre saúde na psicologia: uma proposta de orientação heideggeriana

A reading method (Cervo & Bervian, 1983) was applied to select psychology publications on health. The rejection of the biomedical model is a recurring theme in these publications. Its point of view is that the model is reductionistic because it emphasizes (1) the disease (2) as a body dysfunction and by consequence health is understood as the absence of disease. The implications of the biomedical model for health are biological materialism and physiological mechanicism. Psychology publications counterpoint to biomedicine is to include attention to life contexts and consider the role of individual behavior and lifestyle in the health-disease process. Those thoughts about the nature of health imply a conception of man, especially when some articles claim that Descartes’ ideas are the ground to biomedicine development. Psychology publications reviewed highlight health characteristics related to a different view of the human mode of being. The thesis presented develops an understanding that Martin Heidegger’s Dasein Analytic is a conception of human being consistent with the selected psychology works’ view of health. It means psychology’s discussion about what is health is based on an implicit approach to the human being, one that allows the rethinking of health. The heideggerian Dasein is a vision of man in tune with the comprehension of health presented in the selected publications. It is understood that the manner a human phenomenon is conceptualized is related even implicitly to a conception of man. To take into account health’s contextual aspects like society, environment, and culture call attention to the man world relationship to which Heidegger calls being in the world. To highlight the role of behavior on one’s own health makes a point of the relationship man has with her/his own being, which Heidegger calls mineness.

Influência da utilização do fluido de corte com adição de grafeno na temperatura de usinagem e formação de rebarba no processo de micro fresamento

As time passed, humanity needed the development of new materials used in various activities. High strength materials such as titanium and Inconel for example, had been studied because they are widely used for implants in biomedicine, as well as their use in aerospace and automotive industries. Because of its thermal and mechanical properties, these materials are considered difficult to machine, promoting a rapid wear of cutting tools, primarily caused by the high temperatures in machining. With the development of new materials has emerged the need of developing new manufacturing processes. One of today’s innovative processes is the micro-manufacturing. Being a process with a defined cutting tool geometry, burr formation is a constant and undesirable phenomenon formed during the machininig process. Being detrimental to the manufacturing process, overspending deburring operations are constantly employed leading to increase the aggregate cost to the manufactured material. Assembly components are also impaired if there is no control of the burr, with consequences including the disposal of components due to the occurence of this phenomenon. This paper presents the study of micro-milling Inconel 718, investigating influential parameters in the formation of burrs in order to minimize the occurrence of this phenome non. Different feed rates per tooth and cutting speed are evaluated, and different cutting fluids with different methods of applying the fluid. Adding graphene to cutting fluids was considered as a variable to be investigated, which is considered an excellent solid lubricant, in addition to increasing the thermal conductivity of the cooling solution (AZIMI; MOZAF FARI, 2015). The micro-milling temperature was evaluated in the present work. It was observed a new phenomenon that causes the machined surface temperature decreases below room temperature when using the solution water + oil. This phenomenon is explained in further chapters. In order to unravel this phenomenon, a new test was proposed and, from this test, it can be concluded, comparatively, which cutting fluid has a better cooling property.Using cutting fluid with different thermal properties has shown influence when analy zing burr formation and reducing machining temperature.

A medicina baseada na prova na reconfiguração científica da medicina contemporânea: primeiras aproximações exploratórias

No decurso das últimos décadas tem-se assistido à emergência e à rápida consolidação de uma nova abordagem no interior da medicina, inteiramente consagrada à tentativa de conferir bases científicas mais sólidas a uma prática profissional muito marcada pela incerteza e por grandes variações na aplicação de um conhecimento cujos pressupostos são muitas vezes vistos como relativamente ambíguos e refractários a um escrutínio científico rigoroso e sistemático. Entre outros problemas de fundo que aqui irão ser mais demoradamente aflorados, naturalmente a questão da vocação acaba também por surgir largamente desafiada por novas lógicas inscritas na matriz técnico-científica da medicina, pois, ao fim e ao cabo, são os fundamentos de uma longa tradição histórica de humanismo médico que se encontram hoje em profunda reconfiguração, enredados numa difícil encruzilhada em que se afiguram ténues e complexas as formas de compatibilização dos princípios filosóficos fundadores da profissão, com as actuais exigências e imperativos científicos da biomedicina contemporânea.

Projeto de mestrado para implementação de um sistema de gestão da qualidade em farmácia comunitária

Nos últimos anos, a Qualidade em Instituições de saúde tem sido um tema relevante. O conceito de qualidade tem várias definições, sendo um conceito difícil de medir e definir. A Qualidade é uma ferramenta cada vez mais almejada pelas instituições que prestam cuidados de saúde e neste caso particular pela Farmácia Comunitária. Essa procura advém da necessidade de garantir um atendimento aos utentes cada vez mais eficaz e eficiente, capaz de satisfazer as suas reais necessidades e expectativas, por meio da otimização de processos e economização de recursos, tornando-se, por isso, uma prioridade nas áreas onde os farmacêuticos operam. O objetivo deste projeto é clarificar e explicar as etapas para a implementação de um Sistema de Gestão da Qualidade, com base na Norma ISO 9001:2008, numa Farmácia Comunitária, encorajando toda a equipa e promovendo o empenho e envolvência de todos nas práticas de gestão integrada da qualidade e nas estratégias de melhoria contínua. A Implementação de um Sistema de Gestão da Qualidade com base na norma ISO 9001:2008 poderá ter um impacto muito positivo, contribuindo não apenas para a melhoria da qualidade interna da organização, nas suas diversas vertentes, como também para a focalização nos seus clientes, melhorando ainda mais a qualidade dos serviços prestados, demonstrando ser relevante para a saúde, para a forma como os recursos humanos se organizam em torno do trabalho e para racionalização dos recursos. Desta forma se demonstra o valor desta ferramenta na gestão, eficácia e segurança no sistema de utilização do medicamento em Farmácia Comunitária.

Familial amyloid polyneuropathy: TTR sequencing and "in silico" analysis

Familial amyloid polyneuropathy (FAP) or paramiloidosis is an autosomal dominant neurodegenerative disease with onset on adult age that is characterized by mutated protein deposition in the form of amyloid substance. FAP is due to a point alteration in the transthyretin (TTR) gene and until now more than 100 amyloidogenic mutations have been described in TTR gene. FAP shows a wide variation in age-at-onset (AO) (19-82 years, in Portuguese cases) and the V30M mutation often runs through several generation of asymptomatic carriers, before expressing in a proband, but the protective effect disappear in a single generation, with offspring of late-onset cases having early onset. V30M mutation does not explain alone the symptoms and AO variability of the disease observed in the same family. Our aim in this study was to identify genetic factors associated with AO variability and reduced penetrance which can have important clinical implications. To accomplish this we genotyped 230 individuals, using a directautomated sequencing approach in order to identify possible genetic modifiers within the TTR locus. After genotyping, we assessed a putative association of the SNPs found with AO and an intensive in silico analysis was performed in order to understand a possible regulation of gene expression. Although we did not find any significant association between SNPs and AO, we found very interesting and unreported results in the in silico analysis since we observed some alterations in the mechanism of splicing, transcription factors binding and miRNAs binding. All of these mechanisms when altered can lead to dysregulation of gene expression, which can have an impact in AO and phenotypic variability. These putative mechanisms of regulation of gene expression within the TTR gene could be used in the future as potential therapeutical targets, and could improve genetic counselling and follow-up of mutation carriers.

The evolving profile, role and relevance of the medical director in a pharmaceutical company

Over the last years, operations in Pharmaceutical Companies have become more complex, trying to adapt to new demands of the market environment. Overall, the observed change of paradigm requires adapting, mainly by the setting of new priorities, diversification of investments, cost containment strategies, exploring new markets and developping new sets of skills. In this context, new functions have been created, the relevance of some has diminished, and the importance of others has arisen. Amongst these, the medical structure within a Pharmaceutical Company, increased to meet demands, with companies adopting different models to respond to these needs, and becoming a pillar to the business. Assuming the leading role within a medical department, the medical director function often lies in the shadow. It is a key function within Pharma Industry, either on a country or on a Global basis. It has evolved and changed in the past years to meet the constant demands of a changing environment. The Medical Director is a highly skilled and differeniated professional who provides medical and scientific governance within a Pharmaceutical company, since early stages of drug development and up to loss of exclusivity, not only but also by leading a team of other physicians, pharmacists or life scientists whose functions comprise specificities that the medical director needs to understand, provide input to, oversee and lead. As the organization of Pharmaceutical Companies tends to be different, in accordance to values, culture, markets and strategies, the scope of activities of a Medical Director can be broader or may be limited, depending on size of the organization and governance model, but they must fulfil a large set of requirements in order to leverage impact on internal and internal customers. Key technical competencies for medical directors such as an MD degree, a strong clinical foundation, knowledge of drug development, project and team management experience and written and verbal skills are relatively easy to define, but underlying behavioural competencies are more difficult to ascertain, and these are more often the true predictors of success in the role. Beyond seamless proficiency in technical skills, at this level interpersonal skills become far more important, as they are the driver and the distinctive factor between a good and an excelent medical director. And this has impact in the business and in the people doing it.

Saccharomycotin transcriptomics by next-generation sequencing

The non-standard decoding of the CUG codon in Candida cylindracea raises a number of questions about the evolutionary process of this organism and other species Candida clade for which the codon is ambiguous. In order to find some answers we studied the transcriptome of C. cylindracea, comparing its behavior with that of Saccharomyces cerevisiae (standard decoder) and Candida albicans (ambiguous decoder). The transcriptome characterization was performed using RNA-seq. This approach has several advantages over microarrays and its application is booming. TopHat and Cufflinks were the software used to build the protocol that allowed for gene quantification. About 95% of the reads were mapped on the genome. 3693 genes were analyzed, of which 1338 had a non-standard start codon (TTG/CTG) and the percentage of expressed genes was 99.4%. Most genes have intermediate levels of expression, some have little or no expression and a minority is highly expressed. The distribution profile of the CUG between the three species is different, but it can be significantly associated to gene expression levels: genes with fewer CUGs are the most highly expressed. However, CUG content is not related to the conservation level: more and less conserved genes have, on average, an equal number of CUGs. The most conserved genes are the most expressed. The lipase genes corroborate the results obtained for most genes of C. cylindracea since they are very rich in CUGs and nothing conserved. The reduced amount of CUG codons that was observed in highly expressed genes may be due, possibly, to an insufficient number of tRNA genes to cope with more CUGs without compromising translational efficiency. From the enrichment analysis, it was confirmed that the most conserved genes are associated with basic functions such as translation, pathogenesis and metabolism. From this set, genes with more or less CUGs seem to have different functions. The key issues on the evolutionary phenomenon remain unclear. However, the results are consistent with previous observations and shows a variety of conclusions that in future analyzes should be taken into consideration, since it was the first time that such a study was conducted.

Product quality and compliance in the pharmaceutical industry

This thesis aims to highlight the importance of a Product Quality & Compliance department in a Pharmaceutical Industry, on the good performance of company's activities and the achievement of their goals and mission. Despite the wide activities performed by this Department, the purpose of this work will be completed by describing only some of their reponsibilities. The tasks described are specifically the ones I have been performing throughout my professional experience at Bluepharma - Pharmaceutical Industry, SA, initiated in June 2012 in the Quality Assurance Department until today in the currently named Product Quality & Compliance department. This thesis is structured into 4 parts. The first chapter is an introduction to this thesis, and includes its context and objectives, followed by a brief overview of the state-of-the art in the pharmaceutical industry, including the market environment, the regulatory environment and quality requirements. A small presentation of the company and the department where were and still are developed my professional activity is also made in this chapter. In the following chapter are described the main tasks performed, the complementary activities and key skills acquired throughout this professional experience. A discussion and conclusion is presented at the end, including an analysis of the reported activities, main difficulties encountered its role and importance in the company performance as well as the skills acquired during this work experience.