O desenvolvimento de competências em atenção básica à saúde: a experiência no projeto Huka-Katu

O artigo explora a possibilidade de integração no processo de aprendizagem à rede de serviços de saúde do subsistema de saúde indígena integrante do Sistema Único de Saúde e colabora com o processo de formação profissional na área da saúde. Enfatiza também que a concepção pedagógica e as metodologias de ensino-aprendizagem são temas importantes para o desenvolvimento das competências dos novos profissionais da saúde. Com isto, o objetivo deste artigo é apresentar, através da análise descritiva, o contexto em que se desenvolve o processo preparatório para o estágio optativo "Projeto Huka-Katu - a FORP-USP no Xingu", ressaltando os aspectos cognitivos presentes na proposição de ações voltadas para a atenção primária. Considera-se ainda que as competências requeridas para o trabalho do cirurgião-dentista na atenção básica à saúde se constituem em um suporte (base) para a construção do SUS, sendo que estas competências devem atender as necessidades de articulação da prática e da educação, em uma perspectiva do cuidado à saúde.

À "frente" da Semana de Arte Moderna: a presença de Graça Aranha e Paulo Prado

Reconhecidos como personagens centrais pelo grupo de intelectuais e artistas ligados à Semana de Arte Moderna de 1922, Graça Aranha e Paulo Prado são muitas vezes deixados de lado pelos estudiosos e, em geral, se fazem presentes nas análises de bastidores e/ou em referências de terceiros. Este artigo pretende observar mais atentamente suas redes de sociabilidade e inserção, o que revela, entre outras coisas, as ambivalências do engate de ambos os autores em um projeto "moderno", assim como certas ambivalências presentes no interior do próprio movimento modernista.

Etiology of cutaneous leishmaniasis and anthropophilic vectors in Juruti, Pará State, Brazil

In a preliminary study in Juruti, a mining municipality in western Pará State, Brazil, 12 out of 21 patients suspected of presenting cutaneous leishmaniasis showed positive PCR (SSUrDNA and G6PD): Leishmania (Viannia) braziliensis (9/12; 75%) and L. (V.) sp. (3/12; 25%). Entomological studies in the same location revealed the presence of 12 different phlebotomine species (n =105). One of the most common species was Lutzomyia (Psychodopygus) complexa (17%) which is both highly anthropophilic and a known vector of L. (V.) braziliensis in other regions of Pará. These preliminary findings should serve to guide future epidemiological surveillance in Juruti.

Two new species of Moenkhausia Eigenmann (Characiformes: Characidae) from Serra do Cachimbo, Pará, Northern Brazil

Two new species of Moenkhausia, one from the rio Tapajós and the other from the rio Xingu basins are described as apparently endemics of the Serra do Cachimbo. Both species, along with M. petymbuaba, share a distinct color pattern composed of large conspicuous dark blotches on the base of the body scales. Moenkhausia chlorophthalma, from rio Treze de Maio, a tributary to rio Curuá (rio Xingu basin), is distinguished by the presence of a proximal well delimited black area on the adipose fin and a green eye in life. Moenkhausia plumbea of the headwaters of tributaries of the rio Braço Norte, rio Tapajós basin is diagnosed by the presence of a dark longitudinal stripe across the eye and six branched pelvic-fin rays (vs. seven). Relationships of the new species with other Moenkhausia are discussed.

Determinação de As, Cd e Pb em amêndoas e mesocarpo de babaçu, sapucaia, xixá e castanha-do-pará por espectrometria de absorção atômica

This work describes methods for the simultaneous determination of Cd and Pb by graphite furnace atomic absorption spectrometry and As by hydride generation atomic absorption spectrometry in Brazilian nuts. The samples (~ 0.300 g) were digested to clear solutions in a closed vessel microwave oven. The pyrolysis and atomization temperatures for simultaneous determinations of Cd and Pb were 1100 and 2100 °C, respectively, using 0.5% (w v-1) NH4H2PO4 + 0.03% (w v-1) Mg(NO3)2 as chemical modifier. The limits of detection (3Δ) were 3.8 μg kg-1 for As, 0.86 μg kg-1 for Cd and 13 μg kg-1 for Pb. The reliability of the entire procedures was confirmed by peach leaves (No. 1547 - NIST) certified reference material analysis and addition and recovery tests. The found concentrations presented no statistical differences at the 95% confidence level.

O projeto museográfico da exposição Cartografia de uma história - São Paulo colonial: mapas e relatos

Este artigo apresenta o projeto museográfico da exposição Cartografia de uma história, inaugurada no Museu Paulista da Universidade de São Paulo em março de 2005. O projeto museográfico foi concebido e elaborado a partir do diálogo entre as propostas da equipe de pesquisa e os dados do perfil dos visitantes do Museu, constituindo-se assim um trabalho integrado, que buscava tratar de forma lúdica o ato de descobrir.

Características do sistema produtivo da pecuária no município de Santarém, Pará

Com o objetivo de identificar as principais falhas no sistema de produção que limitam a pecuária em Santarém, Pará, foram entrevistados, ao acaso, 21 pecuaristas (90,5% de corte - cria, recria e engorda; 9,5% de leite), proprietários de 10% da população de bovinos do município. 71,4% das propriedades tinham currais para manejo do gado, entretanto apenas 38,1% possuíam balança e 23,8% tronco de contenção. A Brachiaria brizantha estava presente em todas as fazendas, sendo usada exclusivamente em 42,9% das propriedades. A disseminação de plantas invasoras (61,9%) foi considerada a principal dificuldade no manejo das pastagens. Constatou-se que 76,2% dos pecuaristas utilizam misturas minerais com macro e micro-elementos, geralmente de formulações comerciais, enquanto que 19% utilizam apenas sal comum, enriquecido com micro-elementos. A concentração de fósforo (P) na mistura mineral estava abaixo do recomendado para bovinos de corte em 76,9% das propriedades e apenas 19% das propriedades possuía cochos para suplementação mineral adequada.

Desafios de um estudo longitudinal: o projeto SABE

Este ensaio aborda o histórico do Projeto SABE, nas versões de pesquisa do ano 2000 e 2006

Fatores relacionados à autopercepção da audição entre idosos do município de São Paulo - Projeto SABE

Este artigo relata a influência de fatores sociodemográficos e de saúde na autopercepção da audição entre os idosos do projeto " Saúde, Bem-Estar e Envelhecimento" (Projeto SABE) no município de São Paulo. O estudo incluiu 2.143 indivíduos de 60 anos e mais. Um modelo de regressão logística ordinal, considerando o desenho da amostra, foi usado na análise multivariável. O aumento da idade; o sexo masculino; morar acompanhado; relatar tontura; memória regular/ ruim e saúde regular ou ruim aumentaram a chance de autopercepção ruim da audição. O conhecimento da autopercepção da audição e dos seus fatores relacionados é importante para avaliar a qualidade de vida dos idosos e a necessidade de reabilitação auditiva

Modelo de programação linear para otimização econômica do projeto de irrigação Baixo Acaraú - CE

The present work had as objective uses a model of lineal programming algorithm to optimize the use of the water in the District of Irrigation Baixo Acarau-CE proposing the best combination of crop types and areas established of 8,0 ha. The model aim maximize the net benefit of small farmer, incorporating the constraints in water and land availability, and constraints on the market. Considering crop types and the constraints, the study lead to the following conclusions: 1. The water availability in the District was not a limiting resources, while all available land was assigned in six of the seven cultivation plans analyzed. Furthermore, water availability was a restrictive factor as compared with land only when its availability was made to reduce to 60% of its actual value; 2. The combination of soursop and melon plants was the one that presented the largest net benefit, corresponding to R$ 5,250.00/ha/yr. The planting area for each crop made up to 50% of the area of the plot; 3. The plan that suggests the substitution of the cultivation of the soursop, since a decrease in annual net revenue of 5.87%. However, the plan that contemplates the simultaneous substitution of both soursop and melon produced the lowest liquid revenue, with reduction of 33.8%.

PAR evaluation of treated Class I extraction patients

Objective: To evaluate treatment changes and quality of finishing occlusion in Class I patients treated with four premolar extractions. Material and Methods: Dental casts of 94 subjects (50 males and 44 females) were evaluated. Mean pretreatment age was 13.46 years, and mean treatment time was 2.09 years. The peer assessment rating (PAR) index was obtained from pretreatment and posttreatment dental casts. Results: The mean pretreatment PAR index of 29.46 was reduced to 6.32 at posttreatment stage, achieving a reduction of 78.54% with treatment. There was correlation between the initial PAR and correction during treatment, that is, the more severe the malocclusion the greater the treatment changes. Conclusion: The cases evaluated showed a high-standard orthodontic finishing.

Lineage divergence detected in the malaria vector Anopheles marajoara (Diptera: Culicidae) in Amazonian Brazil

Background: Cryptic species complexes are common among anophelines. Previous phylogenetic analysis based on the complete mtDNA COI gene sequences detected paraphyly in the Neotropical malaria vector Anopheles marajoara. The ""Folmer region"" detects a single taxon using a 3% divergence threshold. Methods: To test the paraphyletic hypothesis and examine the utility of the Folmer region, genealogical trees based on a concatenated (white + 3' COI sequences) dataset and pairwise differentiation of COI fragments were examined. The population structure and demographic history were based on partial COI sequences for 294 individuals from 14 localities in Amazonian Brazil. 109 individuals from 12 localities were sequenced for the nDNA white gene, and 57 individuals from 11 localities were sequenced for the ribosomal DNA (rDNA) internal transcribed spacer 2 (ITS2). Results: Distinct A. marajoara lineages were detected by combined genealogical analysis and were also supported among COI haplotypes using a median joining network and AMOVA, with time since divergence during the Pleistocene (< 100,000 ya). COI sequences at the 3' end were more variable, demonstrating significant pairwise differentiation (3.82%) compared to the more moderate 2.92% detected by the Folmer region. Lineage 1 was present in all localities, whereas lineage 2 was restricted mainly to the west. Mismatch distributions for both lineages were bimodal, likely due to multiple colonization events and spatial expansion (similar to 798 - 81,045 ya). There appears to be gene flow within, not between lineages, and a partial barrier was detected near Rio Jari in Amapa state, separating western and eastern populations. In contrast, both nDNA data sets (white gene sequences with or without the retention of the 4th intron, and ITS2 sequences and length) detected a single A. marajoara lineage. Conclusions: Strong support for combined data with significant differentiation detected in the COI and absent in the nDNA suggest that the divergence is recent, and detectable only by the faster evolving mtDNA. A within subgenus threshold of >2% may be more appropriate among sister taxa in cryptic anopheline complexes than the standard 3%. Differences in demographic history and climatic changes may have contributed to mtDNA lineage divergence in A. marajoara.

Increased expression of protease-activated receptor 1 (PAR-1) in human leukemias

Protease-activated receptor 1 (PAR-1) is a G-protein-coupled receptor that is overexpressed in solid tumors, being associated with several pro-tumoral responses including primary growth, invasion, metastasis and angiogenesis. Expression of PAR-1 in human leukemic cell lines is reported but the status of its expression in human leukemic patients is currently unknown. In this study we evaluated the expression pattern of PAR-1 in patients with the four main types of leukemia - chronic lymphocytic leukemia subtype B (B-CLL), acute lymphoblastic leukemia subtype B (B-ALL), acute myeloid leukemia (AML) and chronic myeloid leukemia (CML). Flow cytometry analyses show that lymphocytes from B-CLL patients express this receptor at similar levels to healthy individuals. On the other hand, it was observed a significant increase in PAR-1 expression in B-ALL lymphocytes as compared to B-CLL and healthy donors. Flow cytometric and real-time PCR demonstrated a significant increase in PAR-1 expression in granulocytes from CML patients in blast phase (CML-BP) but not in chronic phase (CML-CP) as compared to healthy donors. Finally, a significant increase in PAR-1 expression has been also observed in blasts from AML (subtypes M4 and M5) patients, as compared to monocytes or granulocytes from healthy donors. We conclude that PAR-1 might play an important biological role in aggressive leukemias and might offer additional strategies for the development of new therapies. (C) 2010 Elsevier Inc. All rights reserved.

Down-regulation of the candidate tumor suppressor gene PAR-4 is associated with poor prognosis in breast cancer

Substantial experimental evidence indicates that PAWR gene (PKC apoptosis WT1 regulator; also named PAR-4, prostate apoptosis response-4) is a central player in cancer cell survival and a potential target for cancer-selective targeted therapeutics. However, little is known about the role of PAR-4 in breast cancer. We investigated the possible role of PAR-4 expression in breast cancer. IHC results on tissue microarrays containing 1,161 primary breast tumor samples showed that 57% (571/995) of analyzable cases were negative for PAR-4 nuclear staining. Down-regulation of nuclear PAR-4 protein expression predicted a poor prognosis for breast cancer patients (OS; P=0.041, log-rank test). PAR-4 down-regulation also correlates with poor survival in the group of patients with luminal A subtype breast cancer (P=0.028). Additionally, in this large series of breast cancer patients, we show that ERBB2/HER2, EGFR and pAKT protein expression are significantly associated with shorter disease-free survival and overall survival, but the prognosis was even worse for HER2-positive, EGFR-positive or pAKT-positive breast cancer patients with tumors negative for nuclear PAR-4 expression. Furthermore, using three-dimensional (3D) cell culture we provide preliminary results showing that PAR-4 is highly expressed in the MCF10A cells inside the acini structure, suggesting that PAR-4 might have a role in the lumen acini formation. Taken together, our results provide, for the first time, evidence that PAR-4 may have a role in the process of the mammary eland morphogenesis and its functional inactivation is associated with tumor aggressive phenotype and might represent an additional prognostic and predictive marker for breast cancer.

Effect of a thrombin receptor (protease-activated receptor 1, PAR-1) gene polymorphism in chronic hepatitis C liver fibrosis

Background and Aim: Tissue injury leads to activation of coagulation and generation of thrombin. Inhibition of thrombin receptor protease-activated receptor 1 (PAR-1) has been shown to reduce liver fibrosis in animals. This study aimed to evaluate the effect of PAR-1 gene polymorphism on rate of liver fibrosis (RF) in chronic hepatitis C. Methods: Polymorphisms studied: C > T transition 1426 bp upstream of translation start site (-1426C/T), 13 bp repeat of preceding -506 5`-CGGCCGCGGGAAG-3` sequence (-506I/D), and A > T transversion in intervening sequence (IVS) 14 bp upstream of exon-2 start site (IVS-14A/T). A total of 287 European and 90 Brazilian patients were studied. Results: 1426C/T polymorphism: There was a trend to higher RF in patients with the TT genotype (P = 0.06) and an association between genotype CC and slow fibrosis (P = 0.03) in Europeans. In males, RF was significantly higher in those with the TT genotype compared to CT (P = 0.003) and CC (P = 0.007). There was a significant association between TT and fast fibrosis (P = 0.04). This was confirmed in an independent cohort of Brazilians where RF was higher in TT than in CC (P = 0.03). Analysis of -506I/D showed no difference in RF and distribution of slow/fast fibrosis among different genotypes in both populations. Analysis of IVS-14A/T showed no difference between genotypes. Conclusion: In conclusion, these findings suggest that PAR-1 receptor polymorphisms influence the progression of liver fibrosis.