A university extension course in leprosy: telemedicine in the Amazon for primary healthcare

There is a high prevalence of leprosy in the Amazon region of Brazil. We have developed a distance education course in leprosy for training staff of the Family Health Teams (FHTs). The course was made available through a web portal. Tele-educational resources were mediated by professors and coordinators, and included the use of theoretical content available through the web, discussion lists, Internet chat, activity diaries, 3-D video animations (Virtual Human on Leprosy), classes in video streaming and case simulation. Sixty-five FHT staff members were enrolled. All of them completed the course and 47 participants received a certificate at the end of the course. At the end of the course, 48 course-evaluation questionnaires were answered. A total of 47 participants (98%) considered the course as excellent. The results demonstrate the feasibility of an interactive, tele-education model as an educational resource for staff in isolated regions. Improvements in diagnostic skills should increase diagnostic suspicion of leprosy and may contribute to early detection.

The time course of vasoconstriction and endothelin receptor A expression in pulmonary arterioles of mice continuously exposed to ambient urban levels of air pollution

The present study aimed to verify the time course of the effects of environmental levels of urban air pollution toxicity on lung arterioles. BALB/c mice (n = 56) were continuously exposed to selective chambers equipped with (filtered, F) or without (non-filtered, NF) filter devices for particles and toxic gases for 24 h/day, over 14, 21, 30 or 45 days. After exposure, we evaluated the lumen-wall relationship (an estimator of arteriolar narrowing), endothelial nitric oxide synthase (eNOS) and endothelin type A receptor (ETAr) expression in the vascular wall and inflammatory influx of the peribronchiolar area. Concentrations of fine particulate matter (PM <= 2.5 mu g/m(3)), nitrogen dioxide (NO(2)), black smoke (BS), humidity and temperature in both the environment and inside the chambers were measured daily. Filters cleared 100% of BS and 97% of PM inside the F chamber. The arteriole wall of the lungs of mice from NF chamber had an increased ETAr expression (p <= 0.042) concomitant to a decrease in the lumen/wall ratio (p = 0.02) on the early days of exposure, compared to controls. They also presented a progressive increment of inflammatory influx in the peribronchiolar area during the study (p = 0.04) and decrement of the eNOS expression on the 45th day of exposure in both vascular layers (p <= 0.03). We found that after 14 days of exposure, the ambient levels of air pollutants in Sao Paulo induced vasoconstriction that was associated with an increase in ETAr expression. These vascular results do not appear to be coupled to the progressive inflammatory influx in lung tissue, suggesting a down-regulation of vasoconstrictive mechanisms through an imbalance in the cytokines network. It is likely that these responses are protective measures that decrease tissue damage brought about by continuous exposure to air pollutants. (C) 2010 Elsevier Inc. All rights reserved.

Clinical significance of lifetime panic disorder in the course of bipolar disorder type I

Objectives: The aim of the study was to analyze the impact of lifetime panic disorder (PD) diagnosis in a sample of patients with bipolar disorder type I (BPI), evaluating clinical and demographic variables. Methods: Ninety-five outpatients from the Bipolar Disorder Research Program at the Institute of Psychiatry of the University of Sao Paulo Medical School were enrolled. Twenty-seven BPI patients with PD were compared to 68 BPI patients without any anxiety disorders regarding clinical and demographic variables. Results: Compared to BPI patients without any anxiety disorders, patients with BPI + PD presented significantly higher number of mood episodes (18.9 +/- 13.8 vs 8.5 +/- 7.8; P < .001), depressive episodes (10.8 +/- 8.2 vs 4.6 +/- 4,8; P = .001), and manic episodes (7.4 +/- 7.3 vs 3.6 +/- 3.6; P = .008). Patients with BPI + PD had more frequently a depressive episode as their first one compared to BPI patients without anxiety disorders (94.1% vs 57.5%; P = .011). Patients with BPI + PD had more comorbidity with lifetime diagnosis of drug abuse or dependence (33.3% vs 8.8%; P = .010) and eating disorders (29.6% vs 6.0%; P = .004). Conclusions: The higher number of mood episodes in general presented by patients with BPI + PD when compared with BPI patients without any anxiety disorders, along with the higher frequencies of drug misuse and eating disorders, indicates that PD comorbidity is associated with a poorer Course and outcome of BPI. The higher frequency of depression as the onset mood episode and the higher number of manic episodes in the group with PD may have important treatment implications and should be further investigated. (C) 2009 Elsevier Inc. All rights reserved.

Inserção de graduados em fonoaudiologia de uma universidade pública em programas de pós-graduação

OBJETIVO: caracterizar a inserção de egressos do Curso de Fonoaudiologia da Universidade Estadual Paulista (UNESP) - Marília, em Programas de Pós-Graduação (PPG) Stricto Sensu brasileiros. MÉTODO: foram utilizadas listas de graduados e Curriculum Vitae do egresso e do orientador. RESULTADOS: dos 537 formados, 16,57% cursaram/estavam cursando PPG e destes, 98,88% em mestrado e 37,08% também em doutorado. Na grande área de conhecimento, 50% dos egressos de mestrado vincularam-se predominantemente a programas em Ciências da Saúde, 31,80% em Ciências Humanas e 13,64% em Linguística, Letras e Artes. No doutorado, 33, 33% em Ciências Humanas, 30,30% em Ciências da Saúde e em Linguística, Letras e Artes. Quanto à área de conhecimento, predominou a vinculação, no mestrado, de 30,68% em Fonoaudiologia, 28,41% em Educação, 13,64% em Linguística e 9,09% em Medicina I; e, no doutorado, de 33,33% em Educação, 30,30% em Linguística e 9,09% em Fonoaudiologia; 55,68% dissertações e 51,52% teses focalizaram a linguagem. A UNESP predominou com 39,77% no mestrado e 48,48% no doutorado. Predominou a vinculação a Programas com conceito 4 para 52,27% dos egressos do mestrado e 45,45% do doutorado. Quando constou a informação (55,68%), todos receberam fomento. O Teste de Razão de Verossimilhança não indicou diferenças significativas dos percentuais obtidos entre o mestrado e o doutorado. CONCLUSÃO: os resultados superaram os apresentados para o mesmo Estado, mostraram a característica interdisciplinar da Ciência Fonoaudiológica e o predomínio de temática em linguagem.

Mentors, students, and the undergraduate medical course: a virtuous circle

BACKGROUND: Mentoring Programs have been developed in several medical schools, but few studies have investigated the mentors'perspective. PURPOSES: To explore mentors'perceptions regarding their experience. METHODS: Mentors at a medical school were invited to participate in an in-depth interview including questions on satisfaction, difficulties, and perception of changes resulting from the program. RESULTS: Mentors' satisfaction and difficulties are strongly associated with students'involvement in the activity. Mentors believe changes observed in students were more related to life issues; for some mentors, there is no recognition or awareness of the program. However, most of the mentors acknowledged important changes in relation to themselves: as teachers, faculty members, and individuals. CONCLUSION: Attendance is crucial for both the mentoring relationship and strengthening of the program. Students involved in the activity motivate mentors in teaching and curriculum development, thereby creating a virtuous circle and benefiting undergraduate medical education as a whole.

Time course of training-induced microcirculatory changes and of vegf expression in skeletal muscles of spontaneously hypertensive female rats

Exercise-induced vessel changes modulate arterial pressure (AP) in male spontaneously hypertensive rats (SHR). Vascular endothelial growth factor (VEGF) is important for angiogenesis of skeletal muscle. The present study evaluated the time course of VEGF and angiogenesis after short- and long-term exercise training of female SHR and Wistar Kyoto (WKY) rats, 8-9 weeks (200-250 g). Rats were allocated to daily training or remained sedentary for 3 days (N = 23) or 13 weeks (N = 23). After training, the carotid artery was catheterized for AP measurements. Locomotor (tibialis anterior and gracilis) and non-locomotor skeletal muscles (temporalis) were harvested and prepared for histologic and protein expression analyses. Training increased treadmill performance by all groups (SHR = 28%, WKY = 64%, 3 days) and (SHR = 141%, WKY = 122%, 13 weeks). SHR had higher values of AP than WKY (174 ± 4 vs 111 ± 2 mmHg) that were not altered by training. Three days of running increased VEGF expression (SHR = 28%, WKY = 36%) simultaneously with an increase in capillary-to-fiber ratio in gracilis muscle (SHR = 19%, WKY = 15%). In contrast, 13 weeks of training increased gracilis capillary-to-fiber ratio (SHR = 18%, WKY = 19%), without simultaneous changes in VEGF expression. Training did not change VEGF expression and capillarity of temporalis muscle. We conclude that training stimulates time- and tissue-dependent VEGF protein expression, independent of pressure levels. VEGF triggers angiogenesis in locomotor skeletal muscle shortly after the exercise starts, but is not involved in the maintenance of capillarity after long-term exercise in female rats.

Ensino de astronomia em um espaço não formal: observação do Sol e de manchas solares

O presente artigo analisa os resultados obtidos num minicurso sobre o Sol e sua dinâmica realizado no Observatório Astronômico do Centro de Divulgação Científica e Cultural (CDCC) pertencente à Universidade de São Paulo (USP) na cidade de São Carlos para alunos do ensino fundamental. As atividades foram desenvolvidas na recente inaugurada, Sala Solar. Ela é dedicada ao estudo do Sol, enfatizando a observação de manchas solares e do espectro do Sol. A metodologia adotada no minicurso consistiu em pequenos experimentos, observações e diálogos expositivos. Isto incentivou os estudantes a tomarem decisões, fazerem questionamentos e refletirem gerando pensamentos mais críticos e produzindo um maior número de conexões entre o real e o abstrato que contribuiu para níveis de maior complexidade conceitual verificados durante entrevistas semiestruturadas e nas respostas ao questionário final.

A experiência de uma formadora de professores de Química: analisando suas ações e reflexões num curso de educação continuada

Objetivou-se analisar a experiência de uma formadora num curso de formação continuada para professores de Química, ocorrido numa universidade pública do estado de São Paulo, em 2004. Os dados apresentados surgiram da observação da prática da formadora e de suas reflexões, nas quais ela própria evidencia ideias, conflitos, angústias e impressões sobre suas ações durante o curso. Entre a prática da formadora e suas reflexões, surgem contrastes que irão se tornar nosso foco de investigação. Interpretamos esses contrastes como a atuação de elementos inconscientes que ora favorecem ora dificultam a sua prática e nos mostram que nem sempre a reflexão e a ação atuam na mesma direção. Defendemos uma prática reflexiva mais profunda e questionadora dos sujeitos como possibilidade para produzir melhores efeitos na formação e na atividade docente. Conceitos do referencial teórico psicanalítico de Freud e Lacan serviram de base para a análise dos dados.

Psicologia, diretrizes curriculares e processos educativos na Amazônia: um estudo da formação de psicólogos

Este estudo objetiva analisar a formação de psicólogos frente às Diretrizes Curriculares Nacionais para os Cursos de Psicologia no que tange aos processos educativos. Realizamos revisão da literatura pertinente ao tema, pesquisa documental e empírica com alunos, professores e coordenador de curso, utilizando questionário, entrevistas e adotando a estratégia de triangulação a partir das categorias: perfil sociocultural; nível de conhecimento acerca das mudanças oriundas das Diretrizes para o curso de Psicologia; percepção na qualidade da prática docente; nível de satisfação com relação à própria formação universitária, tomando como referência os conhecimentos, habilidades e competências adquiridas. Apresenta contribuições para a compreensão da formação de psicólogos no campo da educação na Amazônia no Ensino Superior, centrada na construção de um profissional de pensamento e prática críticos, capaz de analisar as transformações nos vários contextos educacionais e escolares, utilizando referenciais que permitam a compreensão do fenômeno educativo na sua complexidade.

Artigos científicos como recurso didático no ensino superior de Química

Chemistry teachers increasingly use research articles in their undergraduate courses. This trend arises from current pedagogical emphasis on active learning and scientific process. In this paper, we describe some educational experiences on the use of research articles in chemistry higher education. Additionally, we present our own conclusions on the use of such methodology applied to a scientific communication course offered to undergraduate chemistry students at the University of São Paulo, Brazil.

Acupuntura: motivações de médicos para a procura de especialização

Este estudo quanti-qualitativo objetivou identificar concepções sobre Medicina Convencional e Acu puntura que contribuem para entender os motivos que levam médicos a procurarem conhecer ou se especializar em Acupuntura. Foram pesquisados 175 médicos do Curso de Desenvolvimento em Me dicina Chinesa − Acupuntura, do Center-AO − Centro de Pesquisa e Estudo da Medicina Chinesa e Universidade Federal de São Paulo − Escola Paulista de Medicina (Unifesp - EPM), com questio nário composto por perguntas abertas e fechadas. Os dados obtidos foram analisados estatisticamente, e as respostas foram analisadas com a técnica de análise de conteúdo, buscando desvelar unidades de significado. A partir disso, foram estabelecidas categorias gerais e específicas, que passaram a dar significado aos discursos. Dessa forma, foram obtidos três grupos categoriais: "aprimoramento profis sional", "ampliar seu próprio horizonte de vida" e "compreender o paciente em uma dimensão mais abrangente". Nossos dados revelaram que os médicos desejam exercer a Acupuntura de forma inte grada à Medicina Convencional, no bojo da qual a Acupuntura vem se firmando como especialidade médica.

Inpatient dermatological consultations in a university hospital

INTRODUCTION: Dermatology is primarily an outpatient specialty, but it also plays an important role in the care of inpatients. METHODS: We conducted a prospective study that recorded data from inpatient dermatology consultation request forms over a period of four months. The study evaluated 313 requests that led to 566 visits, 86 biopsies, 35 laboratory exams, 41 direct microscopic studies, 18 direct immunofluorescence analyses, 14 skin cultures and a few other exams. RESULTS: The most frequent requesting service was internal medicine (24%), followed by neurology (12%), cardiology (11%), infectious diseases and pediatrics (8% each) and psychiatry and general surgery (6% each). The most frequent diagnostic groups were infectious diseases (25%, divided into fungal infections (13%), bacterial infections (7%) and viral infections (5%)), eczemas (15%) and drug reactions (14%). To our knowledge, this is the first study to attempt to evaluate the impact of the consultations by asking multiple-choice questions that were analyzed by the authors. In 31% of the cases, the consultation was considered extremely relevant because it aided in managing the disease that led to admission or treated a potentially severe dermatological disease. In 58% of the cases, the consultation was considered important because it facilitated diagnosis and/or treatment of a dermatological disease that was unrelated to the reason for admission.

Development, implementation, and assessment of a distance module in endocrine physiology

Rangel EM, Mendes IA, Carnio EC, Marchi Alves LM, Godoy S, Crispim JA. Development, implementation, and assessment of a distance module in endocrine physiology. Adv Physiol Educ 34: 70-74, 2010; doi: 10.1152/advan.00070.2009.-This study aimed to develop, implement, and assess a distance module in endocrine physiology in TelEduc for undergraduate nursing students from a public university in Brazil, with a sample size of 44 students. Stage 1 consisted of the development of the module, through the process of creating a distance course by means of the Web. Stage 2 was the planning of the module's practical functioning, and stage 3 was the planning of student evaluations. In the experts' assessment, the module complied with pedagogical and technical requirements most of the time. In the practical functioning stage, 10 h were dedicated for on-site activities and 10 h for distance activities. Most students (93.2%) were women between 19 and 23 yr of age (75%). The internet was the most used means to remain updated for 23 students (59.0%), and 30 students (68.2%) accessed it from the teaching institution. A personal computer was used by 23 students (56.1%), and most of them (58.1%) learned to use it alone. Access to a forum was more dispersed (variation coefficient: 86.80%) than access to chat (variation coefficient: 65.14%). Average participation was 30 students in forums and 22 students in the chat. Students' final grades in the module averaged 8.5 (SD: 1.2). TelEduc was shown to be efficient in supporting the teaching- learning process of endocrine physiology.

A Análise Matemática no Ensino Universitário Brasileiro: a contribuição de Omar Catunda

The goal of this paper is to show the diffusion, reception, and utilization of Omar Catunda's book Course of Mathematical Analysis for mathematics and engineering teaching in Brazilian universities, e. g., University of Sao Paulo and the University of Bahia from 1950 to 1976. We used interviews of some ex-alumni or users of his book. We also present some signs of the influence of his book and of Catunda himself at University of Rio Grande do Sul. We argue that Catunda and his book were important agents of process of modernizing the teaching of calculus and analysis, through his classes as well as his book.

Lack of Galectin-3 Disturbs Mesenteric Lymph Node Homeostasis and B Cell Niches in the Course of Schistosoma mansoni Infection

Galectin-3 is a beta-galactoside-binding protein that has been shown to regulate pathophysiological processes, including cellular activation, differentiation and apoptosis. Recently, we showed that galectin-3 acts as a potent inhibitor of B cell differentiation into plasma cells. Here, we have investigated whether galectin-3 interferes with the lymphoid organization of B cell compartments in mesenteric lymph nodes (MLNs) during chronic schistosomiasis, using WT and galectin-3(-/-) mice. Schistosoma mansoni synthesizes GalNAc beta 1-4(Fuc alpha 1-3) GlcNAc(Lac-DiNAc) structures (N-acetylgalactosamine beta 1-4 N-acetylglucosamine), which are known to interact with galectin-3 and elicit an intense humoral response. Antigens derived from the eggs and adult worms are continuously drained to MLNs and induce a polyclonal B cell activation. In the present work, we observed that chronically-infected galectin-3(-/-) mice exhibited a significant reduced amount of macrophages and B lymphocytes followed by drastic histological changes in B lymphocyte and plasma cell niches in the MLNs. The lack of galectin-3 favored an increase in the lymphoid follicle number, but made follicular cells more susceptible to apoptotic stimuli. There were an excessive quantity of apoptotic bodies, higher number of annexin V(+)/PI(-) cells, and reduced clearance of follicular apoptotic cells in the course of schistosomiasis. Here, we observed that galectin-3 was expressed in nonlymphoid follicular cells and its absence was associated with severe damage to tissue architecture. Thus, we convey new information on the role of galectin-3 in regulation of histological events associated with B lymphocyte and plasma cell niches, apoptosis, phagocytosis and cell cycle properties in the MLNs of mice challenged with S. mansoni.