O aprender e o orientar na atenção primária: relato de experiência de um semestre de atividades no PET-Saúde

O programa PET-Saúde atua promovendo a formação de grupos de aprendizagem tutorial em áreas estratégicas para o Sistema Único de Saúde. Este trabalho tem o objetivo de relatar a experimentação de um semestre de atividades vivenciadas por acadêmicos da UFPA que compõem uma equipe multiprofissional do PET-Saúde/Ananindeua. Este projeto está atuando como estimulador de diversas atividades que valorizam o aprendizado e a humanização. Dentre as atividades estimuladoras de aprendizado dos acadêmicos estão: palestras e formação complementar; discussão de artigos científicos; e acompanhamento de atividades na Unidade Básica de Saúde. A Atenção Primária representa interessante espaço de aprendizado para acadêmicos em saúde, e a inserção destes em seu âmbito representa grande ganho à comunidade, que passa a receber valiosas orientações em saúde.

Processo de interação ensino, serviço e comunidade: a experiência de um PET-Saúde

Este relato apresenta a experiência de um grupo PET-Saúde da Universidade Estadual de Feira de Santana (Uefs), na Bahia, Brasil, em Unidades de Saúde, em uma perspectiva crítico-reflexiva da interação ensino-serviço-comunidade. Participaram do projeto acadêmicos dos cursos de Ciências Farmacêuticas, Educação Física, Enfermagem, Medicina e Odontologia. A avaliação do processo incluiu reuniões de acompanhamento, bem como o uso do portfólio. A experiência dos diferentes atores no grupo caracterizou-se como uma vivência inovadora, desafiadora e complexa, uma vez que exigiu articulação entre instituição de ensino, serviços de saúde, profissionais e comunidade.

Repercussões do Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) na Reforma Curricular de Escolas Médicas Participantes do Programa de Incentivos às Mudanças Curriculares dos Cursos de Medicina (Promed)

RESUMO O objetivo do estudo foi analisar, na perspectiva dos coordenadores, as repercussões do PET-Saúde no processo de reforma curricular das escolas de Medicina participantes do Promed. Trata-se de pesquisa qualitativa, com utilização de grupos focais com coordenadores do PET-Saúde de 12 escolas médicas. Foi evidenciado que o PET-Saúde fortaleceu o desenvolvimento curricular, contribuindo especialmente no que diz respeito à consolidação da Atenção Primária como local privilegiado para as práticas de ensino-aprendizagem. As contribuições mais expressivas do PET-Saúde foram relacionadas à produção de conhecimento voltada para as necessidades do SUS e ao fortalecimento da integração ensino-serviço, aspectos que se configuraram como pontos de estrangulamento no contexto do Promed. O PET-Saúde, ao envolver profissionais não docentes (preceptores), acabou contribuindo para a melhoria dos serviços de saúde onde atua, ao capacitar, valorizar e empoderar esses profissionais. O papel do PET-Saúde foi menos enfatizado na pós-graduação e educação permanente voltadas para as necessidades do SUS. A oferta dessas oportunidades educacionais em estreita articulação com o SUS continua sendo um desafio para as políticas de formação profissional na área da saúde.

Painéis de partículas aglomeradas de madeira de Pinus elliottii Engelm., poliestireno (PS) e polietileno tereftalato (PET)

O objetivo deste trabalho foi avaliar as propriedades de painéis fabricados com partículas de madeira, poliestireno (PS) e polietileno tereftalato (PET). Foram utilizadas três proporções, em relação à massa seca de madeira, de poliestireno (0, 25 e 50%) e duas proporções de PET/PS (5/20 e 10/40%), combinadas com 50, 75 ou 100% de partículas de madeira de Pinus elliottii. Os painéis foram produzidos com adesivos à base de uréia-formaldeído ou de fenol-formaldeído, em três teores (0, 4 ou 6%) e três níveis de solução de poliestireno em tolueno (0 , 4 e 6%), todos calculados em relação à massa seca total dos painéis. Foram produzidos painéis de aproximadamente 400 x 400 x 10 mm, em camada única, com densidade aproximada de 0,6 g/cm³. Determinou-se a resistência dos painéis à tração perpendicular à superfície, à flexão estática (módulos de ruptura (MOR) e elasticidade (MOE)), ao arrancamento de parafusos, bem como a absorção de água e o inchamento em espessura, após 24 horas de imersão. Todas as propriedades mecânicas dos painéis foram superiores às exigidas pela norma ANSI/A 208.1-1993. Contudo, todos os painéis absorveram água em valores superiores àqueles normalmente observados em painéis comerciais. Apesar disto, o inchamento em espessura foi compatível com o dos painéis de partículas de madeira existentes no mercado. Os painéis nos quais se aplicou a solução de poliestireno foram, de modo geral, os que apresentaram os melhores valores para todas as propriedades.

Evaluation of tear production with modified Schirmer tear test-1 during the neonatal period in cats

The study aimed to evaluate tear production by means of modified Schirmer tear tes-1 (mSTT-1) in neonate cats. Likewise, correlation between mSTT-1 and STT-1 was assessed in vitro. Standard SST strips were cut in half and after eye lid opening, tear production of neonates (n=15) was daily measured in both eyes (mSTT-1), until the 7th day, and at day 14, 21, and 28. Animals were daily weighted until 28 days of age. Results were compared statistically (P<0.05). During the first 7 days, the overall mSTT-1 mean was 0.76 wetting/minute. Significant differences between right and left eyes were not observed at any time point (P=1.00). Tear secretion increased significantly, from the 14th to 28th day, in comparison with 7 first days (P<0.05). Positive correlation between maturity parameters and tear secretion was observed (P<0.0001). Distance between slopes of each strip changed significantly (P<0.0001). It was concluded that tear secretion in the neonatal period of cats is very below the reference values described for young and adults of the same species. It is not possible to extrapolate results obtained with mSTT-1 to standard STT-1.

Pre-and post-puberty physiological plasma oxytocin concentrations in male domestic cats (Felis silvestris catus)

The hormone oxytocin is released by the neuropituitary gland through stimulation of the neurons of the supraoptic and paraventricular nuclei of the hypothalamus. In order to determine the physiological concentrations of this hormone in domestic cats, blood samples were collected from 15 male animals (Felis silvestris catus) during the pre- and post-puberty periods (at four and eight months of age, respectively). Oxytocin determination was accomplished by radioimmunoassay. The average oxytocin concentrations measured in the pre- and post-puberty periods were 2.54±0.24 (μg/dL) and 2.53±0.28 (μg/dL), respectively, and there were no statistical differences between these measurements. Because there are few literature on the analysis of this hormone, especially in the case of male Felis silvestris catus, more studies on the influence of oxytocin on the physiology and reproduction of this species should be conducted under maintenance and situations of stress (such as transportation), and other routine events.

Serum intact parathyroid hormone levels in cats with chronic kidney disease

Chronic kidney disease (CKD) is frequently observed in cats and it is characterized as a multisystemic illness, caused by several underlying metabolic changes, and secondary renal hyperparathyroidism (SRHPT) is relatively common; usually it is associated with the progression of renal disease and poor prognosis. This study aimed at determining the frequency of SRHPT, and discussing possible mechanisms that could contribute to the development of SRHPT in cats at different stages of CKD through the evaluation of calcium and phosphorus metabolism, as well as acid-base status. Forty owned cats with CKD were included and divided into three groups, according to the stages of the disease, classified according to the International Renal Interest Society (IRIS) as Stage II (n=12), Stage III (n=22) and Stage IV (n=6). Control group was composed of 21 clinically healthy cats. Increased serum intact parathyroid hormone (iPTH) concentrations were observed in most CKD cats in all stages, and mainly in Stage IV, which hyperphosphatemia and ionized hypocalcemia were detected and associated to the cause for the development of SRHPT. In Stages II and III, however, ionized hypercalcemia was noticed suggesting that the development of SRHPT might be associated with other factors, and metabolic acidosis could be involved to the increase of serum ionized calcium. Therefore, causes for the development of SRHPT seem to be multifactorial and they must be further investigated, mainly in the early stages of CKD in cats, as hyperphosphatemia and ionized hypocalcemia could not be the only factors involved.

Bronchoalveolar lavage as a tool for evaluation of cellular alteration during Aelurostrongylus abstrusus infection in cats

Bronchoalveolar lavage (BAL) is a procedure that retrieves cells and other elements from the lungs for evaluation, which helps in the diagnosis of pulmonary diseases. The aim of this study was to perform this procedure for cellular analysis of BAL fluid alterations during experimental infection with Aelurostrongylus abstrusus in cats. Fourteen cats were individually inoculated with 800 third stage larvae of A. abstrusus and five non-infected cats lined as a control group. The BAL procedure was performed through the use of an endotracheal tube on the nineteen cats with a mean age of 18 months, on 0, 30, 60, 90, 120, 180 and 270 days after infection. Absolute cell counts in the infected cats revealed that alveolar macrophages and eosinophils were the predominant cells following infection. This study shows that the technique allows us to retrieve cells and first stage larvae what provides information about the inflammatory process caused by aelurostrongylosis.

Red eyes in the necropsy floor: twenty cases of hyphema in dogs and cats

Hyphema (hemorrhage within the anterior chamber of the eye) can be caused by several mechanisms and can easily be detected in routine ophthalmic or necroscopic examination as discolored red eye(s). The purpose of this study is to report the cause of hyphema diagnosed as a postmortem finding in dogs and cats. Twenty cases, 14 dogs and six cats of several ages and breeds and of both sexes were included in the study. Hyphema presented as a unilateral (14 cases out of 20) or bilateral (6/20) disorder in dogs and cats and extension of hemorrhage varied from minimal to diffuse. Hyphema was secondary to systemic disease (15/20) or occurred as a primary ocular lesion (5/20) in four dogs and one cat. Primary hyphema was always unilateral. In four of these cases, the cause of hyphema was trauma and remaining case was caused by phacoclastic uveitis in a dog with bilateral hypermature cataract. Various causes of bleeding disorders were found related to secondary hyphema: in decreasing order of frequency, they included vasculitis (8/15), systemic hypertension (5/15), and acquired coagulopathies (2/15). Vasculitis due to feline infectious peritonitis accounted for half of the cases (n=3) of systemic hyphema in cats. The various pathological aspects and pathogenesis of hyphema in dogs and cats are described and discussed.

Occurrence and characterization of Campylobacter spp.isolates in dogs, cats and children

To improve the understanding of implications of Campylobacterspp. infections in pets and children of different environments were analysed 160 faecal samples from children and 120 from pets (103 dogs and 17 cats). Campylobacter spp. were detected in 6.87% of the children and in 18.3% of the dogs and cats. From 33 stool samples positive for Campylobacter spp., 57.6% were identified as C. jejuni, and 33.4% were identified as C. coli. More than 50% of the isolates in pets were resistant to ceftiofur, sulphazotrim, norfloxacin and tetracycline. In humans, most of the isolates were resistant to amoxicillin, cefazolin, ceftiofur, erythromycin and norfloxacin. From 19 isolates of C. jejuni, 11 isolates from children and 5 from dogs contained two to four of the virulence genes flaA, pldA, cadF or ciaB.We found an association between the presence of virulence genes and diarrhoea. Furthermore, an association was observed between the presence of Campylobacter spp. and diarrhoea in dewormed pets with blood picture suggestive of bacterial infection, and the therapeutic use of antibiotics was associated with more positive detection of Campylobacterspp. in the faeces of pets. Our data indicate that virulent strains of Campylobacter spp. can be risk factor to diarrhoea in animals, and that high resistance to antimicrobial agents is common in pets.

Co-infection by Tritrichomonas foetus and Pentatrichomonas hominis in asymptomatic cats

Abstract: Tritrichomonas foetus, a parasite well known for its significance as a venereally transmitted pathogen in cattle, has been identified as a cause of chronic large bowel diarrhea in domestic cats in many countries of the world. In Brazil, several studies on the diagnosis of bovine trichomoniasis have been performed, but until now, no study was made regarding feline trichomoniasis. Thus, this is the first study to report the occurrence of T. foetus and Pentatrichomonas hominis in cats using morphological and molecular analysis. Feces from 77 cats were examined, four of which (5.2%) were positive for the presence of parabasalids. Morphological analysis of stained smears revealed piriform trophozoites showing the three anterior flagella, elongated nucleus and axostyle ending abruptly in fillet, characteristic of T. foetus. In scanning and transmission electron microscopy, identification characters similar to those previously reported for T. foetus were observed. The cultures containing trophozoites were submitted for molecular analysis, which resulted positive for T. foetus DNA using specific primers (TFR3 and TFR4), and all samples were positive and subjected to sequencing in which they showed 99.7-100% similarity with another isolate sequencing of T. foetus (JX960422). Although no trophozoite with consistent morphology of P. hominis has been visualized in the samples, differential diagnosis was performed using specific primers for P. hominis (TH3 and TH5) amplicon. In three of the four samples (3.89%) sequencing revealed 100% similarity when compared with another sequence of P. hominis deposited in Genbank (KC623939). Therefore, the present study revealed through the diagnostic techniques employed the simultaneous infection by T. foetus and P. hominis in the feces of cats. However, it was necessary to use more than one technique for the diagnosis of the co-infection. These results demonstrate the importance of a correct diagnosis to allow an appropriate treatment by the veterinarian.

Study of a region on yeast chromosome XIII that complements pet G199 mutants (COX7) and carries a new non-essential gene

The mutants of Saccharomyces cerevisiae assigned to complementation group G199 are deficient in mitochondrial respiration and lack a functional cytochrome oxidase complex. Recombinant plasmids capable of restoring respiration were cloned by transformation of mutants of this group with a yeast genomic library. Sequencing indicated that a 2.1-kb subclone encompasses the very end (last 11 amino acids) of the PET111 gene, the COX7 gene and a new gene (YMR255W) of unknown function that potentially codes for a polypeptide of 188 amino acids (about 21.5 kDa) without significant homology to any known protein. We have shown that the respiratory defect corresponding to group G199 is complemented by plasmids carrying only the COX7 gene. The gene YMR255W was inactivated by one-step gene replacement and the disrupted strain was viable and unaffected in its ability to grow in a variety of different test media such as minimal or complete media using eight distinct carbon sources at three pH values and temperatures. Inactivation of this gene also did not affect mating or sporulation

Reversal by methylene blue of tetanic fade induced in cats by nitric oxide

Previous data from our laboratory have indicated that nitric oxide (NO) acting at the presynaptic level increases the amplitude of muscular contraction (AMC) of the phrenic-diaphragm preparations isolated from indirectly stimulated rats, but, by acting at the postsynaptic level, it reduces the AMC when the preparations are directly stimulated. In the present study we investigated the effects induced by NO when tetanic frequencies of stimulation were applied to in vivo preparations (sciatic nerve-anterior tibial muscle of the cat). Intra-arterial injection of NO (0.75-1.5 mg/kg) induced a dose-dependent increase in the Wedensky inhibition produced by high frequencies of stimulation applied to the motor nerve. Intra-arterial administration of 7.2 µg/kg methylene blue did not produce any change in AMC at low frequencies of nerve stimulation (0.2 Hz), but antagonized the NO-induced Wedensky inhibition. The experimental data suggest that NO-induced Wedensky inhibition may be mediated by the guanylate cyclase-cGMP pathway

Methylmercury intoxication and histochemical demonstration of NADPH-diaphorase activity in the striate cortex of adult cats

The effects of methylmercury (MeHg) on histochemical demonstration of the NADPH-diaphorase (NADPH-d) activity in the striate cortex were studied in 4 adult cats. Two animals were used as control. The contaminated animals received 50 ml milk containing 0.42 µg MeHg and 100 g fish containing 0.03 µg MeHg daily for 2 months. The level of MeHg in area 17 of intoxicated animals was 3.2 µg/g wet weight brain tissue. Two cats were perfused 24 h after the last dose (group 1) and the other animals were perfused 6 months later (group 2). After microtomy, sections were processed for NADPHd histochemistry procedures using the malic enzyme method. Dendritic branch counts were performed from camera lucida drawings for control and intoxicated animals (N = 80). Average, standard deviation and Student t-test were calculated for each data group. The concentrations of mercury (Hg) in milk, fish and brain tissue were measured by acid digestion of samples, followed by reduction of total Hg in the digested sample to metallic Hg using stannous chloride followed by atomic fluorescence analysis. Only group 2 revealed a reduction of the neuropil enzyme activity and morphometric analysis showed a reduction in dendritic field area and in the number of distal dendrite branches of the NADPHd neurons in the white matter (P<0.05). These results suggest that NADPHd neurons in the white matter are more vulnerable to the long-term effects of MeHg than NADPHd neurons in the gray matter.