Objeção de Consciência e Aborto Legal: Atitudes de Estudantes de Medicina

RESUMO Introdução No Brasil, o aborto é permitido em caso de risco de morte da mulher, gravidez decorrente de estupro e anencefalia fetal. Objetivo O objetivo deste trabalho foi avaliar as atitudes de estudantes de Medicina em relação à objeção de consciência ao aborto legal. Métodos Todos os estudantes das escolas médicas do Piauí foram convidados a responder a um questionário eletrônico e anônimo com perguntas sobre características sociodemográficas, objeção de consciência ao aborto e obrigações éticas em caso de recusa. Resultados A taxa de resposta foi de 66,7% (n = 1.174). Enquanto 13,2% dos estudantes apresentariam objeção de consciência por risco de morte da mulher, 31,6% objetariam quando houvesse anencefalia fetal e 50,8% em caso de estupro. Na recusa do aborto por estupro, 54% não encaminhariam a mulher a outro profissional e 72,5% não explicariam a ela as opções de tratamento. Religião foi a única característica associada à recusa para o aborto. Conclusões A objeção de consciência no aborto por estupro foi mais frequente do que nas outras circunstâncias previstas pela legislação brasileira. Os estudantes com religião estiveram mais associados à recusa.

Avaliação econômica de sistemas agroflorestais implantados para recuperação de reserva legal no Pontal do Paranapanema, São Paulo

O Pontal do Paranapanema, extremo oeste do Estado de São Paulo, é conhecido em todo o Brasil devido aos conflitos pela posse da terra, protagonizados pelo Movimento dos Trabalhadores Rurais Sem Terra (MST), que transformou significativamente a paisagem da região, onde atualmente se observam pequenas ilhas de assentamentos rurais imersos numa matriz de grandes pastagens. O Código Florestal prevê que esses assentamentos, assim como qualquer propriedade rural, deve manter 20% de sua área com cobertura vegetal arbórea. Essa área, conhecida como Reserva Florestal Legal, deve ser restaurada, caso não exista. Assim, esta pesquisa se desenvolveu no assentamento Santa Zélia, Município de Teodoro Sampaio, São Paulo, numa área de 15 ha de Reserva Legal. Seis famílias desse assentamento foram responsáveis pela restauração da área, através de módulos agroflorestais (Taungya) temporários. Dois indicadores foram utilizados para avaliação econômica da produção agrícola na área: Valor Presente Líquido (VLP) e Relação Benefício-Custo (RB/C). Os resultados indicaram valores positivos em todas as famílias analisadas, levando à conclusão de que sistemas agroflorestais podem ser adotados na recuperação de áreas de reserva legal em propriedades rurais. Sua maior ou menor viabilidade econômica irá depender de um manejo mais intenso na área para produção agrícola e de preços satisfatórios para venda no mercado.

Quantificação das áreas de preservação permanente e de reserva legal em propriedades da bacia do Rio Pomba-MG

Para a efetivação das áreas de preservação permanente (APPs) e de reserva legal (ARL) nas propriedades rurais, dando cumprimento à legislação, é de extrema importância que elas sejam quantificadas, determinando-se o porcentual que ocupam nas propriedades e o que representam essas áreas na atividade econômica dos produtores rurais. Dessa forma, este trabalho teve por objetivo quantificar as APPs e ARL com relação à área total das propriedades rurais pesquisadas. Determinaram-se também a área com vegetação nativa em cada propriedade e as APPs que estavam de acordo com a legislação. Utilizou-se de uma amostra composta por 47 propriedades, divididas em seis estratos, tendo como critério de estratificação o tamanho da área de cada uma delas. A coleta de dados foi realizada com o uso de GPS e a quantificação, com a utilização do SIG ArcView 3.3. Com base nos resultados, observou-se que as 47 propriedades estudadas ocupavam uma área de 1.854.35 ha, dos quais 811,35 ha, referentes a 43,75% do total, eram APPs e ARLs, de acordo com as legislações federal e estadual. Além disso, em apenas 21,09% dessas áreas não ocorria o uso indevido do solo, evidenciando-se o não-cumprimento da lei e a necessidade de medidas efetivas para a sua adequação.

Terrain forms and spatial variability of soil properties in an area cultivatedwith citrus

The technique of precision agriculture and soil-landscape allows delimiting areas for localized management, allowing a localized application of agricultural inputs and thereby may contribute to preservation of natural resources. Therefore, the objective of this work was to characterize the spatial variability of chemical properties and clay content in the context of soil-landscape relationship in a Latosol (Oxisol) under cultivation of citrus. Soil samples were collected at a depth of 0.0-0.2 m in an area of 83.5 ha planted with citrus, as a 50-m intervals grid, with 129 points in concave terrain and 206 points in flat terrain, totaling 335 points. Values for the variables that express the chemical characteristics and clay content of soil properties were analyzed with descriptive statistics and geostatistical modeling of semivariograms for making maps of kriging. The values of range and kriging maps indicated higher variability in the shape of concave topography (top segment) compared with the shape of flat topography (slope and hillside segments below). The identification of different forms of terrain proved to be efficient in understanding the spatial variability of chemical properties and clay content of soil under cultivation of citrus.

Epidemiological profile and postoperative complications of women undergoing gynecological surgery in a reference center in the northern brazilian legal amazon

Objective: To evaluate the epidemiological profile and the operative complications of patients undergoing gynecological operations for benign diseases in a tertiary public hospital in the state of Roraima, Brazil. Methods: We conducted a retrospective survey through the analysis of 518 records of patients submitted to gynecological operations between January and June 2012. We included the three major operations during this period (n = 175): hysterectomy, colpoperineoplasty and suburethral sling placement. We excluded 236 cases of tubal ligation and 25 cases where it was not possible to access to medical records. Results: The mean age was 47.6 years; the education level of most patients was completed junior high (36.6%); 77% were from the State capital, 47.4% were in stable relationships and 26.3% were housewives. The majority of patients had given birth three or more times (86.6%), with previous vaginal delivery in 50.2%, and cesarean delivery, 21%. The main diagnostic indications for surgical treatment were uterine myoma (46.3%), urinary incontinence (27.4%) and genital dystopias (17.7%). We found three cases (1.7%) of high-grade intraepithelial lesions on Pap smear. The most common procedure was total hysterectomy (19.8%), 15.5% vaginally. The most common complication was wound infection (2.2%). Conclusion: Women undergoing gynecological operations due to benign disease had a mean age of 47 years, most had levels of basic education, came from the capital, were in stable relationships, predominantly housewives, multiparous and showed low operative complication rates.

Variações no conhecimento e nas opiniões dos ginecologistas e obstetras brasileiros sobre o aborto legal, entre 2003 e 2005

OBJETIVO: avaliar o conhecimento e a opinião de ginecologistas e obstetras acerca do aborto induzido, comparando resultados de dois inquéritos, realizados em 2003 e 2005. MÉTODOS: questionário estruturado e pré-testado enviado a todos associados à Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO). Solicitou-se preenchê-lo sem identificar-se e retorná-lo em envelope pré-selado que o acompanhava, com o objetivo de assegurar o anonimato. Perguntou-se sobre conhecimento da legislação referente ao aborto no Brasil e opinião sobre a mesma. RESULTADOS: nos dois inquéritos, a porcentagem de médicos que sabiam quais as circunstâncias em que o aborto não é punido esteve acima de 80%. Porém, houve redução significativa na porcentagem daqueles que conheciam a legalidade do aborto por risco de vida. Aumentou em mais de um terço a proporção de respondentes que sabiam que o aborto por malformação congênita grave não está dentro dos permissivos legais atuais. Cresceu consistentemente a porcentagem de médicos favoráveis à permissão do aborto em várias circunstâncias, e diminuiu a proporção dos que consideravam que não deveria ser permitido em nenhuma circunstância. Diminuiu a porcentagem dos que opinaram que os permissivos legais não deveriam ser modificados, e aumentou a proporção dos que entendiam que se deveria deixar de considerar o aborto crime em qualquer circunstância. CONCLUSÕES: de modo geral, tem havido maior reflexão sobre o problema do aborto provocado no período transcorrido entre os dois inquéritos. Porém, continua se evidenciando a necessidade de informar corretamente os gineco-obstetras brasileiros sobre as leis e normas que regulamentam a prática do aborto legal no país, visando assegurar que as mulheres que necessitam tenham, de fato, acesso a esse direito.

Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal

PURPOSE: It was to analyse the most critical areas in Obstetrics and to suggest measures to reduce or avoid the situations most often involved in these disputes. METHODS: Obstetrics cases submitted to the Medico-legal Council since the creation of the National Institute of Legal Medicine and Forensic Sciences in 2001 until 2011 were evaluated. A comprehensive characterization, determination of absolute/relative frequencies, hypothesis of a linear trend over the years and the association between each parameter was done. RESULTS: The analysis has shown no significantly linear trend. The most common reasons for disputes were perinatal asphyxia (50%), traumatic injuries of the newborn (24%), maternal sequelae (19%) and issues related to prenatal diagnosis and/or obstetric ultrasound (5.4%). Perinatal asphyxia showed no significantly linear trend (p=0.58) and was usually related to perinatal deaths or permanent neurologic sequelae in newborn children. Traumatic injuries of the newborn, mostly related to instrumented deliveries, shoulder dystocia or vaginal delivery in breech presentation, has shown a significantly increased linear trend (p<0.001), especially related to instrumented deliveries. The delay/absence of cesarean section was the clinical procedure questioned in a significantly higher number of cases of perinatal asphyxia (68.7%) and of traumatic lesions of the newborn due to instrumented deliveries (20.5%). CONCLUSION: It is important to improve and correct theoretical/practical daily clinical performance in these highlighted areas, in order to reduce or even avoid situations that could end up in medico-legal litigations.

Immunohistochemical study of genital and extragenital forms of canine transmissible venereal tumor in Brazil

Aiming to provide insight and discussing the problems related to the diagnosis and differential diagnosis of canine transmissible venereal tumor (CTVT), especially in its extragenital form, immunohistochemical evaluation was performed and a comparison was established by analysis of the microscopic appearance of 10 genital CTVTs and 13 exclusively extragenital CTVTs previously diagnosed by cytology and histopathology. CTVTs samples were incubated with biotinylated antibodies raised against specific membrane (anti-macrophage) and cytoplasmic antigens (anti-lysozyme, anti-S-100 protein, anti-vimentin and anti-CD18) and subsequently developed using streptavidin-biotin peroxidase and streptavidin-biotin-alkaline phosphatase methods. A strong reactivity with the anti-vimentin antibody was found in 100% of the tumors tested (22/22). No reactivity was found for the anti-lysozyme, anti-macrophage, anti-S-100 protein and anti-CD18. No histopathological or immunoreactivity differences between genital and extragenital CTVTs were found. These findings do not corroborate the hypothesis of histiocytic origin of CTVT (no reactivity to anti-lysozyme, anti-macrophage and anti-CD 18 antibodies). In addition, the antibody panel used is useful to narrow the differential diagnosis for lymphomas, histiocytic tumors, amelanotic melanomas, and poorly differentiated epithelial neoplasias, among others.

Occurrences of anti-Toxoplasma gondii and anti-Neospora caninum antibodies in sheep from four districts of Tocantins state, Brazilian Legal Amazon Region

Toxoplasmosis and neosporosis have been recognized as economically important diseases with considerable impact on the livestock industry. Little is known concerning the occurrence of Toxoplasma gondii and Neospora caninum in sheep from Tocantins state, Brazil. Here, we investigated antibodies against these parasites and associated factors in 182 sheep from Araguaína, Santa Terezinha do Tocantins, Arguianópolis and Palmeiras do Tocantins districts, Tocantins. Sheep sera were assayed for T. gondii and N. caninum IgG antibodies by indirect fluorescence antibody test (IFAT), using cut-off point at a dilution of 1:40 and 1:25 respectively. The prevalence of seropositive animal for T. gondii was 13.74% and 13.74% for N. caninum. None of the characteristics studied including reproductive problems, presence of cats, presence of dogs and veterinary care (p>0.05) was associated with occurrence of T. gondii or N. caninum infection. Only breed was identified as associated factor for the occurrence of toxoplasmosis in sheep (p<0.05). The present study is the first report on serum occurrence of T. gondii and N. caninum in sheep from the state of Tocantins, Brazil.

Multiple forms of cotyledonary b-galactosidases from Vigna unguiculata quiescent seeds

Cotyledonary b-galactosidases were isolated and partially purified from Pitiúba cowpea (Vigna unguiculata (L.) Walp.) quiescent seeds. The purification steps consisted of precipitation of the crude extract with ammonium sulphate in the range of 20-60% saturation, acid precipitation, DEAE-Sephadex ion-exchange chromatography and Lactosyl-Sepharose affinity chromatography. This purification process gave rise to three b-galactosidases-rich fractions: b-gal I, b-gal II and b-gal III, which were purified about 5, 509, and 62 fold, respectively. They reached maximal enzyme activity at different pH ranges: 3.5-4.5 for b-gal I, 3.0-3.5 for b-gal II, and 3.0-4.0 for b-gal III. Their maximal activities were reached when the temperature of the assay medium was 60° C, and preincubation of the enzymes at different temperatures has shown that they were heat-stable up to 50° C. There were no significant differences among the partially purified enzymes as far as their response to the different effectors tested, except for Mn2+ and EDTA, which affected differently b-gal I, b-gal II, and b-gal III. They were slightly affected by Mg2+, Ca2+, Zn2+, Co2+, tartarate, molybdate, glucose, and lactose, strongly inhibited by Cu2+ and galactose, and inactivated by Hg2+. These chemical and physical properties are similar to the ones found for other plant b-galactosidases. Although through this process of purification three isoforms of this enzyme were obtained, isoelectric focusing in polyacrylamide slab gel of these enzyme-proteins suggest that cotyledons of Pitiúba cowpea quiescent seeds possess four isoforms of b-galactosidases.

Oral tolerance induction with altered forms of ovalbumin

As a T cell-dependent phenomenon, oral tolerance is not expected to depend necessarily on native configuration of antigens. We investigated the induction of oral tolerance with modified ovalbumin (Ova). Oral administration of heat-denatured (HD-Ova) and cyanogen bromide-degraded ovalbumin was less effective than native Ova in inducing oral tolerance in B6D2F1 mice. HD-Ova was effective in suppressing delayed-type hypersensitivity (DTH) reactions but did not suppress specific antibody formation. Injection of Ova directly into the stomach, but not into the ileum or cecum, suppressed subsequent immunization to DTH reactions. Gavage with protease inhibitors (aprotinin or ovomucoid) before gavage with Ova was ineffective in blocking tolerance induction. Treatment with hydroxyurea to destroy cycling cells 24 h before gavage with Ova blocked oral tolerance induction and also the possibility to passively transfer tolerance to naive recipients with the serum of mice gavaged with Ova 1 h before. The implications of these findings about oral tolerance induction are discussed

Influence of exercise on the activity and the distribution between free and bound forms of glycolytic and associated enzymes in tissues of horse mackerel

The effects of short-term burst (5 min at 1.8 m/s) swimming and long-term cruiser (60 min at 1.2 m/s) swimming on maximal enzyme activities and enzyme distribution between free and bound states were assessed for nine glycolytic and associated enzymes in tissues of horse mackerel, Trachurus mediterraneus ponticus. The effects of exercise were greatest in white muscle. The activities of phosphofructokinase (PFK), pyruvate kinase (PK), fructose-1,6-bisphosphatase (FBPase), and phosphoglucomutase (PGM) all decreased to 47, 37, 37 and 67%, respectively, during 60-min exercise and all enzymes except phosphoglucoisomerase (PGI) and PGM showed a change in the extent of binding to subcellular particulate fractions during exercise. In red muscle, exercise affected the activities of PGI, FBPase, PFK, and lactate dehydrogenase (LDH) and altered percent binding of only PK and LDH. In liver, exercise increased the PK activity 2.3-fold and reduced PGI 1.7-fold only after 5 min of exercise but altered the percent binding of seven enzymes. Fewer effects were seen in brain, with changes in the activities of aldolase and PGM and in percent binding of hexokinase, PFK and PK. Changes in enzyme activities and in binding interactions with subcellular particulate matter appear to support the altered demands of tissue energy metabolism during exercise.

Circulating forms of parathyroid hormone detected with an immunofluorometric assay in patients with primary hyperparathyroidism and in hyperparathyroidism secondary to chronic renal failure

In patients with uremia, intact parathyroid hormone (PTH) measurement appears to overestimate the biologically active hormone in circulation. The recent description of the accumulation in these patients of a non-intact PTH form measured by the standard immunometric assays, re-opened the question. In this study we submitted serum samples from 7 patients with primary hyperparathyroidism (PHP) and from 10 patients with hyperparathyroidism secondary to chronic renal failure (SHP) to preparative HPLC in order to discriminate the molecular forms measured by our currently used immunofluorometric assay for intact PTH. The elution profile obtained with the HPLC system showed two clearly defined peaks, the first one corresponding to a lower molecular weight form, and the second to the intact PTH (1-84) form. In patients with SHP the area under the curve for the first peak (mean 29.5%, range 20.6 to 40.4%) was significantly greater than that observed for patients with PHP (mean 15.6%, range 5.6 to 21.9%). This confirms previous studies showing accumulation of molecular forms of slightly lower molecular weight, presumably PTH (7-84), in patients with SHP and, to a lesser extent, in patients with PHP. The real necessity of assays that discriminate between these two molecular forms is debatable.