Estratégias para aumentar a sensibilidade da farmacovigilância em Portugal

OBJETIVO: Avaliar os resultados de intervenção para melhoria da quantidade e relevância das notificações de reacções adversas a medicamentos. MÉTODOS: Foi implementado um estudo controlado aleatorizado, por agrupamentos em farmacêuticos a exercer actividade profissional na região norte de Portugal, em 2007. Após aleatorização, 364 indivíduos foram alocados ao grupo de intervenção (261 na intervenção telefónica e 103 nos workshops); o grupo de controlo foi constituído por 1.103 farmacêuticos. Na intervenção educativa foram abordados a problemática das reacções adversas a medicamentos, o impacto na saúde pública e a notificação espontânea. Quanto à relevância, as reações adversas foram classificadas em graves e inesperadas. A análise estatística foi efectuada com base no princípio intention-to-treat; aplicaram-se modelos lineares generalizados mistos, utilizando o método penalized quasi-likelihood. Os farmacêuticos estudados foram seguidos durante um período de 20 meses. RESULTADOS: A intervenção aumentou três vezes a taxa de notificação espontânea das reações adversas (RR = 3,22; IC 95%: 1,33; 7,80) relativamente ao grupo de controlo. Houve incremento da relevância das notificações com aumento das reações adversas graves em cerca de quatro vezes (RR = 3,87; IC 95%: 1,29;11,61) e inesperadas em cinco vezes (RR = 5,02; IC 95%: 1,33;18,93), relativamente ao grupo de controlo. CONCLUSÕES: As intervenções educativas aumentam significativamente, por até quatro meses, a quantidade e a relevância das notificações espontâneas de reacções adversas a medicamentos por parte dos farmacêuticos da região norte de Portugal.

Temporal and spatial variation of rocky shores intertidal benthic communities in Southeast Brazil

The relationships between environmental factors and temporal and spatial variations of benthic communities of three rocky shores of the state of Espírito Santo, Southeast Brazil, were studied. Sampling was conducted every three months, from August 2006 to May 2007, using intersection points. Chthamalus bisinuatus (Pilsbry, 1916) (Crustacea) and Brachidontes spp. (Mollusca) were the most abundant taxa, occupying the upper level of the intertidal zone of the rocky shore. The species richness was higher at the lower levels. The invasive species Isognomon bicolor (C. B. Adams, 1845) (Mollusca) occurred at low densities in the studied areas. The clustering analysis dendrogram indicated a separation of communities based on exposed and sheltered areas. According to the variance analyses, the communities were significantly different among the studied areas and seasons. The extent of wave exposure and shore slope influenced the species variability. The Setibão site showed the highest diversity and richness, most likely due to greater wave exposure. The communities showed greater variation in the lower levels where environmental conditions were less severe, relative to the other levels.

Variação sazonal da fauna vágil de Sargassum stenophyllum (Martens) em duas estações com diferentes graus de exposicäo às ondas, em Ibicuí, Baía de Sepetiba, estado do Rio de Janeiro, Brasil

The seasonal variation of the vagile fauna associated to Sargassum stenophyllum was analyzed from March/1986 to February/1987. The samples were obtained at two stations with differents intensity of wave exposures. Hight density of nematods and amphipods were observed during all of sampling period. Gammarids seems to be more dominant on the exposure site, while nematods, polychaetes and mollusks do on the sheltered one.

Features of host cell invasion by different infective forms of Trypanosoma cruzi

Through its life cycle from the insect vector to mammalian hosts Trypanosoma cruzi has developed clever strategies to reach the intracellular milieu where it grows sheltered from the hosts' immune system. We have been interested in several aspects of in vitro interactions of different infective forms of the parasite with cultured mammalian cells. We have observed that not only the classically infective trypomastigotes but also amastigotes, originated from the extracellular differentiation of trypomastigotes, can infect cultured cells. Interestingly, the process of invasion of different parasite infective forms is remarkably distinct and also highly dependent on the host cell type.

Suitability of containers from different sources as breeding sites of Aedes aegypti (L.) in a cemetery of Buenos Aires City, Argentina

Cemeteries are ideal urban areas to study the importance of different types of containers as breeding sites of Aedes aegypti (L.). In the present study, the suitability of plastic, glass, ceramic and metal containers was evaluated in four patches within a cemetery of Buenos Aires City, Argentina. Between October 1998 and May 2000, we found 215 breeding sites of Ae. aegypti out of 13,022 water-filled containers examined. In two patches containing microenvironments sheltered from the sun, the use of the different types of containers was proportional to the offer (correlation coefficient = 0.99, P < 0.05 in both cases). In the remaining patches, plastic and metal containers were the most and less frequent breeding sites, respectively (P < 0.001 in both cases). The number of immatures per breeding site (median = 4.5) did not show significant differences among the four types of containers examined (H3, 215 = 1.216, P = 0.749). Differences found in patches from a same cemetery suggest that different microenvironmental conditions affect the suitability of each type of container for Ae. aegypti breeding. Plastic containers appeared as key breeding sites that should be removed to reduce the Ae. aegypti population in the study area.

Identification of the best ovitrap installation sites for gravid Aedes (Stegomyia) aegypti in residences in Mirassol, state of São Paulo, Brazil

This study aimed at identifying the best ovitrap installation sites for gravid Aedes aegypti in Mirassol, state of São Paulo, Brazil. Ovitraps were installed in ten houses per block over ten blocks. Four ovitraps were placed per residence, one in the bedroom, one in the living room, and two outdoors with one in a sheltered area and one in an outside site. Each week for eleven weeks, visits were made to examine the ovitraps and to change the paddles used for egg-laying. Eggs were analyzed according to the trap location. The results showed that the outdoor sites received significantly more oviposition than indoor sites. Additionally, in respect to the outdoor sites, the outside site received significantly more oviposition than the sheltered site. A b correlation was observed between positive traps and egg numbers. The results are discussed with respect to the best installation site of the traps and their implications in surveillance and control of dengue vectors.

Development of assistive technology for the visually impaired: use of the male condom

The objectives were to develop and evaluate an assistive technology for the use of the male condom by visually impaired men. It was a technology development study with the participation of seven subjects. Three workshops were performed between April and May of 2010; they were all filmed and the statements of the participants were transcribed and analyzed by content. Three categories were established: Sexuality of the visually impaired; Utilization of the text, For avoiding STDs, condoms we will use, divided in two subcategories, Concept discussion and Text evaluation; and Construction of a simple penile prosthesis. The knowledge transmitted related to STD, the utilization of the condom on the penile prosthesis made by the subjects themselves, and the interaction during the workshops were effective factors for the study. In the context of sexual health, the necessity of developing works involving the visually impaired was noted, addressing sexually transmitted diseases and focusing on the use of the condom by this population.

Access, equity and social cohesion: evaluation of intersectoral strategies for people experiencing homelessness

Objective To understand and evaluate the work of intersectoral assistance on the insertion and the flow of people in situation of street with severe mental illness in public services of Mental Health. Method A case study developed from ten visits to a night shelter between March and April 2012. For data collection, the participant observation and semi-structured interviews were carried out with four sheltered individuals, as well as non-directive group interviews with five technicians of the social-assistance services. Results Were analyzed using Content Analysis and developing a Logic Model validated with the professionals involved. Conclusion The social assistance services are the main entry of this clientele in the public network of assistance services, and the Mental Health services have difficulty in responding to the specificities of the same clientele and in establishing intersectoral work.


Violence against adolescents: an analysis based on the categories gender and generation

Exploratory and descriptive study based on quantitative and qualitative methods that analyze the phenomenon of violence against adolescents based on gender and generational categories. The data source was reports of violence from the Curitiba Protection Network from 2010 to 2012 and semi-structured interviews with 16 sheltered adolescents. Quantitative data were analyzed using SPSS software version 20.0 and the qualitative data were subjected to content analysis. The adolescents were victims of violence in the household and outside of the family environment, as victims or viewers of violence. The violence was experienced at home, mostly toward girls, with marked overtones of gender violence. More than indicating the magnitude of the issue, this study can give information to help qualify the assistance given to victimized people and address how to face this issue.

Microbiologia do solo no ensino médio de Lavras, MG

Os microrganismos realizam processos imprescindíveis para a sustentabilidade dos ecossistemas e para a vida no planeta; apesar disso, a sociedade de modo geral ignora esse papel e os considera apenas do ponto de vista de patógenos. Este trabalho foi realizado com os objetivos de analisar o conteúdo sobre os microrganismos do solo nos livros didáticos de Biologia adotados nas escolas de ensino médio de Lavras, MG; caracterizar estudantes e professores de três escolas desta cidade; e avaliar a percepção sobre Microbiologia do Solo de 334 estudantes do ensino médio dessas escolas após a apresentação do assunto em diversos formatos atrativos (palestras, workshops e aulas práticas). A coleta de dados, a priori e posteriori, foi realizada por questionários; avaliou-se ainda a viabilidade de trabalhar esse conteúdo no ensino médio. Apesar da importância dos microrganismos do solo, os materiais didáticos para o ensino de Biologia no ensino médio os abordam superficialmente e não destacam sua relevância nos contextos agrícola e ambiental. Após apresentação do assunto, houve diferenças significativas na percepção por estudantes das escolas tanto públicas como privadas. Concluiu-se ser possível ensinar e melhorar esse conteúdo da disciplina de Biologia por meio de recursos acessíveis e constatou-se a necessidade de levar os avanços científicos conhecidos na universidade para atualizar o ensino médio.

A formação do Químico

Training of highly qualified personnel is the most transversal axis among those identified in the document "Mobilizing Axes in Chemistry", published by SBQ, in 2002, which demands to deep the discussions, initiated in the symposium "The Chemist's Education", whose main objective was to discuss the repercussions of that training in the teaching and in the industrial section. After the publication of an initial paper, a couple of meetings and workshops held in Rio de Janeiro, in December 2003, involving the national chemist community, discussed the "The role of the graduate degrees in the Chemist's Education" and "The Chemist's Education", and confirmed the need to invest in the formation of qualified human resources in profusion and in all levels. Actions to be taken were delineated. Presently, the graduate programs in Chemistry are showing expressive results. However, although these professionals are mostly absorbed by the academy (the absorption of the industry is less significant), only a few programs give special attention to the didactical and pedagogical training. The regional decentralization is actually a tendency in most programs, but the interaction academy-economic activities is still a challenge. It is necessary to establish with the industrial section, the highly qualified professional's profile in Chemistry that the industry can absorb. The undergraduation is growing in number and quality, however still excessively concentrated in the Southeast area. The national "Curricula Guidelines" for Chemistry Courses, through its flexible approach, propitiate the integral, interdisciplinary (non compartmentalized) and critical-reflexive training of the professionals as citizens and as entrepreneurs. However, deficiencies are still recognized. The evaluation system of undergraduate courses has been able to identify the most fragile modalities of courses and other indicators. It was also verified that Brazilian chemistry industry absorbs minimally the highly qualified professionals, which is attributed to the fact that the Federal Council of Chemistry is vertically organized and does not recognize the graduate degrees as professional qualification. In the conclusion, it stands out, among other aspects, the importance of the effective implantation of the national curricula guidelines, bringing out courses whose didactical and pedagogical projects may offer a solid formation in Chemistry, but comprehensive and general enough to enable the Chemistry professionals to develop varied skills.

Desafios da escola atual: a educação pelo trabalho

This work aims at investigating and proposing strategies to improve the comprehension of Chemistry concepts by high school students. One of these strategies consists in workshops that emphasize the notion of work as a general educational principle, in the perspective of polytechnic education. Interviews (pre and post-workshops) were used to evaluate the results. In post-workshop interviews, a significant incorporation of scientific concepts was observed, as well as a considerable improvement in the interpretation of experiments.

A comunicação na transição para os cuidados paliativos: artigo de revisão

Ao receber o diagnóstico de uma doença cuja cura não é possível e vivenciar a ameaça ou a concretude de perdas inerentes a essa nova condição, o paciente e seus familiares vivenciam um momento de crise, percorrendo algumas fases ou estados psicológicos aos quais o profissional de saúde deve estar atento para que consiga orientá-los, suprindo suas necessidades. Com o aumento da demanda e dos serviços em cuidados paliativos no contexto atual, o objetivo deste trabalho é apresentar uma breve revisão da literatura nacional e internacional sobre a comunicação na transição do cuidado curativo para o cuidado paliativo em oncologia. Para sua realização, foi feito um levantamento bibliográfico, sendo analisados artigos das bases de dados SciELO e Medline no período de 2006 a 2013, a partir dos descritores palliative care e breaking bad news. Os artigos localizados nas bases de dados e considerados relevantes ao tema foram incluídos, totalizando 32 estudos. Destes, 24 foram utilizados e subdividos nas seguintes categorias: treinamento de habilidades de comunicação; workshops; estudos sobre a qualidade da comunicação; e protocolos para comunicação em cuidados paliativos.

Instrumentos legais podem contribuir para a restauração de florestas tropicais biodiversas

O insucesso da maioria das iniciativas de restauração de florestas naturalmente biodiversas como a Mata Atlântica desencadeou um movimento intenso de discussão sobre a ciência e prática da restauração ecológica no Estado de São Paulo. Isso convergiu na construção participativa de uma resolução estadual de caráter técnico e orientador para restauração, a qual tem sido revisada e atualizada periodicamente em workshops que reúnem mais de 200 profissionais em cada evento. Essa resolução objetivou potencializar o estabelecimento de florestas biologicamente viáveis e com riqueza de espécies vegetais condizente com a dos ecossistemas de referência, a fim de garantir a persistência das florestas restauradas e proteger a biodiversidade nativa. As contribuições dessa resolução para o aperfeiçoamento e estímulo das ações de restauração são hoje evidentes. Entre 2003 e 2008, período de discussão dessa resolução, a produção de mudas de espécies arbustivas e arbóreas nativas no Estado cresceu de 13.000.000 (55 viveiros) para 33.000.000 (114 viveiros) por ano, e o número médio de espécies produzidas nos viveiros também aumentou de 30 para mais de 80, refletindo o crescimento das ações de restauração. Do ponto de vista deste estudo, esse instrumento legal tem servido como mecanismo legítimo de política pública ambiental e de proteção dos interesses coletivos da sociedade. Particularmente, ele guia e orienta a maior parte dos investimentos em restauração ecológica e aumenta as perspectivas de maximização dos benefícios para a sociedade, que podem e devem ser obtidos com a restauração, incluindo a persistência da biodiversidade nas paisagens antrópicas tropicais.

Proteoliposomes as matrix vesicles' biomimetics to study the initiation of skeletal mineralization

During the process of endochondral bone formation, chondrocytes and osteoblasts mineralize their extracellular matrix by promoting the formation of hydroxyapatite (HA) seed crystals in the sheltered interior of membrane-limited matrix vesicles (MVs). Ion transporters control the availability of phosphate and calcium needed for HA deposition. The lipidic microenvironment in which MV-associated enzymes and transporters function plays a crucial physiological role and must be taken into account when attempting to elucidate their interplay during the initiation of biomineralization. In this short mini-review, we discuss the potential use of proteoliposome systems as chondrocyte- and osteoblast-derived MVs biomimetics, as a means of reconstituting a phospholipid microenvironment in a manner that recapitulates the native functional MV microenvironment. Such a system can be used to elucidate the interplay of MV enzymes during catalysis of biomineralization substrates and in modulating in vitro calcification. As such, the enzymatic defects associated with disease-causing mutations in MV enzymes could be studied in an artificial vesicular environment that better mimics their in vivo biological milieu. These artificial systems could also be used for the screening of small molecule compounds able to modulate the activity of MV enzymes for potential therapeutic uses. Such a nanovesicular system could also prove useful for the repair/treatment of craniofacial and other skeletal defects and to facilitate the mineralization of titanium-based tooth implants.