Preservation of Nitric Oxide Availability as Nitrite and Nitrosothiols

Nitric Oxide (NO) has been known for long to regulate vessel tone. However, the close proximity of the site of NO production to “sinks” of NO such as hemoglobin (Hb) in blood suggest that blood will scavenge most of the NO produced. Therefore, it is unclear how NO is able to play its physiological roles. The current study deals with means by which this could be understood. Towards studying the role of nitrosothiols and nitrite in preserving NO availability, a study of the kinetics of glutathione (GSH) nitrosation by NO donors in aerated buffered solutions was undertaken first. Results suggest an increase in the rate of the corresponding nitrosothiol (GSNO) formation with an increase in GSH with a half-maximum constant EC50 that depends on NO concentration, thus indicating a significant contribution of ∙NO2 mediated nitrosation in the production of GSNO. Next, the ability of nitrite to be reduced to NO in the smooth muscle cells was evaluated. The NO formed was inhibited by sGC inhibitors and accelerated by activators and was independent of O2 concentration. Nitrite transport mechanisms and effects of exogenous nitrate on transport and reduction of nitrite were examined. The results showed that sGC can mediate nitrite reduction to NO and nitrite is transported across the smooth muscle cell membrane via anion channels, both of which can be attenuated by nitrate. Finally, a 2 – D axisymmetric diffusion model was constructed to test the accumulation of NO in the smooth muscle layer from reduction of nitrite. It was observed that at the end of the simulation period with physiological concentrations of nitrite in the smooth muscle cells (SMC), a low sustained NO generated from nitrite reduction could maintain significant sGC activity and might affect vessel tone. The major nitrosating mechanism in the circulation at reduced O2 levels was found to be anaerobic and a Cu+ dependent GSNO reduction activity was found to deliver minor amounts of NO from physiological GSNO levels in the tissue.

Dishonest assistance and accessory liability

Dishonest Assistance and Accessory Liability, Paul S. Davies, Accessory Liability, Oxford: Hart Publishing, 2015, 294 pp, hb £54.99 In this essay review of Paul Davies' Accessory Liability, it is questioned whether dishonest assistance can be accommodated with other forms of third party liability in private law. It is argued that dishonest assistance does not involve the same conduct element as other forms of third party liability which are included in Davies’ book. Liability can arise for ‘weak’ causal links in dishonest assistance claims such as where a third party fails to intervene. It is also the case that liability can arise for involvement which arises ‘after the event’, which undermines Davies’ suggestion that there must be a causal link between a third party’s conduct and a primary wrong.

Hybridity in contemporary commercial organizations: implications for employee trust

This study advances the concept of organizational hybridity (OH). By doing so, it takes into account the individual level of analysis often neglected in organizational theory. More specifically, it aims to understand the implications of organizational hybridity for employees’ trust in contemporary commercial organizations. Informed and guided by current literature, this study argues that the current literature on organizational hybridity fails to adequately address the consequences of hybridity for employees' behaviour. The empirical study was conducted in 2014 using data collected via semi-structured interviews and document analysis. The study was based on a comparison of two case studies in Nigeria: Alter Securities Limited and Barak Petroleum Limited. A total of forty (40) interviews were conducted; twenty (20) from each organization. The data were analysed using thematic analysis. The main findings are that organizational hybridity in this study produced tensions that resulted in negative behavioural responses and employees’ distrust in the commercial hybrid organizations. However, employees’ identification with non-market orientated institutional logics such as family, philanthropic and religious logics is seen to facilitate their commitment, honesty, and trust in the organizations. Nevertheless, caution is required here as religious logics may also lead to an acceptance of unethical behaviour by employees. Overall, this study contributes to the literature on organizational hybridity by extending on Battilana and Lee’s (2014) framework, which highlights governance, leadership, organizational culture and intra-organizational relationships as core organizational attributes in the context of which issues may arise in commercial hybrid organizations. Furthermore, it addresses a gap in Besharov and Smith’s (2014) hybrid typology framework by providing an alternative line of argument focused on understanding how tensions manifest within commercial hybrid organizations. The key recommendations of this research underscore the need for commercial hybrid organizations to invest in mechanisms for improving employees’ trust so as to reap the benefits associated with trust. This could be achieved by involving employees in the decision-making process and clearly communicating the organizations’ values, so as to minimise the misinterpretation of the embodied institutional logics by employees.

The impact and control of malignant catarrhal fever in Tanzania

Malignant Catarrhal Fever (MCF), an often-lethal infectious disease, presents as a variable complex of lesions in susceptible ungulate species. The disease is caused by a -herpesvirus following transmission from an inapparent carrier host. Two major epidemiological forms exist: wildebeest-associated MCF (WA-MCF), in which the virus is transmitted to susceptible species by wildebeest calves less than approximately four months of age, and sheepassociated MCF (SA-MCF) in which the virus is spread by sheep (primarily adolescents). Due to the lack of an in-vitro propagation system for the causative agent of the more economically significant SA-MCF, and with the expectation that cross-protective immunity may be provided, vaccine development has focused on the more easily propagated alcelaphine herpesvirus-1 (AlHV-1) that causes WA-MCF. In 2008 a direct viral challenge trial showed that a novel vaccine, employing an attenuated AlHV-1 (atAlHV-1) `C5000 virus strain, protected British Friesian-Holstein (FH) cattle against an intranasal challenge with virulent AlHV-1 `C5000 virus. For cattle keeping people living near wildebeest calving areas in sub-Saharan Africa an effective vaccine would have value as it would release them from the costly annual disease avoidance strategy of having to move their herds away from the oncoming wildebeest. On the other hand, an effective vaccine will release herd owners from the need to avoid MCF, allowing them to graze their cattle alongside wildebeest on the highly nutritious pastures of the calving areas. As such conservationists have raised concerns that the development of a vaccine might lead to detrimental grazing competition. The principle objective of this study was to test the novel vaccine on Tanzanian shorthorn zebu cross cattle (SZC).We did this firstly using a natural challenge field trial (Chapter Two) which demonstrated that immunisation with the atAlHV-1 vaccine was well tolerated and induced an oro-nasopharyngeal AlHV-1-specific and -neutralising antibody response. This resulted in an immunity in SZC cattle that was partially protective and reduced naturally transmitted infection by 56%. We also demonstrated that non-fatal infections occurred with a much higher frequency than previously thought. Because the calculated efficacy of the vaccine was less than that seen in British FH cattle we wanted to determine whether host factors, particular to SZC cattle, had impacted the outcomes of the field trial. To do this we repeated the 2008 direct viral challenge trial using SZC cattle (Chapter Four). During this trial we also investigated whether the recombinant bacterial flagellin monomer (FliC), when used as an adjuvant, might improve the vaccine’s efficacy. The findings from this trial indicated that direct challenge with pathogenic AlHV-1 is effective at inducing MCF in SZC cattle and that FliC is not an appropriate adjuvant for this vaccine. Furthermore, with less control group cattle dying of MCF than expected we speculate that SZC cattle may have a degree of resistance to MCF that affords them protection from infection and developing fatal disease. In Chapter Three we investigated aspects of the epidemiology of MCF, specifically whether wildebeest placenta, long implicated by Maasai cattle owners as a source of MCF, might play a role in viral transmission. Additionally, through comparative sequence analysis, at two specific genes (A9.5 and ORF50) of wild-type and atAlHV-1, we investigated whether the `C5000 strain, the source of which was taken from Africa more than 40 years ago, was appropriate for vaccine development. The detection of AlHV-1 virus in approximately 50% of placentae indicated that infection can occur in-utero and that this tissue might play a role in disease transmission. And, despite describing three new alleles of the A9.5 gene (supporting previous evidence that this gene is polymorphic and encodes a secretory protein with interleukin-4 as the major homologue), the observation that the most frequently detected haplotypes, in both wild-type and attenuated AlHV-1, were identical suggests that AlHV-1 has a slow molecular clock and that the attenuated strain was appropriate for vaccine development. In Chapter Five we present the first quantitative assessment of the annual MCF avoidance costs that Maasai pastoralists incur. In particular we estimated that as a result of MCF avoidance 64% of the total daily milk yield during the MCF season was not available to be used by the 81% of the family unit remaining at the permanent boma. This represents an upper-bound loss of approximately 8% of a household0s annual income. Despite these considerable losses we concluded that, given an incidence of fatal MCF in cattle living in wildebeest calving areas of 5% to 10%, if herd owners were to stop trying to avoid MCF by allowing their cattle to graze alongside wildebeest, any gains made through increased availability of milk, improved body condition and reduced energy demands would be offset by an increase in MCF-incidence. With the development of an effective vaccine, however, this alternative strategy might become optimal. The overall conclusion we draw therefore is that, despite the substantial costs incurred each year avoiding MCF, the partial protection afforded by the novel vaccine strategy is not sufficient to warrant a wholesale change in disease avoidance strategy. Nonetheless, even the partial protection provided by this vaccine could be of value to protect animals that cannot be moved, for example where some of the herd remain at the boma to provide milk or where land-use changes make traditional disease avoidance difficult. Furthermore, the vaccine may offer a feasible solution to some of the current land-use challenges and conflicts, providing a degree of protection to valuable livestock where avoidance strategies are not possible, but with less risk of precipitating the potentially damaging environmental consequences, such as overgrazing of highly nutritious seasonal pastures, that might result if herd owners decide they no longer need to avoid wildebeest.

Correlacion entre hemoglobina glicosilada con hallazgos sintax score ii en pacientes con sospecha clínica de enfermedad coronaria, hospitalizados en la unidad coronaria del hospital San José centro en enero a septiembre del año 2015

Se realiza un estudio de corte transversal en el periodo de enero a septiembre del año 2016 en la unidad coronaria del Hospital San José Centro de la Ciudad de Bogotá; en pacientes con sospecha de enfermedad coronaria (Síndrome coronario agudo y angina estable) y antecedente de Diabetes Mellitus Tipo 2, se recolectaron 42 pacientes con los criterios de inclusión a quienes se realizó angiografía coronaria como parte del protocolo de estudio y manejo de la unidad, el objetivo primario fue demostrar la posible correlación entre niveles de hemoglobina glicosilada y la escala de severidad SYNTAX Score I y II de enfermedad coronaria, como objetivos secundarios; caracterizar las variables sociodemográficas, comorbilidades y posible relación con el tipo de presentación de enfermedad coronaria. Como hallazgos relevantes no se encontró correlación importante ni significativa entre niveles de hemoglobina glicosilada y la escala Syntax score II ni Syntax score I, a pesar de que la mayoría de pacientes mostraban mal control crónico de su diabetes mellitus tipo 2, con niveles mayores > 7%, como hallazgo positivo se encontro asociación estadísticamente significativa con niveles de LDL y las diferentes formas de presentación de enfermedad coronaria, a mayor niveles de LDL mayor probabilidad de IAM e IAM con elevación del segmento ST. Se considera que con estudios multicentricos en diferentes ciudades y unidades de cuidado cardiovascular con diferentes niveles de riesgo, se podría demostrar la posible correlación entre niveles de hemoglobina glicosilada y los grados de severidad de enfermedad coronaria representados por las escalas Syntax score I y II.

Efectos de una intervención educativa en la promoción de la actividad física, los conocimientos y comportamientos saludables para la prevención del cáncer colorrectal en jóvenes de una institución educativa secundaria en Bogotá Colombia

El cáncer colorrectal es un serio problema de salud pública a nivel mundial. Evidencias epidemiológicas han sugerido que al menos el 50% de la enfermedad puede ser prevenida mediante un estilo de vida saludable. Las intervenciones educativas surgen como una herramienta clave de movilización social para la prevención y han sido sugeridas desde las autoridades nacionales para el control del cáncer en el país.

Liderazgo transformacional y cambio organizacional en una empresa de transporte privado en Cartagena de Indias

El presente trabajo de grado se define desde el punto de vista metodol6gico como una aproximaci6n significativa al modelo organizacional transformacional y transaccional de la empresa, mediante un proceso de implementaci6n concreta en un estudio de caso de la empresa colombiana HB & CIA. LTDA, con miras al mejoramiento cualitativo y cuantitativo ideal de la misma. Desde esta perspectiva, el proyecto se divide en tres grandes ejes: la formulaci6n y delimitaci6n del problema, en donde se presenta un analisis detallado de todos los problemas relacionados con el cambio organizaci6n y con la necesidad de un trabajo de liderazgo, como una via para la soluci6n de los mismos. El segundo eje, presenta el desarrollo del estudio de caso, partiendo del diagn6stico de la empresa, con el fin de que se identificaran las debilidades, oportunidades, amenazas y fortalezas. El estudio de caso se circunscribe al marco te6rico en terminos del deber ser y hacer de la organizaci6n, de la visi6n y la misi6n que debe orientar la organizaci6n y del liderazgo transformacional como un medio para solucionar problemas de gesti6n y optimizaci6n de los recursos dentro de una organizaci6n.

Comunidade de parasitos metazoários em Piaractus brachypomus (Serrasalmidae) do Baixo Rio Amazonas, Brasil.

No Brasil, a produção pesqueira de Piaractus brachypomus (pirapitinga) vem apresentando pequeno aumento anual. Porém, essa produção extrativista é baixa se comparada à produção da aquicultura dessa espécie de peixes nativo da Amazônia. Piaractus brachypomus é um peixe bastante comercializado em mercados e feiras das capitais de estados da Amazônia brasileira. O objetivo deste estudo foi investigar a comunidade de parasitos metazoários em P. brachypomus do baixo Rio Amazonas, estado do Pará, Norte do Brasil. Métodos usuais de coleta, fixação, conservação e identificação dos parasitos foram usados neste estudo. Os termos ecológicos usados foram os recomendados na literatura. O índice de Brillouin (HB), uniformidade (E), índice de dominância de Berger-Parker (d), riqueza de espécies e frequência de dominância (FD%) foram calculados para avaliar a comunidade componente de parasitos. O índice de dispersão e índice de discrepância foram calculados, para detectar o padrão de distribuição das infracomunidades de parasitos para espécies com prevalência >10%. Os dados de peso (g) e comprimento total (cm) foram usados para calcular o fator de condição relativo (Kn) dos hospedeiros. Em 34 espécimes de P. brachypomus (31,7 ± 5,7 cm e 745,6 ± 304,9 g) necropsiados, 27.384 parasitos foram coletados, tais como Anacanthorus spathulatus, Mymarothecium viatorum, Notozothecium janauachensis (Monogenoidea), Spectatus spectatus, larvas de Contracaecum sp. (Nematoda), Clinostomum marginatum, Dadaytrema oxycephala (Digenea), Argulus carteri e Ergasilus sp. (Crustacea). A dominância foi de S. spectatus, seguida por espécies de monogenoideas, e houve dispersão agregada dos parasitos, exceto D. oxycephala e Contracaecum sp., que apresentaram uma dispersão randômica. A riqueza de espécies de parasitos (5 ± 1), índice de Billouin (1,02 ± 0,25), equitabilidade (0,39 ± 0,09) e índice de dominância de Berger-Parker (0,53 ± 0,13) variam. Foi encontrada correlação positiva entre a abundância das três espécies de monogenoideas, indicando que não houve uma competição entre as espécies desses parasitos nas brânquias. A abundância de algumas espécies de parasitos mostrou correlação positiva com o tamanho dos hospedeiros, e o fator de condição não foi afetado pelos níveis de parasitismo dos peixes. Mostrou-se que esse hospedeiro teve comunidade de metazoários, caracterizada por elevada riqueza de espécies de metazoários, baixa uniformidade e elevada diversidade de parasitos com predominância de endoparasitos, inclusive em estágios larvais. Esse é o primeiro relato de C. marginatum, A. carteri, Ergasilus sp., e Contracaecum sp. para P. brachypomus.

Ottimizzazione di materiali e trattamenti per componenti critici destinati a motociclette da competizione

L’attività svolta durante il dottorato è stata incentrata su due tematiche riguardanti: (i) la modifica della composizione chimica delle classiche leghe di alluminio da fonderia per incrementarne la resistenza e stabilità termica; (ii) lo studio del comportamento a fatica di acciai innovativi alto-resistenziali, allo scopo di valutarne il loro utilizzo per la produzione di alberi motore e distribuzione in sostituzione dei tradizionali acciai utilizzati dopo bonifica e trattamento superficiale di nitrurazione. La messa a punto di una lega di alluminio da fonderia con elevata resistenza in temperatura ha richiesto, oltre all’individuazione della composizione chimica, l’ottimizzazione del trattamento termico e una completa caratterizzazione meccanica statica a fatica sia a temperatura ambiente sia a 200°C. L’attività ha permesso di sviluppare una lega, ottenuta aggiungendo 1,3% in peso di rame alla classica lega A357 (Al-Si-Mg), cha ha mostrato avere proprietà meccaniche superiori a quelle delle tradizionali leghe Al-Si-Mg-Cu quali la A354 e C355 sia a temperatura ambiente che a 200 °C dopo lunga esposizione in temperatura. Per quanto riguarda gli acciai innovativi, dopo una preliminare analisi di mercato per individuare quali acciai potessero essere oggetto di studio, è stato valutato come migliorarne le prestazioni a fatica, anche in presenza d’intaglio, attraverso la scelta del trattamento termico più opportuno e del processo di pallinatura. I risultati delle caratterizzazioni microstrutturale e meccanica svolte hanno permesso di individuare due acciai (nomi commerciali K890 e ASP2017) ottenuti per metallurgia delle polveri, ad oggi utilizzati solo per la produzione di stampi e/o utensili, in grado di sostituire gli acciai con cui vengono oggi realizzati i componenti, senza la necessità di eseguire il trattamento di nitrurazione

Valutazione della concordanza e della capacità predittiva degli score prognostici per la definizione di rapida progressione della malattia renale conica nei pazienti con malattia policistica epato renale. Analisi di una coorte multicentrica.

Introduzione: La malattia policistica autosomica dominante (ADPKD) è una causa comune di malattia renale terminale (ESKD). È caratterizzata dallo sviluppo di cisti renali bilaterali che aumentano progressivamente di volume. Il Tolvaptan viene prescritto in base a 3 criteri: volume renale totale (HtTKV) e Mayo Clinic Imaging Class (MCIC), tasso di declino dell'eGFR e al Predicting Renal Outcome in Polycystic Kidney Disease (PROPKD), che combina variabili cliniche e genetiche. In questa coorte multicentrica retrospettiva, l'obiettivo era di valutare e migliorare la concordanza di sensibilità e specificità predittive di MCIC e PROPKD. Metodi: I dati di pazienti adulti affetti da ADPKD sono stati ottenuti da 2 centri di Bologna (B) e Dublino (D). Abbiamo definito RP un calo dell'eGFR ≥3 mL/min/1,73m2/anno su 4 anni (Clinical Score), o classi MCIC 1C-D-E, o punteggio PROPKD da 7 a 9. Per i parametri clinici sono state utilizzate statistiche descrittive. La concordanza tra i punteggi è stata valutata tramite la statistica Kappa. Nelle varianti missenso di PKD1, il punteggio REVEL è stato trattato come una variabile continua; (>0,65 patogeno'). Risultati: Abbiamo valutato 201 pazienti con ADPKD. Il Propkd e il MCIC erano rispettivamente: 90% specifico e 31,3% sensibile; 89,6% sensibile e 28,6% specifico per identificare il calo dell'eGFR. Kappa di Cohen era di 0,025. Il 47,9% (n=143) è risultato concorde. Il punteggio Revel applicato alle mutazioni PKD1NT identifica da 15 a 19 pazienti che potrebbero avere una RP. L'analisi multivariata mostra dati statisticamente significativi per HB (p:0,016), eventi urologici (p: 0,005) e MCIC (p: 0,074). Conclusioni: La concordanza tra i punteggi risulta bassa. Il PROPKD è più selettivo rispetto al Mayo. Tuttavia, il PROPKD permette di identificare alcune RP escluse dall'uso del solo MCIC. L'uso combinato dei punteggi può aumentare la capacità di identificare le RP. Il punteggio REVEL potrebbe migliorare questa concordanza

Exploring the white dwarf cooling sequence in Globular Clusters

White dwarfs (WDs) are electron-degenerate structures that are commonly assumed to evolve via a pure cooling process, with no stable thermonuclear activity at work. Their cooling rate is adopted as a cosmic chronometer to constrain the age of several Galactic populations, including the disk, Globular Clusters (GCs) and open clusters. This thesis work is aimed at the study of the WD populations in globular clusters and is articulated in two branches. The first was focused on the study of the bright portion of the WD cooling sequence. By analyzing high resolution UV data acquired with the Hubble Space Telescope (HST), we compared the WD luminosity functions (LFs) in four Galactic GCs (namely M13, M3, NGC6752, and M5) finding an unexpected over-abundance of WDs in M13 and NGC6752 with respect to M3 and M5. Theoretical models suggest that, consistently with the blue-tail horizontal branch (HB) morphology of M13 and NGC6752, this overabundance is due to a population of slowly cooling WDs, i.e., WDs fading more slowly than in a pure cooling process thanks to an extra-energy source provided by stable thermonuclear burning in their residual hydrogen-rich envelope. This is the first empirical evidence of WDs fading at a slower rate than usually assumed, and has a crucial impact on the use of the cooling sequence as a cosmic chronometer. The second branch was focused on the search for the companion star to binary millisecond Pulsars (MSP) in the globular clusters M13 and NGC 6652: the identified companions turned out to be helium-core WDs, and provided a invaluable constraints on the mass of the neutron star and the epoch of the MSP formation.

AAGL 2021 classification system and risk of surgical complications in women submitted to surgery for endometriosis

Introduction: Recently, the American Association of Gynecologic Laparoscopists proposed a new classification and scoring system with the specific aim to assess surgical complexity. This study sought to assess if a higher AAGL score correlates with an increased risk of peri-operative complications in women submitted to surgery for endometriosis. Methods: This is a retrospective cohort study conducted in a third level referral center. We collected data from women with endometriosis submitted to complete surgical removal of endometriosis from January 2019 to December 2021. ENZIAN, r-ASRM classifications and AAGL total score was calculated for each patient. Population was divided in two groups according to the occurrence or not of at least one peri-operative complication. Our primary outcome was to evaluate the correlation between AAGL score and occurrence of complications. Results: During the study period we analyzed data from 282 eligible patients. Among them, 80 (28.4%) experienced peri-operative complications. No statistically significant difference was found between the two groups in terms of baseline characteristics, except for pre-operative hemoglobin (Hb), which was lower in patients with complications (p=0.001). Surgical variables associated with the occurrence of complications were recto-sigmoid surgery (p=0.003), ileocecal resection (0.034), and longer operative time (p=0.007). Furthermore, a higher ENZIAN B score (p=0.006), AAGL score (p=0.045) and stage (p=0.022) were found in the group of patients with complications. The multivariate analysis only confirmed the significant association between the occurrence of peri-operative complications and lower pre-operative Hb level (OR 0.74; 95% CI, 0.59 - 0.94; p=0.014), longer operative time (OR 1.00; 95% CI, 1.00 – 1.01; p=0.013), recto-sigmoid surgery - especially discoid resection (OR 8.73; 95% CI, 2.18 – 35; p=0.016) and ENZIAN B3 (OR 3.62; 95% CI, 1.46 – 8.99; p= 0.006). Conclusion: According to our findings, high AAGL scores or stages do not seem to increase the risk of peri-operative complications.

O usuário com doenças transmissíveis para enfermeiro

Tópico 1 – Considerações gerais sobre doenças transmissíveis O tópico demonstra que o quadro de doenças transmissíveis (DT) será tanto mais grave, quanto piores forem as condições de vida da população e a qualidade dos serviços de saúde. Ressalta a importância se atualizar sobre o cenário de doenças transmissíveis no Brasil. Mostra a cadeia de processo que envolve as doenças transmissíveis, a estrutura epidemiológica, os fatores de complexidade do tema, o fenômeno iceberg, a classificação das DT em três grandes grupos, conforme persistência e emergência. Tópico 2 – Tuberculose Quanto à tuberculose, o tópico apresenta: características, sinais, sintomas, transmissibilidade tratamento ambulatorial, hospitalização, situação no Brasil, metas internacionais e nacionais, PNCT, importância da atuação da AB para alcance das metas, ações de combate, importância da adesão do indivíduo ao tratamento, normas do CIPE e do CIPESC e sua importância na classificação dos fenômenos nas ações de enfermagem. Tópico 3 – Hepatites virais Sobre as hepatites virais, o tópico apresenta: características; distribuição universal, variação e magnitude conforme regiões no Brasil e no planeta; dados estatísticos; reflexão sobre presença de hepatites virais na própria área de atuação; ações do MS nos diferentes níveis de atenção; ações contra a doença; formas de prevenção; vacinação; uso de imunoglobina humana antivírus HB; importância do conhecimento do Manual de Exposição Ocupacional e cuidados. Tópico 4 – Os usuário com DST e AIDS O tópico apresenta a definição de DST da OMS e aborda a AIDS, apresentando: características e fases da síndrome; políticas públicas e situação brasileira; o programa para DST e AIDS do SUS, suas políticas e práticas; diagnóstico e tratamento do HIV, testes, janela imunológica, diagnóstico diferencial; avanços no tratamento; papel das equipes de saúde na prevenção e na detecção precoce e no tratamento. Apresenta, também, caso para reflexão. Conteúdo Online do módulo de Atenção integral à saúde do adulto: O usuário com doenças transmissíveis para enfermeiro. Unidade 3 do módulo 13 para dentista que compõe o Curso de Especialização Multiprofissional em Saúde da Família.

Atenção integral ao portador de doença falciforme: plano de ação na Estratégia Saúde da Família

A doença falciforme, uma das doenças hereditárias mais comuns no Brasil, é uma questão de saúde pública relevante. No país, a doença é predominante entre negros e pardos e raramente entre brancos. É caracterizada pela predominância da hemoglobina (Hs) S nas hemácias: anemia falciforme (Hb SS). A gravidade clínica é variável, mas um número significativo de pacientes tem as formas crônica e grave da doença, a qual leva a disfunções orgânicas múltiplas. O diagnóstico precoce pela triagem neonatal (teste do pezinho) e o tratamento adequado oferecido pelos hemocentros são fundamentais para reduzir as complicações. Assim, este estudo objetivou elaborar um projeto de intervenção com o intuito capacitar uma equipe multidisciplinar e de promover uma assistência integral aos portadores de Doença Falciforme. Para elaboração do plano, fez-se pesquisa bibliográfica na Biblioteca Virtual em Saúde e nos manuais do Ministério da Saúde, com os descritores: Doença Falciforme; Estratégia de Saúde da Família; Atenção Primária. A proposta deste trabalho foi, portanto a de construir um plano de ação específico na Estratégia de Saúde da Família do Município de Ibirité, Minas Gerais a fim de capacitar os profissionais da atenção básica para que possam prestar uma assistência interdisciplinar e resolutiva voltada para o paciente com doença falciforme.