RESUMO

The balance between precipitation and evapotranspiration (ET) has direct effect on vegetation, and any change in its structure and composition can influence it. The aim of this study is to determine experimentally the daily evapotranspiration (ET) of the invasive species, Hedychium coronarium, and to compare with a group of four native species of the riparian forest. The experiment was carried out in a greenhouse with three different treatments: (1) only the invasive species; (2) only native species; and (3) a mixture of invasive and native species. In each lysimeter, pressure transducers recorded the water level at every 15 min along 14 months. Daily ET was calculated by the method of Gribovszki et al. (2008) and varied according to the treatment, indicating that different species (invasive or native) use the water differently. The maximum accumulated daily ET occurred for mixture treatment (2540.16 mm), while the treatment with the invasive plant presented the lowest value (2172.53 mm). H. coronarium, in monodominant stands, can reduce evapotranspiration on invaded areas and increase it when immersed in the riparian forest.

RESUMO

This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19 in the Xingu Health Region. Consequently, this study adopted an ecological framework, employing secondary data of COVID-19-positive individuals from the Xingu Health Region, Pará State, Brazil. The data were obtained through the database of the State of Pará Public Health Secretary (SESPA) for the period from March 2020 to March 2021. The incidence and mortality were higher in Vitória do Xingu and Altamira. Municipalities with a higher percentage of citizens with health insurance and higher public health expenditure showed a higher incidence and mortality. A higher gross domestic product was associated with a higher incidence. Females were found to be associated with better clinical management. To live in Altamira was a risk factor for intensive care unit admission. The symptoms and comorbidities that predicted worse clinical management were dyspnea, fever, emesis, chills, diabetes, cardiac and renal diseases, obesity, and neurological diseases. There were higher incidence, mortality, and lower survival rates among the elderly. Thus, it can be concluded that SDH indicators, symptomatology, and comorbidities have implications for the incidence, mortality, and clinical management of COVID-19 in the Xingu Health Region of eastern Amazonia, Brazil.

Assuntos

RESUMO

BACKGROUND: Studies have shown a low accuracy of urgent care physicians in interpreting electrocardiogram (ECG) in severe cardiovascular conditions. OBJECTIVE: To evaluate the effectiveness of an ECG learning method in internal medicine internships and to know the perception of interns regarding learning before and after the methodology. METHODS: This study used a database with the results of an ECG pre- and post-test of the classes in the internal medicine internship from 2017 to 2022. A qualitative questionnaire was sent with questions for self-assessment of perception of learning. RESULTS: The study included a total of 227 students, 161 of whom (70.9%) were female. The mean age was 26.4 ± 4.2 years old. The pre-test mean was 3.75 ± 2.0 points, and the post-test mean was 8.48 ± 1.5 points, showing a statistically significant difference, even after stratification by sex, age, and course period (p < 0.001 for all comparisons). Sixty-nine (30%) of the students responded to the qualitative questionnaire. The three predominant feelings prior to learning were despair, fear, and insecurity. After the Club, the predominant feelings were security, tranquility, and confidence. CONCLUSION: The level of prior knowledge regarding ECG was low among students in the medical internship, and the proposed methodology was effective for learning ECG, regardless of age, sex, or course period. It was possible to transform negative beliefs regarding ECG learning and make learning meaningful and enjoyable. A more incisive look at medical courses for learning the ECG in a more practical and contextualized way can improve this scenario.

FUNDAMENTO: Estudos têm mostrado uma baixa acurácia de médicos urgentistas em interpretar o eletrocardiograma (ECG) em quadros cardiológicos graves. OBJETIVO: Avaliar a eficácia de um método de aprendizagem do ECG no internato de clínica médica e conhecer a percepção dos internos quanto ao aprendizado antes e após a metodologia. MÉTODOS: Foi utilizado um banco de dados com os resultados do pré e pós-teste de ECG das turmas de internato em clínica médica de 2017 a 2022. Foi enviado um questionário qualitativo com perguntas para autoavaliação da percepção do aprendizado. RESULTADOS: Foram incluídos 227 estudantes, 161 (70,9%) do sexo feminino, com idade de 26,4 ± 4,2 anos. A média do pré-teste foi 3,75 ± 2,0 pontos e do pós-teste 8,48 ± 1,5 pontos, diferença estatisticamente significativa, mesmo após estratificação por sexo, idade e período do curso (p < 0,001 para todas as comparações). Sessenta e nove (30%) dos alunos responderam ao questionário qualitativo. Os três sentimentos predominantes anteriores ao aprendizado foram desespero, medo e insegurança. Após o Clube, os sentimentos predominantes foram segurança, tranquilidade e confiança. CONCLUSÃO: Foi baixo o nível de conhecimento prévio do ECG entre os egressos do internato médico e a metodologia proposta foi eficaz em melhorar o grau de conhecimento do ECG, independente da idade, sexo ou período do curso. E foi possível transformar as crenças negativas quanto à aprendizagem do ECG e torná-la significativa e leve. Um olhar mais incisivo nos cursos de medicina para o aprendizado do ECG de forma mais prática e contextualizada, pode melhorar este cenário.

Assuntos

RESUMO

Resumo Fundamento Estudos têm mostrado uma baixa acurácia de médicos urgentistas em interpretar o eletrocardiograma (ECG) em quadros cardiológicos graves. Objetivo Avaliar a eficácia de um método de aprendizagem do ECG no internato de clínica médica e conhecer a percepção dos internos quanto ao aprendizado antes e após a metodologia. Métodos Foi utilizado um banco de dados com os resultados do pré e pós-teste de ECG das turmas de internato em clínica médica de 2017 a 2022. Foi enviado um questionário qualitativo com perguntas para autoavaliação da percepção do aprendizado. Resultados Foram incluídos 227 estudantes, 161 (70,9%) do sexo feminino, com idade de 26,4 ± 4,2 anos. A média do pré-teste foi 3,75 ± 2,0 pontos e do pós-teste 8,48 ± 1,5 pontos, diferença estatisticamente significativa, mesmo após estratificação por sexo, idade e período do curso (p < 0,001 para todas as comparações). Sessenta e nove (30%) dos alunos responderam ao questionário qualitativo. Os três sentimentos predominantes anteriores ao aprendizado foram desespero, medo e insegurança. Após o Clube, os sentimentos predominantes foram segurança, tranquilidade e confiança. Conclusão Foi baixo o nível de conhecimento prévio do ECG entre os egressos do internato médico e a metodologia proposta foi eficaz em melhorar o grau de conhecimento do ECG, independente da idade, sexo ou período do curso. E foi possível transformar as crenças negativas quanto à aprendizagem do ECG e torná-la significativa e leve. Um olhar mais incisivo nos cursos de medicina para o aprendizado do ECG de forma mais prática e contextualizada, pode melhorar este cenário.

Abstract Background Studies have shown a low accuracy of urgent care physicians in interpreting electrocardiogram (ECG) in severe cardiovascular conditions. Objective To evaluate the effectiveness of an ECG learning method in internal medicine internships and to know the perception of interns regarding learning before and after the methodology. Methods This study used a database with the results of an ECG pre- and post-test of the classes in the internal medicine internship from 2017 to 2022. A qualitative questionnaire was sent with questions for self-assessment of perception of learning. Results The study included a total of 227 students, 161 of whom (70.9%) were female. The mean age was 26.4 ± 4.2 years old. The pre-test mean was 3.75 ± 2.0 points, and the post-test mean was 8.48 ± 1.5 points, showing a statistically significant difference, even after stratification by sex, age, and course period (p < 0.001 for all comparisons). Sixty-nine (30%) of the students responded to the qualitative questionnaire. The three predominant feelings prior to learning were despair, fear, and insecurity. After the Club, the predominant feelings were security, tranquility, and confidence. Conclusion The level of prior knowledge regarding ECG was low among students in the medical internship, and the proposed methodology was effective for learning ECG, regardless of age, sex, or course period. It was possible to transform negative beliefs regarding ECG learning and make learning meaningful and enjoyable. A more incisive look at medical courses for learning the ECG in a more practical and contextualized way can improve this scenario.

RESUMO

Mercury is a ubiquitous pollutant in the environment with potential neurotoxic effects. Several populations are susceptible to mercurial exposure, especially methylmercury (MeHg) at low doses for long periods through food consumption. Given this, the present work aimed to assess the effects of long-term MeHg exposure on the cerebellum of rats from a translational perspective using a representative dose, assessing molecular, biochemical, morphological, and behavioral parameters. The model was produced by administering 40 µg/kg of MeHg for 60 days to adult male Wistar rats by oral gavage. As a result of this exposure, the animals presented motor deficits in open field and rotarod tests which were associated with an increase in total mercury content in cerebellar parenchyma, a reduction in antioxidant competence against peroxyl radicals, and increased nitrite and lipid peroxidation levels. The proteomic approach showed 317 modulated proteins. Such findings were associated with reductions in mature neuron and Purkinje cell densities and glial fibrillary acidic protein immunostained areas and increased microglial density. In addition, decreases in myelin basic protein and synaptophysin immunostaining were also observed. The results thus provided new evidence of the mechanisms underlying complex MeHg-induced neurodegeneration, especially the proteins underlying the biochemical and morphological features associated with motor dysfunction.

RESUMO

Methylmercury (MeHg) is the most common organic form of mercury (Hg) that humans are exposed and is considered an environmental pollutant. Several populations that live in endemic regions of MeHg exposure are subject to the toxicant for long periods, including pregnant women and children, causing damage to several organs during early periods of development. Alveolar bone is an essential structure for the oral cavity, responsible for supporting teeth and masticatory forces. However, evidence on the effects of MeHg on alveolar bone and the intrauterine and lactation period is lacking. Thus, this study aimed to investigate the effects of MeHg exposure during gestation and lactation on the developing alveolar bone of offspring rats after maternal exposure. Dams were exposed during 41 days of pregnancy and lactation, and the mandibles of the offspring were collected. The alveolar bone was analyzed by Fourier Transform Infrared Spectroscopy to evaluate the physicochemical composition; by Scanning Electron Microscopy for ultrastructural evaluation; by histopathological, histochemical, and morphometric for tissue analyses. In addition, bone quality was assessed by X-ray microtomography. MeHg exposure altered the mineral composition and caused histological damage associated with a lower quantity and thickness of bone trabeculae, as well as reduced osteocyte density and collagen fiber content. A reduction in trabecular thickness and bone volume and an increase in trabecular spaces were observed and were associated with anatomical compromise of the vertical bone dimensions. Thus, the results suggest that the developing alveolar bone is susceptible to the toxic effects of MeHg when organisms are exposed during intrauterine and lactation periods. From a translational perspective, these changes in the alveolar bone can help us understand possible abnormalities induced by toxic metals and highlight the need for care for structures other than those already seen as targets for damage triggered by environmental MeHg exposure.

Assuntos

RESUMO

Introdução: A educação inclusiva é um processo em constante movimento ao longo dos anos, seja por atualização das políticas públicas ou pela modificação de práticas que se desenvolvem no contexto escolar. Apesar destes avanços, muitas barreiras ainda se apresentam para que a inclusão escolar seja realmente efetiva. Sendo assim, a articulação da escola com profissionais como o terapeuta ocupacional é potente na promoção do desempenho ocupacional de alunos com necessidades educativas específicas. Objetivo: Entender de que maneira a intervenção do terapeuta ocupacional, com o professor de sala de aula regular, facilitou o processo de educação inclusiva em uma escola municipal. Resultados/Discussão: A partir da coleta de dados, percebeu-se que a maioria das demandas identificadas pelos participantes estavam relacionadas a alterações nas funções e estruturas do corpo, habilidades de desempenho e de interação social. As estratégias direcionadas aos professores envolveram tecnologia assistiva, orientações e adaptações curriculares. Observou-se como o trabalho colaborativo entre terapeuta ocupacional e docente é promotor da construção de possibilidades para melhorar o engajamento dos alunos incluídos nas atividades do cotidiano escolar. A percepção dos docentes sobre a atuação do terapeuta ocupacional confirma o que é indicado na literatura sobre a importância da sua atuação no contexto escolar. Considerações finais: De modo geral, os docentes se mostraram comprometidos com a pesquisa e acreditam que as estratégias contribuíram para a aprendizagem de alunos com necessidades educacionais especiais.(AU) Palavras-chave: Terapia Ocupacional. Inclusão Escolar. Consultoria Escolar. Necessidades Educativas Específicas

Introduction: Inclusive education is a process in constant movement over the years, either by updating public policies or by modifying practices that develop in the school context. Despite these advances, many barriers still exist for school inclusion to be effective. Thus, the articulation between the school and professionals such as occupational therapists is powerful in promoting the occupational performance of students with specific educational needs. Objective: To understand how the intervention of the occupational therapist with the regular classroom teacher facilitated the process of inclusive education in a municipal school. Results/Discussion: From the data collection, it was noticed that most of the demands identified by the participants were related to changes in body functions and structures, performance skills, and social interaction. Strategies aimed at teachers involved assistive technology, guidance, and curriculum adaptations. It has been observed how the collaborative work between occupational therapists and teachers its a promote the construction of possibilities to improve the engagement of students included in daily school activities. The teachers' perception about the role of occupational therapists confirms what is indicated in the literature about the importance of their role in the school context. Final considerations: In general, teachers were committed to the research and believed that the strategies contributed to learn of students with special educational need.(AU) Keywords: Occupational Therapy. Special Education. Collaborative Consulting. Special Educational Needs

Introducción: La educación inclusiva es un proceso en constante movimiento a lo largo de los años, ya sea mediante la actualización de las políticas públicas o modificando las prácticas que se desarrollan en el contexto escolar. A pesar de estos avances, aún existen muchas barreras para que la inclusión escolar sea realmente efectiva. Así, la articulación de la escuela con profesionales como los terapeutas ocupacionales es poderosa para promover el desempeño ocupacional de los estudiantes con necesidades educativas específicas. Objetivo: Comprender cómo la intervención del terapeuta ocupacional con el maestro de aula regular facilitó el proceso de educación inclusiva en una escuela municipal. Resultados / Discusión: A partir de la recolección de datos, se notó que la mayoría de las demandas identificadas por los participantes estaban relacionadas con cambios en las funciones y estructuras corporales, habilidades de desempeño e interacción social. Las estrategias dirigidas a los maestros involucraron tecnología de asistencia, orientación y adaptaciones curriculares. Se observó cómo el trabajo colaborativo entre terapeutas ocupacionales y docentes promueve la construcción de posibilidades para mejorar el involucramiento de los estudiantes incluidos en las actividades escolares diarias. La percepción de los docentes sobre el rol de los terapeutas ocupacionales confirma lo señalado en la literatura, sobre la importancia de su rol en el contexto escolar. Consideraciones finales: En general, los docentes estuvieron comprometidos con la investigación y creen que las estrategias contribuyeron al aprendizaje de los estudiantes con necesidades educativas especiales.(AU) Palavras claves: Terapia Ocupacional. Integración Escolar. Consultoría escolar. Necesidades educativas especiales

Assuntos

RESUMO

The environmental contamination by methylmercury (MeHg) is a major concern for public health. The effects of MeHg in the central nervous system (CNS) of adult animals have been extensively investigated; however, little is known about the effects of MeHg exposure during intrauterine and lactation periods on motor and cognitive functions of adolescent rats. Therefore, this study aimed to investigate the effect of MeHg exposure during intrauterine life and lactation on both motor and cognitive functions of offspring rats. Ten female Wistar rats were exposed to 40 µg/kg/day of MeHg through cookie treats from the first day of pregnancy until the last day of breastfeeding. Both motor and cognitive functions of offspring male rats were assessed by open field, rotarod, and step-down inhibitory avoidance tests. Forty-one days after birth, the hippocampus and cerebellum were collected to determine total Hg content, antioxidant capacity against peroxyl radicals (ACAP), reduced glutathione (GSH) levels, lipid peroxidation (LPO), and nitrite levels. MeHg exposure during CNS development increased Hg levels in both hippocampal and cerebellar parenchymas, triggered oxidative stress throughout ACAP and GSH decrease, increased LPO and nitrite levels. These alterations resulted in reduced spontaneous and stimulated locomotion and short- and long-term memory deficits. Therefore, damages triggered by MeHg exposure during intrauterine life and lactation had detrimental effects on oxidative biochemistry and motor and cognitive functions of offspring rats.

RESUMO

Methylmercury (MeHg) is one of the most dangerous toxic pollutants spread throughout the earth. Chronic MeHg intoxication by contaminated food ingestion is the most common threat to human health, including impairment to the developing fetus. The present study aims at investigating the effects of maternal exposure to MeHg during gestation and lactation on the spinal cord of offspring. Pregnant rats received oral doses of MeHg (40 µg/kg/day) over a period of 42 days (21 gestation and 21 lactation). Control animals received the vehicle only. Total mercury concentration was measured in blood samples from offspring collected at the 41st postnatal day. Counting of motor neurons and immunoreactivity for myelin basic protein (MBP) were assessed in the spinal cords in both control and MeHg-intoxicated animals. Our results showed that MeHg promoted an increase in blood Hg levels. In addition, it caused a reduction in the number of spinal cord motor neurons as well as decreased MBP immunoreactivity in the cervical, thoracic and lumbar segments. Our present findings suggest that MeHg intoxication during rat pregnancy and lactation is associated with a pattern of motor neuron degeneration and downregulation of myelin basic protein in different segments of a developing spinal cord. Further studies are needed to establish the effect of MeHg intoxication in both young and adult rats.

Assuntos

RESUMO

OBJECTIVE: The objective of this study was to analyze the association between orthostatic changes in blood pressure and mortality in elderly cardiopath patients. METHODS: A cohort of 455 elderly cardiopath patients, monitored at a referral outpatient cardiology clinic in Pernambuco, Brazil, from October 2015 to July 2018. The exposure groups were formed according to their orthostatic changes in blood pressure following the requirements of the Brazilian Guidelines for Hypertension. RESULTS: Orthostatic hypotension was present in 46 patients (10.1%), 91 had orthostatic hypertension (20%), and 318 had no orthostatic alterations (69.9%). There were 52 deaths during follow-up. The results demonstrated that there was no statistically significant association between orthostatic hypotension and overall mortality (HR 1.30; 95%CI 0.53-3.14; p=0.567) nor between orthostatic hypertension and overall mortality (HR 0.95; 95%CI 0.65-1.39; p=0.34). Survival in relation to the exposure groups presented no statistically significant difference (p=0.504). CONCLUSION: There was a low frequency of orthostatic hypotension and a mild high frequency of orthostatic hypertension when compared with previous studies, and no association was observed with overall mortality or with the survival time of elderly patients with heart disease.

Assuntos