Carnival in Brazil as production of health care: narratives from a samba school community

Introduction

Carnival is a popular festival that was introduced in Brazil from the European heritage. However, it was the enslaved African people who saw forms and processes of resistance for the construction of identity during this festive period. The reframing and resistance that blacks establish with carnival is the result of a cultural need to stay alive both as a subject and as a collective. This is how samba schools emerge in the urban peripheries of Rio de Janeiro as a form of artistic, cultural and leisure production. Associations acquire for themselves the role of the State in providing access to rights that many are denied, neglected or scrapped. In these schools, it is possible to observe a relationship of belonging and donation (”principle of gift”) on the part of their so-called community, they are passions and meanings that produce relationships of self-care reaffirmation of intersubjectivity.

Objective

This work aims to identify the carnival as a space for the production of projects, resistances and protagonisms and to analyze the meanings of the subjective processes of health, disease, care and carnival, through the narratives of a samba school community.

Methodology

This is an exploratory analysis of a qualitative approach in public health. A samba school was chosen from the special group of the capixaba carnival, which is located in a peripheral region. We will use it to define snowball technical sampling. The data will be collected through semi-structured interviews and on-site observations by the researcher. The data analysis methodology used will be discourse analysis.

Expected Results

It is expected to understand the different practices and processes of health, disease, care and carnival, among a peripheral community that is part of a samba school.

Key messages

This work aims to analyze health care about a cultural aspect of marginalized populations and how health policies are related to carnival. Impact on the production of knowledge about popular culture and health.

Care for women in a situation of violence: an institutionalist look

Objective

To know the dynamic processes that involve the production of care for women in situations of violence.

Methods

Study of qualitative approach and cartographic inspiration based on the theoretical reference of Institutionalism that had as scenario a reference center for women in domestic violence located in Espírito Santo, Brazil. Six professionals who worked directly in the care of women participated in the research. Interventions were carried out, through seven workshops, using storytelling. The material production tools were narratives, the researcher's field diary and the collective field diary, which was built from the record and observation of all the participants in the study. The workshops were held at the center according to the availability of participants and lasted an average of 60 minutes. The meetings were recorded and later transcribed together with the notes of the field diaries, seeking, through a cartography, to give meaning to the experiences lived by the participants. Through the analysis of implication, it was possible to give visibility to the various relationships that constitute a certain reality, in which the researcher is involved.

Results

The study pointed out that violence crosses all women influencing the production of care offered by professionals at the reference center. The narratives multiplied senses contributing to the problematization of the care offered, providing the qualification of other ways of thinking/acting in health.

Conclusions

From an ethical-aesthetic-political paradigm it is possible to produce reflections that broaden the view of care for women in violent situations beyond biological issues, contributing with desirable productive processes in the prevention of violence and the promotion of health.

Key messages

It gives visibility to micropolitical processes and contributes to the construction of policies for women's health capable of welcoming differences and singularities. It shows innovation for the field of qualitative health research, broadening the view on the care of women in situations of violence beyond biological issues.

The access to complementary and integrative health practices in public health system in Brazil

Background

A qualitative and exploratory study that analyzed the perspective of access to Integrative and Complementary Practices in Health (PICS) by listening users from a selected service of primary care of a municipality.

Objective

Analyze the access to PICS in a health public service of a municipality in a state of Brazil, from the perspective of users, as well as aimed at understand the needs and desires of health care these users in the search process and use of PICS, identifying facilitators and barriers in this trajectory.

Methods

The theoretical reference from Frenk on access was used, which systematizes the flow of events at the moment when the health need is perceived until the effectiveness of the care, besides the demand and entrance in the health services and the continuity of the treatment. The data collection was done by participant observation and semi-structured interview with 29 users of the service. The narratives were worked through the analysis of thematic content.

Results

The results indicated two groups of PICS: complex medical systems and therapeutic resources. There were differences in the organization of the offer with consequent influence on the different forms of access. It was registered the interest for the use of health care in a non-biomedical logic and a re-signification of the health-disease process in PICS users, contributing to the continuity of health production.

Conclusions

It was concluded that the current models of access analysis do not contemplate the diversities of access to the PICS, and the various possibilities of encounters with these practices allow the identification of the marginality of this care in all cases analyzed.

Key messages

Integrative and Complementary Health Practices gain national relevance as they contribute to the development of health promoting activities, focus on the individual, prevention and comprehensive care. However, considered a controversial topic in a hegemonically biomedical scenario, the incorporation of these new knowledge and practices in the health field occurs in a marginal way.

Hybrid triad provides fracture plane stability in a computational model of a Pauwels Type III hip fracture

The study utilized finite element method to determine displacements and stresses in a set of Pauwels Type III femoral neck fractures repaired using 3 techniques (cannulated screws (Triad), sliding hip screw (SHS), and a Hybrid (SHS + cannulated screws). The research found that shear displacement doubled between the 65° and 75° fracture angles regardless of fixation construct. The SHS alone was the least stable construct, with highest construct stresses and shear displacement along the fracture plane. The stability of the Hybrid and Triad constructs were similar, but stress in the Hybrid was lower suggesting it would provide a higher load to failure than the Triad.

Occipital blood-brain barrier permeability is an independent predictor of visual outcome in type 2 diabetes, irrespective of the retinal barrier: A longitudinal study

Blood-brain barrier (BBB) permeability in type 2 diabetic patients has been previously shown to be altered in certain brain regions such as the basal ganglia and the hippocampus. Because of the histological and functional similarities between the BBB) and the blood-retinal barrier (BRB), we aimed to investigate how the permeability of both barriers predicts visual outcome. We included 2 control groups (acute unilateral stroke patients, n = 9; type 2 diabetics without BRB leakage n = 10) and a case study group of type 2 diabetics with established BRB leakage (n = 17). We evaluated sex, age, disease duration, metabolic impairment, retinopathy grade and BBB permeability as predictors of visual acuity at baseline, 12  and 24 months in the type 2 diabetics without BRB leakage group and the case study group. We have also explored differences in BBB permeability in the occipital lobe and frontal lobe in the 3 different groups. K^trans (volume transfer coefficient) and V_p (fractional plasma volume) were estimated. The BBB permeability parameter V_p was higher in the case study group compared to the unaffected hemisphere of the stroke patient control group, suggesting vascular dynamics were changed in the occipital lobe of type 2 diabetics with established BRB leakage. These patients showed a significant correlation between glycated hemoglobin (HbA1C) levels and occipital and frontal K^trans . We report for the first time that occipital BBB permeability is an independent predictor of visual acuity at baseline, as well as at 12 and 24 months, in type 2 diabetics with established BRB leakage. Our results suggest that occipital BBB permeability might be an independent biomarker for visual impairment in patients with established BRB leakage.

BioCode gold-nanobeacon for the detection of fusion transcripts causing chronic myeloid leukemia

BACKGROUND

Gold-nanobeacons (Au-nanobeacons) have proven to be versatile systems for molecular diagnostics and therapeutic actuators. Here, we present the development and characterization of two gold nanobeacons combined with Förster resonance energy transfer (FRET) based spectral codification for dual mode sequence discrimination. This is the combination of two powerful technologies onto a single nanosystem.

RESULTS

We proved this concept to detect the most common fusion sequences associated with the development of chronic myeloid leukemia, e13a2 and e14a2. The detection is based on spectral shift of the donor signal to the acceptor, which allows for corroboration of the hybridization event. The Au-nanobeacon acts as scaffold for detection of the target in a homogenous format whose output capability (i.e. additional layer of information) is potentiated via the spectral codification strategy.

CONCLUSIONS

The spectral coded Au-nanobeacons permit the detection of each of the pathogenic fusion sequences, with high specificity towards partial complementary sequences. The proposed BioCode Au-nanobeacon concept provides for a nanoplatform for molecular recognition suitable for cancer diagnostics.

A Sensitive and Selective Label-Free Electrochemical DNA Biosensor for the Detection of Specific Dengue Virus Serotype 3 Sequences

Dengue fever is the most prevalent vector-borne disease in the world, with nearly 100 million people infected every year. Early diagnosis and identification of the pathogen are crucial steps for the treatment and for prevention of the disease, mainly in areas where the co-circulation of different serotypes is common, increasing the outcome of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Due to the lack of fast and inexpensive methods available for the identification of dengue serotypes, herein we report the development of an electrochemical DNA biosensor for the detection of sequences of dengue virus serotype 3 (DENV-3). DENV-3 probe was designed using bioinformatics software and differential pulse voltammetry (DPV) was used for electrochemical analysis. The results showed that a 22-m sequence was the best DNA probe for the identification of DENV-3. The optimum concentration of the DNA probe immobilized onto the electrode surface is 500 nM and a low detection limit of the system (3.09 nM). Moreover, this system allows selective detection of DENV-3 sequences in buffer and human serum solutions. Therefore, the application of DNA biosensors for diagnostics at the molecular level may contribute to future advances in the implementation of specific, effective and rapid detection methods for the diagnosis dengue viruses.

Examination Portability

Truly global radiology would exist if patients could visit any European physician without their CDs or films. It would be possible for patients to go to a hospital or a clinic in any European country and have their examinations done in a different country, analyzed and eventually compared with the examination done at that hospital. This paper analyzes two national projects that should be documented and analyzed: Scotland with a national archive with radiology images and Finland which is implementing a system that will create an online personal health record of the citizen with all health-related information. This possibility would improve quality in European radiology and create a true network of images and knowledge that can be the seed to improve efficiency by reducing costs and exposure to radiation and increasing knowledge sharing among European radiologists/neuroradiologists. We present here the idea of a network between three centers in three different countries that can be the start for a global project.

The Brain-Heart Connection in Mitochondrial Respiratory Chain Diseases

Mitochondrial respiratory chain disorders (MRCD) are a heterogeneous group of diseases leading to an inadequate production of ATP. Brain and heart are among the most affected organs. Thus far, no specific relationship has been found between specific affected areas in the central nervous system and cardiac involvement. This study investigated the relationship between specific brain involvement and heart disease in mitochondrial disorders. We hypothesize that specific areas of brain lesions in children with MRCD are more frequently correlated to heart disease than others. A retrospective evaluation of the clinical records of 63 children with a definite MRCD, was performed searching for heart disease, namely, dilated and hypertrophic cardiomyopathy and arrhythmia. Brain MR images were evaluated and characterized regarding specific areas of atrophy and involvement. These findings were correlated using the Fischer exact test whose strength was determined with the Phi coefficient. During the period analyzed, 13 children (20.6%) developed cardiac disease, of whom nine (14.3%) exhibited isolated cardiomyopathy, one (1.6%) exhibited arrhythmia and three both. The main MRI abnormalities observed were brain atrophy (65.1%) and among this group 17.5% of subjects had cerebellar involvement. In addition, supratentorial, cerebellar and brainstem white and grey matter lesions were also found. There was a statistically significant relationship between progression to cardiac disease and cerebellar atrophy (Fisher's Exact Test −0.005 and Phi 0.394) and lesions in the cerebral peduncles (0.035/0.358). Moreover, there was an additional correlation between thalamic lesions and progression to hypertrophic myocardiopathy (0.029/0.397). A statistical relationship between thalamic, mesencephalic and cerebellar involvement and cardiac disease in children with definite MRCD was observed. The true significance of this connection warrants further assessment.

Anatomic evaluation of the membranous labyrinth by imaging: 3D-MRI volume-rendered reconstructions

OBJECTIVES

Recent advances in magnetic resonance imaging (MRI) technology has allowed the development of imaging sequences tailored to the assessment of minute anatomic detail of the temporal bone structures. Volume Rendering (VR) is a 3D rendering method used in MRI. It helps in understanding complex anatomic conditions and is particularly useful in the evaluation of tiny structures as the membranous labyrinth. The authors aimed at verifying the contribution of VR in the study of labyrinthine pathology in view of all the possible anatomic correlation.

MATERIAL AND METHODS

We performed 3D T2-weighted FSE MRI at 1.5 T with a dedicated surface coil, at high resolution (0.5 mm partition). All selected patients were volunteers and unknown for temporal bone pathology.

RESULTS

The anatomy of the cochlea and vestibule were clearly defined. We could distinguish components of the cochlea to the level of the scala tympani, the vestibule and the cochlear duct. The saccule, utricle, endolymphatic duct and sac, and semicircular canals were also distinguished.

CONCLUSION

Volume reconstructions yielded excellent spatial information regarding the cochlea, vestibule, semicircular canals and all three ampullae. Maximum Intensity Projection (MIP) images are useful as a preliminary study, to show eventual inner acoustic canal pathology and to provide information with the use of contrasting agents. We conclude therefore that VR seems to be essential in evaluating labyrinthine anatomy and pathology. Our results suggest that improved diagnostic information can be obtained by applying this volume visualization reconstruction technique in all inner ear neuroradiological protocols.

Nasal septum perforation as the presenting sign of lupus erythematosus

Nasal septum perforation is an uncommon and not well known feature of lupus erythematosus (LE). In general, it occurs during exacerbations and in a context of systemic vasculitis. Very rarely it can be a presenting sign, accompanying more usual manifestations of LE. We report the case of a 30-year-old woman who presented with a 2-year history of painful, slowly progressive nasal septum perforation. Laboratory study disclosed positive antinuclear antibodies, circulating immune complexes, hypocomplementemia, nuclear epidermal deposition of IgG in normal skin and transitory positive antiphospholipid antibodies. Symmetric peripheral joint arthritis, photosensitivity and diffuse alopecia subsequently developed. This case seems unique in that the nasal septum perforation occurred as an isolated presenting sign; it emphasizes the value of this feature in the diagnosis of LE.

Genome analysis of dengue type-1 virus isolated between 1990 and 2001 in Brazil reveals a remarkable conservation of the structural proteins but amino acid differences in the non-structural proteins

We have investigated the genetic diversity of dengue type-1 (DEN-1) virus in Brazil. The full nucleotide sequences of three DEN-1 virus isolated from DEN fever (DF) and DEN hemorrhagic fever patients in northeastern Brazil in 1997 (BR/97) and one from a DF patient in the south of Brazil in 2001 (BR/01) were compared to that of the reference strain BR/90 obtained in the city of Rio de Janeiro in 1990. Sequence analysis showed that the structural proteins were remarkably conserved between all isolates. A total of 27 amino acid changes occurred throughout the non-structural proteins. Among them, nine amino acid substitutions were specific of BR/97 and BR/01 isolates, indicating that in situ evolution of these strains had occurred. Within the BR/97 and BR/01 samples, some amino acid substitutions have been previously identified in DEN-1 virus strains sequenced so far, suggesting that recombination events might have occurred.

Adolescents and school asthma knowledge and attitudes

INTRODUCTION

bronchial asthma is a chronic disease that affects a high percentage of adolescents, with a significant restriction of daily activities, and is a cause of school absenteeism. The relationships between adolescents and asthma disease in school were assessed, with a view to improving knowledge about the asthmatic adolescent.

METHODS

a survey was conducted in the Lisbon metropolitan area, covering urban (Lisbon) and rural (LourinhU a ) zones and including 1879 students and 81 teachers from the 7th to 9th high school years. The study groups were asthmatic students, their peers, and teachers. A self-administered questionnaire was applied to collect information. The results were compared with a reference group of 91 asthmatic students attending our Department of Immunoallergy-Hospital Dona Estefânia. Cotinine urinary measurements were made in a sample of asthmatics and a control group.

RESULTS

the prevalence of current asthma among students was 10%. Estimates of asthma annual burden among 7th to 9th year students from Lisbon and LourinhUa high schools included 4,307 days missed from school, 4,148 medical consultations and a minimum of 351 hospital emergency care and 80 hospital admissions. Exposure to passive smoking was not significantly different between asthmatic students and theirs peers. Cotinine urinary measurements did not discriminate between exposed and non-exposed individuals. Cigarette smoking was almost as common among adolescent asthmatics (5.4%) as it was in non-asthmatic subjects (6.7%). However, 55% of asthmatics mentioned active and passive smoking as an asthma-exacerbating factor. Asthmatic students, theirs peers and teachers showed a deficient knowledge about asthma (mean group scores: 17.6; 14.2 and 17.7 of a possible 30), particularly in the areas related to asthma recognition and its management. Asthmatics attending our Allergy Department had the highest scores. All groups showed tolerance in the sense of a positive and understanding attitude toward a person with asthma. However, traditional beliefs about asthma disease (dependence, inferiority.) were confirmed. A positive correlation between knowledge levels and tolerance attitudes was found.

CONCLUSION

in view of the dimension of the asthma problem in adolescence and its social and economic impact, it is justifiable to assess the need for the implementation of asthma education programs in schools in order to improve asthma management by the adolescents and their schools.

RT-PCR based diagnosis and molecular characterisation of mumps viruses derived from clinical specimens collected during the 1996 mumps outbreak in Portugal

Clinical specimens collected during an outbreak of mumps were characterised by RT-PCR, nested PCR, and nucleotide sequencing. Mumps virus was positively identified in 12/21(57%) saliva, 9/21(43%), throat and 1/33(3%) urine specimens and further sequence comparison revealed that at least six strains of viruses, which differed from 0-9.43% at the nucleotide levels, were cocirculating during the epidemic. However, phylogenetic analysis showed that these viruses grouped with two previously identified lineages which were mostly composed of other European mumps virus isolates.

[Health care delivered to Portuguese children. The past, present and new challenges]

The socio-economic development of a country as well as the state of its health, its communications network, cultural level and health care organisation together affect what is known as the health indicators. Portugal belongs to the group of UNICEF countries with the best indicators in what concerns infant mortality and death below the age of five. It is still, however, 25th and 28th respectively at world level. The authors review some of the factors which have most contributed towards the progress of the indicators over the last twenty years, namely, the role played by general practitioners, the creation of health centers, the development of a maternal-infant assistance programme and the activity of Central and District Hospitals. They analyse the recent maternal-infant programme and discuss the main short and mid-term problems in the perinatal and paediatric age groups. The socio-economic changes seen in Portuguese society, together with sociological changes and those observed in the field of pathology, call for a new approach in the organisation of care which includes the need for a new dialogue between the different health structures of a society, namely, through maintaining the functional coordinating maternal-infant units, the creation of the same units for paediatrics, new efforts by the general paediatrician, the community paediatrician and the sub-specialised paediatrician together with the general practitioners within a specific action programme of a Health Unit.

Dicaffeoylquinic acid inhibitors of human immunodeficiency virus integrase: inhibition of the core catalytic domain of human immunodeficiency virus integrase

Integration of a cDNA copy of the human immunodeficiency virus (HIV) genome is mediated by an HIV-1-encoded enzyme, integrase (IN), and is required for productive infection of CD4+ lymphocytes. It had been shown that 3,5-dicaffeoylquinic acid and two analogues were potent and selective inhibitors of HIV-1 IN in vitro. To determine whether the inhibition of IN by dicaffeoylquinic acids was limited to the 3,5 substitution, 3,4-, 4,5-, and 1,5-dicaffeoylquinic acids were tested for inhibition of HIV-1 replication in tissue culture and inhibition of HIV-1 IN in vitro. All of the dicaffeoylquinic acids were found to inhibit HIV-1 replication at concentrations ranging from 1 to 6 microM in T cell lines, whereas their toxic concentrations in the same cell lines were > 120 microM. In addition, the compounds inhibited HIV-1 IN in vitro at submicromolar concentrations. Molecular modeling of these ligands with the core catalytic domain of IN indicated an energetically favorable reaction, with the most potent inhibitors filling a groove within the predicted catalytic site of IN. The calculated change in internal free energy of the ligand/IN complex correlated with the ability of the compounds to inhibit HIV-1 IN in vitro. These results indicate that the dicaffeoylquinic acids as a class are potent and selective inhibitors of HIV-1 IN and form important lead compounds for HIV drug discovery.

Mumps epidemic in Portugal despite high vaccine coverage - preliminary report

A measles, mumps, and rubella (MMR) trivalent vaccine was added to Portugal's National Immunisation Programme (NIP) in 1987. All vaccines are given at health centres, free of charge, but an epidemic of mumps began in 1995, firstly in northern Portugal and

Heterochromatic chromosomes and satellite DNAs of Drosophila nasutoides

Drosophila nasutoides is distinguished from other Drosophila species in that the metaphase karyotype shows a pair of very large V-shaped chromosomes. With Giemsa, a distinctive C-banding pattern is revealed along the arms of this large chromosome, indicating a largely heterochromatic nature. Furthermore, the banding patterns of the arms are symmetrical, indicating that it is an iso-chromosome. A comparison between the metaphase karyotype and polytene chromosomes suggests that the large V chromosome appears as the dot chromosome in polytene squash. One autosome has twice the arm length of typical Drosophila polytene chromosomes and arose either by centric fusion and a pericentric inversion, or by translocation connecting distal ends with a subsequent loss of one centromere. This chromosome appears to have a short arm which ectopically pairs with the proximal region of the long arm, representing a duplication of about ten bands. When the nuclear DNA is examined by neutral CsCl gradient, four satellites are observed. As much as sixty percent of the total DNA appears as satellites in the lysate of larval brains. No satellite was detectable in the lysate of salivary glands. These observations led us to suggest that the heterochromatic nature of the large V chromosome is due to the presence of all four satellites in this chromosome and that this large chromosome appears as the dot because of the under-reduplication of the satellites during polytenization.