João José Batista de Campos

A Saúde Coletiva no curso de Medicina da Universidade Estadual de Londrina: reflexões iniciais

This qualitative study aims analyzing to which extent collective health is approached in the curriculum of the graduate course in medicine of the UE with special attention to the viewpoint of managers, professors and students regarding the teaching-learning process. To this purpose, four managers, four professors and a focal group of students were interviewed. The results revealed an important commitment of the teaching body in this area to the net of health services. However, internship and the teaching strategies in use apart, the subjects making part of this field participate with only 5% in the current curriculum. It was concluded that the professors of the Community Health Department have always held a vanguard position with regard to promoting changes in the medical course of the UEL and that there are strong efforts towards using the reality of the health services in Londrina as an articulating axle in the teaching of collective health so as to educate practitioners with greater awareness of the reality and commitment to the Unified Health System.

Perfil de pacientes diabéticos tipo 1: insulinoterapia e automonitorização

OBJECTIVES: A study carried out in Londrina - PR, with the cohort of local patients from Brazilian Study on the incidence of Diabetes Mellitus Type 1 (EDID). To know the insulin treatment and the plan for glycemic self-monitoring used by these patients; to verify their knowledge as for what they consider the optimization of these parameters and limitations of use.METHODS: A survey was conducted with objective questions to 63 patients of the cohort.RESULTS: The average age was 13 years, without gender predominance. It was verified that most of the patients, 79.36%, (n=50) took at least 2 daily applications of insulin. All of them used insulin NPH in one (n=13) or two (n=50) doses. The use of regular insulin, in variable programs, was associated to the NPH in 41.27% (n=26) of the patients (The most frequent insulin type used was human 53.97% (n=34). Of the patients not making use of human insulin, 44.83% (n=13) considered it of high cost and 95.24% (n=60) would make use of it if it was distributed by the Government Unified Health System. As for the monitoring, 63.40% (n=40) took the tests up to 7 times a week, 20.63% (n=13) from 15 to 21 and only 1 patient from 29 to 35 tests. The high cost was the reason for 48.21% (n=27) not to take the tests; 58.73% (n=37) would take the test in the blood and 33.33% (n=21) either in the blood or in the urine if they were given the reactive ribbons.CONCLSION: In this cohort of patients, although the human insulin is already adopted as the use of choice, the outline insulin treatment plan is still traditional and the monitoring is far behind the ideal.

Early Bird Assemblages under Different Subtropical Forest Restoration Strategies in Brazil: Passive, Nucleation and High Diversity Plantation:

Ecological restoration encourages management for the complexity and heterogeneity of habitats, which are crucial for avian fauna structure. Two-year-old bird assemblages were evaluated based on diversity parameters of three different ecological restoration technologies applied in southern Brazil: passive restoration (PR), nucleation (NC) and high diversity plantation (HD). Richness, abundance and diversity were compared using ANOVA factorial design (three treatments × four seasons, with six samplings per season). The highest richness was observed for NC (49 ± 2.45 SD species) and the lowest richness occurred in the HD treatment (37 ± 3.14 SD species), with a similar statistical pattern for abundance and diversity (NC>PR>HD). NC responded favorably to the hypotheses of dynamic equilibrium, heterogeneity and habitat complexity, which are the probable mechanisms that influence primarily assemblage richness. Due to the presence of exclusive species for each treatment, we recommend the application of a mix of the different techniques tested to maximize the number of habitats and their interactions with birdlife.

Teaching public health in undergraduate medical courses: a case study in three universities in Paraná.

CONTEXT AND OBJECTIVE Historically, different concepts of public health have influenced both the specific teaching in this field and its participation in general physician training. Starting from this assumption, the objective of this paper was to study how public health has been taught in undergraduate medical courses, focusing on structure and on how this has affected curriculum design in three universities in the State of Paraná, Brazil. DESIGN AND SETTING Qualitative investigation developed at Universidade Federal do Paraná (UFPR), Universidade Estadual de Londrina (UEL) and Universidade Positivo (UnicenP). METHODS This study included a documentary analysis on pedagogical projects and on how these are actually experienced by those working on them. Eleven managers and 18 teachers were interviewed, as well as four groups of students that were formed in the three medical courses. RESULTS Between 5 and 20% of Public Health topics were shown to be included in the curriculums, depending on the teaching strategies used. However, they were always set up within academic approaches that were strongly linked to healthcare services. This situation has been strengthened through the degree of progress made by the National Health System (Sistema Unico de Saúde, SUS) in both cities (Curitiba and Londrina). CONCLUSIONS Regardless of the nature of the university, the administrative and academic setup of the course and of the different ways of incorporating teachers, Public Health is present and takes on considerable relevance for medical training, even if it does not constitute a linking thread within undergraduate medical courses.

Endoscopic ultrasound in the diagnosis of foreign bodies of the colon and rectum

Although the ingestion of foreign bodies is a common clinical problem, severe complications such as perforation are rare and occur in less than 1% of cases. Different types of foreign bodies and the various affected regions within the gastrointestinal tract make foreign body ingestion a complex entity, with a wide range of presentation requiring different diagnostic modalities. We report two cases of patients who underwent endoscopic ultrasound for evaluation of sub-epithelial lesions consisting of foreign body granulomas in the colon and rectum. Colorectal foreign body granuloma is a rare complication after accidental ingestion. Endoscopic ultrasound can be a useful diagnostic tool and can avoid the need for more invasive procedures.

Ultrasonographic Diagnosis of Schistosoma mansoni Eggs in Rectum

Schistosomiasis is a trematode infection endemic in more than 70 countries that affects an estimated 250 million people. We report the case of a 60-year-old healthy female referred for endoscopic ultrasound after rectal examination revealed granular lesions. Ultrasound revealed the presence of deep mucosal nodular lesions with calcified/hyperechoic inclusions. Histologic evaluation has confirmed the final diagnosis of chronic schistosomal colitis. In patients with nonspecific intestinal lesions without a suspected diagnosis of schistosomiasis, endoscopic ultrasound can be enlightening. Schistosomiasis is still an endemic infection in some parts of Brazil and other tropical regions, causing colorectal lesions with unspecific presentation.