Rodrigo Roger Vitorino

Sepse: atualidades e perspectivas

This paper aims to provide an update on the main aspects of sepsis, a very relevant health care issue. A number of hypotheses have been proposed to explain its origin, involving interactions between microorganisms and the innate immune system, inflammation/immune mediation and the coagulation system. The clinical features of sepsis are variable and depend on the primary site of infection. The identification of early signs and symptoms is crucial for starting therapeutic measures fundamentally based on volume resuscitation, antibiotic therapy, use of steroids, anticoagulant therapy, biologic viability maintenance interventions and nutritional support.

Malária grave por Plasmodium falciparum

A malaria e uma das principais doencas parasitarias do mundo, acometendo importante contingente de pessoas. Por seu alcance epidemiologico e pela possibilidade de desenvolvimento de quadros graves - quase sempre devidos ao Plasmodium fqalciparum -, se faz necessario o conhecimento adequado de suas manifestacoes clinicas e da terapeutica, para otimizacao da conduta. Na malaria grave a internacao em unidade de terapia intensiva e mandatoria para reducao das complicacoes decorrentes da infeccao. O inicio do tratamento deve ser o mais precoce possivel, o qual tem impacto na sobrevida do paciente, e e baseado na combinacao de drogas antimalaricas e medidas de suporte. Neste âmbito, o presente artigo destina-se a discussao da forma grave da malaria por P. falciparum, com enfase no quadro clinico e no tratamento

Formação Médica na Estratégia de Saúde da Família: Percepções Discentes

Given current social demands, it has become essential for medical education to break from the traditional model of biological reductionist and training based only at hospitals and redefine itself towards a holistic care (integrality). The construction of new training practices in health with the use of new outdoor scenarios, in partnership with (Unified National Health System — SUS), assumed a key role. In 2005 the Centro Universitario Serra dos Orgaos (Unifeso) incorporated into its curriculum the Problem-Based Learning and the insertion of medical undergraduates into Basic Health Units Family. This paper describes the perception of medical students in this scenario. We conducted a qualitative research working from the application of interviews and the utilization of thematic analysis of responses with the creation of categories. The results show the combination of positive impressions — integration between theory and practice — and negative — problems in the organization of activities, as well as the necessity to identify a local preceptor. A plan is proposed, guided by the new Directives, for teaching in the primary health care in the context of the condition of integrality.

Atualidades proteômicas na sepse

The increased knowledge regarding proteomic analysis techniques has allowed for better understanding of the molecular bases related to the identification of cell signaling, modifying protein, and post-translational modification pathways, in addition to the characterization of specific biological markers. Thus, documenting certain proteins expressed in sepsis is a promising approach to elucidate pathophysiological, diagnostic, therapeutic, and prognostic aspects in this condition with a purpose of applying them to clinical practice. Although the studies are still preliminary, proteomics may offer good benefits for the better management of septic patients. Thus, this article aims to introduce a short review of the applications of proteomic studies to sepsis.

Proteomic updates on sepsis.

The increased knowledge regarding proteomic analysis techniques has allowed for better understanding of the molecular bases related to the identification of cell signaling, modifying protein, and post-translational modification pathways, in addition to the characterization of specific biological markers. Thus, documenting certain proteins expressed in sepsis is a promising approach to elucidate pathophysiological, diagnostic, therapeutic, and prognostic aspects in this condition with a purpose of applying them to clinical practice. Although the studies are still preliminary, proteomics may offer good benefits for the better management of septic patients. Thus, this article aims to introduce a short review of the applications of proteomic studies to sepsis.

Biology of Trypanosoma cruzi: An update

Chagas disease, an illness caused by the protozoan Trypanosoma cruzi, is clinically and epidemiologically important in Latin America, and particularly in Brazil. This article presents the main biological characteristics of Trypanosoma cruzi, emphasizing ultrastructural, morphological, evolutionary, transcriptomic, and proteomic aspects. With this purpose a literature review was conducted, which allowed for the construction of different sections of the text. The efforts to expand the knowledge of this protist biology may bring positive implications for the understanding of the pathogenesis, control, and above all, treatment of patients affected by this disease.

Linfócitos T CD4+CD25+ e a regulação do sistema imunológico: perspectivas para o entendimento fisiopatológico da sepse

The systemic inflammatory response represents the core pathogenic event of sepsis, underlying clinical manifestations and laboratory findings in patients. Numerous studies have shown that CD4+CD25+ T lymphocytes, also known as regulatory T lymphocytes (Treg), participate in the development of sepsis due to their ability to suppress the immune response. The present article discusses the role of Treg lymphocytes in sepsis based on a specific search strategy (Latin American and Caribbean Health Sciences / Literatura Latino-americana e do Caribe em Ciencias da Saude - LILACS, PubMed, and Scientific Electronic Library Online - SciELO) focusing on two main topics: the participation of Treg cells in inflammation and immunity as well as perspectives in the computational physiological investigation of sepsis.

As redes neurais artificiais e o ensino da medicina

The transformations that medical practice has undergone in recent years - especially with the incorporation of new information technologies - point to the need to broaden discussions on the teaching-learning process in medical education. The use of new computer technologies in medical education has shown many advantages in the process of acquiring skills in problem solving, which encourages creativity, critical thinking, curiosity and scientific spirit. In this context, it is important to highlight artificial neural networks (ANN) - computer systems with a mathematical structure inspired by the human brain - which proved to be useful in the evaluation process and the acquisition of knowledge among medical students. The purpose of this communication is to review aspects of the application of ANN in medical education.

Probable chronic renal failure caused by Lonomia caterpillar envenomation

Erucism is a skin reaction to envenomation from certain poisonous caterpillar bristles. In Brazil, most reports of erucism provoked by Lonomia caterpillars are from the southern region. Most manifestations of erucism are local and include burning pain, itching, local hyperthermia and, rarely, blisters (benign symptoms with spontaneous regression in a few hours). General symptoms such as nausea and vomiting, headache, fever, myalgia, abdominal pain and conjunctivitis may also occur. Uncommon symptoms include arthritis, coagulation disorders (manifested as bruising and bleeding), intracerebral hemorrhage and acute renal failure, which comprise serious complications. The present study reports the case of 60-year-old patient from Rio de Janeiro state, Brazil, who came into contact with a caterpillar and developed, a few days later, chronic renal disease.

Visceral Leishmaniasis: A Brazilian Perspective

Objective: The scope of this paper is to present the main aspects related to the causative agent of visceral leishmaniasis and implications of this interaction with the human host, allowing the improvement of health care actions. Methods: The paper was put together based on a literature review with a defined search strategy. To obtain the articles we consulted the Scientific Electronic Library Online (SciELO) and the U. S. National Library of Medicine (PubMed). Results: The leishmaniases are a group of diseases that pose a serious public health problem in at least 88 countries, and are included among the six priority endemic diseases in the world, according to the World Health Organization (WHO). In this scenario the visceral form stands out kala-azar (visceral leishmaniasis) which, despite its endemic nature, has been reported in different areas of Latin America associated with the process of expansion and urbanization, as well as the unchecked deforestation. Conclusion: The importance of this discussion of the clinical and diagnostic aspects of VL relates particularly to delayed diagnosis of cases by professionals unfamiliar with the disease – which is becoming quite common due to the intense flow of people in the world resulting in the delayed initiation of therapy.