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Resumo Com o crescente número de terapeutas ocupacionais atuantes no Sistema Único de Assistência Social (SUAS), amplia-se a necessidade por processos formativos que desenvolvam criticamente a atuação profissional neste campo. A partir desta demanda formativa foi criado, em outubro de 2020, um projeto de extensão intitulado "Comunidade de práticas em terapia ocupacional no SUAS: articulação profissional e construção de estratégias", com o intuito de promover trocas de conhecimento e experiências entre terapeutas ocupacionais trabalhadoras em unidades socioassistenciais. Neste artigo se apresentam as possibilidades e os limites do trabalho no SUAS sob o ponto de vista de terapeutas ocupacionais que nele atuam e que foram participantes da Comunidade de Práticas, analisando se e como suas ações profissionais têm se relacionado com a fundamentação teórico-metodológica da terapia ocupacional social. Para isso, foi revisitado todo o material de registro produzido nos dois ciclos do projeto, efetivados de outubro de 2020 a julho de 2021. As informações extraídas das atas foram organizadas em um quadro que agrupou as temáticas encontradas. A análise dos dados revelou dois principais aspectos que possibilitam a correlação das ações das profissionais com a fundamentação teórico-metodológica da terapia ocupacional social, sendo: a necessária leitura acerca da indissociabilidade entre os fatores micro e macrossociais para o desenvolvimento do trabalho e a dimensão técnico-política da atuação terapêutico-ocupacional. Em ambos os debates a fundamentação teórico-metodológica da terapia ocupacional social foi e tem sido o fio condutor do processo, possibilitando uma leitura social e maior apropriação das finalidades técnico-profissionais no âmbito da assistência social.

Abstract With the growing number of occupational therapists working at the Unified Social Assistance System (SUAS) in Brazil, there has been an increasing need for education processes focusing on the critical development of professional practice in this field. From this education demand, a project was created in October 2020: "Communities of Practice in Occupational Therapy at SUAS: professional planning and construction of strategies" aiming to promote the exchange of knowledge and experiences between occupational therapists working in social assistance. This study aims to present the work possibilities and limits at SUAS from the point of view of occupational therapists who work at its units and who participated in the Community of Practice, analyzing whether and how their professional actions have been related to the social occupational therapy theoretical-methodological framework. To this end, all the recording material produced in the two project cycles from October 2020 to July 2021 was revisited. The collected information was organized in a table that grouped the themes found. Data analysis revealed two main aspects that allow the correlation of the professionals' actions with the social occupational therapy theoretical-methodological framework, namely, the necessary interpretation of the inseparability between micro- and macro-social factors for the development of work and the professional and political dimensions of the occupational-therapeutic actions. In both debates, the social occupational therapy theoretical-methodological framework has been the guiding thread of the process, enabling a social reading and a greater understanding of technical-professional purposes within the scope of social assistance.

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Resumo Introdução Estudos feministas contribuíram para o entendimento dos papéis de gênero atribuídos à mulher e ao homem enquanto processos socialmente construídos e não biologicamente determinados. No trabalho em saúde no Brasil, marcado pela predominância numérica de mulheres, a divisão sexual do trabalho é influenciada pela naturalização do cuidado como atributo feminino. Na terapia ocupacional, segundo o Conselho Regional da categoria, apenas 3,7% dos profissionais do Estado de São Paulo são homens, o que confere singularidade às relações entre gêneros na profissão. Objetivo Busca-se identificar e analisar experiências e percepções relacionadas ao gênero entre terapeutas ocupacionais autodeclarados homens. Método Estudo qualitativo de tipo exploratório, realizado por meio de entrevistas em profundidade com cinco terapeutas ocupacionais no município de São Paulo, SP, Brasil, posteriormente analisadas por meio de análise temática. Resultados Os entrevistados identificaram experiências que consideram ser privilégios de gênero não dissimulados, principalmente no que tange ao acesso ao emprego e à valorização profissional. Percebem que, no ambiente profissional, atuam estereótipos ligados ao padrão de comportamento atribuído ao gênero masculino, associando-o à força, autoridade e poder. Em se tratando de relações de cuidado com usuários, alguns participantes não percebem a presença de normas de gênero, o que parece convergente com a invisibilidade social desses processos. Conclusão Questões de gênero estão presentes nas vivências profissionais dos entrevistados, os quais, de modo geral, percebem-nas sob uma perspectiva crítica. Mostra-se relevante para a terapia ocupacional brasileira que novos estudos adensem reflexões e abordem distintas faces das relações de gênero na prática profissional.

Abstract Introduction Feminist studies have contributed to the understanding of the gender roles assigned to women and men as socially constructed and not biologically determined processes. In health work in Brazil, marked by the numerical predominance of women, the sexual division of labor is influenced by the naturalization of care as a female attribute. In occupational therapy, according to the Regional Council of the category, only 3.7% of professionals in the State of São Paulo are male, which gives uniqueness to gender relations in the profession. Objective We seek to identify and analyze gender-related experiences and perceptions among self-declared male occupational therapists. Method Qualitative exploratory study, carried out through in-depth interviews with five occupational therapists in the city of São Paulo, SP, Brazil, later analyzed through thematic analysis. Results Respondents identified experiences that they consider to be undisguised gender privileges, especially regarding access to employment and professional development. They perceive that, in the professional environment, there are stereotypes linked to the pattern of behavior attributed to the male gender, associating it with strength, authority and power. When it comes to care relationships with users, some participants do not perceive the presence of gender norms, which seems to converge with the social invisibility of these processes. Conclusion Gender issues are present in the professional experiences of the respondents, who, in general, perceive them from a critical perspective. It is relevant for Brazilian occupational therapy that new studies increase reflections and address different aspects of gender relations in professional practice.

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Infections caused by Staphylococcus aureus are increasingly prevalent, and treatment has become more difficult due to the emergence of strains that are resistant to multiple drugs, such as methicillin-resistant Staphylococcus aureus (MRSA). Penicillin-binding proteins (PBPs) are essential enzymes in peptidoglycan biosynthesis. Only found in bacteria, they are an excellent target for the development of bacterial control strategies. S. aureus has 4 PBPs, and only PBP2 has transglycosylation activity, making it a good model to evaluate whether the inactivation of the transglycosylase domain (PBP2t) could lead to bacterial death. (His6)-tagged PBP2t was purified from the E. coli cell lysate using Ni-charged resin, and ELISA and immunoblotting assays demonstrated that PBP2t is immunogenic. Flow cytometry analysis was performed to verify the binding of polyclonal antibodies to the bacterial cell surface. In order to verify the ability to provide protection, immunized mice were challenged with a sublethal dose of MRSA, and the bacterial loads in kidneys and spleen were evaluated. A reduction of 2-2.5 logs was seen in organs from immunized mice compared with the negative controls in two independent assays (p < 0.01). Our results demonstrate that the PBP2t is a promising target for the development of novel antimicrobial strategies, but further testing should be performed to validate the protection conferred by immunization with this protein.

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In Brazil, a large part of adopted children and adolescents were sheltered after a protective court order. In the adoption process, after the steps of gradual contact, children and parents start to live together permanently, when they experience the process of building a new daily life, in which activities and interactions already known undergo transformations. The study aimed to understand the deinstitutionalization process by adoption from the point of view of fathers and mothers who adopted children over two years. It was support by references that constitute the understanding of everyday life in the scope of occupational therapy, from a perspective that denaturalizes it, putting into view its complexity in the constellation of human interactions. It took place through the collection and analysis of interviews with adopting fathers and mothers. The results composed thematic axes gathering the perspectives of the parents, indicating that: a) their projections about future daily life were relevant in defining the profile of the children to be adopted; b) children's daily experiences in SAI were not properly presented to them prior to the phase of definitive coexistence; c) the process of building parenthood was essentially linked to the constitution of a common daily life, in family. It is essential to pay attention to the centrality of everyday life to build bonds and a stable socio-relational environments It is essential to pay attention to the centrality of everyday life to build bonds and stable socio-relational environments that are conducive to the development of children and adolescents

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Introdução: Coletivos juvenis de periferias urbanas têm se constituído em torno de linguagens artísticas diversas e adquirido importância central na mediação das juventudes com a sociedade. Alguns se reúnem em torno dos Sound Systems de música reggae, que com a ocupação sonora de espaços públicos com caixas de som empilhadas e discos de vinil criam eventos culturais de rua. Objetivos: Conhecer os Sound Systems como atividade cultural, bem como suas repercussões no cotidiano de jovens que participam de coletivos que os promovem. Metodologia: Observações em eventos de Sound System e entrevistas com seletores de coletivos, interpretadas por análise temática. Resultados e discussão: Os coletivos se organizam na conjunção entre sonoridade, celebração e difusão de valores ligados à cultura negra. Para os seletores, o Sound System deve oferecer oportunidades de aprendizagem sobre a opressão histórica dos povos negros, bem como de fortalecimento da identidade e cultura negra. O pertencimento social, a elevação da autoestima e as oportunidades de aprendizagem pessoal foram mudanças associadas por eles à participação na cultura Sound System. Considerações finais: Os coletivos buscam ativamente produzir pontes entre o universo reggae jamaicano e as realidades dos jovens negros das periferias pobres da cidade de São Paulo, investindo no resgate da história e dos poderes agregadores da memória, da sonoridade, e de símbolos e mensagens da cultura reggae.

Introduction: Youth groups from urban peripheries have been constituted around diverse artistic languages and have acquired central importance in the mediation of youths with society. Some gather around the reggae music Sound Systems, which with the sound occupation of public spaces through stacked speakers and vinyl records create cultural street events. Objectives: To learn about the Sound Systems as a cultural activity as well as its repercussions on the daily lives of young people who participate in groups that promote them. Methodology: Observation in Sound System events and interviews with young people who work as selectors of these groups, interpreted by thematic analysis. Results and discussion: Sound System groups have been organized around the conjunction between sonority, celebration and dissemination of values linked to black culture. The selectors interviewed argue that the Sound System should provide opportunities to learn about the historical oppression of black people, as well as to strengthen of black identity and culture. Social belonging, increased self-esteem and opportunities for personal learning were changes they associated with participation in the Sound System culture. Final considerations: The groups actively seek to build bridges between the Jamaican reggae universe and the realities experienced by young black people from the disadvantaged peripheral areas of São Paulo city, investing in the rescue of history and the aggregating powers of memory, sound, symbols and messages from reggae culture.

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In this study, we aimed to evaluate the effect of concentrate supplementation containing crude glycerin (CG) before and during the breeding season on the physiological and blood biochemical variables as well as on the reproductive performance of Santa Inês ewes. A total of 24 ewes (12 pluriparous and 12 nulliparous ewes, 4 and 1.5 years old, weighing an average of 40 ± 5 and 27 ± 3 kg, respectively) were randomly assigned to three treatments consisting of different dietary concentrations of CG (0%, 5%, and 10 % of the total dry matter). The experiment lasted 63 days and was divided into three 21-day phases. In the first and second phases, the animals were subjected to flushing. In the second and third phases, we evaluated the animals' reproductive performance. Weather, physiological, and blood biochemical variables were also studied. The results indicated that the inclusion of CG did not influence significantly (P > 0.05) either the ewes' body weight or their body condition score. All ewes exhibited estrus during the breeding season. Their respiratory rate was significantly influenced by the time of day (P < 0.0001). A 10% CG supplementation did not drastically change the hematological and biochemical variables, which were within the reference ranges. However, the week of supplementation influenced sérum metabolites (P < 0.05). Thus, these results indicate that CG could be used in up to 10% in replacement of ground corn without significantly affecting the physiological, hematological, and biochemical parameters of the ewes or their reproductive performance before and during the breeding season.(AU)

Neste estudo, objetivamos avaliar o efeito da suplementação concentrada contendo glicerina bruta (GB) antes e durante a estação de monta sobre as variáveis bioquímicas e fisiológicas, bem como sobre o desempenho reprodutivo das ovelhas Santa Inês. Um total de 24 ovelhas (12 pluríparas e 12 nulíparas, de 4 e 1,5 anos de idade, pesando em média 40 ± 5 e 27 ± 3 kg, respectivamente) foram distribuídas aleatoriamente em três tratamentos constituídos por diferentes concentrações dietéticas de GB (0, 5 e 10% da matéria seca total). O experimento durou 63 dias e foi dividido em três fases de 21 dias. Na primeira e segunda fase, os animais foram submetidos ao flushing alimentar. Na segunda e terceira fase, avaliamos o desempenho reprodutivo dos animais. Variáveis climáticas, fisiológicas e bioquímicas sanguíneas também foram estudadas. Os resultados indicaram que a inclusão de GB não influenciou significativamente (P > 0,05) no peso corporal das ovelhas nem em seu escore de condição corporal. Todas as ovelhas exibiram estro durante a estação reprodutiva. A frequência respiratória foi significativamente influenciada pela hora do dia (P < 0,0001). Uma suplementação com 10% de GB não alterou drasticamente as variáveis hematológicas e bioquímicas, que estavam dentro do intervalo de referência. No entanto, a semana de suplementação influenciou os metabólitos séricos (P < 0,05). Sendo assim, esses resultados indicam que a GB pode ser utilizada em até 10% na substituição do milho moído, sem afetar significativamente os parâmetros fisiológicos, hematológicos e bioquímicos das ovelhas assim como o desempenho reprodutivo antes e durante a estação de monta.(AU)

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OBJETIVOS: identificar e descrever as estratégias de enfrentamento utilizadas perante o craving por usuários de crack que estavam em tratamento internados em Comunidades Terapêuticas. MÉTODO: a amostra foi composta por 133 homens. Os instrumentos utilizados foram: Questionário sociodemográfico e rastreio do uso de drogas, Mini-Exame do Estado Mental e uma Escala de Perguntas sobre craving. A análise utilizada foi a estatística descritiva e de frequências para análise exploratória com nível de significância de 5%. RESULTADOS: os participantes relataram um predomínio da categoria Força de Vontade e de comportamento de Esquiva em resposta ao craving. CONCLUSÃO: esses resultados são importantes contribuições na compreensão do enfrentamento do craving, sinalizando a importância do trabalho da prevenção de recaídas, da família e tratamentos eficazes.

OBJECTIVES: to identify and describe the coping strategies used in the face of craving by crack-cocaine users who were under treatment in the Therapeutic Communities. METHOD: the sample consisted of 133 men. The instruments were a socio-demographic questionnaire and on drug use screening, the Mini-Mental State Examination and the scale of questions on craving. The analysis used was descriptive and frequency statistics for exploratory analysis with significance level of 5%. RESULTS: the results demonstrate a predominance of the Willpower category and Dodge in response to craving. CONCLUSION: these results are important contributions in understanding the coping of craving, signaling the importance of relapse prevention work, of the family and of effective treatments.

OBJETIVOS: el objetivo del estudio fue identificar y describir las estratégias de afrontamiento utilizadas frente al craving por consumidores de crack que estaban em tratamiento internados en Comunidades Terapéuticas. MÉTODO: la muestra consistió en 133 hombres. Los instrumentos fueron: cuestionario sociodemográfico y la detección del consumo de drogas; Mini Examen del Estado Mental y Craving Cuestionario. El análisis utilizada fue descriptiva y las estadísticas de frecuencia para el análisis exploratorio con un nivel de significación del 5%. RESULTADOS: los resultados muestran el predominio de la categoría de fuerza de voluntad y el comportamiento de Esquivar en respuesta a las ansias. CONCLUSIÓN: estos resultados son importantes contribuciones en la comprensión de la cofia antojo, lo que indica la importancia de la labor de prevención de recaídas, la familia y los tratamientos eficaces.

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Introducition: Domestic violence against children interferes in their psychological development, leading to sequels that manifest and persist up to adulthood. Physical evidence of domestic violence is easily observed in the orofacial complex and eventually becomes detected by dentists. Case Report: We report the case of a 9-year-old victim of maltreatment who was diagnosed during dental treatment. The existence of physical injuries (a hematoma in the left orbit and burns on the left hand and in the lips) aroused the attention of the pediatric dentistry, whose brought the case to the responsible authorities. Custody of the child was granted to the grandmother by a court decision, which enabled the recovery of health and quality of life. Conclusion: Professionals must properly conduct cases through complaints in order to protect children from future occurrences.

Introdução: A violência doméstica contra as crianças interfere no seu desenvolvimento psicológico, levando a sequelas que se manifestam e persistem até a idade adulta. A evidência física da violência doméstica é facilmente observada no complexo orofacial e, eventualmente, é detectada pelos dentistas. Relato do Caso: Relatamos o caso de uma vítima de maus-tratos, de 9 anos de idade, que foi diagnosticada durante o tratamento odontológico. Um odontopediatra, durante as consultas de rotina, após identificar injúrias físicas (hematoma na órbita esquerda e queimaduras na mão esquerda e lábios), suspeitou tratar-se de maus tratos, levando o caso às autoridades responsáveis. A custódia da criança foi concedida à avó por uma decisão judicial, o que permitiu a recuperação da saúde e qualidade de vida. Conclusão: Os profissionais devem conduzir adequadamente os casos de abuso, a fim de proteger as crianças de ocorrências futuras.

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The objective was evaluate inclusion of increasing levels of lipid residue in diet, replacing energysources commonly used in blood biochemical parameters of woolless sheep during the breeding season. Wasused 24 sheep, between 1 and 6 years old, with an average of 40 kg. The experiment lasted nine weeks. In firstsix weeks the sheep received flushing, where diets were formulated with increasing levels of lipid residue includereplacing corn and soybean meal, and (T1) without addition of waste, (T2) with 5% (T3 ) 10%. The blood serumchemistries for performing was collected once weekly throughout the trial period. The results of the biochemicalanalyzes of cholesterol, triglycerides and glucose showed no statistical difference. The increasing levels of lipidresidue in the diet did not change the blood biochemical parameters of woolless sheep during the breedingseason.

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The objective was evaluate inclusion of increasing levels of lipid residue in diet, replacing energysources commonly used in blood biochemical parameters of woolless sheep during the breeding season. Wasused 24 sheep, between 1 and 6 years old, with an average of 40 kg. The experiment lasted nine weeks. In firstsix weeks the sheep received flushing, where diets were formulated with increasing levels of lipid residue includereplacing corn and soybean meal, and (T1) without addition of waste, (T2) with 5% (T3 ) 10%. The blood serumchemistries for performing was collected once weekly throughout the trial period. The results of the biochemicalanalyzes of cholesterol, triglycerides and glucose showed no statistical difference. The increasing levels of lipidresidue in the diet did not change the blood biochemical parameters of woolless sheep during the breedingseason.(AU)

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The choice of the ideal anesthetic protocol must consider a number of factors, providing minimum anesthetic time, little cardiopulmonary depression and management of anesthesia must keep vital signs and physiological parameters monitored. Patients with neoplasia are even more important, because, normally, middle-aged or elderly animals show changes who qualified him as patients with risk category III or IV. The present study reports the case of a female dog SRD 10-year-old carrier of breast cancer submitted to unilateral mastectomy, highlighting the importance of the anesthetic protocol used.

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The choice of the ideal anesthetic protocol must consider a number of factors, providing minimum anesthetic time, little cardiopulmonary depression and management of anesthesia must keep vital signs and physiological parameters monitored. Patients with neoplasia are even more important, because, normally, middle-aged or elderly animals show changes who qualified him as patients with risk category III or IV. The present study reports the case of a female dog SRD 10-year-old carrier of breast cancer submitted to unilateral mastectomy, highlighting the importance of the anesthetic protocol used.(AU)

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Trata-se de apresentar e discutir referências conceituais e práticas do projeto O território e seus protagonistas: novos olhares para a infância e juventude, que tem se desenvolvido como atividade de extensão universitária em Terapia Ocupacional Social pelo núcleo da USP do Projeto Metuia. As atividades têm por foco a juventude que reside na região do Butantã, no município de São Paulo, as suas famílias e, em especial, os profissionais que atuam com esse segmento. Seu objetivo é influir na produção coletiva de novas representações sociais sobre a juventude, confrontando preconceitos. Oferece condições para a reelaboração crítica das representações sociais que desqualificam o jovem e suas ações, promovendo o encontro e o diálogo entre jovens protagonistas de iniciativas culturais ou de experiências exitosas na esfera da defesa dos direitos, e profissionais e/ou familiares ligados ao desafio de oferecer proteção e oportunidades para o desenvolvimento integral dos jovens. Observações que se desdobram da concretização do projeto sugerem que, embora se encontrem na região iniciativas importantes, originadas em coletivos juvenis, de modo geral os jovens não têm encontrado estímulo para desenvolver seu papel protagônico na esfera das produções culturais. A despeito das dificuldades enfrentadas para viabilizar o encontro dialogado entre jovens, profissionais e comunidade, o desenvolvimento do projeto tem permitido que se observem atitudes solidárias e a valorização da pluralidade cultural entre os jovens.

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There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.George's), submaximal (6 minutes' walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70% of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125% (p = 0.0001) for rH group and 63% (p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77%, p = 0.0421 in rH and 79 %, p = 0.0197 in rD group) and in 6 minutes' test (12% in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32% abandoned in rD vs. 20% in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.

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Existe poca experiencia sobre el efecto del entrenamiento domiciliario (rD) en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). El objetivo de este trabajo fue comparar el efecto del rD sobre la tolerancia al ejercicio, disnea y calidad de vida versus el entrenamiento ambulatorio hospitalario (rH). Se compararon dos grupos de pacientes con EPOC. Ambos entrenaron durante 24 sesiones, 8 semanas. Antes y después del entrenamiento se realizaron: espirometría, cuestionarios de disnea (MRC, Mahler y Borg) y calidad de vida (St. George y SF-36), pruebas de ejercicio submáximas (caminata 6 minutos, shuttle de resistencia y resistencia en cicloergómetro -tiempo límite-Tlim) y máximas (shutlle test-ST- y cardiopulmonar). El grupo rH realizó ejercicios aeróbicos y de fuerza para miembros inferiores (MI) y superiores (MS). El grupo rD realizó caminatas al 70% de la velocidad alcanzada en ST y ejercicios de fuerza para MI y MS. Se aleatorizaron 25 rH y 25 rD. La condición basal fue similar en ambos grupos. El Tlim aumentó 125% (p = 0.0001) para grupo rH y 63% (p = 0.0011) para rD, sin diferencias entre sí. También mejoraron distancia en shuttle resistencia (77%, p = 0.0421 en grupo rH y 79%, p = 0.0197 en rD) y distancia en prueba 6 minutos (12% en rD, p = 0.0135). El puntaje en cuestionario St. George se redujo solo en el grupo rH (p = 0.0034); en el rD abandonaron 32% vs. 20% en el rH (p = 0.4521). El entrenamiento domiciliario resultó tan eficaz como el ambulatorio hospitalario en pacientes con EPOC, aunque con mayor tendencia al abandono.(AU)

There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.George´s), submaximal (6 minutes’ walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70% of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125% (p = 0.0001) for rH group and 63% (p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77%, p = 0.0421 in rH and 79 %, p = 0.0197 in rD group) and in 6 minutes´ test (12% in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32% abandoned in rD vs. 20% in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.(AU)

RESUMEN

Existe poca experiencia sobre el efecto del entrenamiento domiciliario (rD) en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). El objetivo de este trabajo fue comparar el efecto del rD sobre la tolerancia al ejercicio, disnea y calidad de vida versus el entrenamiento ambulatorio hospitalario (rH). Se compararon dos grupos de pacientes con EPOC. Ambos entrenaron durante 24 sesiones, 8 semanas. Antes y después del entrenamiento se realizaron: espirometría, cuestionarios de disnea (MRC, Mahler y Borg) y calidad de vida (St. George y SF-36), pruebas de ejercicio submáximas (caminata 6 minutos, shuttle de resistencia y resistencia en cicloergómetro -tiempo límite-Tlim) y máximas (shutlle test-ST- y cardiopulmonar). El grupo rH realizó ejercicios aeróbicos y de fuerza para miembros inferiores (MI) y superiores (MS). El grupo rD realizó caminatas al 70% de la velocidad alcanzada en ST y ejercicios de fuerza para MI y MS. Se aleatorizaron 25 rH y 25 rD. La condición basal fue similar en ambos grupos. El Tlim aumentó 125% (p = 0.0001) para grupo rH y 63% (p = 0.0011) para rD, sin diferencias entre sí. También mejoraron distancia en shuttle resistencia (77%, p = 0.0421 en grupo rH y 79%, p = 0.0197 en rD) y distancia en prueba 6 minutos (12% en rD, p = 0.0135). El puntaje en cuestionario St. George se redujo solo en el grupo rH (p = 0.0034); en el rD abandonaron 32% vs. 20% en el rH (p = 0.4521). El entrenamiento domiciliario resultó tan eficaz como el ambulatorio hospitalario en pacientes con EPOC, aunque con mayor tendencia al abandono.

There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.George´s), submaximal (6 minutes’ walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70% of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125% (p = 0.0001) for rH group and 63% (p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77%, p = 0.0421 in rH and 79 %, p = 0.0197 in rD group) and in 6 minutes´ test (12% in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32% abandoned in rD vs. 20% in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.

Asunto(s)

RESUMEN

Since the first studies reporting the TP53 p.R337H mutation as founder mutation in Southern and Southeastern Brazil, there has been controversy on its origin. Preliminary analysis of a small subset of Brazilian mutation carriers revealed that the haplotype incided on a Caucasian background. The vast majority of carriers identified today reside in Brazil or, if identified in other countries, are Brazilian immigrants. To our knowledge, the only two exceptions of carriers without a recognizable link with Brazil are two European families, from Portugal and Germany. Haplotype analysis in the Portuguese family revealed the same haplotype identified in Brazilian individuals, but in the German family, a distinct haplotype was found. Knowing that a significant proportion of women with breast cancer (BC) in Southern Brazil are p.R337H carriers, we analyzed p.R337H in a Portuguese cohort of women diagnosed with this disease. Median age at diagnosis among the first 573 patients tested was 60 years and 100 (17.4%) patients had been diagnosed at or under the age of 45 years. Mutation screening failed to identify the mutation in the 573 patients tested. These results are in contrast with the mutation frequency observed in a study including 815 BC-affected women from Brazil, in which carrier frequencies of 12.1 and 5.1% in pre- and postmenopausal women were observed, respectively. These findings suggest that the Brazilian founder mutation p.R337H, the most frequent germline TP53 mutation reported to date, is not a common germline alteration in Portuguese women diagnosed with BC.

Asunto(s)

RESUMEN

There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.Georges), submaximal (6 minutes walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70

of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125

(p = 0.0001) for rH group and 63

(p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77

, p = 0.0421 in rH and 79

, p = 0.0197 in rD group) and in 6 minutes test (12

in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32

abandoned in rD vs. 20

in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.