Resumen Las enfermedades cardiovasculares y la depresión se consideran problemas de salud pública, la depresión es un factor de riesgo para pacientes con insuficiencia cardiaca (IC) por sus implicaciones clínicas. El objetivo de este estudio fue describir dos modalidades de intervenciones psicoterapéuticas en el abordaje de la depresión en pacientes con IC. Métodos de búsqueda: Se realizaron búsquedas en las bases especializadas MEDLINE, PubMed, PsycINFO, Web of Science, CINAHL y Cochrane Library de 2010 a 2020. Criterios de selección: Se seleccionaron los artículos por título y resumen, publicados en los últimos 10 años, escritos en castellano o inglés y se eliminaron los registros repetidos. Obtención de los datos: Tres autores recopilaron la información de los estudios que se documentan. Resultados principales: Se incluyeron 4 estudios clínicos con 911 pacientes, se realizaron en 4 países en los últimos 10 años y se implementaron diferentes métodos de intervenciones digitales y visitas domiciliarias, los efectos de estos tratamientos han sido estadísticamente significativos para reducir los puntajes de depresión autoinformada en pacientes con IC que recibieron la intervención psicoterapéutica en alguna de estas modalidades a comparación de aquellos pacientes que solo recibieron un tratamiento estándar. Conclusiones: Debido al número limitado de estudios y de los diferentes métodos de intervención no se identifica un tratamiento estándar de la depresión en IC en estos formatos de atención, por lo que se recomienda más investigación en este campo de estudio.

Abstract Cardiovascular disease and depression are considered public health problems, depression is a risk factor for patients with heart failure (HF) for its clinical implications. The objective of this study was to describe two modalities of psychotherapeutic interventions in the approach to depression in patients with HF. Search methods: We searched the specialized databases MEDLINE, PubMed, PsycINFO, Web of Science, CINAHL and Cochrane Library from 2010 to 2020. Selection criteria. Articles were selected by title and abstract., published in the last 10 years, written in Spanish or English and repeated registrations were deleted. Obtaining the data: Three authors collected information from the studies being documented. Main results: We included 4 clinical studies with 911 patients, were conducted in 4 countries in the last 10 years and implemented different methods of digital interventions and home visits, the effects of these treatments have been statistically significant to reduce self-reported depression scores in patients with HF who received psychotherapeutic intervention in any of these modalities compared to those patients who only received a treatment. Conclusions: Due to the limited number of studies and different methods of intervention, a standard treatment of HF depression in these care formats is not identified, so more research in this field of study is recommended.

Resumen La hipoglucemia inadvertida (HI) es una complicación del tratamiento de la diabetes mellitus tipo 1 (DM1) y DM2 tratada con insulina o sulfonilureas, que se caracteriza por una capacidad reducida para percibir el inicio de los episodios de hipoglucemia. En general, coexiste con una insuficiente respuesta hormonal contrarreguladora a la hipoglucemia denominada falla autonómica asociada a la hipoglucemia (FAAH). El desarrollo de HI y de falla contrarreguladora a la hipoglucemia aumentan significativamente el riesgo de hipoglucemias severas. Se han desarrollado escalas de puntuación para identificar, en la consulta clínica, a este grupo de personas con elevado riesgo de hipoglucemias severas. La piedra angular del tratamiento consiste en evitar las hipoglucemias mediante una intervención multifactorial de cuidados clínicos y educación estructurada.

Abstract Hypoglycemia unawereness is a complication of type 1 diabetes treatment and of type 2 diabetes treatment treated with insulin or sulfonylureas, characterized by a reduced ability to perceive the onset of episodes of hypoglycemia. In general, it coexists with an insufficient counterregulatory hormonal response to hypoglycemia called: hypoglycemia associated autonomic failure (HAAF). The development of hypoglycemia unawereness and counterregulatory failure to hypoglycemia significantly increase the risk of severe hypoglycemia. Scoring scales have been developed to identify this group of people at high risk of severe hypoglycemia in the clinic. The cornerstone of treatment is to avoid hypoglycemia through a multifactorial intervention of clinical care and structured education.

ABSTRACT Background: To provide recommendations based on the best available scientific evidence for the multidisciplinary management of febrile neutropenia. The development included the stages: approval of the creation of the Working Group (WG); CPG search; analysis and synthesis of the evidence that led to establishing the recommendation of the selected CPGs, design of the consensus document, internal review. All phases were carried out through panel meetings using virtual platforms during 03 months. The "GRADE" system was used to establish the strength and direction of the recommendations. The recommendations cover the prevention, diagnosis and treatment of febrile neutropenia in oncohematological patients. Twenty-eight recommendations were developed. The topics approached were: correct evaluation; timely diagnosis, adequate antibiotic treatment, vaccination against influenza and pneumococcus, administration of colony-stimulating factor and special management of pediatric patients for diagnosis, treatment.

RESUMEN Introducción: Brindar recomendaciones basadas en la mejor evidencia científica disponible para el manejo multidisciplinario de la neutropenia febril. El desarrollo abarco las etapas: aprobación de la conformación del Grupo Elaborador (GE); búsqueda de GPC; análisis y síntesis de la evidencia que llevó a la formulación de las recomendaciones, diseño del documento consenso, revisión interna. Todas las fases fueron llevadas a cabo mediante reuniones de panel a través del uso de plataformas virtuales durante 03 meses. Se utilizó el sistema "GRADE" para establecer la fuerza y dirección de las recomendaciones. Se formularon 28 recomendaciones sobre prevención, diagnóstico y tratamiento de la neutropenia febril en pacientes oncohematológicos. Los temas abordados han sido relacionados a: correcta evaluación; diagnóstico oportuno, tratamiento antibiótico adecuado, vacunación contra influenza y neumococo, administración de factor estimulante de colonias y manejo especial en pacientes pediátricos para diagnóstico, tratamiento.

Abstract: Background: Many institutions in Mexico perform routine coagulation tests, prior to an elective surgery to prevent an intra or postoperative bleeding. However, some publications do not approve this practice. Objective: Analyze the utility of coagulation tests for elective surgeries and the possibility for intra or postoperative bleeding. Material and methods: A retrospective comparative study was performed; it included 263 patients who underwent elective abdominal surgeries from a single institution. coagulation tests were compared with: sex, groups of age, intra or post-operative bleeding, surgical time and hospital length of stay. Results: A total of 2 (0.76%) intra or postoperative bleeding was found. Abnormal tests were reported in INR with minimal risk of bleeding (10/3.8%), INR with the maximal risk of bleeding (3/1.1%), PTT (66/25.1%) and PT (25/9.5%). There was no significant difference when coagulation tests was compared with sex, intra or postoperative bleeding or surgical time. Abnormal INR with maximal risk of bleeding was more common in patients ≥ 60-years old (p = 0.002). Surgical time and hospital length of stay were longer in patients with abnormal INR with maximal (p = 0.003) and minimal risk of bleeding (p = 0.005), respectively. Conclusions: Routine use of coagulation tests prior to elective abdominal surgery has no justification and it should be avoided.

Resumen: Introducción: Muchas instituciones en México realizan pruebas de coagulación (PC) de rutina previas a una cirugía electiva para prevenir hemorragia intraoperatoria o postoperatoria. Sin embargo, algunas publicaciones no aprueban esta práctica. Objetivo: Evaluar la utilidad de las pruebas de coagulación previas a cirugías abdominales electivas para predecir el riesgo de SIP. Material y métodos: Se llevó a cabo un estudio retrospectivo comparativo. Se incluyeron 263 pacientes a quienes se les realizó cirugía abdominal electiva. Las pruebas de coagulación se compararon con variables de género, grupos de edad, presencia de hemorragia intraoperatoria o postoperatoria, tiempo quirúrgico y tiempo de estancia intrahospitalaria. Resultados: Se informó un total de dos (0.76%) hemorragias intraoperatorias o postoperatorias. Se observaron resultados anormales en 10 (3.8%) pacientes con international normalized ratio con riesgo mínimo de sangrado, en tres (1.1%) con INR con riesgo máximo de sangrado, 66 (25.1%) con tiempo parcial de tromboplastina y 25 (9.5%) con tiempo de protrombina. No hubo diferencia significativa cuando las PC se compararon con género, presencia de hemorragia intraoperatoria o postoperatoria o tiempo quirúrgico. International normalized ratio anormal con riesgo máximo de sangrado fue significativamente más común en pacientes ≥ 60 años (p = 0.002). El tiempo quirúrgico y el tiempo de estancia intrahospitalaria fueron más prolongados en pacientes con international normalized ratio anormal con riesgo máximo (p = 0.003) y mínimo de sangrado (p = 0.005), respectivamente. Conclusiones: La práctica de solicitar pruebas de coagulación de rutina previa a cirugías abdominales electivas no tiene justificación y debería evitarse.

RESUMEN Objetivo: Presentar el caso de una paciente con diagnóstico de sarcoma de Ewing extraóseo cervicovaginal y realizar una revisión de la literatura, con especial atención al diagnóstico histopatológico y las posibilidades terapéuticas de estas neoplasias. Materiales y métodos: Mujer de 53 años de edad, en seguimiento por antecedente de cáncer de mama ductal infiltrante, que presenta un sangrado genital anómalo. Tras la exploración física y los estudios con pruebas de imagen se observa una tumoración cervicovaginal que se extiende hacia la pelvis, de la cual se toma una biopsia. El resultado de la misma es compatible con sarcoma de Ewing/ tumor neuroectodérmico primitivo cervical. Se realizó una búsqueda en las bases de datos Medline vía PubMed, con los términos: "sarcoma; ewing", "neuroectodermal tumors", "primitive", "peripheral" y "uterine cervical neoplasms", rastreando artículos de revisión bibliográfica, reportes y series de casos clínicos en inglés y español publicados desde 2009. Resultados: Se hallaron doce artículos correspondientes a revisiones de literatura, reportes y series de casos clínicos, donde se describen los aspectos más importantes referentes al tratamiento, las manifestaciones clínicas y el diagnóstico molecular, inmunohistoquímico e histopatológico de esta patología. Conclusiones: El tumor de Ewing extraóseo ginecológico es una lesión extremadamente rara, cuyo diagnóstico se basa en el estudio de la morfología histopatológica, el examen inmunohistoquímico y las pruebas genéticas. La combinación de cirugía, quimioterapia y radioterapia se considera actualmente el tratamiento de elección.

ABSTRACT Objective: To present the case of a female patient diagnosed with cervico-vaginal extraosseous Ewing's sarcoma and to conduct a review of the literature, with special emphasis on histopathological diagnosis and therapeutic options for these neoplastic lesions. Materials and methods: Woman of a 53 year-old on follow-up due to a history of infiltrating ductal breast cancer, who presents with abnormal genital bleeding. On physical examination, a cervico-vaginal mass extending to the pelvis was observed. A biopsy was taken and the result was consistent with Ewing's sarcoma/primitive neuroectodermal tumour of the cervix. A search was conducted in the Medeline databases via PubMed, using the terms "sarcoma; ewing", "neuroectodermal tumours", "primitive", "peripheral" and "uterine cervical neoplasms", looking for reviews of the literature, case reports and clinical case series both in English and Spanish, published since 2009. Results: Overall, 12 articles were found, including reviews of the literature, case reports and clinical case series, describing the most relevant aspects of the treatment, clinical manifestations and molecular, immunohistochemical and histopathological diagnosis of this disease. Conclusions: Gynaecological extraosseous Ewing's tumour is an extremely rare lesion whose diagnosis is based on the study of the histopathological morphology, immunohistochemical tests and genetic testing. A combination of surgery, chemotherapy and radiotherapy is considered the treatment of choice at the present time.

RESUMO Introdução: O aumento da incidência de microrganismos multirresistentes é considerado um dos principais problemas de saúde pública. Uma das rotinas incluídas na prática hospitalar é a busca de pacientes colonizados e/ou infectados. Objetivo: Avaliar a variabilidade genética e as relações clonais de K. pneumoniae produtoras de betalactamases de espectro estendido (ESBL) em culturas de vigilância de unidade de terapia intensiva (UTI) no Rio de Janeiro, Brasil. Materiais e métodos: Setenta isolados obtidos a partir de swab retal, (março/2013 a março/2014). O perfil de suscetibilidade a antibióticos foi avaliado pelo sistema VITEK 2. Foram pesquisados os genes de resistência: blaSHV, blaTEM, blaOXA-1, blaKPC, blaOXA-48, blaCTX-M-15, blaVIM, blaIMP e blaNDM pela reação em cadeia da polimerase (PCR). A diversidade genética foi avaliada por Enterobacterial Repetitive Intergenic Consensus-PCR (ERIC-PCR). Resultados: Foram detectados altos percentuais de resistência a cefepime (94%), ceftazidima (96%), ertapenem (61%), imipenem (54%) meropenem (43%) e ciprofloxacino (69%). Os genes prevalentes foram: blaSHV (69%), blaTEM (63%), blaOXA-1 (60%), blaKPC (57%), blaCTX-M-15 (47%), blaOXA-48 (16%). Os genes blaVIM, blaIMP e blaNDM não foram detectados. Foram observados 29 perfis em relação aos genes de resistência, com 23% apresentando pelo menos cinco genes. Uma grande diversidade genética (68 perfis) foi observada entre as cepas. Conclusão: Embora não tenha sido observada relação clonal entre os isolados, este estudo revelou dados alarmantes quanto à resistência microbiana em monitoramento preventivo, abordagem ainda pouco adotada no Brasil. Nossos dados permitem concluir que a inclusão de culturas de vigilância nas unidades de saúde é uma estratégia recomendada, visando principalmente à prevenção da disseminação dos genes de resistência no ambiente hospitalar e, consequentemente, redução da morbimortalidade.

ABSTRACT Introduction: The increasing incidence of multi-resistant microorganisms has been considered a public health problem. One of the routines included in hospital practice is the screening of colonized and/or infected patients. Objective: The aim of this study was to evaluate the genetic variability and clonal relationships of extended-spectrum beta-lactamase (ESBL)-producing K. pneumoniae, from surveillance cultures, at an intensive care unit, in Rio de Janeiro, Brazil. Material and methods: Seventy K. pneumoniae isolates were obtained from rectal swabs (March 2013 to March 2014). Antimicrobial susceptibility was assessed by VITEK 2 System. Resistant genes blaSHV, blaTEM, blaOXA-1, blaKPC, blaOXA-48, blaCTX-M-15, blaVIM, blaIMP and blaNDM were investigated by polymerase chain reaction (PCR); genetic diversity, by Enterobacterial Repetitive Intergenic Consensus-PCR (ERIC-PCR). Results: Strains showed high resistance rates to cefepime (94%), ceftazidime (96%), ertapenem (61%), imipenem (54%) meropenem (43%) and ciprofloxacin (69%). The most prevalent genes were blaSHV (69%), blaTEM (63%), blaOXA-1 (60%), blaKPC (57%), blaCTX-M-15 (47%), blaOXA-48 (16%). Genes blaVIM, blaIMP and blaNDM were not detected. Twenty nine profiles of resistance genes were observed, with 23% carrying at least five genes. A great genetic diversity (68 ERIC profiles) was also observed among the strains. Conclusion: Although no clonal relationship was observed within the isolates, this study revealed alarming data on the antimicrobial resistance deficiently monitored for preventive purposes in Brazil. Our data allow us to conclude that the inclusion of surveillance cultures in health facilities is a recommended strategy aiming particularly at preventing the spread of resistance genes in the hospital environment and, consequently, reducing morbidity and mortality.

RESUMO Introdução: A contaminação cruzada por Staphylococcus aureus entre pacientes, profissionais e materiais de uso médico em unidades de saúde é uma preocupação constante, o que leva pesquisadores a estudar a prevalência desse patógeno em portadores assintomáticos. Objetivos: Investigamos a colonização e o perfil de suscetibilidade aos antimicrobianos de Staphylococcus spp. em superfícies de artigos médicos e em profissionais de duas unidades básicas de saúde no município do Rio de Janeiro. Materiais e métodos: Foram coletadas 79 amostras que resultaram em 49 isolados, submetidos à caracterização fenotípica e molecular por meio da reação em cadeia da polimerase (PCR) dos genes coa, femA e mecA. Resultados: De acordo com os fenótipos apresentados, os isolados foram identificados como S. aureus (n = 35; 71,42%) e Staphylococcus coagulase negativa (CoNS) (n = 14; 28,57%). Destes 14 isolados, 42,85% foram Staphylococcus coagulase negativa resistentes a meticilina (MRCoNS). Dos 35 S. aureus, 31,42% foram resistentes a meticilina (MRSA). Uma cepa foi resistente a vancomicina e identificada como S. aureus resistente a vancomicina (VRSA) após a detecção do gene vanB. Sessenta e oito por cento foram suscetíveis a meticilina (MSSA). Os genes coa, femA e mecA foram amplificados em 75,51%; 71,42% e 30,61% dos isolados, respectivamente. Após amplificação do gene mecA, 20,41% foram classificados como MRSA e 10,20% como MRCoNS. Conclusão: Nossos resultados mostraram frequência maior de MSSA e MRCoNS entre S. aureus e CoNS, respectivamente, colonizando equipamentos e profissionais de saúde. No entanto, a já descrita transferência do cassete cromossômico estafilocócico mec (SSCmec) de MRCoNS para MSSA poderia alterar esses resultados, aumentando a frequência de cepas MRSA.

ABSTRACT Introduction: Cross-contamination by Staphylococcus aureus among patients, professionals and medical supplies in health facilities is a constant concern, leading many researchers to study the prevalence of this pathogen in asymptomatic carriers. Objective: We investigated the colonization and the antimicrobial susceptibility profile of Staphylococcus spp. on surfaces of medical articles and in professionals from two basic health units in the city of Rio de Janeiro. Materials and methods: Seventy-nine samples resulted in 49 isolates which underwent phenotypic and molecular characterization by polymerase chain reaction (PCR) of coa, mecA and femA genes. Results: According to the phenotypes, the isolates were identified as S. aureus (n = 35, 71.42%) and coagulase-negative Staphylococcus (CoNS) (n = 14, 28.57%). Among these 14 isolates, 42.85% were methicillin-resistant coagulase negative Staphylococcus (MRCoNS). Among the 35 S. aureus, 31.42% were methicillin resistant (MRSA), and 2.8% were vancomycin resistant, characterized as VRSA. Sixty-eight percent were susceptible to methicillin (MSSA). Genes coa, femA and mecA were amplified from 75.51%, 71.42% and 30.61% of the isolates, respectively. After amplification of the mecA gene, 20.41% were characterized as MRSA, and 10.20% as MRCoNS. The vancomycin-resistant strain was characterized as VRSA after detection of the vanB gene. Conclusion: Our results show a higher frequency of MSSA and MRCoNS among S. aureus and CoNS respectively, colonizing devices and health professionals. However, the already described transfer of the staphylococcal cassette chromosome mec (SSCmec) from MRCoNS to MSSA may alter these results, increasing the frequency of MRSA strains.

El consumo creciente ha estimulado el desarrollo de los vegetales cuarta gama o mínimamente procesados. Actualmente, se promueve el uso de tecnologías aplicadas a estos productos que les brinden mayor duración y garanticen la reducción de pérdidas poscosecha. En esta investigación se evaluó el efecto de tres de estas tecnologías poscosecha sobre la intensidad de la respiración y la calidad sensorial general de las hortalizas mínimamente procesadas: brócoli (Brassica oleracea var. Itálica), coliflor (Brassica oleracea var. Botrytis), zucchini (Cucurbita pepo L.), apio (Apium graveolens), zanahoria (Daucus carota) y chayote (Sechium edule). Para el recubrimiento comestible se utilizó pectina de bajo metoxilo (2%), cera carnauba (1%), glicerol (1.5%) y ácido ascórbico (0.05%). El tratamiento térmico se hizo a 60 °C durante 2 min, con adición de ácido ascórbico (0.25%), ácido cítrico (0.5%) y cloruro de calcio (0.025%). El baño químico se realizó con una solución de ácido cítrico (0.5%), ácido ascórbico (0.05%) y cloruro de calcio (0.05%). La tasa de producción de CO2 se midió por el método estático, monitoreando la composición de los gases del espacio de cabeza durante 24 h a 8 °C y humedad relativa de 90%. La evaluación sensorial de color, aroma, crujencia y sabor objetable fueron las características organolépticas tomadas en cuenta para evaluar la calidad general de cada vegetal, la cual fue realizada con un panel de siete jueces previamente entrenados. Se utilizó un diseño de bloques completos al azar, siendo los bloques cada uno de los vegetales y las variables de respuesta la tasa de respiración y la calidad sensorial general. Se encontró que el tratamiento térmico y el recubrimiento comestible permitieron que los vegetales conservaran la calidad sensorial. El análisis estadístico no mostró diferencias significativas respecto al control (P > 0.05). La celeridad de la respiración disminuyó en el apio, el brócoli, el chayote, la coliflor y la zanahoria, cuando se aplicó el tratamiento térmico. Los tratamientos poscosecha se mostraron como una alternativa posible para la conservación de hortalizas mínimamente procesadas.

The fresh-cut vegetables consumption is increasing in the worldwide since its foray in the early 90s. The international association of fresh cut products, reported sales in 2000 of 12 billion dollars. The interest in feed quickly and healthy, has stimulated the development of vegetable fourth range, however their high metabolic activity reduces its stability and shelf life. It has promoted the adoption of technologies for minimally processed products that give them longer life and ensure the reduction of postharvest losses. In this research evaluated the effect of 3 postharvest technologies on the respiration intensity and general sensory quality of six freshcut vegetables (broccoli (Brassica oleracea var. Italic), cauliflower (Brassica oleracea var. Botrytis), zucchini (Cucurbita pepo L.), celery (Apium graveolens), carrot (Daucus carota) and vegetable pear (Sechium edule)). Experimental design was applied in a randomized complete block, blocks made by each of the vegetables and the response variables respiration rate and general sensory quality. For the edible coating was used low methoxyl pectin 2%, 1% of carnauba wax, 1,5% glycerol and 0,05% ascorbic acid; the heat treatment was 60 °C for 2 min, adding 0,25% ascorbic acid, 0,5% citric acid and calcium chloride 0,025%; the chemical dip was carried out with a solution of 0,5% citric acid, ascorbic acid 0,05% and calcium chloride 0,05% and one control. The rate production of CO2 was measured by the static method, monitoring the gas composition of the headspace for 24 hours at 8 °C and relative humidity of 90%, the sensory evaluation of color, aroma, crispness objectionable taste were sensory characteristics taken into account in assessing the general quality of each vegetal, which was performed with a panel of seven judges trained. It was concluded that the heat treatment and edible coating, allowed the vegetables retain the sensory quality. Statistical analysis showed no significant differences from control (p<0.05). Respiration rate decreased celery, broccoli, vegetable pear, cabbage and carrot applying heat treatment. The postharvest treatments was found to be a viable alternative for the conservation of fresh-cut vegetables.

Abstract: We used the optical contrast technique to identify layers of graphene, in a simpler way in contrast with other authors; this technique was validated by Raman spectroscopy. Layers of graphene were obtained by mechanical exfoliation of Kish graphite, and were deposited on silicon substrate with a 306.2 nm film of silicon oxide. Digital images of these samples were taken to use green component of the RGB numbers in the optical contrast calculation. We can identify from one to four layers of graphene.

Resumen: En este trabajo hemos usado la técnica de contraste óptico como herramienta de identificación preliminar y sencilla de capas de grafeno, la cual es más simple en comparación con la propuesta de otros autores y es validada con espectroscopia Raman. Para ello obtenemos grafeno y pocas capas de grafeno por exfoliación mecánica de grafito Kish. Adquirimos imágenes digitales, a través de un microscopio óptico, de las diferentes muestras depositadas sobre un sustrato de silicio con una película de óxido de silicio de 306.2 nm. Con un programa de análisis de imágenes adquirimos la componente verde de los números RGB, tanto de la muestra como del sustrato; con ello, calculamos el contraste óptico y determinamos el número de capas de grafeno. Logramos determinar de una a cuatro capas de grafeno.

Background: The uterus has been described as a feminine symbol, sexuality and reproduction, therefore the hysterectomy has a multiple meaning by the woman. Aims: To describe the meaning that hysterectomy has by a group of hysterectomized women. Method: Qualitative study with 52 hysterectomized women. By the data collection interviews and focus group was used. Results: It were identified 6 dimensions: previous symptoms, sense of wellness of not having uterus, beliefs and myths, the meaning of uterus and surgery, fear and sexuality. Hysterectomy only like a disease solution would be and slanted vision about the reality that the woman live, and therefore moved away of the needs that they and their partners have. Conclusion: The health care professionals must understand the complex process that means her to assume herself like hysterectomized woman.

Antecedentes: El útero ha sido descrito como un símbolo de femineidad, sexualidad y reproducción por lo que su extracción conlleva una serie de significados para la mujer. Objetivo: Describir el significado de la histerectomía para un grupo de mujeres sometidas a esta cirugía. Método: Estudio cualitativo realizado en 52 mujeres histerectomizadas. Para la recolección de los datos se utilizaron entrevistas en profundidad y grupos focales. Resultados: Se identificaron 6 dimensiones: síntomas previos, alivio de no tener útero, mitos y creencias, significado del útero y de la cirugía, miedo y sexualidad. Considerar a la histerectomía solamente como tratamiento de una enfermedad sería una visión sesgada de la realidad que vive la mujer, y por lo tanto, alejada de las necesidades que ellas y sus parejas tienen. Conclusión: Los profesionales que intervienen a la mujer deben comprender el proceso complejo que significa para ella asumirse como mujer histerectomizada.

Com a implantação de cursos de licenciatura em Matemática e em Física na modalidade de ensino a distância, em 2005, na Universidade Federal de Santa Catarina, destacou-se a preocupação com a avaliação de tais cursos, a fim de viabilizar uma prática avaliativa sistematizada destes cursos. Assim, paralelamente ao trabalho das equipes que planejavam os cursos de licenciatura, foi instituída uma comissão, no âmbito do Centro de Ciências da Educação e do Centro de Ciências Físicas e Matemática, para pensar a avaliação dos cursos. Um modelo de avaliação foi elaborado e colocado em prática desde então. O modelo tem como idéia primordial a integração das vertentes de avaliação e de pesquisa, garantindo abarcar as dimensões quantitativa e qualitativa dos cursos. O objetivo neste artigo é apresentar, discutir e analisar o modelo de pesquisa e avaliação que até este momento tem orientado a realização das avaliações e pesquisas, relativas à implementação dos cursos de Licenciatura em questão.

The implementation of undergraduate distance learning programs in Mathematics and Physics in 2005, at the Federal University of Santa Catarina, brought about concerns related to quality and excellence in distance education, resulting in the need of a systematized practice of evaluation. Thus, along with the work of the groups planning the programs, a committee was instituted, encompassing the Education, Mathematics and Physics Departments. An evaluation design was worked out and put into practice since then. The design has as its main idea the integration of evaluation and research areas, asserting the accomplishment of the quantitative and qualitative dimensions of the programs. The purpose of this article is to present, discuss and analyze the evaluation and research design which, up to this moment, has guided the studies related to the implementation of the distance learning bachelor programs.

Abstract One of the short term goals of mucogingival surgery is to accomplish complete root coverage in teeth with gingival recession, in order to reduce root sensibility and improve dental esthetics. Multiple surgical alternatives have been proposed to preserve the residual tissue and blood supply around the defect. The purpose of this article was to present a clinical case (report to one year) using the surgical technique of subepithelial graft of connective tissue and coronal graft for the treatment of two gingival recessions Miller class II.

Resumen Una de las metas de la cirugía mucogingival es lograr cobertura radicular en dientes donde se presentan recesiones gingivales, las cuales pueden llegar a causar problemas de sensibilidad radicular y comprometer la estética dental. Para obtener cobertura radicular se han propuesto varias alternativas quirúrgicas que promueven la preservación del tejido residual y la irrigación sanguínea alrededor del defecto. En el artículo se presenta un caso clínico (reporte a un año) utilizando la técnica de injerto subepitelial de tejido conjuntivo para el tratamiento de dos recesiones gingivales clase II de Miller.

The following study describes the attitudes that Elementary School training teachers and High School History and Geography training teachers show towards including special needs students (NEE) in the regular education system. An enquiry considering variables rela-ted to students, teachers and classrooms was applied. Outcomes show that, in general, the sample presents a favorable tendency towards inclusión; nevertheless, this positive tendency only appears in variables related to students. Besides, significant statistical differences were detected when comparing responses of both groups on study. These dissimilarities are probably associated to the training teachers' academic formation and/or the professional interests of this particular group of training teachers.

El siguiente estudio describe las actitudes que un grupo de estudiantes de pedagogía en Educación General Básica y Pedagogía en Historia y Geografía manifiesta hacia la inclusión de alumnos/as con necesidades educativas especiales (NEE) en el sistema de educación regular. El diseño descriptivo de tipo encuesta consideró variables relativas al alumnado, profesorado y aula. Los resultados indican que, en general, la muestra presenta una tendencia favorable hacia la inclusión, sin embargo, esta disposición positiva sólo se presenta decididamente en las variables referidas al alumnado. Además, se encontraron diferencias estadísticamente significativas entre las respuestas obtenidas en ambas titulaciones estudiadas. Probablemente estas diferencias estén asociadas a la formación académica y/o a los propios intereses profesionales de los futuros profesores.

Com o objetivo de verificar a biodisponibilidade do beta-caroteno da folha de mandioca (Manihot esculenta Crantz) foi realizado um ensaio biológico baseado no modelo de esgotamento das reservas hepáticas de vitamina A em ratos. Um grupo de ratos depletados de vitamina A hepática recebeu folha desidratada de mandioca como fonte beta-caroteno durante 25 dias, e foram comparados com um grupo que recebeu ração com vitamina A, outro grupo com ração sem vitamina A e um último grupo com beta-caroteno. O grupo Zero foi constituído de 8 animais que receberam durante 15 dias ração à base de caseína, deficiente de vitamina A. Ao final do experimento todos os animais foram sacrificados e seus fígados e plasmas analisados por Cromatografia Líquida de Alta Eficiência (CLAE), sendo verificado que a biodisponibilidade do beta-caroteno da folha desidratada de mandioca foi baixa.

The biological availability of beta-carotene in cassava leaves (Manihot esculenta Crantz), was verified by means of an assay based on the hepatic depletion of vitamin A reserves model in rats. Rats depleted of hepatic vitamin A received dehydrated cassava leaves as beta-carotene source for 25 days and were compared to groups that received diets with vitamin A, beta-carotene and without vitamin A. The Zero group was formed of 8 animals that received a diet based on casein, lacking vitamin A, during 15 days. At the end of the experiment, all animals were killed and their livers, serum and feces were analyzed by high performance liquid chromatography (HPLC), and it was verified that the bioavailability of beta-carotene of dehydrated cassava leaves was lower.

Com o objetivo de verificar alterações estruturais nos isômeros todo-trans, 9- e 13-cis do beta-caroteno foi realizado um ensaio biológico baseado no modelo de esgotamento das reservas hepáticas de carotenóides em ratos. Animais depletados desses carotenóides receberam, durante quinze dias, os isômeros puros todo-trans, 9-cis e 13-cis do beta-caroteno. Ao final deste período, verificou-se a ocorrência de re-isomerização in vivo desses isômeros, a partir da quantificação dos mesmos depositados no fígado dos animais. Foi observada re-isomerização do 9-cis em todo-trans, do todo-trans em 9-cis, do 13-cis em 9-cis e todo-trans. O 13-cis foi mais susceptível à isomerização que o 9-cis, pois este último passou a todo-trans e nunca a 13-cis. Já o 13-cis, tanto pode se transformar em 9-cis quanto em todo-trans.

A biological assay was conducted in order to verify the possible structural interconversion of the 9-cis, 13-cis and all-trans beta-carotene isomers. The different beta-carotene isomers (either all-trans b-carotene, 9-cis beta-carotene or 13-cis b-carotene) were administered for fifteen days to rats that had been previously depleted of liver carotenoids. It was possible to verify the in vivo re-isomerization of the isomers. The 9-cis beta-carotene isomer can be converted into all-trans beta-carotene, the latter re-isomerized into 9-cis beta-carotene, and the 13-cis beta-carotene modified into 9-cis beta-carotene and all-trans beta-carotene. From these results it can be concluded that the 13-cis isomer was more susceptible to isomerization than was the 9-cis beta-carotene, because the latter could be isomerized into all-trans, but not into 13-cis beta-carotene, while the 13-cis can be either modified to 9-cis or to all-trans beta-carotene.