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Chikungunya fever is caused by an RNA arbovirus belonging to the Togaviridae family of the alphavirus genus, called "chikungunya virus", this virus is vectored by Aedes aegypti and Aedes albopictus. In its acute phase, the disease is manifested by fever, arthritis or severe arthralgia, myalgia, headache, photophobia, lymphadenopathy and skin rashes. The symptoms can progress to a subacute to chronic phase, where joint manifestations and fatigue persist. A bibliographic search was carried out in the PubMed, Cochrane, Dovepress and SciELO databases, using the keywords: chikungunya and chikunguña, crossed with the words: chronic arthritis and treatment. A total of 16 articles were included: 6 review articles, 1 systematic review, 4 original articles, 2 clinical trials, 1 letter to Editor letter and 2 case reports. Among the pharmacological options, methotrexate is the most studied drug and competes with the effects of NSAIDs. Non-pharmacological therapies are physiotherapy and physical therapy, used as complements to pharmacological therapy. The use of home therapies, including homeopathy, could also be added, mainly addressing the psychological and cultural factors of the patients.

La fiebre Chikungunya es causada por un arbovirus ARN perteneciente a la familia Togaviridae del género alphavirus, llamado “virus del chikungunya”, este virus tiene como vector el Aedes aegypti y el Aedes albopictus. En su fase aguda la enfermedad se manifiesta por fiebre, artritis o artralgias severas, mialgias, cefalea, fotofobia, linfadenopatías y brotes cutáneos, los síntomas pueden progresar a una fase subaguda hasta crónica, donde persisten las manifestaciones articulares y la fatiga. Se realizó una revisión sistemática en las bases de PubMed, Cochrane, Dovepress y SciELO, utilizando las palabras claves: chikungunya y chikunguña, cruzadas con las palabras: artritis crónica y tratamiento. Se incluyeron en el estudio un total de 16 artículos, 6 artículos de revisión, 4 artículos originales, 2 ensayos clínicos, 2 reportes de caso, 1 revisión sistemática y 1 carta al editor. Entre las opciones farmacológicas, el metotrexato es el fármaco más estudiado y compite con los efectos de los AINE. Como terapias no farmacológicas se encuentran la fisioterapia y la terapia física, utilizados como complementos a la terapia farmacológica. El uso de terapias caseras, incluso la homeopatía, también podrían agregarse, atendiendo principalmente el factor psíquico y cultural de los pacientes.

https://doi.org/10.18004/rpr/2023.09.02.64

Estrategias de agregado de valor territorial: experiencia de bioeconomía circular en Balcarce, Argentina
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Bruno, Mariana Paola

; Cendón, María Laura

; Viteri, María Laura

RIVAR (Santiago)

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jan 2023, Volume 10 N. 28 Pages 58 - 76

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen La preocupación creciente por el incremento de la población mundial, el aumento de la demanda de alimentos y energía, así como por el cambio climático, genera la emergencia de iniciativas de agregado de valor vinculadas al desarrollo de territorios sustentables. El presente artículo se propone analizar el concepto de agregado de valor, y específicamente el agregado de valor territorial, a partir de una experiencia en torno a la bioeconomía circular en el municipio de Balcarce, Buenos Aires, Argentina. Se trata de una empresa innovadora orientada a la cría de insectos a partir de residuos orgánicos, obteniendo proteínas para la alimentación animal y abono. Bajo la metodología de estudio de caso revisamos fuentes secundarias y primarias, y analizamos el conjunto de actividades desarrolladas y coordinadas por la firma. Esta empresa muestra altas potencialidades en generar agregado de valor territorial con cuidado del medioambiente, para lo cual muestra un elevado desarrollo de construcción de redes multiescalares y multidimensionales, articulado entre modelos antagónicos para el desarrollo a nivel local.

Abstract The growing concern about world population increases, high demand for food and energy, as well as climate change, generates the emergence of value-added initiatives linked to the development of sustainable territories. This article aims to analyze the add value concept, and specifically the territorial add value, based on an experience around the circular bioeconomy in Balcarce, Buenos Aires, Argentina. It is an innovative firm oriented to insect breeding from organic waste, obtaining proteins for animal feed and compost. Under the case study methodology, secondary and primary sources were reviewed, and activities developed and coordinated by the firm were analyzed. This firm shows high potential in generating strategies for territorial add value in a sustainable way. Besides, it shows a high development of multiscale and multidimensional networks, articulating between antagonistic models at local level.

https://doi.org/10.35588/rivar.v10i28.5339

Ophthalmological findings in patients suspected with COVID-19 at a tertiary hospital in Pernambuco, Brazil
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Silveira, Ana Karina Téles

; Lynch, Maria Isabel

; Medeiros, Clistenes Stênio Lima De

; Moraes, Bruno Teixeira De

; Remígio, Maria Cecília

; Paiva, Michelle Maria Figueiredo

; Silva, Renata Ribeiro

; Torres, Virgínia Laura Lucas

Arquivos Brasileiros de Oftalmologia

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dec 2022, Volume 85 N. 6 Pages 614 - 619

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Avaliar a frequência dos sintomas oftalmológicos, neurológicos e sistêmicos mais comuns em pacientes sintomáticos atendidos no serviço de triagem de COVID-19 do Hospital das Clínicas da UFPE. Métodos: Cento e quatro pacientes com suspeita clínica de infecção por Sars-Cov-2 foram submetidos a avaliação médica e aplicação de questionário sobre a sintomatologia oftalmológica, neurológica e sistêmica. Todos os participantes do estudo tiveram exame de RT-PCR para COVID-19 solicitado. Resultados: A média de idade foi de 38,8 anos, com 44,23% entre 31 e 40 anos. Mulheres corresponderam a 68,27% dos atendimentos e homens a 31,73%. Os sintomas mais frequentes nos pacientes com RT-PCR positivo foram: tosse (69,23%), febre (42,3%), mialgia (38,46%), hiposmia (38,46%), e ageusia (30,77%). Neste grupo, os sintomas oftalmológicos estiveram presentes em 34,61%, sendo: ardor (19,23%), dor ocular (11,54%), sensação de corpo estranho (7,7%), hiperemia (7,7%) e lacrimejamento (3,84%) os mais encontrados. Conclusões: O quadro clínico sistêmico foi característico de infecção respiratória alta, porém os achados neurológicos de hiposmia e anosmia mostraram-se importantes marcadores para a suspeição dos casos de infecção por COVID-19. Os sintomas oftalmológicos dos pacientes com COVID-19 foram semelhantes aos presentes em outros quadros virais, podendo preceder o quadro sistêmico. Houve uma alta taxa de automedicação para os sintomas gerais quando comparado ao quadro oftalmológico.

ABSTRACT Purpose: This study evaluated the frequency of the most common ophthalmological, neurological, and systemic findings in symptomatic patients seen at a COVID-19 screening service at Hospital das Clínicas - Universidade Federal de Pernambuco. Methods: A total of 104 patients under clinical suspicion of SARS-CoV-2 infection underwent medical evaluation through an ophthalmological and systemic symptoms survey. All participants selected for the study underwent COVID-19 RT-PCR testing. Results: The mean age was 38.8 years, with 44.23% between 31 and 40 years old, 68.27% female, and 31.73% male. The most common symptoms in patients with a positive RT-PCR test were cough (69.23%), fever (42.3%), hyposmia (38.46%), myalgia (38.46%), and ageusia (30.77%). In the positive group, 34.61% presented with ophthalmological symptoms: burning (19.23%), eye pain (11.54%), foreign body sensation (7.7%), hyperemia (7.7%), and tearing (3.84%). Conclusions: Systemic clinical features were characteristic of upper respiratory infection, but neurological findings of hyposmia and anosmia proved to be important markers for suspicion of SARS-CoV-2 infection. Ophthalmic symptoms in patients with COVID-19 were similar to those observed in other viral conditions and may precede systemic conditions. A high rate of self-medication was observed for general symptoms compared with ophthalmological conditions.

https://doi.org/10.5935/0004-2749.20220083

ESTADO DE SITUACIÓN DE LAS ÁREAS DE INVESTIGACIÓN PROVINCIALES
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Barrenechea, Rosario

; Traverso Vior, Natacha

; Torales, Santiago

; Faletty, Carolina

; Gónzalez Villa Monte, Gabriel

; Cabrera, Jorge

; Sandoval, Alejandra

; Mercado, Daniel

; Andino, Gerardo

; Pisarello, María Susana

; Benzi, Patricia

; Zamponi, Hernán

; Elorza, Claudia

; Laino, Carlos

; Laconi, Myriam

; Martín, María Cristina

; Margaría, Laura

; Oliva, Valeria

; Pérez Paso, Andrea

; Fanny Suarez, Elsa

; Pejkovic, Celina

; Mansilla, Celina

; Perichón, Mario

; Andrek, Gastón

; Burgos, Graciela

; Laio, Alejandro

; Peral de Bruno, María

Revista Argentina de Salud Pública

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jan 2022, Volume 14 Pages 66 - 66

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT INTRODUCTION The progress report on provincial areas for public health research was updated through the Ministerial Network for Health Research (REMINSA) METHODS Virtual meetings were held for discussion with REMINSA referents, and a survey in Google Forms® on regulatory, organizational and budgetary behavior was conducted, including task scope and needs for improvement RESULTS A total of 21 responses were received from 21 provinces with referents. There is a broad framework of regulations for human health research and, to a lesser extent, for the promotion of public health research. The results showed that 71% have some institutional structure, 20% offer research grants, and 20% have medical residencies with a research profile. The main activity is regulation or participation in ethics committees. The promotion, dissemination of results and development of evidence-based research projects were relegated (20%). The research areas are well-established in most of the provinces DISCUSSION The challenge lies in promoting the development of these systems in provinces without ministerial areas and strengthening the jurisdictions that do have such areas. REMINSA has identified opportunities to improve communication between jurisdictions, regulations for the promotion of research, and networking for research, management and decision-making.

RESUMEN INTRODUCCIÓN A través de la Red Ministerial de Investigación en Salud (REMINSA) se actualizó el estado de situación de las áreas provinciales de investigación en salud pública MÉTODOS Se realizaron reuniones virtuales de debate con los referentes REMINSA y una encuesta en Google Forms® sobre funcionamiento normativo, organizacional, presupuestario, alcance de tareas y necesidades de mejoras RESULTADOS Se recibieron 21 respuestas de un total de 21 provincias con referentes. Se verificó la existencia de un amplio marco de normativas regulatorias de la investigación en salud humana y, en menor medida, para impulsar la investigación en el marco de la salud pública. El 71% tiene cierta estructura institucional, el 20% ofrece becas de investigación, y el 20% posee residencias con perfil en investigación. La principal actividad es la regulación o participación en comités de ética. La promoción, difusión de resultados y elaboración de proyectos de investigación basada en evidencia quedaron relegadas (20%). Las áreas de investigación están consolidadas en la mayoría de las provincias DISCUSIÓN El desafío consiste en promover el desarrollo de estos sistemas en las provincias que no cuentan con áreas ministeriales y fortalecer las provincias que sí las poseen. REMINSA ha identificado oportunidades de mejorar la comunicación entre jurisdicciones, las normativas de promoción de la investigación y el trabajo en red para la investigación, la gestión y la toma de decisiones. ^s+

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Implementation of Group Interpersonal Psychotherapy in primary care
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Mattos, Maria Isabel Perez

; Mosqueiro, Bruno Paz

; Stuart, Scott

; Salum, Giovanni

; Duzzo, Rosana de Lima

; Souza, Laura Wolf de

; Chini, Ariane

; Fleck, Marcelo Pio de Almeida

Revista de Saúde Pública

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2022, Volume 56 elocation 23

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE To show the implementation process of IPT-G in primary care, including facilitating and obstructing factors, implementation strategies, and training and supervision of primary care professionals. METHODS Quantitative (cross-sectional and longitudinal) analysis of pre and post-knowledge tests; qualitative analyses of the training courses; patient recruitment; conduction of IPT-G sessions; supervision of IPT-G therapists; application of a semi-structured questionnaire to assess, investigate, and develop strategies against the identified barriers. RESULTS About 120 clinicians answered the pre-test; 84 completed the post-test. Pre- and post-test scores of IPT-G knowledge were significantly different. Twenty initially trained clinicians completed additional supervision in IPT-G. Qualitative analysis identified twelve barriers and six facilitators to IPT-G implementation in individual, organizational, and systemic contexts. CONCLUSIONS Implementation of IPT-G in primary care is a complex process with several steps. In the first step, health professionals were successfully trained in IPT-G. However, subsequent steps were more complex. Therefore, careful planning of IPT-G implementation is essential to maximize the success of this innovation.

https://doi.org/10.11606/s1518-8787.2022056003731

Implementation of Group Interpersonal Psychotherapy in primary care
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Mattos, Maria Isabel Perez

; Mosqueiro, Bruno Paz

; Stuart, Scott

; Salum, Giovanni

; Duzzo, Rosana de Lima

; Souza, Laura Wolf de

; Chini, Ariane

; Fleck, Marcelo Pio de Almeida

Revista de Saúde Pública

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2022, Volume 56 elocation 23

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2022056003731

Estudo de Propriedades Psicométricas do M-Chat no Brasil
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Alves, Maria Rachel

; Maia, Fernanda Alves

; Almeida, Maria Tereza Carvalho

; Saeger, Vanessa Souza de Araújo

; Silva, Victor Bruno da

; Bandeira, Laura Vicuña Santos

; Cezar, Ionara Aparecida Mendes

; Oliveira, Steffany Lara Nunes

; Costa, Amanda de Andrade

; Oliveira, Amanda Amaral de

; Silveira, Marise Fagundes

Psicologia: Ciência e Profissão

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2022, Volume 42 elocation e238467

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

Abstract This study aims to assess the psychometric properties of the instrument Modified Checklist for Autism in Toddlers (M-CHAT) in children from 24 to 36 months old with (Group 1/n = 88) and without (Group 2/n = 1116) Autism Spectrum Disorder (ASD). Internal consistency was evaluated and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were estimated. Also, the Receiver Operating Characteristic (ROC) curve was generated. To evaluate the discriminant validity, the proportion of flaws among children with and without ASD was assessed by applying the Chi-square test or by the Exact Fisher test. The number of flaws based on sex, age group, and participant’s group was also compared with the Mann-Whitney Test. The M-CHAT showed high internal consistency (0.78 and 0.86), satisfactory reproductivity (Kappa 0.60 and 0.79 and ICC = 0.87 and 0.89), high sensibility (0.807 and 0.932), specificity (0.927 and 0.706), and NPV (0.984 and 0.992); however, PPV estimates (0.467 and 0.250) were not satisfactory. Regarding the discriminant validity, the proportion of flaws was significantly higher in the group of children with ASD. Moreover, the number of flaws was larger among boys, in the age group 25-36 months, and in the group with ASD. The Brazilian version of M-CHAT has adequate psychometric properties concerning reliability, sensitivity, specificity, NPV and discriminant validity, which makes its application recommendable to track children with ASD signs.

Resumen Ese estudio tuvo como objetivo evaluar las propiedades psicométricas del Modified Checklist for Autism in Toddlers (M-CHAT) en niños de 24 a los 36 meses de edad con (grupo 1/n=88) y sin (grupo 2/n=1116) el trastorno del espectro autista (TEA). Fueron evaluadas la consistencia interna y estimadas la sensibilidad, especificidad, valor predictivo positivo (VPP), valor predictivo negativo (VPN). Además, se construyó la curva Receiver Operating Characteristic (ROC). Para evaluar la validad discriminante se comparó la proporción de los fracasos entre los niños con y sin TEA, utilizando el examen chi-cuadrado o la prueba exacta de Fisher. Se compararon también el número de fracasos según el sexo, edad y grupo de participantes por medio del teste Mann-Whitney. El M-CHAT presentó consistencia interna elevada (0,78 y 0,86), reproductividad satisfactoria (Kappa de 0,60 a 0,79 e CCI = 0,87 e 0,89), alta sensibilidad (0,807 e 0,932), especificidad (0,927 e 0,706) y VPN (0,984 e 0,992), pero las estimativas del VPP (0,467 e 0,250) no fueron satisfactorias. Acerca de la validad discriminante, se observó que la proporción de fallas fue significativamente mayor en el grupo de niños con TEA. El número de fracasos fue mayor entre los niños varones, de 25 a 36 meses de edad y no en el grupo con TEA. La versión brasileña del M-CHAT tiene propiedades psicométricas adecuadas en lo que concierne a la confiabilidad, sensibilidad, especificidad, VPN y validad discriminante, lo que hace que su aplicación sea recomendada para rastrear los niños con señales de TEA.

Resumo O objetivo deste estudo foi avaliar as propriedades psicométricas do Modified Checklist for Autism in Toddlers (M-Chat) em crianças de 24 a 36 meses de idade com (Grupo 1/n = 88) e sem (Grupo 2/n = 1116) o transtorno do espectro do autismo (TEA). Avaliou-se a consistência interna e estimou-se a sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN). Além disso, construiu-se a curva Receiver Operating Characteristic (ROC). Para avaliar a validade discriminante, comparou-se a proporção de falhas entre as crianças com e sem o TEA, utilizando o teste qui-quadrado ou teste Exato de Fisher. Comparou-se ainda o número de falhas segundo sexo, faixa etária e grupo do participante por meio do teste de Mann-Whitney. O M-Chat apresentou consistência interna elevada (0,78 e 0,86), reprodutibilidade satisfatória (Kappa de 0,6 a 0,79 e CCI = 0,87 e 0,89), alta sensibilidade (0,807 e 0,932), especificidade (0,927 e 0,706) e VPN (0,984 e 0,992), porém as estimativas do VPP (0,467 e 0,250) não foram satisfatórias. Quanto à validade discriminante, observou-se que a proporção de falhas foi significativamente maior no grupo de crianças com TEA. Observou-se também que o número de falhas foi maior entre as crianças do sexo masculino, com faixa etária de 25-36 meses e no grupo com TEA. A versão brasileira do M-Chat tem propriedades psicométricas adequadas no que se refere à confiabilidade, sensibilidade, especificidade, VPN e validade discriminante, o que torna recomendável sua aplicação para rastrear crianças com sinais do TEA.

https://doi.org/10.1590/1982-3703003238467

“I don’t need any treatment” – barriers to mental health treatment in the general population of a megacity
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Coêlho, Bruno M.

; Santana, Geilson L.

; Viana, Maria C.

; Wang, Yuan-Pang

; Andrade, Laura H.

Brazilian Journal of Psychiatry

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dec 2021, Volume 43 N. 6 Pages 590 - 598

Abstract: En | Text: En | PDF: En

Objective: Most countries fail to treat individuals with psychopathologies. Investigating treatment barriers and reasons for dropout are key elements to overcoming this scenario. Methods: A representative sample of 2,942 urban-dwelling adults was interviewed face-to-face within a cross-sectional, stratified, multistage probability survey of the general population. Psychiatric diagnosis, severity level, use of services, reasons for not seeking treatment, and treatment dropout were investigated. Results: Only 23% of individuals with a psychopathology of any severity level in the last 12 months received treatment. Low perceived need for treatment (56%) was the most common reason for not seeking treatment. The most visited settings were psychiatric, other mental health care, and general medical care. Among those with a perceived need for treatment (44%), psychological barriers were the most common reason for not seeking it. Treatment dropout was more prevalent among those who visited a general medical care setting. Among individuals still in treatment, human services and psychiatric care were the most common types. Female sex was associated with structural barriers (OR = 2.1). Disorder severity was negatively associated with need barriers (OR = 0.4), and positively associated with structural barriers (OR = 2.5) and psychological barriers (OR = 2.5). Conclusion: Despite the need for treatment and better services, psychological barriers were the major reason for not seeking treatment. Apart from providing more specialists, investing in awareness, de-stigmatization, and information is the ultimate strategy for improving psychiatric care.

https://doi.org/10.1590/1516-4446-2020-1448

Las fiestas como estrategia de valorización de recursos territoriales: experiencias en la Provincia de Buenos Aires, Argentina
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Velarde, Irene

; Barrionuevo, Cintia

; Bruno, Mariana

; Cendón, María Laura

RIVAR (Santiago)

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sep 2021, Volume 8 N. 24 Pages 199 - 217

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract In recent decades, due to the advance of standardization, relocation and other transformations in the agri-food system, initiatives have emerged to enhance products considered typical and somehow related to cultural heritage. Identity, tradition and typicality, among other concepts, were among the arguments mobilized in a type of territorial innovation processes: the Agri-food Festivities. In a context where many different festivals take place in Argentina, this paper focuses on six cases from Buenos Aires Province: Fiesta del Vino de la Costa de Berisso, Fiesta del Alcaucil platense, Fiesta del Tomate Platense, Fiesta Salame Quintero de Mercedes, Fiesta del Postre Balcarce and Fiesta del Salame de Tandil. Through bibliographic review and interviews, those experiences are compared using the Localized Agri-Food Systems approach and examining their processes, tensions and the role they play as a value enhancement strategy. Among the results, heterogeneity stands out. Through agri-food festivals, local products are promoted for tourism but visibility and link between spaces and actors of the territory are also given. Recognition, after all, not only reinforces and resignifies links between the products and the places, it also rises contradictions.

Resumen En las últimas décadas, ante el avance de procesos de estandarización, deslocalización en el sistema agroalimentario, emergieron iniciativas de valorización de productos típicos, relacionados con el patrimonio cultural. Identidad, tradición y tipicidad estuvieron entre los argumentos movilizados en un tipo de innovación territorial: las Fiestas agroalimentarias. Después de indagar en fiestas que tienen lugar en el territorio argentino, este artículo focaliza en seis casos de la Provincia de Buenos Aires: Fiesta del Vino de la Costa de Berisso, Fiesta del Alcaucil Platense, Fiesta del Tomate Platense, Fiesta del Salame Quintero de Mercedes, Fiesta del Postre Balcarce y Fiesta del Salame de Tandil. A partir de una revisión bibliográfica y entrevistas, se comparan experiencias desde el enfoque de Sistemas Agroalimentarios Localizados para reflexionar en torno a características, tensiones y qué rol desempeñan como estrategia de valorización. Los resultados destacan que las fiestas agroalimentarias promocionan productos locales para el turismo pero también refuerzan y resignifican vínculos entre actores, producto y territorio. Asimismo emergen tensiones en torno a la fidelización del consumidor/asistente al producto y/o al evento, la producción artesanal/industrial, la articulación de los actores locales y/o extralocales que ponen en debate a las fiestas como estrategia de valorización.

https://doi.org/10.35588/rivar.v8i24.5191 42 downloads

10.

El rol de las agronomías y acopios en la consolidación del modelo de agronegocios en Balcarce (2000 – 2019)
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Bruno, Mariana Paola

; Viteri, Maria Laura

; Sili, Marcelo

Mundo agrario

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aug 2021, Volume 22 N. 50 elocation e171

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract The aim of this research paper was to reflect upon the role of agronomies and cereal traders in the social construction of Balcarce territory (Southeast of Buenos Aires province) since the year 2000. It focused on the interactions between global and local practices. After having carried out and analysed semi-structured interviews to company managers, employees and qualified informants, it was concluded that agricultural supply distributors are key in organizing local production systems. The practices and interactions among the different actors of this assemblage collaborate in the construction of a space of control and discipline under the command of transnational companies.

Resumen El objetivo de este trabajo es reflexionar sobre el rol de las agronomías y acopios en la construcción social del territorio de Balcarce (sudeste bonaerense) a partir del año 2000. Para ello, se focaliza en las interacciones entre lo global y local, a través de entrevistas semiestructuradas a responsables de empresas, empleados e informantes calificados. Se concluye que los distribuidores de agroinsumos son clave en la organización de los sistemas productivos locales. Las prácticas e interacciones entre los diferentes actores de este ensamblaje colaboran en la construcción de un espacio de control y disciplinamiento al comando de las empresas transnacionales.

https://doi.org/10.24215/15155994e171 34 downloads

11.

Cashew nut-based beverage: development, characteristics and stability during refrigerated storage
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LIMA, Janice Ribeiro

; BRUNO, Laura Maria

; WURLITZER, Nedio Jair

; SOUSA, Paulo Henrique Machado de

; HOLANDA, Samara Alves de Mesquita

Food Science and Technology

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jun 2021, Volume 41 Pages 60 - 64

Abstract: En | Text: En | PDF: En

Abstract A cashew nut-based beverage was obtained using broken cashew kernels and its composition and stability were evaluated during refrigerated storage for 60 days. Sensory tests were performed to define the formulation, testing the best proportion between kernels and water, the effect of kernel roasting, the ideal sweetness, the beverage attributes and the sensory acceptance. A cashew nut beverage can be obtained by grinding the kernel with water in the proportion of 1:10 (m/m) with added sugar at 3%, followed by heat treatment at 140ºC for four seconds. The proximate composition was 11.49% total solids, 0.26% ashes, 1.83% proteins, 3.97% lipids and 5.43% total carbohydrates. The pH remained above 6.49 and the color darkened during storage. The product was considered microbiologically safe and shelf-stable for at least 2 months, and sensory acceptance remained at an average value of 7.1 on a 9-point hedonic scale.

https://doi.org/10.1590/fst.33819 570 downloads

12.

PROCESO DE ACTUALIZACIÓN DE LA AGENDA NACIONAL DE INVESTIGACIÓN EN SALUD PÚBLICA 2021-2022
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Vior, Natacha Traverso

; Barrenechea, Rosario

; Torales, Santiago

; Lago, Manuel

; Carbonelli, Carla

; Faletty, Carolina

; Monte, Gabriel González Villa

; Cabrera, Jorge

; Sartor, Paula

; Sandoval, Alejandra

; Mercado, Daniel

; Andino, Gerardo

; Pisarello, María Susana

; Benzi, Patricia

; Zamponi, Hernán

; Elorza, Claudia

; Lamo, Carlos

; Laconi, Myriam

; Martín, María Cristina

; Margaría, Laura

; Oliva, Valeria

; Paso, Andrea Pérez

; Suarez, Elsa Fanny

; Pejkovic, Celina

; Mansilla, Celina

; Perichón, Mario

; Andrek, Gastón

; Burgos, Graciela

; Laio, Alejandro

; Bruno, María Peral de

; Sobarzo, Analía

; Cava, Gonzalo La

; Crudo, Denis

; Pozo, Luciana

; Ceriotto, Mariana

; Álvarez, Daniela

; Silberman, Pedro

; Pereyra, Ana Teresa

; Toledo, Laura

Revista Argentina de Salud Pública

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feb 2021, Volume 13 Pages 301 - 310

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT INTRODUCTION : A participatory National Public Health Research Agenda (ANISP) with thematic prioritization is a strategic element to generóte evidence-based recommendations and public policies that have a positive impact on the health of populations and enable to achieve health objectives. The Directorate of Health Research (DIS) ofthe Argentine Ministry of Health (MSAL), through the Ministerial NetWork of Health Research (REMINSA), along with adors from the provincial and national government levels belonging to public, privóte, health, academic and research sectors participated in the update of the ANISP. They adapted the original tooI proposed by the Pan American Health Organizatlon and used in the process in 2019. The update included different stages. The selection ofthe topics had the legitimacy, recognition and participation ofthe actors involved, related to health, to government and privóte management and to scientific research; the work was conducted in a federal and transversal manner by consensus with the provincial networks and a Central Advisory Committee in the MSAL. Based on the preliminary guidelines obtained, a semi-structured online survey was developed and distributed to all federal actors, receiving 431 responses. The process resulted in 55 priorilized guidelines, divided into 6 thematic oreas and 33 sub-themes, selected by voting according to importance, impact and feasibility.

RESUMEN INTRODUCCIÓN : Una Agenda Nacional de Investigación en Salud Pública (ANISP) participativa y con priorización temática constituye un elemento estratégico para generar recomendaciones y políticas públicas basadas en evidencia, que imparten positivamente en la salud de las poblaciones y permitan lograr los objetivos sanitarios. En la actualización de la ANISP participaron la Dirección de Investigación en Salud (DIS) del Ministerio de Salud de la Nación (MSAL), a través de la Red Ministerial de Investigación en Salud (REMINSA), y actores de los niveles gubernamentales provinciales y nacionales pertenecientes a los sectores público, privado, de la salud, académico y de investigación. Se adaptó la herramienta original propuesta por la Organización Panamericana de la Salud, utilizada en el proceso en 2019. La actualización abarcó diferentes etapas. La selección de los temas contó con la legitimidad, reconocimiento y participación de los actores vinculados a la salud, a la gestión gubernamental y privada y a la investigación científica; se trabajó de manera federal y transversal, por consenso con las redes provinciales y un Comité Central Asesor en el MSAL. A partir de los lineamientos preliminares obtenidos, se elaboró una encuesta en línea semiestructurada, que fue distribuida a todos los actores federales y recibió 431 respuestas. El proceso resultó en 55 lineamientos priorizados, divididos en 6 áreas temáticas y 33 subtemas, seleccionados por votación según importancia, impacto y factibilidad.

620 downloads

13.

Soybean meal from damaged grains replacing standard soybean meal in diets of feedlot lambs
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Carvalho, Laura Barbosa de

; Abreu, Matheus Lima Corrêa

; Caneppele, Maria Aparecida Braga

; Corrêa, Gerusa da Silva Salles

; Vieira, Bruno Serpa

; Lima, Leni Rodrigues

; Guerra, Wanderlei Dias

; Cabral, Luciano da Silva

Revista Brasileira de Zootecnia

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2021, Volume 50 elocation e20190268

Abstract: En | Text: En | PDF: En

ABSTRACT Two studies were carried out to evaluate the effects of levels of soybean meal produced from damaged soybean grains replacing normal soybean meal on in vitro and in situ digestibility of ruminant diets as well as on intake, digestibility, and animal performance of growing/finishing lambs. In trial 1, we evaluated the in vitro digestibility of each soybean meals (normal and damaged), as well as diets containing levels of the damaged replacing the normal (0, 333, 667 and 1,000 g.kg−1) soybean meal on kinetic parameters of in vitro cumulative gas production, in vitro dry matter and crude protein digestibility, in situ rumen-degradable protein, rumen-undegradable protein, and in vitro intestinal digestibility of rumen-undegradable protein. In trial 2, we used 48 growing/finishing lambs to evaluate the effects of damaged soybean meal levels (0, 333, 667, and 1,000 g.kg−1) replacing normal soybean meal in feedlot diets (20:80 roughage:concentrate ratio) on intake and digestibility of nutrients and on animal performance. The damaged soybean meal presented lower values for total gas production and in vitro dry matter digestibility than normal soybean meal. Higher rumen-undegradable protein was estimated for damaged soybean meal than for the normal and consequently lower rumen-degradable protein for damaged compared to normal. Because of the lower rumen-degradable protein, damaged soybean meal promoted lower in vitro ammonium nitrogen (NH3-N) concentrations than the normal in feedlot diets. In the in vivo trial, there were no effects of damaged soybean meal levels in the diets on intake and digestibility of nutrients (dry matter, organic matter, crude protein, and fiber) as well as on total weight gain, average daily gain, carcass yield, or feeding efficiency. Thus, damaged soybean meal can fully replace the normal one in lamb feedlot diets (in up to of 1,000 g.kg−1 of the normal soybean meal) without causing adverse effects on intake and digestibility of nutrients and on animal performance.

https://doi.org/10.37496/rbz5020190268 59 downloads

14.

SHORTEN PREOPERATIVE FASTING AND INTRODUCING EARLY EATING ASSISTANCE IN RECOVERY AFTER GASTROJEJUNAL BYPASS?
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WENDLER, Eduardo

; NASSIF, Paulo Afonso Nunes

; MALAFAIA, Osvaldo

; BRITES NETO, Jose Luzardo

; RIBEIRO, José Guilherme Agner

; PROENÇA, Laura Brandão DE

; MATTOS, Maria Eduarda

; ARIEDE, Bruno Luiz

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2021, Volume 34 N. 3 elocation e1606

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Racional: A resposta metabólica ao trauma cirúrgico é potencializada pelo jejum pré-operatório prolongado que contribui para o aumento da resistência à insulina. Esta manifestação é mais intensa no 1º e 2º dias de pós-operatório e é diretamente proporcional ao porte da operação. Objetivo: Comparar se a abreviação do jejum pré-operatório e a realimentação precoce no pós-operatório associado à restrição hídrica no trans e pós-operatório interferem na evolução dos pacientes submetidos ao bypass gastrojejunal. Métodos: Foram recrutados 80 pacientes indicados ao bypass gastrojejunal em Y-de-Roux. Eles foram distribuídos randomicamente em dois grupos: ringer lactato (RL) que fizeram jejum de 6 h para sólidos, administrando 50 g de maltodextrina em 100 ml de água mineral 2 h antes do início da anestesia e de soro fisiológico (SF) que fizeram jejum de 12 h para sólidos e líquidos. A anestesia foi padronizada para os dois grupos. Durante o procedimento operatório no RL foi administrado 1500 ml solução de ringer lactato e no SF 2500 ml de soro fisiológico (0,9% de cloreto de sódio). Em ambos os grupos foram analisados durante a intubação a ocorrência ou não de bronco-aspiração e mensurado o volume gástrico residual após abertura da cavidade abdominal. No pós-operatório do Grupo RL, os pacientes iniciaram dieta liquida após 24 h do término do procedimento operatório; no Grupo SF foi mantido jejum nas primeiras 24 h, prescrição de 2000 ml de soro fisiológico e início da dieta líquida restrita com 36 h. Cada paciente realizou no pós-operatório imediato, ainda na sala de cirurgia, a dosagem de CPK, insulina, sódio, potássio, ureia, creatinina, PaCO2, pH e bicarbonato e em 48 h repetiu-se a coleta destes exames. Resultados: Não houve episódios de broncoaspiração e fístulas gastrojejunais em ambos os grupos. Na análise do volume residual gástrico dos grupos SF e RL, as médias de volume foram respectivamente 16,5 e 8,8 apresentando significância estatística entre os grupos. Nos exames laboratoriais não houve diferença entre os grupos no sódio; nível sérico de potássio no SF foi maior (p=0,029); ureia e creatinina maiores no RL; CPK não apresentou diferenças; insulina no grupo SF foram maiores; pH foi maior no SF; bicarbonato de sódio evidenciou diferença significativa em todos o momentos; PaCO2 no RL foi maior. Na análise de incidência de náusea e flatos não foram observados significância estatística entre os grupos. Conclusões: A abreviação do jejum pré-operatório e a realimentação precoce no pós-operatório de bypass gastrojejunal em Y-de-Roux com a aplicação de programas como ERAS ou Projeto Acerto aceleram a recuperação do paciente, diminuindo o volume gástrico residual e o nível de insulina, e não predispõem complicações.

ABSTRACT Rational: The metabolic response to surgical trauma is enhanced by prolonged preoperative fasting, contributing to increased insulin resistance. This manifestation is more intense on the 1st and 2nd postoperative days and is directly proportional to the size of the operation. Aim: To compare whether preoperative fasting abbreviation and early postoperative refeeding associated with intraoperative and postoperative fluid restriction interfere in the evolution of patients undergoing gastrojejunal bypass. Methods: Eighty patients indicated for Roux-en-Y gastrojejunal bypass were selected. They were randomly divided into two groups: Ringer Lactate (RL) group, who underwent a 6 hours solids fasting, with the administration of 50 g of maltodextrin in 100 ml of mineral water 2 hours before the beginning of anesthesia; and Physiologic Solution (PS) group, who underwent a 12 hours solids and liquids fasting. Anesthesia was standardized for both groups. During the surgical procedure, 1500 ml of ringer lactate solution was administered in the RL and 2500 ml of physiological solution (0.9% sodium chloride) in the PS. In both groups, the occurrence of bronchoaspiration was analyzed during intubation, and the residual gastric volume was measured after opening the abdominal cavity. In the postoperative period in Group RL, patients started a liquid diet 24 hours after the end of the operative procedure; whilst for PS group, fasting was maintained for the first 24 hours, it was prescripted 2000 ml of physiological solution and a restricted liquid diet after 36 hours. Each patient underwent CPK, insulin, sodium, potassium, urea, creatinine, PaCO2, pH and bicarbonate dosage in the immediate postoperative period, and 48 hours later, the exams were repeated. Results: There were no episodes of bronchoaspiration and gastrojejunal fistulas in either group. In the analysis of the residual gastric volume of the PS and RL groups, the mean volumes were respectively 16.5 and 8.8, which shows statistical significance between the groups. In laboratory tests, there was no difference between groups in sodium; PS group showed a higher level of serum potassium (p=0.029); whilst RL group showed a higher urea and creatinine values; CPK values were even for both; PS group demonstrated a higher insulin level; pH was higher in PS group; sodium bicarbonate showed a significant difference at all times; PaCO2 values in RL group was higher than in PS. In the analysis of the incidence of nausea and flatus, no statistical significance was observed between the groups. Conclusions: The abbreviation of preoperative fasting and early postoperative refeeding of Roux-en-Y gastrojejunal bypass with the application of ERAS or ACERTO Project accelerated the patient’s recovery, reducing residual gastric volume and insulin level, and do not predispose to complications.

https://doi.org/10.1590/0102-672020210003e1606

15.

IS THE WAIST/HEIGHT RATIO A BETTER PARAMETER THAN BMI IN DETERMINING THE CARDIOMETABOLIC RISK PROFILE OF OBESE PEOPLE?
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MALAFAIA, Andressa Bressan

; NASSIF, Paulo Afonso Nunes

; LUCAS, Ricardo Wallace das Chagas

; GARCIA, Rodrigo Ferreira

; RIBEIRO, José Guilherme Agner

; PROENÇA, Laura Brandão DE

; MATTOS, Maria Eduarda

; ARIEDE, Bruno Luiz

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2021, Volume 34 N. 3 elocation e1610

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Racional: O aumento da prevalência da obesidade levou ao aumento significativo da ocorrência de síndrome metabólica, fator de risco reconhecido para aumento da morbimortalidade por doenças cardiovasculares. A hiperglicemia ou diabetes mellitus do tipo 2, dislipidemia e hipertensão arterial são seus principais componentes. Desde 2015, diretrizes internacionais reconheceram os benefícios da cirurgia bariátrica em cada fator isolado desta síndrome. Objetivos: Avaliar o impacto do bypass gástrico em Y-de-Roux nesta síndrome comparando períodos pré e pós-operatório com análise laboratorial, e comparar a razão cintura/estatura e o IMC em relação a determinação do perfil de risco cardiometabólico. Métodos: Realizou-se um estudo retrospectivo com base prospectiva selecionando 80 pacientes submetidos à bypass gástrico em Y-de-Roux. Foram analisados o colesterol total, HDL, LDL, triglicerídeos, glicemia de jejum, hemoglobina glicada, insulina, índice de massa corpórea (IMC), vitamina D, vitamina B12, perímetro abdominal e relação cintura/estatura em três períodos: o pré-operatório de 1 a 6 meses, pós-operatório de 1 a 6 meses e pós-operatório de 1 a 2 anos. Resultados: Houve melhora em todos os parâmetros das análises clínicas. O IMC, no pré-operatório, teve a média dos valores de 39,8, no pré-operatório de 1 a 6 meses, os valores caíram para 33,2 e no pós-operatório de 1 ano média foi de 26. O perímetro abdominal teve média dos valores de 118,5, no pré-operatório, 105,2 no pós-operatório de 1 a 6 meses e 90,3 no pós-operatório de 1 a 2 anos. A relação cintura/estatura teve 0,73, 0,65 e 0,56 no pré, pós 1 a 6 meses e 1 a 2 anos respectivamente. Conclusão: O bypass gástrico em Y-de-Roux melhora a síndrome metabólica e a relação cintura/estatura é superior ao IMC na avaliação do perfil do risco cardiometabólico.

ABSTRACT Background: The increased prevalence of obesity has led to a significant increase in the occurrence of metabolic syndrome, a recognized risk factor for increased morbidity and mortality from cardiovascular diseases. Hyperglycemia or type 2 diabetes mellitus, dyslipidemia and arterial hypertension are its main components. Since 2015, international guidelines have recognized the benefits of bariatric surgery in each isolated factor of this syndrome. Aim: To evaluate the impact of Roux-en-Y gastric bypass in this syndrome comparing pre- and postoperative periods with laboratory analysis and to compare waist/height ratio and BMI in relation to the determination of the cardiometabolic risk profile. Methods: A retrospective study was carried out, selecting 80 patients undergoing Roux-en-Y gastric bypass. Total cholesterol, HDL, LDL, triglycerides, fasting glucose, glycated hemoglobin, insulin, body mass index (BMI), vitamin D, vitamin B12, waist circumference and waist/height ratio in three periods were analyzed: the preoperative period from 1 to 6 months, postoperative from 1 to 6 months and postoperative from 1 to 2 years. Results: There was an improvement in all parameters of the clinical analyses. The preoperative BMI had a mean value of 39.8, in the preoperative period from 1 to 6 months, the values dropped to 33.2 and in the postoperative period of 1 year, the mean was 26. The perimeter mean values of 118.5 preoperatively, 105.2 postoperatively from 1 to 6 months and 90.3 postoperatively from 1 to 2 years. Waist/height ratio was 0.73, 0.65 and 0.56 in pre, post 1 to 6 months and 1 to 2 years respectively. Conclusion: Roux-en-Y gastric bypass improves metabolic syndrome and waist-to-height ratio is superior to BMI in the assessment of the cardiometabolic risk profile.

https://doi.org/10.1590/0102-672020210003e1610

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