The education that we have and the one we want: a perspective on discourses

This research has the purpose of gaining more understanding about the actions and policies put in place in order to ensure the training of professionals that work in the services of the State Health Care System, considering the direct and intrinsic relation between the education and its final quality. Broken down into 3 perspectives, here labeled as voices, we have tried to identify, by means of the discourses on social control in the area of health, the system's administration, and education represented by the schools of nursing, what are the criticisms and propositions concerning the theme of professional training for the State Health Care System. The text deals with the terms used in the context of professional training, as well as a critical reflection about the new tendencies and paradigms that are on the agenda in current debates and discussions.     

Effects of long-term exposure to Cu2+ and Cd2+ on the pentose phosphate pathway dehydrogenase activities in the ovary of adult Bufo arenarum: possible role as biomarker for Cu2+ toxicity

The effects of copper and cadmium on metabolism through the pentose phosphate pathway were evaluated in Bufo arenarum toad ovary. The effects of the two metals on dehydrogenases from this pathway were evaluated by three experiments: (1) in samples obtained from control females with addition of the metals to the reaction mixture (in vitro), (2) in samples obtained from control females and after long-term exposure of females to 4 and 100 microg/L of Cu or Cd in the incubation media (in vitro after exposure to the metals in vivo), and (3) 14CO2 production through the pentose phosphate pathway was evaluated after [U-14C]glucose microinjection on ovulated oocytes (in vivo after microinjection of the metals). Results from (1) evidenced inhibition of both enzyme activities but only above 1.5 mM Cu and Cd added to the reaction mixture. In (2) both glucose 6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase activities decreased in samples from the ovaries of females exposed in vivo to Cu, in a concentration-dependent manner (up to 90% in females exposed to 100 microg/L Cu: 2.12 +/- 1.57 NADPH micromol/min microg protein x 10(-5) vs 19.97 +/- 8.54 in control females). Cd treatment of the toads only rendered an inhibitory effect on 6-phosphogluconate dehydrogenase activity after exposure to 4 microg/L of the bivalent cation. (3) In vivo 14CO2 evolution significantly decreased in oocytes coinjected with 6.3 x 10(-3) mM Cu (calculated intracellular final concentration of the metal injected) and radioactive glucose. Cu and Cd concentration in samples from exposed females were always under detection limit by particle-induced X-ray emission. The results presented here are in agreement with a role for both glucose 6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase activities determination as biomarkers of effect and exposure for Cu but not for Cd toxicity.     

The role of age in the development of Schneiderian symptoms in patients with a first psychotic episode

OBJECTIVE: The likelihood of developing psychotic symptoms greatly increases after puberty. In acute psychotic disorders, first rank symptoms (FRS) are prevalent and considered useful for the diagnostic process. The aim of this study was to test for a linear association between age and the probability of occurrence of FRS in patients with a first psychotic episode (FPE). METHOD: A total of 112 patients, consecutively admitted with an FPE, were included at baseline and evaluated yearly over a 3-year period using SCID-I and a checklist of 11 items of FRS. RESULTS: FRS were documented for 65.2% patients at baseline. There was a dose-response relationship in the association between age and FRS. There was no interaction with sex or with final diagnostic category. CONCLUSION: Variation in the expression of the core positive symptoms of psychosis is subject to the influence of underlying age-dependent maturational processes both in terms of occurrence and level of severity.     

Temperature effect in the production of multiple xylanases by Aspergillus fumigatus

This work has evaluated the temperature effect in the production of multiple xylanases by a locally isolated strain of Aspergillus fumigatus Fresenius. Three isoenzymes, identified as xylanases I, II, and III with apparent molecular weight of 45.7 KDa, 39.8 KDa and 18.2 KDa, respectively, were produced in cultures developed at 30 degrees C and at 42 degrees C. The pattern of distribution of xylanase activity among the three isoenzymes was greatly affected by the growth temperature: at 30 degrees C, the total xylanase activity was distributed homogeneously among the three enzymes, while at 42 degrees C, the total xylanase activity was mainly due to the fractions with the highest MW (I and II) and the xylanase III was a minor component.     

Pharmacokinetics of an ultralong sustained-release theophylline formulation when given twice daily in elderly patients with chronic obstructive pulmonary disease: monitoring implications

The steady-state pharmacokinetics of an ultralong sustained release formulation of theophylline (Unilong) twice daily (bid) in elderly hospitalized patients suffering from chronic obstructive pulmonary disease (COPD) have been studied in order to establish guidelines for monitoring. The study was carried out in 37 patients (33 men), aged 60-87 years. Samples were collected from 0 to 12 h after the morning dose on day 9 of treatment with 250 mg bid (n=25) or 375 mg bid (n=12). Considerable variability in apparent clearance (range 0.33-1.49 ml/min per kg of ideal body weight), Css(min)/D (range 0.28-1.86), Css(max)/D (range 0.65-2.33) and (Css(max)-Css(min))/Css(avg) (range 0.18-0.80) was observed. There was no significant correlation between the patient's age and apparent clearance within this elderly population. The concentration-to-dose ratio and the relationship between the steady-state plasma concentration at different times during the dosage interval and Css(avg) are described. It is concluded that the interpatient variability in peak-trough fluctuation of this formulation was higher than that described in healthy volunteers by other investigators, and that the apparent clearance did not decrease with age within this elderly population with COPD. The importance of theophylline monitoring is emphasized and rules to estimate Css(avg) and Css(5h) from Css(0h) when only a single sample obtained before the morning dose is available are given.     

Profile of urinary arsenic metabolites during pregnancy

Chronic exposure to inorganic arsenic (In-As) from drinking water is associated with different health effects, including skin, lung, bladder, and kidney cancer as well as vascular and possibly reproductive effects. In-As is metabolized through the process of methylation, resulting in the production and excretion of methylated species, mainly monomethylarsenate (MMA) and dimethylarsenate (DMA). Because a large percentage of the dose is excreted in urine, the distribution of urinary In-As, MMA, and DMA is considered a useful indicator of methylation patterns in human populations. Several factors affect these patterns, including sex and exposure level. In this study, we investigated the profile of urinary In-As, MMA, and DMA of pregnant women. Periodic urine samples were collected from early to late pregnancy among 29 pregnant women living in Antofagasta, Chile, who drank tap water containing 40 micro g/L In-As. The total urinary arsenic across four sampling periods increased with increasing weeks of gestation, from an initial mean value of 36.1 to a final value of 54.3 micro g/L. This increase was mainly due to an increase in DMA, resulting in lower percentages of In-As and MMA and a higher percentage of DMA. Our findings indicate that among women exposed to moderate arsenic from drinking water during pregnancy, changes occur in the pattern of urinary arsenic excretion and metabolite distribution. The toxicologic significance of this is not clear, given recent evidence suggesting that intermediate methylated species may be highly toxic. Nevertheless, this study suggests that arsenic metabolism changes throughout the course of pregnancy, which in turn may have toxicologic effects on the developing fetus. Key words: arsenic, arsenic metabolism, arsenic methylation, Chile, pregnancy, urinary arsenic.     

Effect of atorvastatin 15 mg/week on serum lipids in patients with hypercholesterolemia

Atorvastatin 15 mg/week was administered to 21 patients with hypercholesterolemia for 2 months. The mean low-density lipoprotein concentration decreased by 20% after treatment.     

Psychopathological dimensions in first-episode psychoses. From the trunk to the branches and leaves

BACKGROUND: Dimensional frameworks for structuring psychopathology have been formulated in recent years to overcome classification problems of categorical approaches. However, few studies have addressed the dilemma of hierarchy within symptoms or dimensions in psychosis. METHODS: This study was designed to examine the hierarchical structure of psychopathological dimensions in first episode psychosis. The sample consisted of 94 first-episode patients psychosis. An exhaustive psychopathological assessment was carried out using the AMDP-system. Consecutive principal component analyses of AMDP symptoms, determining 'a priori' the number of factors to be extracted, were carried out. RESULTS: Following the track of the resulting factor analyses, a 'vertical hierarchical' framework was achieved. Our schema organized dimensions in a series of echelons in which lower tiers are subsumed as subsets of those assigned to higher ranks. In addition, a final model comprising 10 dimensions provided an 'horizontal' and multidimensional structure comprising all relevant psychopathological dimensions in first-episode psychosis. CONCLUSIONS: This study confirmed to a great extent the existence of a hierarchical organization within psychopathological dimensions in 'first-episode' psychosis. The present 'hierarchical and multidimensional' model of psychopathological dimensions allows for selection of the level of complexity of 'candidate phenotypes' to use in neurobiological research of psychosis.