This study presents a Brazilian teaching-learning experience in basic education where game development is used to promote both digital and scientific literacy throughout the National Common ...Curricular Base (BNCC). Focused on students’ cognitive aspects, the approach presents a pedagogical architecture based on systems development. Thus, it was possible to catalyze convergence between interest in the Science curricular program and the result of knowledge acquisition - such as skills development - by its means. The experiment was carried out centered on genetics studies where students collaboratively produced a digital game, improving in school assessment performance as an outcome. Therefore, we corroborate the effectiveness of creating games as an educational strategy able to optimize aspects of creativity, communication, collaboration, logical reasoning, problem-solving, abstract thinking and resilience.
Atrial fibrillation is the most common cardiac arrhythmia and has important clinical repercussions, increasing thromboembolic events and mortality. The CHA2DS2-VASc and HAS-BLED scores assist the ...clinician in assessing the benefits and risks of antithrombotic therapy.
The aim of this study was to assess and improve the quality of prophylactic antithrombotic therapy prescribed to patients with atrial fibrillation.
This was a quality study, based on a cycle of assessment and improvement, applied to the population of a family health unit, consisting of an initial assessment, an educational intervention and a second assessment. Both scores were calculated for all patients. Whenever the CHA2DS2-VASc score recommended initiation of anticoagulation, the risk was calculated by the HAS-BLED score; it was thus possible to determine for each patient if the prescribed therapy was appropriate.
The first assessment included 105 patients, of whom 49.5% had appropriate prophylactic therapy according to their scores. In the second assessment, four months after the educational intervention, 60.0% had been prescribed appropriate therapy, which represented a 21.2% improvement.
In both assessments, inappropriate treatment was due to non-prescription of prophylactic oral anticoagulation. This quality cycle serves as a tool for continuous assessment in the pursuit of improved care for patients with atrial fibrillation.
A fibrilhação auricular é a arritmia cardíaca mais comum. Tem repercussões clínicas importantes pelo aumento de fenómenos tromboembólicos e da mortalidade. Os scores CHA2DS2VASc e HAS-BLED auxiliam o ...clínico a ponderar os benefícios e riscos da terapêutica antitrombótica.
Pretendeu-se avaliar e melhorar a qualidade da terapêutica profilática antitrombótica prescrita a doentes com fibrilhação auricular.
É um estudo de qualidade integrando um circuito de avaliação e melhoria, aplicado à população de uma unidade de saúde familiar. O ciclo era composto por uma primeira avaliação, intervenção educacional e fechava-se com uma segunda avaliação. Calcularam-se ambos os scores para todos os doentes. Sempre que o CHA2DS2VASc recomendava o início de anticoagulantes ponderou-se o risco versus benefício com o HAS-BLED. Assim foi possível determinar para cada doente se a terapêutica prescrita era adequada.
Na primeira avaliação foram incluídos 105 doentes, dos quais 49,5%, segundo a ponderação dos scores, tinham uma terapêutica profilática adequada. Na segunda avaliação, quatro meses após a intervenção, a adequação terapêutica foi de 60,0%. A variação correspondeu a uma melhoria de 21,2% quanto ao número de doentes com terapêutica adequada.
Em ambas as avaliações a inadequação terapêutica deveu-se à não instituição de profilaxia com anticoagulantes orais. Este ciclo de qualidade serve como ferramenta para se manter uma avaliação contínua na busca de uma melhoria de assistência aos doentes com fibrilhação auricular.
Atrial fibrillation is the most common cardiac arrhythmia and has important clinical repercussions, increasing thromboembolic events and mortality. The CHA2DS2-VASc and HAS-BLED scores assist the clinician in assessing the benefits and risks of antithrombotic therapy.
The aim of this study was to assess and improve the quality of prophylactic antithrombotic therapy prescribed to patients with atrial fibrillation.
This was a quality study, based on a cycle of assessment and improvement, applied to the population of a family health unit, consisting of an initial assessment, an educational intervention and a second assessment. Both scores were calculated for all patients. Whenever the CHA2DS2-VASc score recommended initiation of anticoagulation, the risk was calculated by the HAS-BLED score; it was thus possible to determine for each patient if the prescribed therapy was appropriate.
The first assessment included 105 patients, of whom 49.5% had appropriate prophylactic therapy according to their scores. In the second assessment, four months after the educational intervention, 60.0% had been prescribed appropriate therapy, which represented a 21.2% improvement.
In both assessments, inappropriate treatment was due to non-prescription of prophylactic oral anticoagulation. This quality cycle serves as a tool for continuous assessment in the pursuit of improved care for patients with atrial fibrillation.
Abstract Introduction Atrial fibrillation is the most common cardiac arrhythmia and has important clinical repercussions, increasing thromboembolic events and mortality. The CHA2 DS2 ‐VASc and ...HAS‐BLED scores assist the clinician in assessing the benefits and risks of antithrombotic therapy. Objective The aim of this study was to assess and improve the quality of prophylactic antithrombotic therapy prescribed to patients with atrial fibrillation. Methods This was a quality study, based on a cycle of assessment and improvement, applied to the population of a family health unit, consisting of an initial assessment, an educational intervention and a second assessment. Both scores were calculated for all patients. Whenever the CHA2 DS2 ‐VASc score recommended initiation of anticoagulation, the risk was calculated by the HAS‐BLED score; it was thus possible to determine for each patient if the prescribed therapy was appropriate. Results The first assessment included 105 patients, of whom 49.5% had appropriate prophylactic therapy according to their scores. In the second assessment, four months after the educational intervention, 60.0% had been prescribed appropriate therapy, which represented a 21.2% improvement. Conclusions In both assessments, inappropriate treatment was due to non‐prescription of prophylactic oral anticoagulation. This quality cycle serves as a tool for continuous assessment in the pursuit of improved care for patients with atrial fibrillation.
AqF from Costus spiralis reduces the calcium entry in myocardial cells as showed by its effect on the Bowditch phenomenon and on the positive inotropic effect produced by both BAY K8644 and ...isoproterenol. Direct measurements of the L-type calcium current (ICa, L) as well as of the intracellular free calcium determined by the fluorescence of FLUO 4AM (F/F0) confirmed such hypothesis.
Brazilian folk medicine uses infusion of Costus spiralis leaf to help people to treat arterial hypertension and syndromes of cardiac hyperexcitability.
Evaluate the aqueous fraction (AqF) effect on atrial contractility and investigate its mechanism of action.
The AqF effect on the cardiac contractility was studied on isolated electrically driven guinea pig left atria. Atropine and tetraethylammonium (TEA) were employed to investigate whether potassium contributes for the inotropic mechanism of the AqF. The role of calcium in this effect was also studied. This was done by analysing the AqF effect on the Bowditch's phenomenon, as well as by studying whether it could interfere with the concentration–effect curve for CaCl2, isoproterenol, and BAY K8644. Mice isolated cardiomyocytes were submitted to a whole-cell patch-clamp technique in order to evaluate whether the L-type calcium current participates on the AqF effect. Furthermore, the intracellular calcium transient was studied by confocal fluorescence microscopy.
AqF depressed the atrial contractile force. It was the most potent fraction from C. spiralis leaf (EC50=305±41mg/l) (crude extract: EC50=712±41; ethyl acetate: EC50=788±121; chloroform: EC50=8948±1346mg/l). Sodium and potassium content in the AqF was 0.15mM and 1.91mM, respectively. Phytochemical analysis revealed phenols, tannins, flavones, xanthones, flavonoids, flavonols, flavononols, flavonones, and saponins. Experiments with atropine and TEA showed that potassium does not participate of the inotropic mechanism of AqF. However, this fraction decreased the force overshoot characteristic of the Bowditch's phenomenon, and shifted the concentration–response curve for CaCl2 (EC50 from 1.12±0.07 to 7.23±0.47mM) indicating that calcium currents participate on its mechanism of action. Results obtained with isoproterenol (1–1000pM) and BAY K8644 (5–2000nM) showed that AqF abolished the inotropic effect of these substances. On cardiomyocytes, 48mg/l AqF reduced (∼23%) the L-type calcium current density from −6.3±0.3 to −4.9±0.2 A/F (n=5 cells, p<0.05) and reduced the intracellular calcium transient (∼20%, 4.7±1.2 a.u., n=42 cells to 3.7±1.00 a.u., n=35 cells, p<0.05). However, the decay time of the fluorescence was not changed (control: 860±32ms, n=42 cells; AqF: 876±26ms, n=35 cells, p>0.05).
The AqF of C. spiralis leaf depresses myocardial contractility by reducing the L-type calcium current and by decreasing the intracellular calcium transient. Despite the lack of data on the therapeutic dose of AqF used in folk medicine, our results support, at least in part, the traditional use of this plant to treat cardiac disorders.
O óleo essencial e o extrato etanólico obtidos a partir de folhas de Myrtus communis foram avaliados quanto 'a atividade inibitória frente a vários microrganismos. Os halos de inibição de crescimento ...foram avaliados através das técnicas de "template" e difusão em disco para as linhagens de Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Bacillus subtilis e Serratia marcescens. Os resultados obtidos evidenciaram que o óleo de M. communis apresentou atividade antibacteriana superior ao extrato etanólico frente a todas as bactérias. A atividade demonstrada tanto para o óleo como para o extrato etanólico frente a algumas linhagens, foi melhor evidenciada pela técnica "template". E. coli foi resistente ao óleo e extrato etanólico testados.
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