This research aims to describe and problematize special education settings in terms of their organization and provision in the Municipal Department of Education of Santa Maria, RS. The investigative process was conducted through qualitative research, organized using the methodological approach of bricolage. Data were collected through questionnaires administered to the Municipal Education Secretariat, analysis of public documents such as Resolution No. 31/2011 and Law 6001/2015, and information gathered from the City Administration's website. The analysis of the data produced three main areas of analysis, namely: "Continuing education as a means to strengthen inclusive education," "The provision of special education from the perspective of inclusive education in the public policies of RMESM," and "The space of special education support, training for action, and the formation of pedagogical practice." In-service training for teachers, the existence of regulations, and the guarantee of providing Special Education Support constitute and organize special education from the perspective of inclusive education in the Municipal Education Network of Santa Maria.
Antibiotic use in aquaculture poses increasing risks to environmental and public health, highlighting the need for effective alternatives for disease control. This study investigated whether dietary supplementation with autochthonous Weissella cibaria modulates host immunophysiological responses and enhances resilience to Aeromonas hydrophila infection in tambaqui (Colossoma macropomum). Juveniles were fed for 90 days with two probiotic strains at different feeding frequencies and subsequently subjected to experimental challenge. Probiotic supplementation did not affect growth performance or intestinal morphometry but improved body composition, particularly in fish receiving strain I10, which showed increased protein deposition and reduced carbohydrate levels. At the basal stage, supplementation enhanced leukocyte populations and antioxidant activity without inducing clinical alterations, indicating improved immunological readiness and physiological stability. Following A. hydrophila challenge, supplemented fish exhibited modulated innate immune responses and improved hematological and biochemical profiles associated with septic conditions, despite no significant differences in mortality. Intestinal microbiota analyses revealed that community structure was primarily driven by infection rather than by probiotic supplementation, with a shift from dominance of Fusobacteria and Cetobacterium somerae to increased Proteobacteria and Enterobacteriaceae-related taxa. Notably, probiotic supplementation did not induce major taxonomic restructuring of microbiota. These findings demonstrate that autochthonous W. cibaria enhances disease resilience in tambaqui predominantly through host immunophysiological modulation rather than microbiota restructuring, supporting its application as a functional and sustainable strategy for health management in tropical aquaculture.
A urticária crônica (UC) é uma doença inflamatória cutânea caracterizada pela presença recorrente de urticas, angioedema ou ambos por período superior a seis semanas, comprometendo significativamente a qualidade de vida dos pacientes. Este estudo reuniu e discutiu as principais atualizações sobre a fisiopatologia, o diagnóstico e o tratamento da UC, com destaque para as terapias biológicas e as novas moléculas direcionadas. Foi realizada uma revisão bibliográfica narrativa, com busca na base de dados PubMed, utilizando os descritores “Chronic Urticaria” e “Therapeutics”, combinados pelos operadores booleanos AND e OR. Foram selecionados artigos originais, ensaios clínicos randomizados, revisões sistemáticas e consensos internacionais publicados nos últimos cinco anos, nos idiomas português ou inglês. A literatura analisada demonstra que os anti-histamínicos H1 de segunda geração permanecem como tratamento de primeira linha, com possibilidade de aumento da dose em até quatro vezes. O omalizumabe consolidou-se como importante alternativa para casos refratários. Entre as novas opções terapêuticas, destacam-se o dupilumabe, os inibidores da tirosina quinase de Bruton (especialmente o remibrutinibe) e os tratamentos direcionados ao receptor KIT, como o barzolvolimabe. Outras estratégias, incluindo os antagonistas do MRGPRX2 e os inibidores de JAK, apresentam resultados iniciais promissores. Apesar dos avanços, persistem desafios relacionados ao diagnóstico tardio, à ausência de biomarcadores preditivos e à dificuldade de remissão sustentada. Conclui-se que o tratamento da UC tende à individualização, pautada em mecanismos moleculares e na resposta clínica.
O presente artigo examina a violência sexual contra mulheres em situação de rua na cidade de Manaus, à luz dos direitos fundamentais e da responsabilidade estatal na proteção da dignidade humana. Trata-se de uma pesquisa qualitativa, de caráter bibliográfico e documental, com abordagem jurídico-analítica, fundamentada em estudos científicos recentes, relatórios institucionais e dispositivos normativos relacionados à violência de gênero, vulnerabilidade extrema e acesso à justiça. Os resultados evidenciam que a condição de rua intensifica a exposição das mulheres a múltiplas formas de violência, agravada pela invisibilidade social, fragilidade das redes públicas de proteção e insuficiência de políticas intersetoriais. Constatou-se ainda que a violência sexual configura grave violação de direitos humanos, exigindo respostas estatais que ultrapassem o campo penal e incorporem estratégias integradas de acolhimento, prevenção e garantia de cidadania. Conclui-se que o enfrentamento efetivo demanda articulação entre justiça, assistência social, saúde pública e políticas urbanas, especialmente em contextos regionais marcados por desigualdade e omissão institucional.
BACKGROUND:We aimed to evaluate the efficacy and tolerability of dihydroartemisinin-piperaquine as an alternative schizontocide to chloroquine for the treatment of Plasmodium vivax malaria in Brazil, where early recurrences despite chloroquine therapy and operational challenges with primaquine adherence highlight the need to assess alternative treatment regimens. METHODS:Curavivax was an open-label, single-centre, parallel-group, randomised trial done in a public reference centre for infectious diseases in Manaus (Brazilian Amazon). Patients older than 6 months with microscopically confirmed P vivax malaria, weighing up to 100 kg, with glucose-6-phosphate dehydrogenase activity greater than 30% of normal, were randomly assigned (1:1:1:1), based on a computer-generated list of blocks of five participants, to dihydroartemisinin-piperaquine or chloroquine plus primaquine initiated on day 0 or delayed until day 42. Dihydroartemisinin-piperaquine (40/320 mg or 20/160 mg oral tablets) and chloroquine (150 mg oral tablets) were administered once daily for 3 days. Primaquine (15 mg oral tablets) was administered once daily for 14 days. All medicines were dosed by bodyweight and dispensed open-label. The primary outcome was the recurrence rate at day 42 in the per-protocol population. Safety was assessed in all participants who received at least one dose of study medication. This trial was registered with ClinicalTrials.gov, NCT03208907, and is completed. FINDINGS:Between July 5, 2018, and Jan 13, 2021, 1649 patients were screened for eligibility, 419 of whom were randomly assigned to chloroquine plus primaquine (n=114), dihydroartemisinin-piperaquine plus primaquine (n=112), chloroquine plus delayed primaquine (n=98), and dihydroartemisinin-piperaquine plus delayed primaquine (n=95). One patient in the chloroquine plus primaquine group was excluded owing to a severe protocol deviation. 287 (69%) of 418 patients were male and 131 (31%) were female. Day 42 recurrence rate in the per-protocol population was similar for chloroquine plus primaquine (2·0% [95% CI 0·2-7·0]) and dihydroartemisinin-piperaquine plus primaquine (1·0% [0·0-5·3]; hazard ratio [HR] 0·48 [95% CI 0·00-40 209·06; p=0·44); whereas dihydroartemisinin-piperaquine alone (delayed primaquine; 2·4% [0·3-8·5]) was superiorto chloroquine alone (delayed primaquine; 27·3% [18·3-37·8]; HR 0·08 [95% CI 0·00-0·22]; p<0·0001). All treatments were well tolerated. INTERPRETATION:The high therapeutic efficacy and early recurrence prevention with dihydroartemisinin-piperaquine with primaquine started on day 0 or delayed to day 42 supports the use of this schizontocide for P vivax treatment in Latin America. FUNDING:Ministry of Health of Brazil and the National Council for Scientific and Technological Development.
