RESUMO
Breast cancer is the most commonly diagnosed type of cancer among the female population worldwide. It is a disease with a high incidence and geographic distribution that negatively impacts global public health and deleteriously affect the quality of life of cancer patients. Among the new approaches, cancer immunotherapy is the most promising trend in oncology by stimulating the host's own immune system to efficiently destroy cancer cells. Recent evidence has indicated that iron oxide nanoparticles can promote the reprograming of M2 into M1 macrophages with anti-tumor effects in the tumor microenvironment. Thus, the aim of the present work was to evaluate the ability of polyaniline-coated maghemite (Pani/γ-Fe2O3) nanoparticles to modulate human macrophages in 2D monolayers and 3D multicellular breast cancer models. It was observed that Pani/γ-Fe2O3 NPs re-educated IL-10-stimulated macrophages towards a pro-inflammatory profile, decreasing the proportion of CD163+ and increasing the CD86+ proportion in 2D models. NPs were successfully taken-up by macrophages presented in the 3D model and were also able to induce an increasing in their CD86+ proportion in triple MCTs model. Overall, our findings open new perspectives on the use of Pani/γ-Fe2O3 NPs as an immunomodulatory therapy for macrophage reprogramming towards an anti-tumor M1 phenotype, providing a new tool for breast cancer immunotherapies.
Assuntos
Neoplasias da Mama , Nanopartículas , Humanos , Feminino , Neoplasias da Mama/terapia , Neoplasias da Mama/patologia , Macrófagos Associados a Tumor/patologia , Qualidade de Vida , Nanopartículas Magnéticas de Óxido de Ferro , Microambiente TumoralRESUMO
The objective of this study was to obtain data on craniometric parameters in the crab-eating fox (Cerdocyon thous) and to define the general skull type of this species, analysing whether the craniometric classification of domestic dogs can be applied. Eleven skulls of C. thous were included in the analysis, irrespective of age and sex. The location of nine craniometric points established for craniometry in domestic dogs was determined and based on the distances between these points, 17 craniometric parameters were measured. Those parameters were used to calculate the following six craniometric indices: 53.17 ± 2.54 mm skull index, 2.33 ± 0.08 mm craniofacial index, 59.17 ± 3.57 mm neurocranial index, 125.58 ± 6.63 mm facial index, 37.52 ± 2.65 mm basal index and the index of the foramen magnum 54.47 ± 3.48 mm. According to the analysed indices, the skull shape in C. thous can be classified as mesaticephalic.
El objetivo de este estudio fue obtener datos sobre los parámetros craneométricos del zorro cangrejero (Cerdocyon thous) y definir el tipo general de cráneo de esta especie, analizando si se puede aplicar la clasificación craneométrica de los perros domésticos. Once cráneos de C. thous fueron incluidos en el análisis, independientemente de la edad y el sexo. Se determinó la ubicación de nueve puntos craneométricos establecidos para la craneometría en perros domésticos y, en función de las distancias entre estos puntos, se midieron 17 parámetros craneométricos. Esos parámetros se usaron para calcular los siguientes índices craneométricos: índice craneal de 53,17 ± 2,54 mm, índice craneofacial de 2,33 ± 0,08 mm, índice neurocraneal de 59,17 ± 3,57 mm, índice facial de 125,58 ± 6,63 mm, índice basal de 37,52 ± 2,65 mm y el índice del foramen magnum 54,47 ± 3,48 mm. Según los índices analizados, la forma del cráneo en C. thous se puede clasificar como mesaticefálica.
Assuntos
Animais , Cães , Crânio/anatomia & histologia , Cefalometria , Canidae/anatomia & histologiaRESUMO
Objetivos: O objetivo desse estudo foi determinar o valor preditivo da Avaliação Geriátrica Ampla (AGA) em relação à toxicidade e mortalidade nos pacientes oncológicos idosos classificados como vulneráveis, submetidos à quimioterapia. Método: Foi realizado um estudo de coorte prospectivo com coleta de informações extraídas de banco de dados já construído do projeto ÂNCORA e disponível online. Foram construídas tabelas de distribuição de frequência das variáveis estudadas e na análise univariada foi usado o chi-quadrado e Teste de Fisher, quando indicado. Por fim, considerou-se o nível de significância de 5% e todos os testes foram aplicados com 95% de confiança. Resultados: Em uma amostra total de 254 pacientes, o percentual de mortalidade foi de 37% e de intercorrências foi de 46,5%, sendo infecção a mais frequente. Houve associação entre o déficit nutricional e o aumento da mortalidade (p=0,003). Conclusão: Observou-se associação estatística entre o aumento da mortalidade em pacientes vulneráveis que realizaram quimioterapia (p=0,046), quando comparados aos pacientes saudáveis. Os resultados deste estudo reforçam constatações da literatura como o uso da AGA pode ajudar oncologistas e geriatras em suas tomadas de decisão.
Objectives: to determine the predictive value of the Comprehensive geriatric assessment (CGA) regarding toxicity and mortality in elderly cancer patients classified as vulnerable who were submitted to chemotherapy. Method: A prospective cohort study was performed with data gathered from the database already built by the anchor project and available online. Tables of the frequency of distribution of the studied variables were created. The chi-square test was used in the univariate analysis, and the Fisher test when indicated. The level of significance of 5% were considered and all the tests were applied with a confidence of 95%. Results: The frequency of patients classified as vulnerable by CGA was 40.2%, and the mortality rate in the total number of patients was 37%. The association between nutritional status and mortality (p=0.003) was observed, where most of the denuded patients (51.4%) died during follow-up, and most patients (46.5%) had some type of complication. Conclusion: There was an association between the increase in mortality in patients vulnerable to chemotherapy (p=0,046), when compared to healthy patients. The results of this study follow the literature on the use of CGA can help oncologists and geriatricians in their decision making.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Avaliação Geriátrica , Indicadores de Morbimortalidade , Valor Preditivo dos Testes , Geriatria , Oncologia/estatística & dados numéricos , Neoplasias/tratamento farmacológicoRESUMO
Pretende-se, no presente artigo, apresentar os resultados da pesquisa/intervenção "Arte e mediação terapêutica: sobre um dispositivo com adolescentes na clínica-escola". Ao longo de vinte e quatro meses, oito adolescentes entre 12 e 18 anos, inscritos nos Serviços de Psicologia Aplicada e de Terapia Ocupacional da Universidade de Fortaleza, foram acompanhados em oficinas semanais de artes plásticas, coordenadas por estagiários dos dois cursos e monitores do curso de Belas Artes. O grupo de jovens apresentava graves impasses no campo da aprendizagem escolar. O trabalho de intervenção objetivou, principalmente, a construção de um dispositivo clínico interdisciplinar, com privilégio da mediação terapêutica da arte, levando em conta as especificidades da problemática adolescente, em especial, aquelas relativas à transferência. Nesse sentido, o dispositivo funcionou inspirado em trabalhos institucionais já conhecidos no campo psicanalítico, como a "prática entre vários". Os resultados apontaram que a transferência, nessa modalidade de intervenção, permite a negociação com algumas formas de movimento transferencial que frequentemente se apresentam na clínica psicanalítica com adolescentes. Simultaneamente, o uso da arte pode ser considerado um mediador terapêutico capaz de respeitar essas particularidades, além de promover estratégias representativas do movimento de separação dos laços primários em direção aos laços de sociabilidade ampliada. Através de uma experiência compartilhada de "re-criação", a travessia do um ao Outro possibilita novas aberturas ao ato de aprender.
The intention of this article is to present the results of the Research/Intervention called "Art and therapeutic mediation: about a device with adolescents in the school-clinic". During twenty-four months, eight teenagers, between twelve and eighteen years, enrolled in an Applied Psychology Service and Occupational Therapy at the University of Fortaleza, where, weekly, they followed art workshops, coordinated by trainees coming from the two mentioned courses and Fine Arts Course's monitors. The teenager group had, in common, severe difficulties on school education field. The intervention work aimed, primarily, at the construction of an interdisciplinary clinical device, with the privileged therapeutic mediation of art, considering the adolescents' specific problems, especially those related to the transference. The clinical device was inspired by an institutional work on the psychoanalytic field known as "practices shared by many." The results showed that the transference, in this type of intervention, allows trading with some transference's movements that often arise in the adolescents' psychoanalytic treatment. Simultaneously, the use of art can be considered a therapeutic mediator able to respect these particularities and to promote strategies representing the movement of separation from the primary relations towards to sociability enlarged. Through a shared experience of "re-creation," the passage from one to another, enables new openings to the act of learning.
Pretendese, en el presente artículo, presentar los resultados de la Investigación/Intervención "Arte y mediación terapéutica: sobre un dispositivo con adolescentes en la clínica escuela". A lo largo de veinte cuatro meses, ocho adolescentes entre doce y dieciocho años, inscriptos en los Servicios de Psicología Aplicada y de Terapia Ocupacional de la Universidad de Fortaleza fueron acompañados en talleres semanales de artes, coordinadas por pasantes de los dos cursos y monitores del Curso de Artes. El grupo de jóvenes presentaba, en común, graves callejones en el campo del aprendizaje escolar. El trabajo de intervención objetivó, principalmente, la construcción de un dispositivo clínico interdisciplinar, con privilegio de la mediación terapéutica de la arte, considerándose las particularidades de la problemática adolescente, en especial, a las relativas a la transferencia. En este sentido, el dispositivo funcionó inspirado en trabajos institucionales conocidos en el campo psicoanalítico como la "practica entre varios". Los resultados señalaran que la transferencia, en esta modalidad de intervención entre varios, permite la negociación con algunas formas de movimiento transferencial que, frecuentemente, presentanse en la clínica psicoanalítica con adolescentes. Simultáneamente, la utilización de la arte puede ser considerado un mediador terapéutico capaz de respetar esas particularidades, además de promover estrategias representativas del movimiento de separación de los lazos primarios en dirección a los lazos de sociabilidad ampliada. A través de una experiencia compartida de "re-creación", la travesía del uno al Otro, posibilita nuevas aperturas al acto de aprender.
Il s'agit, dans cet article, de présenter les résultats de la recherche/intervention intitulée "Art et médiation thérapeuthique": à propos d'un dispositif avec des adolescents dans la Clinique-école". Au long de vingt et quatre mois, huit adolescents agés entre douze et diz-huit ans qui étaient inscrits dans les Services de Psychologie Apliquée et de Thérapie Occupationel de l'Université de Fortaleza, ont été suivis dans le cadre d'ateliers d'arts plastiques, dirigés par des stagiaires des deux cours et d' élèves de la Faculté de Beaux Arts. Le group de jeunes presentait, en commun, des graves difficultés dans le domaine de l'apprentissage scolaire. Le travail d'intervention a eu comme objectif, tout d'abord, la construction d'un dispositif clinique interdisciplinaire, en s'utilisant, de manière privilégiée, de la médiation thérapeutique de l'art, et en prennant en considération les specificités de la problématique adolescent, en particulier, celles concernant le transfert. Dans ce sens, le dispositif a été inspiré dans les travaux institutionnels connus parmi les psychanalystes comme "pratique en plusieurs". Les résultats ont indiqué que le transfert, dans cette modalité d'intervention en plusieurs, permet une négociation avec certaines formes de mouvement du tranfert qui définissent, souvent, la clinique d'adolescents. Au même temps, l'usage de l'art peut être consideré en tant qu'un médiateur thérapeutique capable de respecter ces particularités, et promouvoir des stratégies répresentatives du mouvement de séparation des liens primaires en direction aux liens de sociabilité élargie. La traversée de l'Un à l'Autre, possibilitée par une expérience partagée de "récreation", permet des nouvelles voies à l'act d'apprendre.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Arteterapia , Psicologia Clínica , Saúde Mental , Terapia OcupacionalRESUMO
Pretende-se, no presente artigo, apresentar os resultados da pesquisa/intervenção "Arte e mediação terapêutica: sobre um dispositivo com adolescentes na clínica-escola". Ao longo de vinte e quatro meses, oito adolescentes entre 12 e 18 anos, inscritos nos Serviços de Psicologia Aplicada e de Terapia Ocupacional da Universidade de Fortaleza, foram acompanhados em oficinas semanais de artes plásticas, coordenadas por estagiários dos dois cursos e monitores do curso de Belas Artes. O grupo de jovens apresentava graves impasses no campo da aprendizagem escolar. O trabalho de intervenção objetivou, principalmente, a construção de um dispositivo clínico interdisciplinar, com privilégio da mediação terapêutica da arte, levando em conta as especificidades da problemática adolescente, em especial, aquelas relativas à transferência. Nesse sentido, o dispositivo funcionou inspirado em trabalhos institucionais já conhecidos no campo psicanalítico, como a "prática entre vários". Os resultados apontaram que a transferência, nessa modalidade de intervenção, permite a negociação com algumas formas de movimento transferencial que frequentemente se apresentam na clínica psicanalítica com adolescentes. Simultaneamente, o uso da arte pode ser considerado um mediador terapêutico capaz de respeitar essas particularidades, além de promover estratégias representativas do movimento de separação dos laços primários em direção aos laços de sociabilidade ampliada. Através de uma experiência compartilhada de "re-criação", a travessia do um ao Outro possibilita novas aberturas ao ato de aprender.(AU)
The intention of this article is to present the results of the Research/Intervention called "Art and therapeutic mediation: about a device with adolescents in the school-clinic". During twenty-four months, eight teenagers, between twelve and eighteen years, enrolled in an Applied Psychology Service and Occupational Therapy at the University of Fortaleza, where, weekly, they followed art workshops, coordinated by trainees coming from the two mentioned courses and Fine Arts Course's monitors. The teenager group had, in common, severe difficulties on school education field. The intervention work aimed, primarily, at the construction of an interdisciplinary clinical device, with the privileged therapeutic mediation of art, considering the adolescents' specific problems, especially those related to the transference. The clinical device was inspired by an institutional work on the psychoanalytic field known as "practices shared by many." The results showed that the transference, in this type of intervention, allows trading with some transference's movements that often arise in the adolescents' psychoanalytic treatment. Simultaneously, the use of art can be considered a therapeutic mediator able to respect these particularities and to promote strategies representing the movement of separation from the primary relations towards to sociability enlarged. Through a shared experience of "re-creation," the passage from one to another, enables new openings to the act of learning.(AU)
Pretendese, en el presente artículo, presentar los resultados de la Investigación/Intervención "Arte y mediación terapéutica: sobre un dispositivo con adolescentes en la clínica escuela". A lo largo de veinte cuatro meses, ocho adolescentes entre doce y dieciocho años, inscriptos en los Servicios de Psicología Aplicada y de Terapia Ocupacional de la Universidad de Fortaleza fueron acompañados en talleres semanales de artes, coordinadas por pasantes de los dos cursos y monitores del Curso de Artes. El grupo de jóvenes presentaba, en común, graves callejones en el campo del aprendizaje escolar. El trabajo de intervención objetivó, principalmente, la construcción de un dispositivo clínico interdisciplinar, con privilegio de la mediación terapéutica de la arte, considerándose las particularidades de la problemática adolescente, en especial, a las relativas a la transferencia. En este sentido, el dispositivo funcionó inspirado en trabajos institucionales conocidos en el campo psicoanalítico como la "practica entre varios". Los resultados señalaran que la transferencia, en esta modalidad de intervención entre varios, permite la negociación con algunas formas de movimiento transferencial que, frecuentemente, presentanse en la clínica psicoanalítica con adolescentes. Simultáneamente, la utilización de la arte puede ser considerado un mediador terapéutico capaz de respetar esas particularidades, además de promover estrategias representativas del movimiento de separación de los lazos primarios en dirección a los lazos de sociabilidad ampliada. A través de una experiencia compartida de "re-creación", la travesía del uno al Otro, posibilita nuevas aperturas al acto de aprender.(AU)
Il s'agit, dans cet article, de présenter les résultats de la recherche/intervention intitulée "Art et médiation thérapeuthique": à propos d'un dispositif avec des adolescents dans la Clinique-école". Au long de vingt et quatre mois, huit adolescents agés entre douze et diz-huit ans qui étaient inscrits dans les Services de Psychologie Apliquée et de Thérapie Occupationel de l'Université de Fortaleza, ont été suivis dans le cadre d'ateliers d'arts plastiques, dirigés par des stagiaires des deux cours et d' élèves de la Faculté de Beaux Arts. Le group de jeunes presentait, en commun, des graves difficultés dans le domaine de l'apprentissage scolaire. Le travail d'intervention a eu comme objectif, tout d'abord, la construction d'un dispositif clinique interdisciplinaire, en s'utilisant, de manière privilégiée, de la médiation thérapeutique de l'art, et en prennant en considération les specificités de la problématique adolescent, en particulier, celles concernant le transfert. Dans ce sens, le dispositif a été inspiré dans les travaux institutionnels connus parmi les psychanalystes comme "pratique en plusieurs". Les résultats ont indiqué que le transfert, dans cette modalité d'intervention en plusieurs, permet une négociation avec certaines formes de mouvement du tranfert qui définissent, souvent, la clinique d'adolescents. Au même temps, l'usage de l'art peut être consideré en tant qu'un médiateur thérapeutique capable de respecter ces particularités, et promouvoir des stratégies répresentatives du mouvement de séparation des liens primaires en direction aux liens de sociabilité élargie. La traversée de l'Un à l'Autre, possibilitée par une expérience partagée de "récreation", permet des nouvelles voies à l'act d'apprendre.(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Saúde Mental , Psicologia Clínica , Terapia Ocupacional , ArteterapiaRESUMO
Therapy-related acute myelogenous leukemia (t-AML) is a generally fatal disease with a very poor response to conventional chemotherapy. Allogeneic stem cell transplantation (allo-SCT) has been reported in patients with chemotherapy- responsive t-AML. However its use is limited owing to complications from previous treatments. Nonmyeloablative conditioning provides rapid hematologic engraftment and it is a feasible option for patients who are at increased risk for conventional SCT. There are few data on their use in patients with t-AML. We describe the case of a boy who developed visceral fungal infection with liver abscesses after induction chemotherapy for t-AML. He received allo-SCT with a nonmyeloablative regimen, plus amphotericin B during the transplant procedure. The patient is alive and free of both leukemia and fungal infection 2 years after allo-SCT. Nonmyeloablative allo-SCT may provide durable remission in patients with t-AML, preexisting invasive fungal infections, and a high risk of adverse effects from standard chemotherapy and prolonged cytopenia, without resurgence of the fungal infection.
Assuntos
Candidíase/microbiologia , Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Anfotericina B/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Candidíase/tratamento farmacológico , Criança , Humanos , Leucemia Mieloide Aguda/diagnóstico , Masculino , Transplante Homólogo , Resultado do TratamentoAssuntos
Doença de Hodgkin/diagnóstico , Leishmaniose Visceral/diagnóstico , Linfonodos/patologia , Adolescente , Animais , Doença de Hodgkin/complicações , Humanos , Leishmania donovani/isolamento & purificação , Leishmaniose Visceral/complicações , Leishmaniose Visceral/parasitologia , Linfonodos/parasitologia , MasculinoRESUMO
OBJECTIVE: To report a rare case of self-inflicted eye injury secondary to obsessive-compulsive disorder (OCD). METHOD: Case report. RESULTS: A 41 year-old patient had significant bilateral visual loss and blunt trauma through touching his ocular cavities due to recurrent doubts regarding their shape and urges to check the format of bones and cartilages. Differential diagnosis with tic disorders is discussed, and the patient's treatment approach is described. CONCLUSION: Although rare, severe clinical complications can occur in OCD.
Assuntos
Traumatismos Oculares/complicações , Transtorno Obsessivo-Compulsivo/complicações , Comportamento Autodestrutivo/complicações , Transtornos da Visão/complicações , Transtornos da Visão/etiologia , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Índice de Gravidade de Doença , Inquéritos e Questionários , Transtornos de Tique/diagnóstico , Acuidade VisualRESUMO
The combination of methotrexate and cyclosporine A (MTX-CSA) is the standard regimen for the prevention of graft vs. host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-SCT) from HLA-identical siblings. Mycophenolate mofetil and CSA (MMF-CSA) combination has been successfully used for GVHD prophylaxis after non-reduced intensity conditioning (non-RIC) allo-SCT with peripheral blood or non-G-CSF stimulated bone marrow as stem cell source. We report the results of the first prospective trial of the MMF-CSA combination for acute GVHD prophylaxis in 47 patients after non-RIC G-CSF stimulated allo-BMT (G-BMT) from HLA-identical siblings in patients with severe aplastic anemia (SAA) or hematological malignancies. Median age was 28 yr (range, 6-48 yr). Median follow-up was 22 months. The median time to neutrophil and platelets recovery were nine d (range, 8-17) and 16 d (range, 10-28), respectively. Acute GVHD of grade II-IV and chronic GVHD occurred in 51% and 27%, respectively. Overall survival rates at two yr for patients with SAA and hematological malignancies were 87% and 65%, respectively. The event-free survival at two yr for patients with hematological malignancies was 76%. We concluded that MMF-CSA appears equivalent to MTX-CSA for GVHD prophylaxis in patients receiving non-RIC G-BMT from HLA-identical siblings, with a tendency for more rapid neutrophil engraftment.
Assuntos
Anemia Aplástica/terapia , Transplante de Medula Óssea , Ciclosporina/uso terapêutico , Doença Enxerto-Hospedeiro/prevenção & controle , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Imunossupressores/uso terapêutico , Ácido Micofenólico/análogos & derivados , Adolescente , Adulto , Anemia Aplástica/sangue , Anemia Aplástica/complicações , Criança , Quimioterapia Combinada , Feminino , Rejeição de Enxerto/tratamento farmacológico , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/efeitos dos fármacos , Antígenos HLA/metabolismo , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/uso terapêutico , Neutrófilos/citologia , Neutrófilos/imunologia , Neutrófilos/metabolismo , Estudos Prospectivos , Fatores de Risco , Irmãos , Taxa de Sobrevida , Doadores de Tecidos , Transplante Homólogo , Resultado do Tratamento , Adulto JovemRESUMO
INTRODUCTION: Patients with obsessive-compulsive disorder (OCD) have historically been considered at low risk for suicide, but recent studies are controversial. OBJECTIVE: To study the prevalence of suicidal thoughts and attempts in OCD patients and to compare those with and without suicidality according to demographic and clinical variables. METHODS: Fifty outpatients with primary OCD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) from a Brazilian public university were evaluated. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to assess OCD severity, the Beck Depression Inventory to evaluate depressive symptoms and the Alcohol Use Disorders Identification Test to assess alcohol problems. RESULTS: All patients had obsessions and compulsions, 64% a chronic fluctuating course and 62% a minimum Y-BOCS score of 16. Half of the patients presented relevant depressive symptoms, but only three had a history of alcohol problems. Seventy percent reported having already thought that life was not worth living, 56% had wished to be dead, 46% had suicidal ideation, 20% had made suicidal plans, and 10% had already attempted suicide. Current suicidal ideation occurred in 14% of the sample and was significantly associated with a Y-BOCS score >16. Previous suicidal thoughts were associated with a Beck Depression Inventory score >19. CONCLUSION: Suicidality has been underestimated in OCD and should be investigated in every patient, so that appropriate preventive measures can be taken.
Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Estudos Transversais , Demografia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Prevalência , Inquéritos e QuestionáriosRESUMO
MeCP2 is a protein that selectively binds to methylated cytosines through its methyl-CpG-binding domain (MBD) and connects DNA methylation to transcriptional repression. Mutations in MECP2 gene, located in Xq28, have been reported as being the major cause of Rett syndrome and are also associated with some cases of X-linked mental retardation in both males and females. In this study, we present the first screening in the MECP2 gene in a Brazilian cohort of 239 unrelated males with idiopathic mental retardation. Eight sequence variations were observed in 10 patients: one novel putative pathogenic variant, two never described variants of unknown pathogenic value and five non-pathogenic variations. We conclude that in mentally retarded Brazilian males, non-pathogenic variants in the MECP2 gene are more common than actual pathogenic mutations, and therefore alterations in this gene have a weak relationship with mental retardation in males.
Assuntos
Deficiência Intelectual/genética , Proteína 2 de Ligação a Metil-CpG/genética , Mutação/genética , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Transtornos Cognitivos/genética , Transtornos Cognitivos/psicologia , Estudos de Coortes , DNA/genética , Variação Genética , Humanos , Lactente , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/psicologia , Íntrons/genética , Masculino , Mutação de Sentido Incorreto/genética , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
OBJECTIVE: To estimate the prevalence and assess risk factors of common mental disorders among medical students. METHODS: A cross-sectional study was carried out comprising 551 university medical students in the state of São Paulo, Southeastern Brazil. A self-administered questionnaire to collect sociodemographic and course-related data as well as the Self-Reporting Questionnaire were used. Both Chi-square test and logistic regression were used in data analyses. RESULTS: A total of 82.6% of the students enrolled in the course participated in the study. Most of them were women (61%), 60% aged between 20 and 23 years, and 99% were from other cities. The prevalence of common mental disorders was 44.7% and they were independently associated with: difficulty in making friends (OR=2.0), poor self-evaluation of academic performance (OR=1.7), thoughts of dropping out of the medical course (OR=5.0) and perceived lack of emotional support (OR=4.6). Although prevalence of these disorders was associated with the course period in the first analysis, this association was not maintained in the multivariate analysis. CONCLUSIONS: The prevalence of common mental disorders was shown to be high among medical students, associated with variables concerning support networks. Emotionally tense experiences such as dealing with seriously ill patients and peer group formation in the last years of the medical course are potentially strong stressors, especially for those with poor social support. It is suggested that educational institutions should be aware of that and make interventions aiming at treating and caring for the students' distress.
Assuntos
Adaptação Psicológica , Transtornos Mentais/epidemiologia , Estudantes de Medicina/psicologia , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Educação de Graduação em Medicina/estatística & dados numéricos , Métodos Epidemiológicos , Feminino , Humanos , Relações Interpessoais , Aprendizagem , Masculino , Autoimagem , Distribuição por Sexo , Apoio Social , Fatores Socioeconômicos , Estresse Psicológico/epidemiologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
OBJETIVO: Estimar a prevalência de transtornos mentais comuns entre estudantes de medicina e respectivos fatores de risco. MÉTODOS: Estudo transversal realizado com 551 universitários de um curso de medicina de Botucatu, SP. Utilizou-se questionário auto-aplicável investigando aspectos sócio demográficos, relacionados ao curso e o Self Reporting Questionnaire. Para análise dos dados empregaram-se os testes de qui-quadrado e regressão logística. RESULTADOS: Participaram 82,6 por cento dos alunos matriculados no curso, predominando mulheres (61 por cento), jovens (60 por cento 20-23 anos), procedentes de outros municípios (99 por cento). A prevalência de transtornos mentais comuns foi de 44,7 por cento associando-se independentemente a: dificuldade para fazer amigos (RC=2,0), avaliação ruim sobre desempenho escolar (RC=1,7), pensar em abandonar o curso (RC=5,0), não receber o apoio emocional de que necessita (RC=4,6). Embora na primeira análise a prevalência tenha se mostrado associada ao ano do curso, esta associação não se manteve na análise multivariada. CONCLUSÕES: A prevalência de transtornos mentais comuns mostrou-se elevada entre os estudantes de medicina, associando-se a variáveis relacionadas à rede de apoio. As experiências emocionalmente tensas como o contato com pacientes graves, formação de grupos, entre outras, vividas nos últimos anos do curso, são provavelmente potentes estressores, especialmente para sujeitos com uma rede de apoio considerada deficiente. Sugere-se que instituições formadoras estejam atentas a esse fato, estabelecendo intervenções voltadas ao acolhimento e ao cuidado com o sofrimento dos estudantes.
OBJECTIVE: To estimate the prevalence and assess risk factors of common mental disorders among medical students. METHODS: A cross-sectional study was carried out comprising 551 university medical students in the state of São Paulo, Southeastern Brazil. A self-administered questionnaire to collect sociodemographic and course-related data as well as the Self-Reporting Questionnaire were used. Both Chi-square test and logistic regression were used in data analyses. RESULTS: A total of 82.6 percent of the students enrolled in the course participated in the study. Most of them were women (61 percent), 60 percent aged between 20 and 23 years, and 99 percent were from other cities. The prevalence of common mental disorders was 44.7 percent and they were independently associated with: difficulty in making friends (OR=2.0), poor self-evaluation of academic performance (OR=1.7), thoughts of dropping out of the medical course (OR=5.0) and perceived lack of emotional support (OR=4.6). Although prevalence of these disorders was associated with the course period in the first analysis, this association was not maintained in the multivariate analysis. CONCLUSIONS: The prevalence of common mental disorders was shown to be high among medical students, associated with variables concerning support networks. Emotionally tense experiences such as dealing with seriously ill patients and peer group formation in the last years of the medical course are potentially strong stressors, especially for those with poor social support. It is suggested that educational institutions should be aware of that and make interventions aiming at treating and caring for the students' distress.