RESUMO
The identification of a new strain of the Mpox virus (clade Ib) in the Democratic Republic of the Congo, the alarming rise in cases across Africa linked to sexual activity, and the potential for a new pandemic led the World Health Organization (WHO) to declare a Public Health Emergency of International Concern on August 14, 2024 (https://www.paho.org/en/mpox). Between January 1 and September 15, 2024, a total of 6,201 cases and 32 deaths related to Mpox were confirmed in Africa, with the majority occurring in the Democratic Republic of the Congo. Additionally, cases of Mpox clade Ib were reported in Europe and Asia in August 2024.
Assuntos
Mpox , Monkeypox virus , Desinformação , Infodemia , Desinformação , Infodemia , DesinformaçãoRESUMO
This study aimed to translate and cross-culturally adapt the Family Health Scale into Brazilian Portuguese and analyze evidence of its psychometric validity. The 32 items on family health were cross-culturally adapted, using the content validity index to calculate semantic, idiomatic, cultural, and conceptual characteristics of the scale and its items. A pre-test to identify evidence of validity was applied to 40 families. At another time, the instrument was applied to 354 families in a Brazilian northeastern city. The index of agreement between the raters ranged from 0.84 for the scale items to 0.98 for the total scale, according to Kendall's coefficient. According to Cronbach's alpha, evidence of psychometric validity is adequate. Most families had a moderate degree of health, according to the scale. Therefore, the Brazilian version of the Family Health Scale showed conceptual, semantic, cultural, and operational equivalence with the original items, along with satisfactory psychometric properties for use among the Brazilian population with effectiveness and safety.
Os objetivos deste estudo foram realizar a tradução e adaptação transcultural da Family Health Scale (Escala de Saúde Familiar) para a língua portuguesa brasileira e analisar evidências de validade psicométricas dessa escala. Os 32 itens sobre a saúde familiar foram adaptados transculturalmente. Para a mensuração das evidências de validade do conteúdo, utilizou-se o cálculo do índice de validade de conteúdo das características semântica, idiomática, cultural e conceitual de cada item e da escala. Um pré-teste para identificação de evidência de validade foi realizado com 40 famílias. Em outro momento, a aplicação do instrumento foi executada com 354 famílias, em uma cidade no Nordeste do Brasil. O índice de concordância entre os juízes variou de 0,84, para os itens da escala, a 0,98, para a escala total, conforme o coeficiente de Kendall. As evidências de validade psicométricas mostram-se adequadas, conforme alfa de Cronbach. A maior parte das famílias teve um grau de saúde moderado, conforme aplicação da escala. Assim, a Family Health Scale, versão brasileira, apresentou equivalência conceitual, semântica, cultural e operacional em relação aos itens originais e propriedades psicométricas satisfatórias para a aplicação direcionada à população brasileira, atestando eficácia e segurança de sua utilização.
El objetivo de este estudio fue traducir y realizar la adaptación intercultural de Family Health Scale (Escala de Salud Familiar) al portugués brasileño, y analizar la evidencia de la validez psicométrica de esta escala. Los 32 ítems sobre salud familiar pasaron por una adaptación transcultural y, para medir la evidencia de validez de contenido, se utilizó el cálculo del índice de validez de contenido de las características semántica, idiomática, cultural y conceptual de cada ítem, y la escala. Se realizó una prueba previa con 40 familias para identificar la evidencia de validez. En otro momento, el instrumento se aplicó a 354 familias en una ciudad del Nordeste de Brasil. El índice de acuerdo entre los jueces osciló entre 0,84 para los ítems de la escala y 0,98 para la escala total de acuerdo con el coeficiente de Kendall. La evidencia de validez psicométrica es adecuada conforme el alfa de Cronbach. La mayoría de las familias tenían un grado de salud moderado de acuerdo con la aplicación de la escala. Por lo tanto, la Family Health Scale, versión brasileña, presentó equivalencia conceptual, semántica, cultural y operativa con relación a los ítems originales, y propiedades psicométricas satisfactorias para la aplicación en la población brasileña, lo que da fe de la eficacia y seguridad de su uso.
Assuntos
Comparação Transcultural , Saúde da Família , Humanos , Brasil , Psicometria , Semântica , Inquéritos e Questionários , Reprodutibilidade dos Testes , TraduçõesRESUMO
BACKGROUND: Ulceration of the feet in patients with diabetes is a frequent complication that increases morbidity, mortality, hospitalization, treatment costs, and non-traumatic amputations. OBJECTIVE: To present a systematic review of the treatment of patients with diabetes mellitus and infected foot ulcers using photodynamic therapy. DESIGN AND SETTING: A systematic review was performed in the postgraduate program in nursing at the Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Ceará, Brazil. METHODS: PubMed, CINAHL, Web of Science, EMBASE, Cochrane Library, Scopus, and LILACS databases were screened. The methodological quality, risk of bias, and quality of evidence of each study were assessed. Review Manager was used for the meta-analysis. RESULTS: Four studies were included. They highlighted significantly better outcomes in patient groups treated with photodynamic therapy than those in the control groups that were treated with topical collagenase and chloramphenicol (P = 0.036), absorbent (P < 0.001), or dry covers (P = 0.002). Significant improvements were noted in terms of the microbial load in the ulcers and tissue repair, with a reported reduction in the need for amputation by up to 35 times. Photodynamic therapy resulted in significantly better outcomes between the experimental and control groups (P = 0.04). CONCLUSION: Photodynamic therapy is significantly more effective in treating infected foot ulcers than standard therapies. SYSTEMATIC REVIEW REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) - CRD42020214187, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214187.
Assuntos
Diabetes Mellitus , Pé Diabético , Fotoquimioterapia , Humanos , Brasil , Pé Diabético/tratamento farmacológico , Pé Diabético/cirurgia , CicatrizaçãoRESUMO
Em todo o mundo, as pessoas com Transtorno do Espectro Autista são discriminadas e têm seus direitos violados. Estima-se que uma em cada 160 crianças possuem o distúrbio e os estudos indicam o aumento globalizado da prevalência do Espectro. A psicanálise é conhecida por ser uma clínica do sujeito, e em crianças com TEA, se coloca no lugar de respeito ao jeito de ser de cada indivíduo, independentemente de sua patologia. As intervenções psicossociais com base nas teorias psicanalíticas são uma forma de reduzir as angústias vividas pelo sujeito, às dificuldades de comunicação e convívio social, melhorando a qualidade de vida. Desse modo, a presente pesquisa buscou compreender como a técnica psicanalítica pode contribuir no manejo de crianças com TEA. Para isto foi realizado um estudo de caráter descritivo e qualitativo com 12 psicanalistas que atendem crianças com o espectro. As entrevistas e dados sociodemográficos foram analisados com auxílio do IRAMUTEQ e do SPSS 21.0, respectivamente. Após a análise, as palavras puderam ser agrupadas em dois grandes eixos. O primeiro caracterizando o processo de evolução, onde a importância da família é ponto chave, e o segundo, relacionado ao lugar do psicanalista na direção da análise, caracterizando as especificidades do tratamento, do manejo e linguagem desta demanda. Pode- se perceber que as entrevistas explanaram as vivências da prática clínica, além de um tratamento possível e que mostra resultados no atendimento psicanalítico de crianças diagnosticadas ou em processo de diagnóstico do TEA.
All over the world, people with Autistic Spectrum Disorder are discriminated against and have their rights violated. It is estimated that one in every 160 children has the disorder and studies indicate the global increase in the prevalence of the Spectrum. Psychoanalysis is known to be a clinic of the subject, and in children with ASD, it takes the place of respect for the way of being of each individual, regardless of their pathology. Psychosocial interventions based on psychoanalytic theories are a way to reduce the anxieties experienced by the subject, the difficulties in communication and social interaction, improving the quality of life. Thus, this research sought to understand how the psychoanalytic technique can contribute to the management of children with ASD. For this, a descriptive and qualitative study was carried out with 12 psychoanalysts who assist children with the spectrum. The interviews and sociodemographic data were analyzed using IRAMUTEQ and SPSS 21.0, respectively. After analysis, the words could be grouped into two major axes. The first characterizing the process of evolution, where the importance of the family is a key point, and the second, related to the place of the psychoanalyst in the direction of the analysis, characterizing the specificities of the treatment, handling and language of this demand. It can be seen that the interviews explained the experiences of clinical practice, in addition to a possible treatment that shows results in the psychoanalytic care of children diagnosed or in the process of being diagnosed with ASD.
En todo el mundo, las personas con Trastorno del Espectro Autista son discriminadas y se violan sus derechos. Se estima que uno de cada 160 niños tiene el trastorno y los estudios indican el aumento global de la prevalencia del Espectro. El psicoanálisis se sabe que es una clínica del sujeto, y en los niños con TEA, toma el lugar del respeto por la forma de ser de cada individuo, independientemente de su patología. Las intervenciones psicosociales basadas en las teorías psicoanalíticas son una forma de reducir las ansiedades que experimenta el sujeto, las dificultades en la comunicación y la interacción social, mejorando la calidad de vida. Así, esta investigación buscó comprender cómo la técnica psicoanalítica puede contribuir al manejo de niños con TEA. Para ello, se realizó un estudio descriptivo y cualitativo con 12 psicoanalistas que asisten a niños con el espectro. Las entrevistas y los datos sociodemográficos se analizaron con IRAMUTEQ y SPSS 21.0, respectivamente. Después del análisis, las palabras podrían agruparse en dos grandes ejes. La primera caracterizando el proceso de evolución, donde la importancia de la familia es un punto clave, y la segunda, relacionada con el lugar del psicoanalista en la dirección del análisis, caracterizando las especificidades del tratamiento, manejo y lenguaje de esta demanda. . Se puede apreciar que las entrevistas explicaron las experiencias de la práctica clínica, además de un posible tratamiento que muestra resultados en la atención psicoanalítica de niños diagnosticados o en proceso de ser diagnosticados con TEA. PALABRAS CLAVE: Psicoanálisis; Niños; Trastorno del Espectro Autista.
RESUMO
ABSTRACT BACKGROUND: Ulceration of the feet in patients with diabetes is a frequent complication that increases morbidity, mortality, hospitalization, treatment costs, and non-traumatic amputations. OBJECTIVE: To present a systematic review of the treatment of patients with diabetes mellitus and infected foot ulcers using photodynamic therapy. DESIGN AND SETTING: A systematic review was performed in the postgraduate program in nursing at the Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Ceará, Brazil. METHODS: PubMed, CINAHL, Web of Science, EMBASE, Cochrane Library, Scopus, and LILACS databases were screened. The methodological quality, risk of bias, and quality of evidence of each study were assessed. Review Manager was used for the meta-analysis. RESULTS: Four studies were included. They highlighted significantly better outcomes in patient groups treated with photodynamic therapy than those in the control groups that were treated with topical collagenase and chloramphenicol (P = 0.036), absorbent (P < 0.001), or dry covers (P = 0.002). Significant improvements were noted in terms of the microbial load in the ulcers and tissue repair, with a reported reduction in the need for amputation by up to 35 times. Photodynamic therapy resulted in significantly better outcomes between the experimental and control groups (P = 0.04). CONCLUSION: Photodynamic therapy is significantly more effective in treating infected foot ulcers than standard therapies. SYSTEMATIC REVIEW REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) - CRD42020214187, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214187.
RESUMO
Resumo: Os objetivos deste estudo foram realizar a tradução e adaptação transcultural da Family Health Scale (Escala de Saúde Familiar) para a língua portuguesa brasileira e analisar evidências de validade psicométricas dessa escala. Os 32 itens sobre a saúde familiar foram adaptados transculturalmente. Para a mensuração das evidências de validade do conteúdo, utilizou-se o cálculo do índice de validade de conteúdo das características semântica, idiomática, cultural e conceitual de cada item e da escala. Um pré-teste para identificação de evidência de validade foi realizado com 40 famílias. Em outro momento, a aplicação do instrumento foi executada com 354 famílias, em uma cidade no Nordeste do Brasil. O índice de concordância entre os juízes variou de 0,84, para os itens da escala, a 0,98, para a escala total, conforme o coeficiente de Kendall. As evidências de validade psicométricas mostram-se adequadas, conforme alfa de Cronbach. A maior parte das famílias teve um grau de saúde moderado, conforme aplicação da escala. Assim, a Family Health Scale, versão brasileira, apresentou equivalência conceitual, semântica, cultural e operacional em relação aos itens originais e propriedades psicométricas satisfatórias para a aplicação direcionada à população brasileira, atestando eficácia e segurança de sua utilização.
Abstract: This study aimed to translate and cross-culturally adapt the Family Health Scale into Brazilian Portuguese and analyze evidence of its psychometric validity. The 32 items on family health were cross-culturally adapted, using the content validity index to calculate semantic, idiomatic, cultural, and conceptual characteristics of the scale and its items. A pre-test to identify evidence of validity was applied to 40 families. At another time, the instrument was applied to 354 families in a Brazilian northeastern city. The index of agreement between the raters ranged from 0.84 for the scale items to 0.98 for the total scale, according to Kendall's coefficient. According to Cronbach's alpha, evidence of psychometric validity is adequate. Most families had a moderate degree of health, according to the scale. Therefore, the Brazilian version of the Family Health Scale showed conceptual, semantic, cultural, and operational equivalence with the original items, along with satisfactory psychometric properties for use among the Brazilian population with effectiveness and safety.
Resumen: El objetivo de este estudio fue traducir y realizar la adaptación intercultural de Family Health Scale (Escala de Salud Familiar) al portugués brasileño, y analizar la evidencia de la validez psicométrica de esta escala. Los 32 ítems sobre salud familiar pasaron por una adaptación transcultural y, para medir la evidencia de validez de contenido, se utilizó el cálculo del índice de validez de contenido de las características semántica, idiomática, cultural y conceptual de cada ítem, y la escala. Se realizó una prueba previa con 40 familias para identificar la evidencia de validez. En otro momento, el instrumento se aplicó a 354 familias en una ciudad del Nordeste de Brasil. El índice de acuerdo entre los jueces osciló entre 0,84 para los ítems de la escala y 0,98 para la escala total de acuerdo con el coeficiente de Kendall. La evidencia de validez psicométrica es adecuada conforme el alfa de Cronbach. La mayoría de las familias tenían un grado de salud moderado de acuerdo con la aplicación de la escala. Por lo tanto, la Family Health Scale, versión brasileña, presentó equivalencia conceptual, semántica, cultural y operativa con relación a los ítems originales, y propiedades psicométricas satisfactorias para la aplicación en la población brasileña, lo que da fe de la eficacia y seguridad de su uso.
RESUMO
Congenital microcephaly is caused by a multitude of drivers affecting maternal−fetal health during pregnancy. It is a rare outcome in high-income industrial countries where microcephaly rates are in the range of 0.3−0.9 per 1000 newborns. Prevalence of microcephaly varies considerably across developing countries and can go as high as 58 cases per 1000 live births in pregnancies exposed to infection by Zika virus (ZIKV). Not only ZIKV-infected pregnancies, but other drivers can modulate the occurrence and severity of this outcome. Here, we sought to test the ZIKV−microcephaly association vs. competing hypotheses using a meta-analysis with 8341 microcephaly cases pooled from 10,250,994 newborns in the Americas, Africa, and Asia. Analysis of risk ratios (RR) showed teratogens the most likely microcephaly-associated risk factor (RR = 3.43; 95%-CI 2.69−4.38; p-value < 0.0001), while the statistical significance of the ZIKV−microcephaly association was marginal (RR = 2.12; 95%-CI 1.01−4.48; p-value = 0.048). Other congenital infections showed strong but variable associations with microcephaly (RR = 15.24; 95%-CI 1.74−133.70; p-value = 0.014). Microcephaly cases were associated with impoverished socioeconomic settings, but this association was statistically non-significant (RR = 2.75; 95%-CI 0.55−13.78; p-value = 0.22). The marginal ZIKV−microcephaly association and statistical significance of the competing hypotheses suggest maternal ZIKV infection might not be a cause of microcephaly alone.
RESUMO
Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among primary health care (PHC) nursing professionals in the state of Bahia, Brazil. A sectional multicentered study carried out in 43 municipalities in Bahia, whose study population consisted of nursing professionals. The exposure variables were occupation, professional exhaustion, and working time, and the outcome variable was MS. Interaction measures based on the additivity criteria were verified by calculating the excess risks due to the interactions and according to the proportion of cases attributed to the interactions and the synergy index. The global MS prevalence is 24.4%. There was a greater magnitude in the exposure group regarding the three investigated factors (average level occupation, professional exhaustion, and working time in PHC for more than 5 years), reaching an occurrence of 44.9% when compared to the prevalence of 13.1% in the non-exposure group (academic education, without professional burnout, and working time in PHC for up to 5 years). The study's findings showed a synergistic interaction of work aspects for MS occurrence among PHC nursing professionals.
RESUMO
High spinal cord injured patients (SCI) are susceptible to respiratory muscle impairments. Transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) may influence the diaphragm's central control, but until now they are not described as a therapeutic resource for difficult weaning. We present two case reports of SCI patients (P1 and P2) with long-term tracheostomy (>40 days) and hospital stay (>50 days). In association with respiratory exercise, P1 received a combined application of anodal tDCS over the supplementary motor area plus sensory PES in the thoracic-abdominal muscles, and P2 received isolated excitatory PES in the abdominal muscles, applied daily except on weekends. Maximum inspiratory/expiratory pressure, peak cough flow, diaphragm excursion, and thickening fraction were measured in the first and last days of the protocol. Both patients had improvements, with clinical impact such as cough effectiveness, decannulated after 15 applications of stimulation. Augmentation of neural respiratory drive and corticospinal excitability is suggested.
Assuntos
Terapia por Estimulação Elétrica/métodos , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/terapia , Traqueostomia , Estimulação Transcraniana por Corrente Contínua , Adulto , Exercícios Respiratórios , Vértebras Cervicais/lesões , Tosse , Humanos , Tempo de Internação/estatística & dados numéricos , MasculinoRESUMO
There is robust evidence of using Curcuma longa L. in reducing metabolic levels in people with diabetes. This study analysed the effectiveness of Curcuma longa L. in the metabolic control of patients with type 2 diabetes in Brazil. A randomised double-blind placebo-controlled clinical trial was conducted with 71 participants divided into a Curcuma longa L. group (500 mg/day with piperine 5 mg) and a placebo group, for 120 days. Anthropometric, clinical and biochemical variables were evaluated at baseline, 60 and 120 days after the beginning of the intervention. Paired and independent Student's t-test and chi-square test were used for statistical analysis. The curcuma group presented a significantly decreased glycaemia (p=.013), glycated haemoglobin (p=.015), HOMA index (p=.037) and triglycerides (TGs) (p=.002). The use of piperine-added Curcuma longa L. was effective in the glycaemic and TG control of patients with type 2 diabetes.
Assuntos
Alcaloides/uso terapêutico , Benzodioxóis/uso terapêutico , Curcuma , Diabetes Mellitus Tipo 2 , Piperidinas/uso terapêutico , Preparações de Plantas/uso terapêutico , Alcamidas Poli-Insaturadas/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Método Duplo-Cego , HumanosRESUMO
BACKGROUND: Robust evidence has related yellow passion fruit albedo and long turmeric to the metabolic and glycemic control of diabetes. AIM: To analyze the incremental cost-effectiveness of the flour made from yellow passion fruit albedo versus long turmeric merged with piperine in the glycemic and lipid control of individuals with type 2 diabetes. METHOD: Eighty-nine patients were enrolled in this randomized, placebo-controlled, clinical trial for 120 days. The first group was prescribed 500 mg capsules, three times a day, of yellow passion fruit albedo flour (FAMA). The second group was prescribed long turmeric capsules (500 mg), merged with piperine (5 mg) (CURPI), at fasting. The third group followed the standard advice recommendations, and ingested a placebo of carboxymethyl cellulose (500 mg) at fasting. RESULTS: The group using FAMA showed a higher reduction (-5.9%) of glycemia after fasting, compared to placebo (+9%), and CURPI (-3.2%) (p < 0.05). Regarding HbA1c, the study observed a significant and similar statistical reduction (-0.8%) in the intervention groups, in contrast with the placebo group (p < 0.05). The reduction in HOMA-IR in the CURPI group (-9.4%) was higher than the other groups (p < 0.05). The CURPI group also showed a higher reduction of serum triglyceride levels (-20.8%) compared to the placebo (-0.09%) and FAMA (+1.8%) (p < 0.05) groups. CONCLUSION: It was concluded that turmeric is the most cost-effective in comparison with yellow passion fruit albedo, because of its decrease in the levels of triglycerides and HOMA-IR, even when adjusted for confounding variables. On the other hand, HbA1c cost-effectiveness relation was similar.
Assuntos
Curcuma , Diabetes Mellitus Tipo 2 , Frutas , Passiflora , Preparações de Plantas/uso terapêutico , Glicemia , Análise Custo-Benefício , Curcuma/química , Diabetes Mellitus Tipo 2/tratamento farmacológico , Método Duplo-Cego , Frutas/química , Hemoglobinas Glicadas/análise , Controle Glicêmico , Humanos , Passiflora/químicaRESUMO
BACKGROUND: It is undeniable that diabetes may cause several health complications for the population. Many of these complications are associated with poor glycemic control. Due to this, strategies to handle this problem are of great clinical importance and may contribute to reducing the various complications from diabetes. OBJECTIVE: The aim of this study was to compare the effectiveness of the passion fruit peel flour versus turmeric flour on glycemic control. METHODS: This is a systematic review and meta-analysis following the PRISMA protocol. The following inclusion criteria were applied: (1) Case-control studies, cohort studies, and clinical trials, due to the improved statistical analysis and, in restrict cases, cross-sectional studies; (2) Articles published in any language. The databases used for the search were PubMed, Scopus, Web of Science, Cochrane, and LILACS. A bias analysis and a meta-analyses were undertaken using R Studio (version 3.3.1) using effect- size models. RESULTS: A total of 565 studies were identified from which 11 met the inclusion and exclusion criteria. Through isolated analysis, the effectiveness of turmeric flour on glycemic control was in the order of 0.73 CI (Confidence Interval) (from 0.68 to 0.79) and the effectiveness of passion fruit peel flour was 0.32 CI (0.23 to 0.45). The joint analysis resulted in 0.59 CI (0.52 to 0.68). The assessment of blood glucose was by glycated hemoglobin levels. All values were significant at a p < 0.05 level. CONCLUSION: Both interventions showed significant effects on glycemic control.
Assuntos
Curcuma , Diabetes Mellitus/sangue , Diabetes Mellitus/terapia , Passiflora , Fitoterapia , Preparações de Plantas/uso terapêutico , Glicemia/análise , Hemoglobinas Glicadas/análise , Humanos , Estruturas VegetaisRESUMO
INTRODUCTION: Studies about mental disorders are very rare in the Northeast of Brazil, especially when psychopathologies in children and adolescents are considered. The consequence is a small availability of data and an absence of a real epidemiological profile. METHODS: This is a systematic review with meta-analysis, following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol, in the period from 2003 to 2015, using the databases LILACS, SciELO and BVS. The analysis comprised the keywords 'models of primary and secondary healthcare in mental health', 'psychiatric reform' and 'policies and services in mental health', using the Boolean operator '# AND'. Original texts based on secondary data from the Hospital Information System of the Brazilian Unified Health System were also included via the Citizen Electronic Record System, Instituto Brasileiro de Geografia e Estatística, and Ministry of Health. Grey literature was used by means of hand searching. RESULTS: A combined analysis of the strategies mentioned in the analyzed articles shows a combined odds ratio of 1.291 (confidence interval (CI) = 1.054-1.582), thus it demonstrates the efficacy of using such strategies in the elaboration of institutional apparatus in mental health. The p-value of the chi-square distribution resulted in .9753, which does not reject the hypothesis of association between strategies in mental health and possible development of institutional apparatus in mental health. CONCLUSIONS: A combined analysis of all strategies mentioned in the analyzed studies shows efficacy of using strategies to elaborate institutional apparatus in mental health.
Assuntos
Serviços de Saúde Mental , Saúde Mental/legislação & jurisprudência , Política Pública/legislação & jurisprudência , Adolescente , Brasil , Criança , Humanos , Transtornos Mentais/epidemiologia , Saúde Mental/normasRESUMO
Soil ecotoxicology has been motivated by the increasing global awareness on environmental issues. Northern Hemisphere has been the main driver of this science branch; however, the number and quality of contributions from the Southern Hemisphere are increasing quickly. In this case study, Brazil is taken as an example of how soil ecotoxicology has developed over the last 30 years. It starts with a brief historical overview depicting the main events on soil ecotoxicology in the country. Following, an overview on the Brazilian legislation related to soil ecotoxicology is given, covering regulations with prospective focus, mainly on the registration of pesticides. Regulations with retrospective focus in contaminated areas are also given. Then, an outline of the actors in soil ecotoxicology and examples of prospective ecotoxicological studies performed with soil organisms and plants are given by stressor groups: pesticides, pharmaceuticals, metals, and residues. Experiences from retrospective studies, mainly looking at the assessment of industrial sites, are also covered. Emphasis is given on methodological aspects, pointing to needed actions, mainly regarding the different biotic and abiotic conditions of a tropical country. Finally, the last session discusses how soil ecotoxicology could be improved in methodological adaptations as well as legal requirements.
Assuntos
Conservação dos Recursos Naturais/métodos , Ecotoxicologia/métodos , Regulamentação Governamental , Poluentes do Solo , Solo/química , Animais , Brasil , Conservação dos Recursos Naturais/economia , Conservação dos Recursos Naturais/legislação & jurisprudência , Ecotoxicologia/economia , Ecotoxicologia/legislação & jurisprudência , Guias como Assunto , Medição de Risco , Poluentes do Solo/análise , Poluentes do Solo/toxicidade , Clima TropicalRESUMO
O objetivo é descrever uma nova técnica cirúrgica para fixação iriana de lente intraocular durante transplante de córnea em pacientes sem suporte capsular. A técnica de fixação iriana Tied Out Open Sky é uma técnica de fácil execução comparado com as técnicas já descritas, dispensando manobras cirúrgicas complexas, minimizando a manipulação e as complicações pós-operatórias.
To describe a new method for iris fixation of intraocular lens in the absence of capsular support during penetrating keratoplasty. Its a new technique of iris fixation of intraocular lens without capsular support during penetrating keratoplasty. This technique is used in cases with a healthy iris and partial or total absence of capsular support during penetrating keratoplasty. Tied Out Open Sky is a technique easy to perform for iris fixation of intraocular lens during penetrating keratoplasty. The big advantage is being able to tie off the intraocular lens off the eye and fasten it securely.
Assuntos
Humanos , Feminino , Adulto , Iris/cirurgia , Técnicas de Sutura/instrumentação , Ceratoplastia Penetrante/métodos , Implante de Lente Intraocular/métodos , Lentes Intraoculares , Afacia , Polipropilenos , Materiais Biocompatíveis , Acuidade Visual , Exotropia , Subluxação do Cristalino , Polietilenotereftalatos , Doenças da Córnea/cirurgia , Cápsula do Cristalino/patologiaRESUMO
Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma, characterized by progressive peripheral growth with concomitant healing of the central area of the tumor. We present a patient with KCM who was treated with topical 5% 5-fluorouracil. This is the third reported case of KCM treated with this agent.