RESUMO

The mandibular interforaminal region has been considered safe for surgical procedures; nevertheless, the risk of injury to neurovascular structures, such as the mental foramen (MF) and its related structures (anterior loop [AL] and lingual foramina [LF]) should not be overlooked. The study aimed to evaluate the relative risk of injury to these structures during surgical procedures in the anterior region of the mandible based on cone-beam computed tomography (CBCT) scans. A retrospective cross-sectional and observational study was performed on 250 CBCTs from adults (18-69 years) with dentate jaws. Linear measurements of the MF, AL, and LF were evaluated to estimate the risk of injury to these structures during chin-related surgical procedures. The most frequent distance between the base of the mandible (BM) and MF was 8 mm (30.2%). In addition, 20.4% of the CTs had 6 mm from the vestibular cortical bone to the LF. The commonly found measurement from LF to the apex of the nearest tooth was 7 mm (24.0%); 64.2% of the CTs showed a 2-mm distance between the most distal point of the dental implant site to the most anterior point of the AL. Safety distances for genioplasty techniques (MF to mandible base > 6 mm, 96.6% [CI 95%, 95.0%-98.2%]) were observed. Considering the 5-mm cut-off point between the lower limit of a hypothetical bone graft and the chin, 65.4% (CI 95%, 58.9%-71.9%) of CTs were within this distance. Regarding the safety margin of 8 mm, 85.6% (CI 95%, 80.8%-90.4%) were up to this value. This study found safety margins for genioplasty and chin bone grafting surgical techniques that adopt a 5-mm cut-off point. Further similar studies assessing other surgical methods and employing larger samples from different geographical origins may contribute to this field of investigation.

Assuntos

RESUMO

INTRODUÇÃO: A cardiomiopatia arritmogênica (CA) é uma doença hereditária associada a arritmias ventriculares e risco de morte súbita (MS). Caracteriza-se pela infiltração fibrogordurosa do miocárdio, mutações em genes ligados aos desmossomos, sendo mais comum a apresentação no ventrículo direito (VD) acompanhada de arritmias ventriculares. RELATO DE CASO: Homem, 52 anos, sem história de doença prévia, teve internação recente em Unidade de Pronto Atendimento (UPA) devido à palpitações intensas secundárias à taquicardia ventricular sustentada (TV) com padrão de bloqueio de ramo direito concordante de V1 a V6 e eixo desviado para direita. Tratado com amiodarona endovenosa e liberado com propranolol apenas. Recorreu com palpitações 10 dias após quando procurou pronto socorro de hospital terciário, sendo internado para investigação. Não apresentou TV nessa internação. Os exames evidenciaram: Eletrocardiograma: Ritmo sinusal, área eletricamente inativa em parede inferior, baixa voltagem em plano frontal; Ecocardiograma: fração de ejeção 60%, sem alterações segmentares ou valvares.Angiotomografia coronariana sem lesões obstrutivas. Estudo eletrofisiológico, com estimulação em ápice e base de VD, sem indução de arritmias (procedimento realizado pois até então havia apenas relato de TV na UPA). Ressonância cardíaca mostrou VE com hipocinesia em regiões lateral e apical; sinais de infiltração gordurosa no septo, regiões lateral e apical; realce tardio com padrão ring-like com localização mesoepicárdica, que envolvia pelo menos 3 segmentos contíguos no mesmo corte de eixo curto e pontos isolados do VD; área de realce de 22g (22% do VE). Foi definida conduta com introdução de metoprolol e amiodarona, coleta de teste genético do paciente e familiares imediatos e indicado implante de CDI. Planejou-se ablação de TV caso apresentasse recorrência. No momento, em evolução clínica sem novos eventos. DISCUSSÃO: O paciente em questão preenche critério pelo algoritmo de Pádua 2020 para CA. Essa cardiopatia corresponde a 11% dos casos de MS e, o envolvimento predominante do VE ocorre em apenas 5% dos casos. O padrão ring- -like encontrado têm sido associado a maior probabilidade de eventos arrítmicos potencialmente fatais na CA. Trata-se de desafio diagnóstico pela sua relativa baixa prevalência, mas com importantes implicações prognósticas e terapêuticas, sendo essencial perseguir o diagnóstico etiológico da miocardiopatia, particularmente pelas características eletrocardiográficas da TV em paciente jovem, além de complementar com a investigação dos familiares.

Assuntos

RESUMO

This study aimed to evaluate the scientific evidence on the effect of preemptive drug coadministration (PDC) for relieving inflammatory events (pain, swelling, and trismus) in mandibular third molar surgery. A PROSPERO-registered systematic review (CRD42022314546) was conducted according to the PRISMA guide. The searches were carried out in six primary databases and the gray literature. Studies not written in languages with the Latin alphabet (Roman) were excluded. Potential randomized controlled trials (RCTs) were screened for eligibility. Cochrane's Risk of Bias-2.0 (RoB) tool was assessed. A synthesis without meta-analysis (SWiM) based on a vote counting and an effect direction plot. Nine studies (low RoB) fulfilled the eligibility criteria and were included for data analysis, with a total of 484 patients. PDC mostly involved corticosteroids (Cort) and non-steroidal anti-inflammatory drugs (NSAIDs). PDC of Cort and other drugs mainly reduced pain scores (6 and 12 h postoperatively) and swelling (48 h postoperatively). PDC of NSAIDs and other drugs mainly reduced pain scores at 6, 8, and 24 h follow-up; swelling and trismus intensity ameliorated at 48 h postoperatively. The most frequently prescribed rescue medication was paracetamol, dipyrone, and paracetamol plus codeine. Results from individual studies have shown reduced consumption of ingested rescue analgesics. In summary, the available evidence from clinical trials included in this SWiM suggests that PDC may provide benefits in reducing the severity of inflammatory outcomes related to mandibular third molar surgery, especially the pain scores in the first hours after surgery, and the rescue analgesic consumption during the postoperative period.

Assuntos

RESUMO

The majority of early prediction scores and methods to predict COVID-19 mortality are bound by methodological flaws and technological limitations (e.g., the use of a single prediction model). Our aim is to provide a thorough comparative study that tackles those methodological issues, considering multiple techniques to build mortality prediction models, including modern machine learning (neural) algorithms and traditional statistical techniques, as well as meta-learning (ensemble) approaches. This study used a dataset from a multicenter cohort of 10,897 adult Brazilian COVID-19 patients, admitted from March/2020 to November/2021, including patients [median age 60 (interquartile range 48-71), 46% women]. We also proposed new original population-based meta-features that have not been devised in the literature. Stacking has shown to achieve the best results reported in the literature for the death prediction task, improving over previous state-of-the-art by more than 46% in Recall for predicting death, with AUROC 0.826 and MacroF1 of 65.4%. The newly proposed meta-features were highly discriminative of death, but fell short in producing large improvements in final prediction performance, demonstrating that we are possibly on the limits of the prediction capabilities that can be achieved with the current set of ML techniques and (meta-)features. Finally, we investigated how the trained models perform on different hospitals, showing that there are indeed large differences in classifier performance between different hospitals, further making the case that errors are produced by factors that cannot be modeled with the current predictors.

Assuntos

RESUMO

RESUMO VIEIRA, Alessandra Magela dos Santos. Fatores associados à cobertura vacinal infantil no Brasil e Unidades da Federação. 2023. 91 f. Dissertação (Mestrado Profissional em Gestão de Serviços de Saúde) ­ Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, 2023. A vacinação evita doenças imunopreveníveis, promove o bem-estar na saúde geral da população e, atrelada às melhorias nas condições de vida, resulta na diminuição da morbimortalidade infantil. A imunização no Brasil busca manter os altos índices de cobertura vacinal por meio do Programa Nacional de Imunizações (PNI), criado em 1973, gratuito e universal. Este estudo teve como objetivo analisar os fatores socioeconômicos e demográficos associados a uma menor cobertura, considerando o Brasil e as Unidades Federativas. Como objetivos específicos, estimou-se a cobertura em menores de cinco anos, no período de 2011 a 2022, para as vacinas: BCG, Hepatite B, Meningite C, Rotavírus, Pentavalente, Pneumocócica10, Vacina Inativada da Poliomielite, Hepatite A, Poliomielite Oral; comparou-se a cobertura vacinal entre as Unidades Federativas para imunobiológicos específicos (Rotavírus, Pentavalente, Pneumocócica 10 e Pneumocócica 10 1º reforço) em 2019. Metodologicamente, tratou-se de um estudo ecológico e analítico, de corte transversal e abordagem quantitativa, utilizando-se como fontes de dados: o Sistema de Informação do Programa Nacional de Imunizações (SI PNI), Atlas do Desenvolvimento Humano no Brasil (2022), Pesquisa Nacional de Saúde (2019),Pesquisa Nacional por Amostra de Domicílios Contínua (2019) e Suframa (2019). Na análise dos dados utilizaram-se estatísticas descritivas como medidas de tendência central e variabilidade, além da correlação de Pearson e Spearman. Os resultados apontaram a crítica situação da cobertura vacinal infantil no país que apresentou a maior redução nas taxas de cobertura a partir de 2016 e, desde 2019 nenhuma vacina alcançou a meta de cobertura recomendada, ocorrendo um agravamento da cobertura vacinal nos períodos pandêmico (2020) e pós-pandêmico. As vacinas de primeiro e segundo reforços, assim como a vacina da Hepatite B em crianças com até 30 dias, nunca atingiram a meta de cobertura vacinal no período analisado, 2011 a 2022. Os estados com a pior cobertura dos imunobiológicos Rotavírus, Pentavalente, Pneumocócica 10 e Pneumocócica 1º reforço em 2019 foram: Rio de Janeiro, Pará e Amapá. Nesse ano, não houve o alcance da meta da cobertura vacinal desses imunobiológicos específicos no país e a vacina Pentavalente (indicador de acesso aos serviços de saúde) obteve o pior índice de cobertura. A taxa de mortalidade infantil , o Índice de Gini e a taxa de desemprego foram as variáveis que tiveram associação com a cobertura vacinal de imunobiológicos específicos. Como conclusão, verificou-se que os anos de 2016, 2020 e 2021 tiveram taxas de cobertura vacinal defasadas, coincidindo com crises na política e na economia do país, além da pandemia da COVID-19. Em 2021, pior ano da cobertura vacinal infantil no país e em 2022, houve indícios de uma incipiente recuperação nas taxas de cobertura. A compreensão de fatores associados à cobertura vacinal, incluindo as taxas de mortalidade infantil, de desemprego e o Índice de Gini, é crucial para a implementação de políticas públicas eficazes para a promoção da vacinação infantil. Palavras-chave: cobertura vacinal; crianças; fatores socioeconômicos e demográficos associados; Brasil.

ABSTRACT VIEIRA, Alessandra Magela dos Santos. Factors associated with childhood vaccination coverage in Brazil and Federation Units. 2023. 91 p. Dissertation (Professional Master's Degree in Health Services Management) - School of Nursing, Federal University of Minas Gerais, Belo Horizonte, 2023. Vaccination prevents vaccine-preventable diseases, promotes well-being in the general health of the population and, linked to improvements in living conditions, results in a decrease in childhood morbidity and mortality. Immunization in Brazil seeks to maintain high vaccination coverage rates through the National Immunization Program (PNI), created in 1973, free and universal. This study aimed to analyze the socioeconomic and demographic factors associated with lower coverage, considering Brazil and the Federative Units. As specific objectives, the coverage in children under five years of age was estimated, from 2011 to 2022, for the following vaccines: BCG, Hepatitis B, Meningitis C, Rotavirus, Pentavalent, Pneumococcal 10, Inactivated Polio Vaccine, Hepatitis A, Oral Polio; the vaccination coverage was compared between the Federative Units for specific immunobiologicals (Rotavirus, Pentavalent, Pneumococcal 10 and Pneumococcal 10 1st booster) in 2019. Methodologically, this was an ecological and analytical study, with a cross-sectional and quantitative approach, using as data sources: the National Immunization Program Information System (SI PNI), Atlas of Human Development in Brazil (2022), National Health Survey (2019), Continuous National Household Sample Survey (2019) and Suframa (2019). Descriptive statistics were used to analyze the data, such as measures of central tendency and variability, in addition to Pearson and Spearman correlation. The results indicated the critical situation of childhood vaccination coverage in the country, which showed the greatest reduction in coverage rates since 2016 and, since 2019, no vaccine has reached the recommended coverage target, with a worsening of vaccination coverage during the pandemic (2020) and post-pandemic periods. The first and second booster vaccines, as well as the Hepatitis B vaccine in children up to 30 days old, never reached the vaccination coverage target in the period analyzed, 2011 to 2022. The states with the worst coverage of the immunobiologicals Rotavirus, Pentavalent, Pneumococcal 10 and Pneumococcal 1st booster in 2019 were: Rio de Janeiro, Pará and Amapá. This year, the vaccination coverage target for these specific immunobiologicals was not achieved in the country, and the Pentavalent vaccine (an indicator of access to health services) had the worst coverage rate. The infant mortality rate, the Gini Index, and the unemployment rate were the variables that were associated with the vaccination coverage of specific immunobiologicals. In conclusion, it was found that the years 2016, 2020, and 2021 had lagging vaccination coverage rates, coinciding with crises in the country's politics and economy, in addition to the COVID-19 pandemic. In 2021, the worst year for childhood vaccination coverage in the country, and in 2022, there were signs of an incipient recovery in coverage rates. Understanding factors associated with vaccination coverage, including infant mortality rates, unemployment rates, and the Gini Index, is crucial for the implementation of effective public policies to promote childhood vaccination. Keywords: vaccination coverage; children; associated socioeconomic and demographic factors; Brazil.

Assuntos

RESUMO

INTRODUCTION: Out-of-Office Measurement of Blood Pressure (BP) is recommended in addition to office BP for the diagnosis and follow-up of hypertensive patients. Ambulatory Blood Pressure Monitoring (ABPM); Home Blood Pressure Monitoring (HBPM); and Self-Monitoring of BP (SMBP) are the currently available options and their indication may vary according to the context. The aim of the present study was to assess how Out-of-Office Measurement of BP takes place in clinical practice and its impact on BP control in a public tertiary outpatient clinic. METHODS: We evaluated 225 consecutive patients seen at a high-complexity public outpatient facility (mean age: 66.7 ± 11.9 years; female: 62.7%). All patients were routinely requested to perform SMBP according to a prespecified institutional protocol. ABPM and HBPM were indicated for selected cases at the discretion of the attending physician. Patient Adherence to Out-of-Office Measurement of BP was labeled into 5 possible categories: a) No Measurement; b) ABPM; c) HBPM; d) Adequate SMBP e) Inadequate SMBP. Patient Adherence was also stratified according to sex, age, number of antihypertensive drugs, schooling, length of follow-up at the facility, comorbidities and availability of BP monitor at home. Rates of BP control were related with Patient Adherence, as well as with the aforementioned variables. RESULTS: 87.5% of the study population reported having a BP monitor at home. However, adding up the 5 possible categories, adequate Out-of-Office Measurement of BP was available in only 46.7% of the sample (40.9% of the patients did not bring any measurement; 13.8% underwent ABPM; 32.9% adequate SMBP; 12.4% inadequate SMBP; 0% HBPM). Availability of a BP monitor at home (p<0.001) and the number of antihypertensive drugs in use (p=0.019) were strongly associated with adherence to SMBP. Prevalence of smoking was 2 folds higher (7.5% vs 3.4%) in those who returned without SMBP. Rate of BP control based on office BP was 42.6% (79.5% of the sample was under ≥3 classes of antihypertensive drugs). Out-of-office BP measurements were not associated with higher rates of BP control (p=0.377), but allowed to identify a White Coat Effect (WCE) in 1 out of 3 patients with uncontrolled BP according to office BP (WCE prevalence: 29 % among uncontrolled patients vs 3.9% among controlled ones. CONCLUSIONS: Outof-Office Measurement of BP is still an unmet need in the treatment of hypertension.

Assuntos

RESUMO

Aging is characterized by a progressive loss of physiological integrity. One common denominator is the increase of reactive oxygen species (ROS) caused by inhibition of important antioxidant pathways. Resveratrol is a polyphenol known for its potent antioxidant activity. However, antioxidant pathways activated by them change with aging. The objective of our study was to verify the antioxidant effect of resveratrol in an oxidative stress environment in Human Mononuclear Cells (PBMC) from donors with different ages. Resveratrol (5 µM), a stimulus with H2O2 (0,64 % v/v) in addition to inhibitors of PKA, AkT/PKB and MAPK signaling pathways were used in chemiluminescence assay. An incresed basal production of ROS was observed in the elderly than in the middle-aged group. Resveratrol was able to reduce ROS in both groups, but with greater efficiency in the middle-aged group. By inhibiting PKA, Akt/PKB and MAPK signaling pathways we observed that resveratrol presented an altered performance in the aging process, changing signaling pattern of MAPK pathway.

Assuntos

RESUMO

Trata-se de um relato de experiência cujo objetivo é compartilhar o processo de execução da digitalização e disponibilização em meio eletrônico da Revista Leprosy Review e de dar visibilidade aos estudos sobre hanseníase em âmbito nacional e internacional. Constitui-se de um relato baseado na observação dos profissionais envolvidos na execução do projeto. Os resultados obtidos evidenciam que os principais objetivos do projeto foram alcançados, pois a revista já está operando em meio eletrônico em caráter de acesso aberto e as etapas foram concluídas dentro dos critérios estabelecidos inicialmente no projeto (AU)

This is an experience report which main goal is to share the process of scanning and electronic availability of Leprosy Review Journal, and aims to give visibility to studies on leprosy on national and international levels. It is a report based on the observation of the professionals involved in the execution of the project. The results show that the main objectives of the project were achieved, since the journal is already operating online, in open access and has satisfactory levels of access. The stages of the project were completed within the criteria established initially (AU)

Assuntos

RESUMO

The objective of this study was to assess the association of untreated traumatic dental injuries (TDI) with individual-, sociodemographic- and school-related factors among 12-year-old schoolchildren in Midwest Brazil. This cross-sectional study was carried out in 2010 in the city of Goiania, Brazil. A random sample of 2075 schoolchildren was examined and interviewed. Untreated TDI in the permanent incisors was assessed using the methodology of the Brazilian National Oral Health Survey. Rao-Scott test and multinomial logistic regression were used to analyze the associations between independent variables and three categories of TDI, using a hierarchical method. Independent variables were children's sex, self rated color/race and size of incisal overjet, their mother's level of schooling, and the schools' type and geographic location. The prevalence of trauma was 17.3% (CI 95% = 15.2-19.4); enamel fractures were the most common TDI (13.1%). In the adjusted model, a higher chance of having two or more teeth with TDI was found among boys, those whose mothers had lowest level of schooling, and those attending schools located in health districts with lower socioeconomic indicators. It was concluded that the prevalence of TDI was low and that it was associated with individual factors as well as the school environments.

Assuntos

RESUMO

OBJECTIVE: The aim of the present study was to evaluate the effect of periodontal dressing on post-operative pain and swelling after surgical crown lengthening. MATERIALS AND METHODS: A blind, randomized, clinical trial was carried out with 36 patients. Following surgical crown lengthening, the individuals were randomly allocated to the periodontal dressing group (PDG) and control group (CG, non-placement of periodontal dressing). Pain and discomfort were analyzed using a visual analog scale (VAS), verbal scale (VS) and the number of analgesics consumed in 7 days post-operatively. Post-operative infection, stability of the gingival margin and type of healing were also evaluated. RESULTS: The PDG had a significantly higher percentage of responses of 'strong pain' on the VS in the first day post-operatively (33.3% vs 5.3%, p = 0.03) and greater pain on the first and second days post-operatively based on the VAS. Moreover, a significant difference between groups was found regarding gingival swelling after 7 days. However, gingival recession was found in 57.8% of the sites in the CG and only 5.5% of sites in the PDG. No change in condition was found among individuals with conjunctive tissue/bone exposure in the CG in the immediate post-operative period and 80% of the patients in the PDG had healing by first intention after 7 days. CONCLUSION: The use of periodontal dressing seems to be preferable following surgical crown lengthening with connective tissue/bone exposure. However, adequate post-operative analgesic strategies should be employed due to the possibility of intense pain in the first 24 hours.

Assuntos

RESUMO

Este trabalho tem como objetivo apreender a nuance do conceito de puberdade ao longo da obra freudiana. Buscamos compreender como Freud, tendo por base a interface entre "determinismo do período da infância" e "contingência adolescente", articula a puberdade com o momento de irrupção da neurose. Problematizaremos a relevância do "período de latência" e do pressuposto de uma sexualidade "em dois tempos" na compreensão da puberdade e de suas possibilidades no âmbito da constituição do sujeito. Utilizaremos como recurso metodológico a retomada dos principais casos clínicos de Freud, dentre eles, Dora, Homem dos Lobos e a Jovem homossexual, buscando apreender a relevância do momento da irrupção da puberdade, suas possibilidades, seus percalços na causação/manifestação da neurose. Percebemos que Freud, mesmo não tomando a questão como foco de sua pesquisa, passa por ela ao longo de sua obra, permitindo-nos inferir e discutir suas concepções acerca do tema...

This work aims to outline the nuance of the concept of puberty throughout Sigmund Freud's studies. We intend to understand how Freud, based on the interface between 'determinism of childhood period' and 'teenagers contingency', articulates puberty in relation to the irruption of neurosis. We deal with the relevance of the 'latency period' and also with the assumption of sexuality 'in two stages', according to the understanding about puberty and its possibilities for the constitution of the subject. We use as a methodological resource some of the main clinical cases analyzed by Freud such as Dora, The Wolf Man and The Young Homosexual Woman. In this way, our purpose is to stablish the discussion on the relevance of the irruption of puberty, its possibilities and obstacles in the causation/manifestation of any neurosis. We realized that Freud, while not taking this issue as the focus of his research, explores it throughout his studies, allowing us to infer and discuss his point of views about this theme...

Ce travail vise à décrire la nuance du concept de la puberté à travers les études de Sigmund Freud. Nous avons l'intention de comprendre comment Freud, basé sur l'interface entre le "déterminisme de la période de l'enfance" et la "contingence adolescent", articule la puberté par rapport à l'irruption de la névrose. Nous nous occupons de la pertinence de la "période de latence" et également avec l'hypothèse d'une sexualité "en deux étapes", selon la compréhension de la puberté et de ses possibilités pour la constitution du sujet. Nous utilisons les ressources méthodologiques de certains des principaux cas cliniques analysés par Freud comme Dora, L'homme-aux-loups et La Jeune Homosexuelle. De cette façon, nous avons le but de discuter de la pertinence de l'irruption de la puberté, de ses possibilités et les obstacles dans la causalité/ manifestation d'une névrose. Nous avons réalisé que Freud, tout en ne prenant pas cette question comme l'objet de ses recherches, il l'a explorée au long de ses études, ce qui nous permet de considérer et de discuter de son point de vue sur ce thème...

Assuntos

RESUMO

Este trabalho tem como objetivo apreender a nuance do conceito de puberdade ao longo da obra freudiana. Buscamos compreender como Freud, tendo por base a interface entre "determinismo do período da infância" e "contingência adolescente", articula a puberdade com o momento de irrupção da neurose. Problematizaremos a relevância do "período de latência" e do pressuposto de uma sexualidade "em dois tempos" na compreensão da puberdade e de suas possibilidades no âmbito da constituição do sujeito. Utilizaremos como recurso metodológico a retomada dos principais casos clínicos de Freud, dentre eles, Dora, Homem dos Lobos e a Jovem homossexual, buscando apreender a relevância do momento da irrupção da puberdade, suas possibilidades, seus percalços na causação/manifestação da neurose. Percebemos que Freud, mesmo não tomando a questão como foco de sua pesquisa, passa por ela ao longo de sua obra, permitindo-nos inferir e discutir suas concepções acerca do tema.(AU)

This work aims to outline the nuance of the concept of puberty throughout Sigmund Freud's studies. We intend to understand how Freud, based on the interface between 'determinism of childhood period' and 'teenagers contingency', articulates puberty in relation to the irruption of neurosis. We deal with the relevance of the 'latency period' and also with the assumption of sexuality 'in two stages', according to the understanding about puberty and its possibilities for the constitution of the subject. We use as a methodological resource some of the main clinical cases analyzed by Freud such as Dora, The Wolf Man and The Young Homosexual Woman. In this way, our purpose is to stablish the discussion on the relevance of the irruption of puberty, its possibilities and obstacles in the causation/manifestation of any neurosis. We realized that Freud, while not taking this issue as the focus of his research, explores it throughout his studies, allowing us to infer and discuss his point of views about this theme.(AU)

Ce travail vise à décrire la nuance du concept de la puberté à travers les études de Sigmund Freud. Nous avons l'intention de comprendre comment Freud, basé sur l'interface entre le "déterminisme de la période de l'enfance" et la "contingence adolescent", articule la puberté par rapport à l'irruption de la névrose. Nous nous occupons de la pertinence de la "période de latence" et également avec l'hypothèse d'une sexualité "en deux étapes", selon la compréhension de la puberté et de ses possibilités pour la constitution du sujet. Nous utilisons les ressources méthodologiques de certains des principaux cas cliniques analysés par Freud comme Dora, L'homme-aux-loups et La Jeune Homosexuelle. De cette façon, nous avons le but de discuter de la pertinence de l'irruption de la puberté, de ses possibilités et les obstacles dans la causalité/ manifestation d'une névrose. Nous avons réalisé que Freud, tout en ne prenant pas cette question comme l'objet de ses recherches, il l'a explorée au long de ses études, ce qui nous permet de considérer et de discuter de son point de vue sur ce thème.(AU)

Assuntos

RESUMO

Este artigo visa a analisar alguns aspectos do livro Lavoura Arcaica, escrito por Raduan Nassar, publicado em 1975 e posteriormente traduzido para o espanhol, alemão e francês. Esse livro é considerado sua obra-prima e gerou considerável interesse dos críticos literários graças ao seu caráter inovador, marcado por um discurso confessional que é imposto aos seus leitores, convidando-os a uma viagem aos aspectos mais íntimos e profundos da existência humana. Nesta medida, este trabalho diz respeito à complexa construção da identidade social e alteridade nos personagens envolvidos. Analisamos como a identidade pressuposta é quebrada pelo personagem André ao longo do romance e como ela o impulsiona a defender a sua própria alteridade – um movimento que provoca a divisão e a ruptura de valores naturalizados no seio da família. No entanto, ao questionar “os limites da fazenda”, André entra em um constante embate retórico com seu pai Yohama, o que pode representar, no ponto de vista de Sueli Rolnik, o encontro do homem da moral e o homem da ética.

This paper aims to analyze some aspects of the book Lavoura Arcaica, written by Raduan Nassar, published in 1975 and since then translated into Spanish, German, and French. This book is considered his masterpiece and has generated considerable literary critical interest because of its innovative character, marked by a confessional discourse that is imposed onto his readers, inviting them into a trip throughout the most intimate and profound aspects of human existence. This work concerns the complex construction of social identity and alterity by its characters. We analyze how assumed identity is broken down by André’s character along the course of the novel and how this pushes him to defend his own alterity – a movement that causes division and rupture of naturalized values within his family. However, by putting “the boundaries of the farm” into question, André comes into constant rhetorical clash with his father Yohama, who may represent, in Sueli Rolnik’s point of view, the meeting of the man of morals and the man of ethics.

Assuntos

RESUMO

Este artigo visa a analisar alguns aspectos do livro Lavoura Arcaica, escrito por Raduan Nassar, publicado em 1975 e posteriormente traduzido para o espanhol, alemão e francês. Esse livro é considerado sua obra-prima e gerou considerável interesse dos críticos literários graças ao seu caráter inovador, marcado por um discurso confessional que é imposto aos seus leitores, convidando-os a uma viagem aos aspectos mais íntimos e profundos da existência humana. Nesta medida, este trabalho diz respeito à complexa construção da identidade social e alteridade nos personagens envolvidos. Analisamos como a identidade pressuposta é quebrada pelo personagem André ao longo do romance e como ela o impulsiona a defender a sua própria alteridade – um movimento que provoca a divisão e a ruptura de valores naturalizados no seio da família. No entanto, ao questionar “os limites da fazenda”, André entra em um constante embate retórico com seu pai Yohama, o que pode representar, no ponto de vista de Sueli Rolnik, o encontro do homem da moral e o homem da ética.(AU)

This paper aims to analyze some aspects of the book Lavoura Arcaica, written by Raduan Nassar, published in 1975 and since then translated into Spanish, German, and French. This book is considered his masterpiece and has generated considerable literary critical interest because of its innovative character, marked by a confessional discourse that is imposed onto his readers, inviting them into a trip throughout the most intimate and profound aspects of human existence. This work concerns the complex construction of social identity and alterity by its characters. We analyze how assumed identity is broken down by André’s character along the course of the novel and how this pushes him to defend his own alterity – a movement that causes division and rupture of naturalized values within his family. However, by putting “the boundaries of the farm” into question, André comes into constant rhetorical clash with his father Yohama, who may represent, in Sueli Rolnik’s point of view, the meeting of the man of morals and the man of ethics.(AU)

Assuntos

RESUMO

Melanins have been associated with the development of melanoma and its resistance to photodynamic therapy (PDT). Singlet molecular oxygen ((1)O(2)), which is produced by ultraviolet A solar radiation and the PDT system, is also involved. Here, we investigated the effects that these factors have on DNA damage and repair. Our results show that both types of melanin (eumelanin and pheomelanin) lead to DNA breakage in the absence of light irradiation and that eumelanin is more harmful than pheomelanin. Interestingly, melanins were found to bind to the minor grooves of DNA, guaranteeing close proximity to DNA and potentially causing the observed high levels of strand breaks. We also show that the interaction of melanins with DNA can impair the access of repair enzymes to lesions, contributing to the perpetuation of DNA damage. Moreover, we found that after melanins interact with (1)O(2), they exhibit a lower ability to induce DNA breakage; we propose that these effects are due to modifications of their structure. Together, our data highlight the different modes of action of the two types of melanin. Our results may have profound implications for cellular redox homeostasis, under conditions of induced melanin synthesis and irradiation with solar light. These results may also be applied to the development of protocols to sensitize melanoma cells to PDT.

Assuntos

RESUMO

In the present paper, the adsorption of cysteine on hematite, magnetite and ferrihydrite was studied using FT-IR, electron paramagnetic resonance (EPR), Mössbauer spectroscopy and X-ray diffractometry. Cysteine was dissolved in artificial seawater (two different pHs) which contains the major constituents. There were two main findings described in this paper. First, after the cysteine adsorption, the FT-IR spectroscopy and X-ray diffractometry data showed the formation of cystine. Second, the Mössbauer spectroscopy did not show any increase in the amount of Fe(2+) as expected due the oxidation of cysteine to cystine. An explanation could be that Fe(2+) was oxidized by the oxygen present in the seawater or there occurred a reduction of cystine by Fe(2+) generating cysteine and Fe(3+). The specific surface area and pH at point of zero charge of the iron oxides were influenced by adsorption of cysteine. When compared to other iron oxides, ferrihydrite adsorbed significantly (p < 0.05) more cysteine. The pH has a significant (p < 0.05) effect only on cysteine adsorption on hematite. The FT-IR spectroscopy results showed that cystine remains adsorbed on the surface of the iron oxides even after being mixed with KCl and the amine and carboxylic groups are involved in this interaction. X-ray diffractometry showed no changes on iron oxides mineralogy and the following precipitated substances were found along with the iron oxides after drying the samples: cysteine, cystine and seawater salts. The EPR spectroscopy showed that cysteine interacts with iron oxides, changing the relative amounts of iron oxides and hydroxide.

Assuntos

RESUMO

O isoprenóide geraniol (GO) apresentou atividade quimiopreventiva quando administrado continuamente durante as fases de iniciação e pós-iniciação em modelo de carcinogênese experimental de cólon por meio da redução do número de focos de criptas aberrantes (FCAs) totais FCAs ≥ 4 criptas e aumento de apoptose no cólon distal. Dessa forma, optou-se por avaliar os eventuais efeitos de três doses de GO (GO1: 25mg/100g de peso corpóreo [p.c.], G02: 50 mg/100g de p.c. e G03: 100 mg/100g de p.c.) em categorias de lesões pré-neoplásicas (LPNs) induzidas por dimetilhidrazina (DMH) durante a fase de pós-iniciação tardia de modelo de carcinogênese experimental de cólon, caracterizada por apresentar lesões mais avançadas e com alto grau de alterações celulares morfológicas, bioquímicas e moleculares denominadas de displasia. Para isso, analisamos diferentes biomarcadores como: FCAs totais e FCAs < ou ≥ 4 criptas em cólons corados com azul de metileno; focos depletados ou positivos de mucina (FPMs ou FDMs) em cólons corados com azul de toluidina; FCAs convencionais ou displásicos por meio de análise histopatológica em cortes corados com hematoxilina e eosina (HE) e focos positivos ou negativos para beta-catenina (FPBCs ou FNBCs) citoplasmática e/ou nuclear por meio de imunoistoquímica. Além disso, células apoptóticas foram identificadas utilizando-se critérios morfológicos clássicos em FCAs ≥ 4 no cólon distaI e a expressão de genes envolvidos na carcinogênese de cólon foi avaliada por meio de RT-PCR: HMGCoA-redutase na mucosa colônica e K-Ras e c-myc em FCAs microdissecados. Em relação ao grupo controle, foi possível observar que o grupo tratado com a maior dose de GO (G03) reduziu a freqüência de FCAs ≥ 4 criptas e FDMs, além de aumentar a apoptose em FCAs ≥ 4 displásicos no cólon distaI (p ≤ 0,05). Já, em relação aos outros biomarcadores e às expressões de HMGCoA-redutase, K-Ras e c-myc não observamos diferenças estatísticas entre os tratamentos (p > 0,05). A partir desses resultados, podemos concluir que a dose de 100 mg/100 g de p.c. de GO mostrou ser mais interessante do ponto de vista quimiopreventivo com efeitos observados principalmente no cólon distaI, onde há maiores relatos de incidência de adenocarcinomas colônicos, tanto em animais quanto em humanos. Assim, a indução da morte celular programada em FCAs ≥ 4 preferencialmente displásicos poderia representar um mecanismo importante de atuação de G03 na redução da freqüência de FCAs ≥ 4 criptas e de FDMs (também utilizado como marcador de displasia) durante a fase de pós-iniciação tardia de modelo de carcinogênese experimental de cólon

The isoprenoid geraniol (GO) showed chemopreventive activity when administered continuously during the initiation and post-initiation phases in an experimental model of colon carcinogenesis by reducing the number of total aberrant crypt foci (ACF) and ACFs ≥ 4 crypts, as well as increasing apoptosis in the distal colon. We therefore chose to evaluate the effects of three different doses of GO (GO1: 25 mg/100 g body weight [b.w.], GO2: 50 mg/100 g b.w. and GO3: 100 mg/100 g of b.w.) on preneoplastic lesions (PNLs) induced by dimethylhydrazine (DMH) during late post-initiation in an experimental model of colon carcinogenesis that is characterized by more advanced lesions and a higher degree of cellular alterations morphological, biochemical and molecular (dysplasia) than previous models. For this study, we analyzed the following biomarkers: total ACFs, ACFs < 4 crypts, and ACFs ≥ 4 erypts in colons stained with methylene blue; mucin-depleted or mucin-positive foci (MDFs or MPFs) in colons stained with toluidine blue; ACFs, through conventional or dysplastie histopathological analysis of sections stained with hematoxylin and eosin (HE); and cytoplasmic vs. nuclear foci reactivity for beta-catenin (foci positive for beta-eatenin (FPBC) or foci negative for beta catenin (FNBC)) using immunohistochemistry. Additionally, apoptotic cells were identified using classical morphologic criteria in ACFs ≥ 4 crypts in the distal colon, and the expression of several genes involved in colon carcinogenesis was assessed by RT-PCR, including HMG-CoA reductase in the colonic mucosa and K-Ras and c-myc in microdissected ACFs. Relative to the control group, we observed that the group receiving the highest dose of GO (GO3 group) had a reduced frequency of both ACFs ≥ 4 crypts and MDFs and that apoptosis increased in dysplastic ACFs ≥ 4 crypts in the distal colon (p < 0, 05). Expression of HMG-CoA reductase, K-Ras and c-myc did not differ between treatments (p > 0, 05). Based on these results, we conclude that the 100 mg/100 g b.w. dose of GO is the most promising, as it shows evidence of chemopreventive effects mainly in the distal colon, which is a region that is reported to have a higher incidence of colonic adenocarcinomas, both in animaIs and in humans. lnduction of programmed cell death by GO3 in ACFs ≥ 4 specifically dysplastic could represent an important mechanism of action in reducing the frequency of both ACFs ≥ 4 crypts and MDFs during late post-initiation in this experimental model of colon carcinogenesis

Assuntos

RESUMO

Fundamentado na perspectiva teórica da psicologia cultural e numa metodologia qualitativa, este estudo teórico objetiva contribuir para a análise da dinâmica dos processos de internalização que decorrem das práticas culturais e das relações sociais entre crianças gêmeas e adultos, em contextos específicos. Como parte de uma pesquisa mais ampla, ilustramos o estudo com a análise microgenética de um episódio interativo entre um avô e um par de crianças gêmeas, integrada às orientações para crenças do avô, obtidas durante entrevista. Os resultados mostram que as teorias, crenças e interações mediadas pelo avô atuaram de forma consistente, com a promoção da ôigualdadeõ entre as crianças. O impacto de crenças e interações vividas pelas crianças pode ter um forte efeito na trajetória desenvolvimental de cada um, inclusive na coconstrução das respectivas individualidades. Crenças fortemente enraizadas em níveis afetivos se manifestam através de práticas culturais e processos de mediação merecendo, portanto, maior atenção investigativa.

The cultural psychology approach demands a qualitative, systemic analysis of complexities of twin development, considering the dynamics of internalization processes taking place within culture, and across social relations with significant adults. This article draws on a larger projectïs data. We take a microgenetic approach to investigate the issue, illustrated by the analysis of an episode between a pair of male twin children and their grandpa. We integrated these data with the narrative of the grandpa during an interview. The study revealed that grandpaïs beliefs and theories consistently drove the children towards sameness, across the episode and his narrative as well. The impact of beliefs and corresponding social interactions may have a strong effect on children developmental trajectories, in addition to its influence on the processes concerning each child co-construction of individuality and self. Summing up, deeply affective beliefs manifest through cultural practices and mediation, therefore deserving more investigative attention.

La psicología cultural permite el análisis cualitativo y sistémico de los fenómenos complejos del desarrollo de los gemelos, incluso amplía la comprensión de los procesos de internalización en las prácticas culturales y en las relaciones sociales con adultos significativos. El estudio es parte de un estudio más amplio, y se ilustra con el análisis microgenético de un episodio interactivo entre un abuelo y dos niños gemelos, los datos están formados por las narrativas del abuelo durante una entrevista. Los resultados señalan que las teorías, creencias y interacciones del abuelo actúan de forma consistente en la promoción de la ôigualdadõ entre los niños. Creencias e interacciones, donde participan adultos significativos, suelen tener un fuerte efecto en la trayectoria de desarrollo de los gemelos, incluso en los procesos de individualización. Las creencias afectivas fuertemente enraizadas se hacen presentes a través de las prácticas culturales y procesos de mediación, haciéndose necesario constituir un objeto de investigación.

Assuntos

RESUMO

Fundamentado na perspectiva teórica da psicologia cultural e numa metodologia qualitativa, este estudo teórico objetiva contribuir para a análise da dinâmica dos processos de internalização que decorrem das práticas culturais e das relações sociais entre crianças gêmeas e adultos, em contextos específicos. Como parte de uma pesquisa mais ampla, ilustramos o estudo com a análise microgenética de um episódio interativo entre um avô e um par de crianças gêmeas, integrada às orientações para crenças do avô, obtidas durante entrevista. Os resultados mostram que as teorias, crenças e interações mediadas pelo avô atuaram de forma consistente, com a promoção da ôigualdadeõ entre as crianças. O impacto de crenças e interações vividas pelas crianças pode ter um forte efeito na trajetória desenvolvimental de cada um, inclusive na coconstrução das respectivas individualidades. Crenças fortemente enraizadas em níveis afetivos se manifestam através de práticas culturais e processos de mediação merecendo, portanto, maior atenção investigativa.(AU)

The cultural psychology approach demands a qualitative, systemic analysis of complexities of twin development, considering the dynamics of internalization processes taking place within culture, and across social relations with significant adults. This article draws on a larger projectïs data. We take a microgenetic approach to investigate the issue, illustrated by the analysis of an episode between a pair of male twin children and their grandpa. We integrated these data with the narrative of the grandpa during an interview. The study revealed that grandpaïs beliefs and theories consistently drove the children towards sameness, across the episode and his narrative as well. The impact of beliefs and corresponding social interactions may have a strong effect on children developmental trajectories, in addition to its influence on the processes concerning each child co-construction of individuality and self. Summing up, deeply affective beliefs manifest through cultural practices and mediation, therefore deserving more investigative attention.(AU)

La psicología cultural permite el análisis cualitativo y sistémico de los fenómenos complejos del desarrollo de los gemelos, incluso amplía la comprensión de los procesos de internalización en las prácticas culturales y en las relaciones sociales con adultos significativos. El estudio es parte de un estudio más amplio, y se ilustra con el análisis microgenético de un episodio interactivo entre un abuelo y dos niños gemelos, los datos están formados por las narrativas del abuelo durante una entrevista. Los resultados señalan que las teorías, creencias y interacciones del abuelo actúan de forma consistente en la promoción de la ôigualdadõ entre los niños. Creencias e interacciones, donde participan adultos significativos, suelen tener un fuerte efecto en la trayectoria de desarrollo de los gemelos, incluso en los procesos de individualización. Las creencias afectivas fuertemente enraizadas se hacen presentes a través de las prácticas culturales y procesos de mediación, haciéndose necesario constituir un objeto de investigación.(AU)

Assuntos