RESUMEN
Background: Histoplasmosis is a fungal disease endemic in some regions of the United States of America, Canada, and Latin America. The geographic characteristics, humidity, soil, and climate are responsible for such distribution. In Brazil, there are case reports of histoplasmosis throughout its territory, being considered an endemic region. It is considered an opportunistic disease, affecting mostly immunocompromised patients. To the present date, scientific publications dealing with pediatric cases of histoplasmosis are restricted to case series. Spinal cord injuries caused by histoplasmosis are rare, even in the adult population, being described in few studies. Case Description: The present report deals with a 4-year-old patient, from the southeast region of Brazil, who started a condition of fever, weight loss, cervicobrachialgia, and symmetrical tetraparesis, with evolution over 2 months. In the diagnostic investigation, she was found to have primary immunodeficiency and neuroimaging examinations showed a cervical spinal cord lesion at the level of C4-C6. The anatomopathological diagnosis of histoplasmosis was possible after surgery for decompression and biopsy of the lesion. Conclusion: According to our research, there are no reports in the literature that address the situation of spinal cord compression syndrome due to histoplasmosis in the pediatric population.
RESUMEN
Introducción: El aprendizaje de la psicopatología ha sido considerado una piedra angular en la formación de los residentes de psiquiatría. Objetivo: Evaluar el impacto de la enseñanza de un curso sobre autores clásicos de la psiquiatría y psicopatología en los residentes del programa de psiquiatría para determinar cambios en el nivel de conocimientos y valoración de la historia y fundamentos de la psicopatología. Método: Estudio de corte transversal pre post, con una encuesta anónima y voluntaria que se aplicó a todos los residentes con evaluación de las características socio demográficas, interés, utilidad y pertinencia de los contenidos, entre otros. Al inicio de cada seminario, evaluación de los conocimientos con una prueba escrita de desarrollo. Resultados: Participaron 24 residentes en total, 14 del programa adultos y 10 de infantojuvenil. La tasa de participación promedio fue de 87,5 por ciento. El 87,5 por ciento declaró tener conocimientos insuficientes o muy insuficientes. Entre las características de los residentes destacaron el interés por el deporte, la música y la literatura. Un 95,8 por ciento se proyecta como clínico y solo un 12,5 por ciento como docente. Al inicio del seminario solo hubo 29,16 por ciento de respuestas correctas en relación al origen y autor de los conceptos psicopatológicos revisados lo que aumentó a 65,4 por ciento al finalizar la serie de seminarios. Un 83 por ciento consideró los seminarios muy interesantes y el 75 por ciento muy útil para conocer la historia de la psiquiatría y mejorar su práctica clínica. Conclusión: La enseñanza de la psicopatología a partir de las descripciones clínicas de autores clásicos de la psiquiatría es altamente valorada por los residentes de psiquiatría en múltiples aspectos incluyendo el enriquecimiento de su práctica clínica.(AU)
Objective: To evaluate the impact of learning psychopathology in seminars, focusing on clinical cases described by classic psychiatry authors. Methods: A specially designed questionnaire was administered to 24 residents of the psychiatry program at the beginning and end of a series of 12 seminars analyzing the life, work and selected clinical cases of classic psychiatry authors including S. Freud, K. Kraepelin, E. Bleuler and K. Schneider. Data were collected included respondents characteristics, how interesting and useful the seminars were perceived to be and respondents' knowledge of classic psychiatry authors. Results: Respondents were interested in sports, music and literature; 95.8 percent regarded themselves as clinicians and 12.5 percent regarded themselves as teachers. The seminars were rated very interesting by 83.0 percent and very useful by 58.3 percent; they were considered to contribute to knowledge of the history of psychiatry, professional development and clinical practice. Most respondents (87.5 percent ) stated that their knowledge of classic authors was inadequate or very inadequate. At the beginning of the seminar series only 29.2 percent of responses about the origin and author of the psychopathological concepts covered in the seminars were correct; increasing to 65.4 percent by the end of the course. Conclusion: Teaching psychopathology through the study of classical cases is valued by residents for various reasons, including its potential to enrich clinical practice.(AU)
