Accelerating Healing and Relieving Pain: High-Intensity Laser Therapy for Paraneoplastic Cutaneous Vasculitis Associated with Multiple Myeloma.

BACKGROUND Leukocytoclastic vasculitis (LCV) is an atypical form of cutaneous paraneoplastic manifestation. Its association with multiple myeloma (MM) is even rarer and is associated with poor prognosis and short survival, regardless of the therapy instituted. Different treatment approaches are necessary. We present a case in which LCV was the first manifestation of MM, and high-intensity laser therapy (HILT) was used as an option to accelerate healing and control pain. CASE REPORT A 76-year-old woman presented with pain and paresthesia in her lower limbs, associated with palpable purpura. The clinical diagnosis was small-vessel vasculitis. Laboratory tests showed an elevated gamma globulin monoclonal peak on protein electrophoresis. The immunophenotypic study of bone marrow aspirates led to the diagnosis of MM. Due to pain refractory to conventional analgesics, and the progressive evolution of the lesions, despite corticosteroid therapy, we performed photo-biomodulation with a neodymium-doped yttrium aluminum garnet laser (Nd: YAG), wavelength 1064 nanometers, using a 7-mm probe and energy density 6 J/cm². After the first session, the patient was referred for pain management, and after 5 weeks, we observed complete healing in ulcerated lesions and involution of bullous lesions. CONCLUSIONS This case report shows the positive effects of the Nd: YAG laser in modulating healing and reducing pain. HILT is an innovative, non-invasive, and effective treatment and should be considered a promising technique to accelerate healing and controlling pain.

Drebrin expression patterns in patients with refractory temporal lobe epilepsy and hippocampal sclerosis.

OBJECTIVE: Drebrins are crucial for synaptic function and dendritic spine development, remodeling, and maintenance. In temporal lobe epilepsy (TLE) patients, a significant hippocampal synaptic reorganization occurs, and synaptic reorganization has been associated with hippocampal hyperexcitability. This study aimed to evaluate, in TLE patients, the hippocampal expression of drebrin using immunohistochemistry with DAS2 or M2F6 antibodies that recognize adult (drebrin A) or adult and embryonic (pan-drebrin) isoforms, respectively. METHODS: Hippocampal sections from drug-resistant TLE patients with hippocampal sclerosis (HS; TLE, n = 33), of whom 31 presented with type 1 HS and two with type 2 HS, and autopsy control cases (n = 20) were assayed by immunohistochemistry and evaluated for neuron density, and drebrin A and pan-drebrin expression. Double-labeling immunofluorescences were performed to localize drebrin A-positive spines in dendrites (MAP2), and to evaluate whether drebrin colocalizes with inhibitory (GAD65) and excitatory (VGlut1) presynaptic markers. RESULTS: Compared to controls, TLE patients had increased pan-drebrin in all hippocampal subfields and increased drebrin A-immunopositive area in all hippocampal subfields but CA1. Drebrin-positive spine density followed the same pattern as total drebrin quantification. Confocal microscopy indicated juxtaposition of drebrin-positive spines with VGlut1-positive puncta, but not with GAD65-positive puncta. Drebrin expression in the dentate gyrus of TLE cases was associated negatively with seizure frequency and positively with verbal memory. TLE patients with lower drebrin-immunopositive area in inner molecular layer (IML) than in outer molecular layer (OML) had a lower seizure frequency than those with higher or comparable drebrin-immunopositive area in IML compared with OML. SIGNIFICANCE: Our results suggest that changes in drebrin-positive spines and drebrin expression in the dentate gyrus of TLE patients are associated with lower seizure frequency, more preserved verbal memory, and a better postsurgical outcome.

Psicanálise, educação e redes sociais virtuais: escutando os adolescentes na escola / Psychoanalysis, education and virtual social networds: listen adolescents in school / El psicoanálisis, la educación y las redes sociales virtuales: escuchar los adolescentes en la escula

O interesse e a preocupação em relação ao uso de dispositivos tecnológicos pelos adolescentes têm se acentuado a cada dia. As redes sociais da internet têm sido utilizadas pelos jovens não só para a comunicação, mas também para a segregação social. Este trabalho apresenta uma reflexão sobre uma pesquisa e intervenção realizadas em uma escola pública que teve como tema o uso das redes sociais pelos jovens. Para tanto, utilizou-se a metodologia de conversação de orientação psicanalítica com quatro grupos de adolescentes. Depreendeu-se um processo próprio a cada grupo, além de efeitos das conversações sobre cada sujeito.

The interest and concern regarding the use of technological devices by adolescents is growing every day. The social networks of the internet have been used by adolescents not only for communication, but also for social segregation. This study analyzes the results of a research intervention carried out in a public school whose subject was the use of social networks by adolescents. For this, it was used a psychoanalytic conversational methodology with four groups of adolescents. It was observed a specific process for each group and the effects of conversations on each subject.

El interés y la preocupación por el uso que los adolescentes hacen de los dispositivos tecnológicos son más visibles cada día. Las redes sociales de Internet son utilizadas por los jóvenes no solo para la comunicación, sino también para la segregación social. En este estudio se analizan los resultados de la investigación y la intervención llevada a cabo en una escuela pública cuyo tema fue el uso de las redes sociales por los jóvenes. Para ello, se utilizó la metodología de conversación psicoanalítica con cuatro grupos de adolescentes. Deducimos un proceso específico para cada grupo, además de los efectos de las conversaciones sobre cada sujeto.