Alfabetización en salud mental: conocimientos y creencias de una población adolescente / Mental Health Literacy: knowledge and beliefs of an adolescent population

Introducción: la alfabetización en salud mental (ASM) abarca los conocimientos y las creencias sobre los trastornos mentales, incluido el reconocimiento, la gestión y la prevención. Varios estudios revelan un nivel inadecuado de la ASM en adolescentes, lo que lleva a un aplazamiento en la búsqueda de ayuda. El objetivo fue evaluar el nivel de ASM en una población de adolescentes. Material y métodos: se aplicó el cuestionario de alfabetización en salud mental (MHLq). El análisis estadístico se realizó en el SPSS®22.0, utilizando la prueba t-Student (significación estadística p <0,05). Resultados: se obtuvieron 179 cuestionarios correctamente completados. En el 24% de los casos hubo una respuesta afirmativa con respecto a la presencia de enfermedad mental en la familia. En cuanto a la puntuación total obtenida en el MHLq, se obtuvo un promedio de 122 puntos (+/- 8) con un valor máximo de 145 puntos. En cuanto a las subescalas definidas en el cuestionario, encontramos 2 relaciones estadísticamente significativas con el género femenino: la primera tiene que ver con tener menos creencias/mitos erróneos sobre la enfermedad mental (p = 0,02) y la segunda, con la presencia de una enfermedad mental en la familia (p = 0,001). Conclusiones: el MHLq demostró ser un método fácil de cribado en ASM. La población considerada presentó un conocimiento razonable en esta área y la presencia de enfermedad mental en la familia influye positivamente en los resultados. Se destaca la importancia de una futura intervención para la educación y la deconstrucción de mitos que, especialmente en este grupo de edad, condicionan actitudes y prejuicios (AU)

Introduction: mental Health Literacy (MHL) encompasses knowledge and beliefs about mental disorders, including aspects related to their recognition, management and prevention. Several studies reveal an inadequate level of MHL in the adolescent population, leading to a delay in seeking help. the objective was to assess the level of MHL in a population of adolescents.Material and methods: we administered the mental health literacy questionnaire (MHLq) to the sample. The statistical analysis was performed with the software SPSS®22.0, using the Student t test (statistical significance p <0.05).Results: we received 179 correctly completed questionnaires, and 24% of respondents reported the presence of mental illness in the family. The mean total score in the MHLq, was 122 points (SD, 8) out of a total maximum of 145 points. When it came to the subscales of the questionnaire, we found a statistically significant lower level of erroneous beliefs/myths about medical illness in female vs male participants (p = 0.02) and respondents who reported mental illness in the family (p = 0.001).Conclusions: the MHLq proved to be an easy method for screening MHL. The population under study exhibited reasonable knowledge in this area, and the presence of mental illness in the family had a favourable impact on the results. The study highlighted the importance of future interventions for education and dispelling myths that condition attitudes and prejudices, especially in this age group. (AU)

Lipschütz ulcer and Epstein-Barr virus infection: a case report / Úlcera de Lipschütz e infecção pelo vírus Epstein-Barr: um relato de caso

Aims: Lipschütz ulcer (LU), also known as acute vulvar ulcer, is a rare cause of vulvar ulcerations of nonvenereal origin. Our aim is to alert about this manifestation of the disease and to prevent unnecessary treatment. Case description: we present a 15 years old female, without relevant family and past history, admitted in the emergency room with a painful vulvar ulcer, preceded by five days of fever and sore throat. On physical examination, she had enlarged, and erythematous tonsils and bilateral anterior cervical lymphadenopathy and the genital examination revealed vulvar oedema and a deep ulcer with necrotic plaques in labium minus. The exclusion of transmitted sexual disease led to a diagnosis of Lipschütz ulcer. She started symptomatic treatment, oral antibiotic and corticoid therapy. She was discharged from the hospital after 6 days of admission and returned to a consult one month later when it was observed an almost complete resolution of the lesions. No recurrences occurred until 3 months. Conclusion: LU is a misdiagnosed pathology, probably because doctors, in general, are not familiarized with that, and since the diagnosis is made by exclusion. Infectious, such as Epstein-Barr Virus infections, are proposed etiologies.

Objetivo: a úlcera de Lipschütz, ou úlcera vulvar aguda, é uma causa rara de ulceração de origem não venérea. O nosso objetivo é alertar para essa manifestação da doença e prevenir tratamentos desnecessários. Descrição: adolescente, sexo feminino, 15 anos, sem história pessoal ou antecedentes familiares de relevo. Recorreu ao Serviço de Urgência por febre e odinofagia, com cinco dias de evolução, associada a uma úlcera vulvar dolorosa, que surgiu no próprio dia. O exame clínico revelou amígdalas hipertrofiadas e eritematosas, linfadenopatia cervical anterior, e o exame ginecológico apresentou edema da vulva e uma úlcera profunda, com placas necróticas nos lábios menores. A exclusão de uma doença sexualmente transmissível levou ao diagnóstico de úlcera de Lipschütz. Ficou internada no Serviço de Pediatria e iniciou tratamento sintomático, antibioterapia por sobreinfeção da úlcera e corticoterapia tópica. Teve alta após seis dias de hospitalização e foi reavaliada em consulta um mês depois, com resolução completa do caso. Não apresentou recorrência da úlcera até aos três meses seguintes. Conclusão: a úlcera de Lipschütz é uma doença subdiagnosticada, muito provavelmente porque os médicos não estão familiarizados com ela e por ser um diagnóstico de exclusão. A infeção pelo vírus Epstein-Barr é uma das etiologias propostas.

A complexidade em alergologia pediátrica: o doente polissensibilizado / The complexity in pediatric allergology: the polysensitized patient

OBJETIVOS: No presente estudo os autores pretendem demonstrar as vantagens do diagnóstico molecular em imunoalergologia atráves da descrição de um caso clínico. DESCRIÇÃO DO CASO: Apresentamos o caso de uma criança, do sexo masculino, 9 anos de idade seguido em consulta de imunoalergologia pediátrica com os diagnósticos de asma persistente moderada, rinite persistente, eczema atópico e alergia alimentar com manifestações graves (vários episódios de anafilaxia), cujo estudo do perfil molecular de sensibilização alérgica contribuiu para melhor conhecimento do doente, adequação terapêutica e, inclusive, prognóstica. CONCLUSÕES: O estudo molecular alergológico, conforme análise do caso em estudo, permite o estabelecimento e escalonamento em termos de gravidade de um perfil de sensibilização mais individualista, que é sobretudo importante no doente polissensibilizado e com relato de alergias respiratórias e alimentares.

AIMS: In the present study, the authors intend to demonstrate the advantages of molecular diagnosis in immunoallergology through the description of a clinical case. CASE DESCRIPTION: We present the case of a 9-year-old male, followed by pediatric immunoallergology with the diagnoses of moderate persistent asthma, persistent rhinitis, atopic eczema and food allergy with severe manifestations (several episodes of anaphylaxis). molecular profile of allergic sensitization contributed to better knowledge of the patient, therapeutic and even prognostic adequacy. CONCLUSIONS: The molecular allergy diagnostic tests, according to the analysis of the present case, allows the establishment and escalation in terms of severity of a more individualistic sensitization profile, which is especially important in the patient who is polysensitized and with reports of respiratory and food allergies.

Effect of cyclodextrins and pH on the permeation of tetracaine: supramolecular assemblies and release behavior.

This work provides a new insight on fundamental principles of the interaction mechanism between two forms of tetracaine - a potent local anesthetic - both in neutral (TC) and ionized (TC(+)) states, with beta- (ß-CD) and hydroxypropyl-beta-cyclodextrin (HP-ß-CD), and how such interactions affect the transport of tetracaine, at different concentrations, across a model membrane. The kinetics and mechanism of TC release from HPMC gels is also evaluated giving an insight on the role of cyclodextrin on the tetracaine transport. HPLC, fluorescence and NMR spectroscopies provided solid physicochemical knowledge of these systems and in vitro studies were performed to obtain relevant data on the transport and mechanism parameters. HPLC and fluorescence spectroscopy data revealed that tetracaine interacts with both cyclodextrins on a 1:1 stoichiometry but it is observed that neutral tetracaine forms more stables complexes (ca. 1050 M(-1) for both cyclodextrins) than in its ionized form (628 and 337 M(-1) for ß-CD and HP-ß-CD respectively). Despite of that, no host-guest interactions take place as seen by ROESY. This study clearly demonstrates that both forms of tetracaine are successfully released from the formulations at a controlled rate, following a Super-Case transport mechanism and the transport of tetracaine can be tuned by using cyclodextrins.