O uso das tecnologias da informação e comunicação na monitoria acadêmica de enfermagem com base na metodologia ativa / Use of information and communication technologies in academic nursing tutoring based on active methodology / El uso de las tecnologías de la información y la comunicación en el monitoreo académico de enfermería basado en la metodología activa

Objetivo: relatar a experiência do processo de implementação da monitoria acadêmica de enfermagem durante a pandemia de covid-19, utilizando as Tecnologias da Informação e Comunicação (TICs). Metodologia: estudo descritivo e qualitativo na modalidade "relato de experiência" sobre as atividades realizadas na monitoria de enfermagem no período de isolamento social acerca do uso de tecnologias digitais na educação em saúde, pautado pela interação do referencial teórico, metodologia problematizadora de ensino e tecnologias. Resultados: desenvolvimento de conteúdo didático, empregando as ferramentas digitais na produção de conhecimento em saúde, além da interação e inclusão social na educação. Conclusão: através da revisão científica, interação interpessoal e desenvolvimento de habilidades e competências na área de pesquisa e docência, as alunas participantes aprimoraram sua formação acadêmica e, ainda, despertaram em si a valorização do ensino e do aprendizado, bem como a prática da carreira docente

Objective: to report on the experience of implementing an academic nursing tutoring during the COVID-19 pandemic using information and communication technologies (ICTs). Methodology: this is a descriptive, qualitative experience report on the activities developed by nursing tutoring during social distancing regarding the use of digital technologies in health education, mobilizing the theoretical framework, active methodology and technologies. Results: pedagogical content was developed by using digital tools in health-related knowledge production, as well as interaction and social inclusion in education. Conclusion: scientific review, interpersonal interaction, development of research and teaching skills and competencies allowed the participating students to improve their academic education and even awaken their appreciation for teaching and learning

Objetivo: relatar la experiencia del proceso de implementación del seguimiento académico de enfermería, en tiempos de la pandemia del covid-19 mediante las tecnologías de la información y la comunicación. Metodología: estudio descriptivo y cualitativo, en forma de informe de experiencia, sobre las actividades realizadas en el acompañamiento de enfermería durante el período de aislamiento social, utilizando tecnologías digitales en la educación en salud, orientado por la interacción del marco teórico con la técnica de problematizar la enseñanza y las tecnologías. Resultados:producción de contenidos didácticos utilizando herramientas digitales en la producción de conocimiento en salud, interacción e inclusión social en educación. Conclusión:desde la revisión científica, la interacción interpersonal y el desarrollo de habilidades y competencias en el área de la investigación y la docencia, las estudiantes participantes mejoraron su formación académica e incluso despertaron en sí mismas el aprecio por la enseñanza y el aprendizaje, así como la práctica de la docencia como carrera profesiona

Microextraction technique associated with gas chromatography-mass spectrometry for determining pesticide residues in urine.

Urine is one of the biological matrices most used for detecting human contamination, as it is representative and easily obtained via noninvasive sampling. This study proposes a fast, accurate, and ecological method based on liquid-liquid microextraction with low-temperature partition (µLLE/LTP). It was validated to determine nine pesticides (lindane, alachlor, aldrin, chlorpyrifos, dieldrin, endrin, DDT, bifenthrin, and permethrin) in human urine, in association with gas chromatography coupled with mass spectrometry (GC-MS). The technique was optimized through a factorial design. The best conditions for the simultaneous extraction of the analytes comprised the addition of 600 µL of water and 600 µL of acetonitrile (extracting solvent) to a 500-µL urine sample, followed by vortexing for 60 s. By freezing the samples for 4 h, it was possible to extract the pesticides and perform the extract clean-up simultaneously. The parameters selectivity, linearity, limit of detection (LOD), limit of quantification (LOQ), precision, and accuracy were used to appraise the performance of the method. Good values of selectivity and linearity (R2 > 0.990), LOQ (0.39-1.02 µg L-1), accuracy (88-119% recovery), and precision (%CV ≤ 15%) were obtained. The µLLE/LTP-GC-MS method was applied to authentic urine samples collected from volunteers in Southeast Brazil.

Cuidados Paliativos: O Enfermeiro como facilitador com objetivo de promover o significado do cuidar no processo da morte

O surgimento dos Cuidados Paliativos foi como uma filosofia de cuidados integrais, a pacientes em estado terminal com alívio da dor e do sofrimento. Estes cuidados oferecem a ação de uma equipe interdisciplinar, e cada profissional reconhece o limite da sua atenção que contribuirá para que o paciente, em estado de finitude, tenha uma boa morte. Objetivo: Assim, este estudo teve como objetivo compreender os significados do cuidar na visão dos enfermeiros e dos respectivos familiares, em cuidados paliativos, trazendo a possibilidade de revelar suas implicações no cotidiano do trabalho, além de perceber todo o processo da morte. Metodologia: Trata-se de um estudo de pesquisa descritivo com abordagem qualitativa, por meio de levantamento bibliográfico. Resultados e Discussão: Desta forma, observa-se que para alcançar resultados que levam ao entendimento da morte digna, é primordial que o enfermeiro empregue uma linguagem simples e explicativa, destacando a importância de uma assistência especializada ao paciente terminal. Conclusão: Esta pesquisa visa ampliar o conhecimento do significado das práticas dos cuidados paliativos tendo o Enfermeiro como ponte para melhor entendimento desse processo, e fornecer subsídios a futuros estudos que tratarão da temática

The Geographic Information System applied to study schistosomiasis in Pernambuco.

OBJECTIVE: Diagnose risk environments for schistosomiasis in coastal localities of Pernambuco using geoprocessing techniques. METHODS: A coproscopic and malacological survey were carried out in the Forte Orange and Serrambi areas. Environmental variables (temperature, salinity, pH, total dissolved solids and water fecal coliform dosage) were collected from Biomphalaria breeding sites or foci. The spatial analysis was performed using ArcGis 10.1 software, applying the kernel estimator, elevation map, and distance map. RESULTS: In Forte Orange, 4.3% of the population had S. mansoni and were found two B. glabrata and 26 B. straminea breeding sites. The breeding sites had temperatures of 25ºC to 41ºC, pH of 6.9 to 11.1, total dissolved solids between 148 and 661, and salinity of 1,000 d. In Serrambi, 4.4% of the population had S. mansoni and were found seven B. straminea and seven B. glabrata breeding sites. Breeding sites had temperatures of 24ºC to 36ºC, pH of 7.1 to 9.8, total dissolved solids between 116 and 855, and salinity of 1,000 d. The kernel estimator shows the clusters of positive patients and foci of Biomphalaria, and the digital elevation map indicates areas of rainwater concentration. The distance map shows the proximity of the snail foci with schools and health facilities. CONCLUSIONS: Geoprocessing techniques prove to be a competent tool for locating and scaling the risk areas for schistosomiasis, and can subsidize the health services control actions.

Dissecting the Yale-Brown Obsessive-Compulsive Scale severity scale to understand the routes for symptomatic improvement in obsessive-compulsive disorder.

We aimed to investigate which items of the Yale-Brown Obsessive-Compulsive Severity Scale best discriminate the reduction in total scores in obsessive-compulsive disorder patients after 4 and 12 weeks of pharmacological treatment. Data from 112 obsessive-compulsive disorder patients who received fluoxetine (⩽80 mg/day) for 12 weeks were included. Improvement indices were built for each Yale-Brown Obsessive-Compulsive Severity Scale item at two timeframes: from baseline to week 4 and from baseline to week 12. Indices for each item were correlated with the total scores for obsessions and compulsions and then ranked by correlation coefficient. A correlation coefficient ⩾0.7 was used to identify items that contributed significantly to reducing obsessive-compulsive disorder severity. At week 4, the distress items reached the threshold of 0.7 for improvement on the obsession and compulsion subscales although, contrary to our expectations, there was greater improvement in the control items than in the distress items. At week 12, there was greater improvement in the time, interference, and control items than in the distress items. The use of fluoxetine led first to reductions in distress and increases in control over symptoms before affecting the time spent on, and interference from, obsessions and compulsions. Resistance did not correlate with overall improvement. Understanding the pathway of improvement with pharmacological treatment in obsessive-compulsive disorder may provide clues about how to optimize the effects of medication.

The Geographic Information System applied to study schistosomiasis in Pernambuco / Os Sistemas de Informação Geográfica em estudo sobre a esquistossomose em Pernambuco

ABSTRACT OBJECTIVE Diagnose risk environments for schistosomiasis in coastal localities of Pernambuco using geoprocessing techniques. METHODS A coproscopic and malacological survey were carried out in the Forte Orange and Serrambi areas. Environmental variables (temperature, salinity, pH, total dissolved solids and water fecal coliform dosage) were collected from Biomphalaria breeding sites or foci. The spatial analysis was performed using ArcGis 10.1 software, applying the kernel estimator, elevation map, and distance map. RESULTS In Forte Orange, 4.3% of the population had S. mansoni and were found two B. glabrata and 26 B. straminea breeding sites. The breeding sites had temperatures of 25ºC to 41ºC, pH of 6.9 to 11.1, total dissolved solids between 148 and 661, and salinity of 1,000 d. In Serrambi, 4.4% of the population had S. mansoni and were found seven B. straminea and seven B. glabrata breeding sites. Breeding sites had temperatures of 24ºC to 36ºC, pH of 7.1 to 9.8, total dissolved solids between 116 and 855, and salinity of 1,000 d. The kernel estimator shows the clusters of positive patients and foci of Biomphalaria, and the digital elevation map indicates areas of rainwater concentration. The distance map shows the proximity of the snail foci with schools and health facilities. CONCLUSIONS Geoprocessing techniques prove to be a competent tool for locating and scaling the risk areas for schistosomiasis, and can subsidize the health services control actions.

RESUMO OBJETIVO Diagnosticar ambientes de risco para esquistossomose em localidades litorâneas de Pernambuco utilizando técnicas de geoprocessamento. MÉTODOS Foi realizado inquérito coproscópico e malacológico nas localidades Forte Orange e Serrambi. Foram coletadas variáveis ambientais (temperatura, salinidade, pH, sólidos totais dissolvidos e dosagem de coliformes fecais da água) relacionadas aos criadouros ou focos de Biomphalaria. A análise espacial foi realizada no software ArcGis 10.1, aplicando-se o estimador kernel, mapa de elevação e mapa de distância. RESULTADOS No Forte Orange, 4,3% da população estava com S. mansoni e existem dois criadouros de B. glabrata e 26 de B. straminea. Os criadouros apresentaram temperaturas de 25ºC a 41ºC, pH de 6,9 a 11,1, sólidos totais dissolvidos de 148 a 661 e salinidade de 1.000 d. Em Serrambi, 4,4% da população estava com S. mansoni e há sete criadouros de B. straminea e sete de B. glabrata. Os criadouros apresentaram temperaturas de 24ºC a 36ºC, pH de 7,1 a 9,8, sólidos totais dissolvidos de 116 a 855 e salinidade de 1.000 d. O estimador de kernel mostra os aglomerados de pacientes positivos e de focos de Biomphalaria, e o mapa de elevação digital indica áreas de concentração de águas pluviais. O mapa de distância mostra a proximidade dos focos dos caramujos em relação às escolas e unidades de saúde. CONCLUSÕES As técnicas de geoprocessamento se mostraram como importantes ferramentas para a localização e dimensionamento das áreas de risco para esquistossomose, podendo subsidiar as ações de controle por parte dos serviços de saúde.

Modelling of the distribution of Biomphalaria glabrata and Biomphalaria straminea in the metropolitan region of Recife, Pernambuco, Brazil.

The occurrence of schistosomiasis is directly linked to the presence of its snail intermediate host Biomphalaria spp. Knowledge of geographical distribution, habitats and behaviour of these snails in relation to the climate is essential for guiding measures for disease prevention and control. This study aims to model the distribution of B. glabrata and B. straminea in schistosomiasis non-endemic areas of the metropolitan region of Recife (MRR) based on environmental data and estimates of snail distributions in endemic and neighbouring areas. We applied Kriging with the aim of determining the spatial distribution of these two snail species and MaxEnt for modelling their ecological behaviour. Kriging showed that the North and the Centre of the MRR were generally either snail-free or contained only B. straminea, while both snail species could be found in the South. MaxEnt supported our observation that the northern and southern coastal regions were favoured by B. glabrata and diurnal mean temperature variation; July rainfall and November rainfall were the three variables favouring Biomphalaria breeding sites that contributed the most in the predictive model we developed. The study showed the location of areas suitable to Biomphalaria spp. and therefore at potential risk, first for invasion of these snails and later for the development of new schistosomiasis- endemic areas. This information should be useful, not only to estimate expansion possibilities of this disease in the MRR, but also to point out the climatic variables that would contribute to this expansion, thereby allowing timely application of prevention and control measures.

First report of schistosomiasis on Serrambi beach, Ipojuca, State of Pernambuco.

INTRODUCTION: The expansion of schistosomiasis to previously unaffected areas is being monitored by identifying new cases and georeferencing outbreaks of vector snails. METHODS: In 2014, the Laboratório de Esquistossomose began an epidemiological survey in Serrambi and registered 2,574 people living there. RESULTS: Of these subjects, 1,414 (54.9%) underwent feces examination and 63 (4.5%) were diagnosed with Schistosoma mansoni infection. At this locality, seven breeding sites each were identified for Biomphalaria straminea and Biomphalaria glabrata. At two sites, B. glabrata were shedding cercariae. CONCLUSIONS: Implementing preventive measures is necessary to avoid the establishment of schistosomiasis in yet another tourist locality, Pernambuco.

Using mobile technology to conduct epidemiological investigations.

INTRODUCTION: The aim of this study was to report the experience of an epidemiological field survey for which data were collected and analyzed using tablets. METHODS: The devices used Epi Info 7 (Android version), which has been modeled a database with variables of the traditional form. RESULTS: Twenty-one households were randomly selected in the study area; 75 residents were registered and completed household interviews with socioeconomic and environmental risk variables. CONCLUSIONS: This new technology is a valuable tool for collecting and analyzing data from the field, with advantageous benefits to epidemiological surveys.

Study of the snail intermediate hosts for Schistosoma mansoni on Itamaracá Island in northeast Brazil: spatial displacement of Biomphalaria glabrata by Biomphalaria straminea.

In 2012 a malacological survey of the breeding sites of Biomphalaria glabrata and B. straminea , the two intermediate host snails of Schistosoma mansoni , was carried out on Itamaraca Island in Pernambuco, Brazil. This study has now been extended by studying the competition between the two species. Snails were collected and dissected to identify the species and tests were performed to verify S. mansoni infection. Student's t test was used to compare the proportion between the two species and their breeding sites and a parasitological survey was conducted among local residents, using the Kato-Katz method. The spatial distribution of the two snail species was determined using TerraView, while a snail density map was constructed by Kernel estimate. The survey identified two breeding sites for B. glabrata with 17 specimens and 19 breeding sites for B. straminea with 459 snails, all of them negative for S. mansoni infection. The statistical analysis revealed that the proportion of the numbers of specimens and breeding sites of B. straminea (37.84 ± 9.01) were significantly greater than those of B. glabrata (8.50 ± 6.50). Parasitological examinations from 41 residents diagnosed two cases of schistosomiasis with parasite loads of 60 and 84 eggs per 1 g of stool, respectively. This indiction of a competitive process between the two snail species requires monitoring of schistosomiasis in the resident and travelling human populations occupying this environment, which could potentially result in social and economic changes on the island risking its attraction as a centre for eco-tourism.

An ecological model for quantitative risk assessment for schistosomiasis: the case of a patchy environment in the coastal tropical area of northeastern Brazil.

We developed a stochastic model for quantitative risk assessment for the Schistosoma mansoni (SM) parasite, which causes an endemic disease of public concern. The model provides answers in a useful format for public health decisions, uses data and expert opinion, and can be applied to any landscape where the snail Biomphalaria glabrata is the main intermediate host (South and Central America, the Caribbean, and Africa). It incorporates several realistic and case-specific features: stage-structured parasite populations, periodic praziquantel (PZQ) drug treatment for humans, density dependence, extreme events (prolonged rainfall), site-specific sanitation quality, environmental stochasticity, monthly rainfall variation, uncertainty in parameters, and spatial dynamics. We parameterize the model through a real-world application in the district of Porto de Galinhas (PG), one of the main touristic destinations in Brazil, where previous studies identified four parasite populations within the metapopulation. The results provide a good approximation of the dynamics of the system and are in agreement with our field observations, i.e., the lack of basic infrastructure (sanitation level and health programs) makes PG a suitable habitat for the persistence and growth of a parasite metapopulation. We quantify the risk of SM metapopulation explosion and quasi-extinction and the time to metapopulation explosion and quasi-extinction. We evaluate the sensitivity of the results under varying scenarios of future periodic PZQ treatment (based on the Brazilian Ministry of Health's plan) and sanitation quality. We conclude that the plan might be useful to slow SM metapopulation growth but not to control it. Additional investments in better sanitation are necessary.

Epidemiologia da esquistossomose no litoral de Pernambuco / Epidemiology of schistosomiasis in coastal areas of Pernambuco State, Brazil

A expansão da esquistossomose para o litoral de Pernambuco vem sendo registrada desde 1992 coma detecção de casos agudos da doença em indivíduos de classe média/alta. Para diagnosticar estenovo cenário de transmissão da endemia em localidades turísticas na orla marítima do estado é defundamental importância o conhecimento prévio da distribuição georreferenciada das espécies demoluscos vetores, por meio de mapas que apontem sua exata localização, assim como é necessárioespacializar as situações de risco biológico e as condições ambientais insalubres. Nos períodos de 15a 18 de setembro de 2008 e 10 a 13 de setembro de 2013 foram realizadas caravanas expedicionárias,por epidemiologistas e parasitologistas por 11 municípios do litoral do estado, percorrendo todasas coleções de água doce distantes até 2 km da beira-mar. Os dados foram georreferenciados paraposterior condução de análises espaciais. Para identificação da positividade dos exemplares deBiomphalaria glabrata, foi utilizada a técnica de exposição à luz. Os espécimes de B. stramineaque permaneceram negativos até o 15º dia foram submetidos à técnica de diagnóstico molecular(PCR-single tube). Nas coletas de 2008 foram capturados 3.392 caramujos B. glabrata e 725 B.straminea, cujas taxas de infecção variaram entre 0,9 por cento a 22,2 por cento. Em 2013, foram coletados 948B. glabrata e 504 B. straminea e somente foram encontrados caramujos eliminando cercarias nalocalidade Porto de Galinhas com taxa de infectividade de 81,4 por cento, permanecendo como localidadede maior risco para transmissão da esquistossomose.

The expansion of schistosomiasis to the coast of Pernambuco has been registered since 1992 withthe detection of acute cases of the disease in individuals of middle/upper class. To diagnose thisnew scenario of transmission of schistosomiasis in tourist areas on the waterfront of the state,knowledge of georeferenced species distribution of vector snails through maps that show theirexact location seems essential, as it is necessary to localize situations with biohazard and unhealthyenvironmental conditions. From 15 to 18 September 2008 and 10 to 13 September 2013, expeditionswere conducted by groups of epidemiologists and parasitologists for 11 coastal municipalities ofthe state, checking all the collections of fresh water up to 2 km away from the seaside. Data weregeoreferenced for a later conduction of spatial analysis. For positive identification of Biomphalariaglabrata, the technique of light exposure was used. Specimens of B. straminea that remainednegative until the 15th day underwent the technique of molecular diagnosis (PCR-single tube). Inthe 2008 expedition, 3,392 B. glabrata snails and 725 B. straminea snails were captured, whose infection rates ranged from 0.9 percent to 22.2 percent. In the 2013 expedition, 948 B. glabrata and 504 B. straminea snails were collected and only in Porto de Galinhas city were B. glabrata snails found releasing S. mansoni cercariae, with an infectivity rate of 81.4 percent, confirming that in this locality the risk of schistosomiasis transmission is still present.

Autochthonous cases of schistosomiasis in children in Recife, Northeastern Brazil.

OBJECTIVE: Investigate breeding sites with host snails and autochthonous human cases of schistosomiasis. METHODS: Between July 2010 and September 2012 were performed: (1) malacological survey searching for breeding sites, collection and identification of Biomphalaria snails positive for Schistosoma mansoni in Recife, PE, Northeastern Brazil; (2) prevalence survey in 2,718 schoolchildren aged from seven to 14 years old to identify cases of schistosomiasis, clinical examination and ultrasound in positive cases of S. mansoni. The autochthony of the cases was investigated and the case were clinically evaluated. The cases and breeding sites were georeferenced and spatially described. RESULTS: The results identified 30 breeding with B. straminea, four of which were potential foci of transmission, as molecular testing identified snails with S. mansoni DNA. There were 14 children diagnosed with schistosomiasis, of which five were considered to be autochthonous cases of the disease. CONCLUSIONS: Urgent measures are required in order to avoid schistosomiasis becoming endemic to Recife, as has happened in other coastal areas of the state of Pernambuco.

Casos autoctones de esquistossomose mansonica em criancas de Recife, PE / Casos autoctonos de esquistosomiasis mansonica en ninos de Recife, PE, Brasil / Autochthonous cases of schistosomiasis in children in Recife, Northeastern Brazil

OBJETIVO : Investigar criadouros com moluscos hospedeiros e casos humanos autóctones para esquistossomose. MÉTODOS : Entre julho de 2010 e setembro de 2012 foram realizados: (1) levantamento malacológico para busca ativa de criadouros, coleta e identificação de caramujos Biomphalaria positivos para Schistosoma mansoni em Recife, PE; (2) inquérito de prevalência com 2.718 escolares, de sete a 14 anos, para diagnóstico de casos de esquistossomose; (3) exame clínico e ultrassonografia nos casos positivos para S. mansoni. Os casos foram investigados quanto à sua autoctonia e avaliados clinicamente. Os casos e criadouros foram georreferenciados e espacializados. RESULTADOS : Foram identificados 30 criadouros de B. straminea , quatro deles potenciais focos de transmissão, uma vez que os testes moleculares identificaram DNA de S. mansoni nos caramujos coletados. Foram diagnosticadas 14 crianças com esquistossomose; entre elas, cinco foram consideradas casos autóctones da doença. CONCLUSÕES : Ações emergenciais pela vigilância em saúde são necessárias para evitar que a esquistossomose se endemize em Recife, como acontece em localidades litorâneas do estado de Pernambuco. .

OBJETIVO Investigar criaderos con moluscos hospedadores y casos humanos autóctonos para esquistosomiasis. MÉTODOS Se ejecutaron: estudio malacológico para búsqueda activa de criaderos, colecta e identificación de caracoles Biomphalaria positivos para S. mansoni en Recife, PE, entre julio de 2010 y septiembre de 2012, pesquisa de prevalencia con 2.718 escolares, de siete a 14 años, para diagnóstico de casos de esquistosomiasis, examen clínico y de ultrason en los casos positivos para S. mansoni. Los casos fueron investigados con respecto a su autoctonía y evaluados clínicamente. Los casos y criaderos fueron geo-referenciados y espacializados. RESULTADOS Se identificaron 30 criaderos de B. straminea, cuatro de ellos potenciales focos de transmisión, luego que las pruebas moleculares identificaron DNA de S. mansoni en los caracoles colectados. Se diagnosticaron 14 niños con esquistosomiasis, entre ellas cinco fueron considerados casos autóctonos de la enfermedad. CONCLUSIONES Acciones de emergencia para vigilancia de salud son necesarias para evitar que la esquistosomiasis se vuelva endémica en Recife como sucede en localidades del litoral de Pernambuco. .

OBJECTIVE : Investigate breeding sites with host snails and autochthonous human cases of schistosomiasis. METHODS : Between July 2010 and September 2012 were performed: (1) malacological survey searching for breeding sites, collection and identification of Biomphalaria snails positive for Schistosoma mansoni in Recife, PE, Northeastern Brazil; (2) prevalence survey in 2,718 schoolchildren aged from seven to 14 years old to identify cases of schistosomiasis, clinical examination and ultrasound in positive cases of S. mansoni. The autochthony of the cases was investigated and the case were clinically evaluated. The cases and breeding sites were georeferenced and spatially described. RESULTS : The results identified 30 breeding with B. straminea, four of which were potential foci of transmission, as molecular testing identified snails with S. mansoni DNA. There were 14 children diagnosed with schistosomiasis, of which five were considered to be autochthonous cases of the disease. CONCLUSIONS : Urgent measures are required in order to avoid schistosomiasis becoming endemic to Recife, as has happened in other coastal areas of the state of Pernambuco. .

Giant hypothalamic hamartoma: case report and literature review.

INTRODUCTION: Hypothalamic hamartomas are very rare (1:200,000) and range in size from 17.9 to 18 mm. When their dimensions exceed 30-40 mm, they are classified as giant hypothalamic hamartomas. METHODS: We present a 14-month-old boy with central precocious puberty and gelastic seizures in whom a magnetic resonance imaging scan revealed a giant hypothalamic hamartoma measuring 50 × 50 × 40 mm. RESULTS: In the 11 cases described so far, we found that in comparison to the average-size lesion, giant hypothalamic hamartomas had a lower frequency of precocious puberty, but a similar frequency of seizures. The mean age at diagnosis was younger, and males were more affected than females. Magnetic resonance imaging results were similar with the exception of mass effect. CONCLUSIONS: Giant hypothalamic hamartomas had a higher tendency to adhere to surrounding structures. Their invasiveness and cystic degeneration were frequent findings among the 11 studies. Surgical removal was ineffective in controlling refractory epilepsy and caused postoperative morbidity in all patients.

Spatial distribution of schistosomiasis and geohelminthiasis cases in the rural areas of Pernambuco, Brazil.

INTRODUCTION: The prevalence and intensity of geohelminth infections and schistosomiasis remain high in the rural areas of Zona da Mata, Pernambuco (ZMP), Brazil, where these parasites still represent a significant public health problem. The present study aimed to spatially assess the occurrences of schistosomiasis and geohelminthiasis in the ZMP. METHODS: The ZMP has a population of 1,132,544 inhabitants, formed by 43 municipalities. An ecological study was conducted, using secondary data relating to positive human cases and parasite loads of schistosomiasis and positive human cases of geohelminthiasis that were worked up in Excel 2007. We used the coordinates of the municipal headquarters to represent the cities which served as the unit of analysis of this study. The Kernel estimator was used to spatially analyze the data and identify distribution patterns and case densities, with analysis done in ArcGIS software. RESULTS: Spatial analysis from the Kernel intensity estimator made it possible to construct density maps showing that the northern ZMP was the region with the greatest number of children infected with parasites and the populations most intensely infected by Schistosoma mansoni. In relation to geohelminths, there was higher spatial distribution of cases of Ascaris lumbricoides and Trichuris trichiura in the southern ZMP, and greater occurrence of hookworms in the northern/central ZMP. CONCLUSIONS: Despite several surveys and studies showing occurrences of schistosomiasis and geohelminthiasis in the ZMP, no preventive measures that are known to have been effective in decreasing these health hazards have yet been implemented in the endemic area.

Spatial distribution of schistosomiasis and geohelminthiasis cases in the rural areas of Pernambuco, Brazil / Distribuição espacial dos casos de esquistossomose e geohelmintoses em áreas rurais de Pernambuco, Brasil

INTRODUCTION: The prevalence and intensity of geohelminth infections and schistosomiasis remain high in the rural areas of Zona da Mata, Pernambuco (ZMP), Brazil, where these parasites still represent a significant public health problem. The present study aimed to spatially assess the occurrences of schistosomiasis and geohelminthiasis in the ZMP. METHODS: The ZMP has a population of 1,132,544 inhabitants, formed by 43 municipalities. An ecological study was conducted, using secondary data relating to positive human cases and parasite loads of schistosomiasis and positive human cases of geohelminthiasis that were worked up in Excel 2007. We used the coordinates of the municipal headquarters to represent the cities which served as the unit of analysis of this study. The Kernel estimator was used to spatially analyze the data and identify distribution patterns and case densities, with analysis done in ArcGIS software. RESULTS: Spatial analysis from the Kernel intensity estimator made it possible to construct density maps showing that the northern ZMP was the region with the greatest number of children infected with parasites and the populations most intensely infected by Schistosoma mansoni. In relation to geohelminths, there was higher spatial distribution of cases of Ascaris lumbricoides and Trichuris trichiura in the southern ZMP, and greater occurrence of hookworms in the northern/central ZMP. CONCLUSIONS: Despite several surveys and studies showing occurrences of schistosomiasis and geohelminthiasis in the ZMP, no preventive measures that are known to have been effective in decreasing these health hazards have yet been implemented in the endemic area.

INTRODUÇÃO: A prevalência e intensidade das infecções produzidas por geohelmintos e esquistossomose continuam elevadas na Zona da Mata de Pernambuco (ZMP), onde essas parasitoses se apresentam como relevante problema de saúde pública. O presente estudo objetivou espacializar a ocorrência da esquistossomose e geohelmintoses na ZMP. MÉTODOS: A ZMP apresenta uma população de 1.132.544 habitantes, composta por 43 municípios. Um estudo ecológico foi desenvolvido, utilizando dados secundários referentes aos casos humanos positivos e cargas parasitárias para esquistossomose e casos humanos positivos para geohelmintoses que foram trabalhados no Excel 2007. Foram utilizadas as coordenadas das sedes municipais para representar o município o qual serviu de unidade de análise deste estudo. Para análise espacial dos dados e identificação de padrões de distribuição e densidade dos casos, foi adotado o estimador de Kernel, sendo as análises feitas no software ArcGIS. RESULTADOS: A análise espacial, a partir do estimador de intensidade de Kernel, permitiu a construção de mapas de densidade mostrando a Mata Norte como a região onde se concentra o maior número de crianças parasitadas e as populações mais intensamente infectadas pelo Schistosoma mansoni. Com relação aos geohelmintos, há uma maior distribuição espacial dos casos de Ascaris lumbricoides e Trichuris trichiura na Mata Sul, destacando a maior ocorrência de ancilostomídeos entre as Matas Norte e Centro de Pernambuco. CONCLUSÕES: Apesar dos inquéritos e dos vários estudos mostrando a ocorrência de esquistossomose e geohelmintoses na ZMP ainda se desconhecem medidas preventivas que tenham sido implementadas na área endêmica mostrando efetividade na redução destes agravos.

Acute chorea and type 1 diabetes mellitus: clinical and neuroimaging findings.

The association of type 1 diabetes mellitus (T1DM) and acute chorea is rare. We report an 8-yr-old boy with T1DM who developed acute hemichorea-hemiballism of the right arm in whom magnetic resonance imaging (MRI) of the brain revealed hyperintense signal in putamen and considerable atrophy and focal area of gliosis in the right putamen. There was a deposition of deoxyhemoglobin indicating recent bleeding in the left lentiform nucleus. A control MRI 2 months later showed complete reabsorption of the blood component in the left lentiform nucleus. Multislice computerized tomography revealed hyperdensities in the corpus striatum and subcortical calcifications. This report describes, for the first time, findings of calcifications in the corticomedullary junction in the brain hemispheres of a child with T1DM and chorea and reviews the possible causal mechanisms of this unusual association.

Investigação epidemiológica sobre a ocorrência de geohelmintoses e casos autóctones de esquistossomose na cidade do Recife / Epidemiological investigation about occurrence of geohelminthiasis and autochthonous cases of schistosomiasis in Recife

Em Pernambuco as geohelmintoses e esquistossomose apresentam prevalências elevadas em áreas rurais e atualmente a esquistossomose tem se expandindo para áreas litorâneas. Em Recife nenhuma investigação epidemiológica confirmou casos autoctónes, consequentemente esta cidade não é atendida pelo Programa de Controle da Esquistossomose (PCE). Em 2008 foi registrada a 1ª ocorrência de caramujos infectados pelo Schistosoma mansoni na cidade do Recife. Diante disto, o presente estudo teve como objetivos: estimar a positividade da esquistossomose e geohelmintoses em Recife; determinar a intensidade de infecção por S. mansoni; conhecer o perfil clínico e investigar a autoctonia dos casos de S. mansoni; espacializar a ocorrência desses agravos. O estudo foi realizado entre maio-11 a maio-12 com crianças entre 7-14 anos em escolas sorteadas. O exame de Kato-Katz permitiu o cálculo da prevalência e intensidade da infecção esquistossomótica. As crianças positivas para S. mansoni fizeram exames clínico e ultrassonográfico e a investigação de autoctonia foi realizada mediante entrevistas. Os casos foram localizados espacialmente utilizando o GoogleEarth e o processamento dos dados realizado no ArcGIS 10.0. Foram feitos 2.718 exames, com 246 crianças infectadas por Ascaris lumbricoides, 235 por Trichuris trichiura, 30 por ancilostomídeos e 12 por S. mansoni. A intensidade de infecção por S. mansoni variou de 24-816 OPG. Oito crianças apresentaram fígado e baço normais, 3 hepatomegalia e 1 hepatoesplenomegalia. A investigação de autoctonia descartou 9 crianças diante da menção de exposição fora do Recife. A distribuição espacial dos casos mostra maior concentração no norte e centro da cidade. As evidências deste estudo devem alertar a Vigilância Epidemiológica para promover a busca de novos casos para que a doença não se propague no Recife. Uma investigação malacológica está em curso para tentar fechar o ciclo de transmissão desta doença no Recife.

[Temporary and permanent breeding sites for Biomphalaria in Jaboatão dos Guararapes, PE]. / Criadouros de Biomphalaria, temporários e permanentes, em Jaboatão dos Guararapes, PE.

A malacological survey of permanent and temporary breeding sites was conducted in the Piedade neighborhood of Jaboatão dos Guararapes, Pernambuco, between November 2006 and November 2007, with the aim of determining the malacological fauna at this locality, along with the potential for Schistosomiasis mansoni transmission. In addition to Biomphalaria glabrata (Say, 1818), the molluscs Drepanotrema cimex (Moricand, 1837), Pomacea sp and Melanoides tuberculatus (Muller, 1774) were collected. Among the specimens of Biomphalaria glabrata that were collected, 1,490 were found alive, and 74 (5%) were positive for Schistosoma mansoni. The largest numbers of molluscs collected, and all of the specimens that were positive for Schistosoma mansoni, were collected during the annual rainy season. The presence of larvae of other trematodes infecting the Biomphalaria glabrata molluscs was also observed. These trematodes were from the families Strigeidae and Diplostomatidae and, at first sight, they presented morphology that could lead to confusion with Schistosoma mansoni cercariae. Thus, knowledge of these trematodes becomes essential for the differential diagnosis of the etiological agent for schistosomiasis.