Distinct features of ANCA-associated hypertrophic pachymeningitis compared to other etiologies: findings from a study of 74 patients.

OBJECTIVES: We aimed to characterize the clinical and radiological features, and outcomes, of a large cohort of hypertrophic pachymeningitis (HP) patients from a single center. METHODS: We conducted a retrospective study at a tertiary referral center, encompassing patients diagnosed with HP between 2003 and 2022. The diagnosis of HP relied on the identification of thickening of the dura mater via magnetic resonance imaging (MRI) of the brain or spine. RESULTS: We included 74 patients with a mean age of 43.6 ± 14.2 years, of whom 37 (50%) were male. Among them, 32 (43.2%) had an immune-mediated origin, including 21 with granulomatosis with polyangiitis (GPA) (predominantly PR3-ANCA positive), four with systemic lupus erythematosus, three with IgG4-related disease, three with idiopathic HP, and one with rheumatoid arthritis. Non-immune-mediated HP accounted for 45 cases (56.8%). Within this category, 21 (28.4%) were infectious cases, with 14 being Mycobacterium tuberculosis infection (TB-HP), and 21 (28.4%) were malignancy-associated HP. Clinical and MRI characteristics exhibited variations among the four etiological groups. Hypoglycorrhachia was primarily observed in infectious and malignancy-associated HP. Immune-mediated HP was associated with a peripheral pattern of contrast enhancement and the Eiffel-by-night sign. MRI features strongly indicative of TB-HP included leptomeningeal involvement, brain parenchymal lesions, and arterial stroke. MPO-ANCA GPA was associated with a higher prevalence of spinal HP. CONCLUSIONS: Within our cohort, GPA and Mycobacterium tuberculosis emerged as the predominant causes of HP. We identified significant disparities in clinical and radiological features among different etiologies, which could have implications for diagnosis.

Vagalumes e biografemas: poéticas e políticas públicas no desligamento institucional por maioridade / Fireflies and biographems: poetics and public policies regarding institutional removal due to adulthood / Luciérnagas y biografemas: poéticas y políticas públicas en desconexión institucional debido a la edad adulta

Este artigo versa sobre o processo de desligamento institucional por maioridade de jovens que residem em serviços de acolhimento. Aposta-se em uma política do sensível para visibilizar os encontros e desencontros que acontecem entre as e os jovens e as políticas públicas brasileiras. Para tanto, realizaram-se encontros com jovens que já haviam passado pelo processo de desligamento e com jovens que logo completariam 18 anos e teriam de sair das instituições de acolhimento. Para tornar visíveis essas existências, investiu-se na escrita de biografemas, inspirados na obra de Roland Barthes. Os conceitos de necropolítica e vidas precárias foram fundamentais para compreender as omissões do Estado no momento do desligamento. Verificou-se que o Estado pode maximizar a precariedade de algumas vidas, especialmente daquelas marcadas por características de raça, gênero e classe culturalmente marginalizados. Contudo, é também o encontro com as políticas públicas que garante melhores condições de vida para alguns, facilitando o acesso à universidade e ao mercado de trabalho. A pesquisa aponta que, diante do abandono, as e os jovens se fazem vagalumes, produzindo luminosidades em meio à escuridão e reivindicando o direito à vida.(AU)

This article discusses the process of institutional removal of young people that reside in foster care institutions for reaching adulthood. It relies on a politics of the sensitive to make visible the encounters and mismatches that take place between young people and Brazilian public policies. To do so, meetings were held with young people who had already experienced the removal process and with young people who would soon turn 18 and would have to leave the host institutions. To make these existences visible, this study invested in the writing of biographems, inspired by the works of Roland Barthes. The concepts of necropolitics and precarious lives were fundamental to understand the omissions of the State at the time of removal. It was also found that the State can maximize the precariousness of some lives, especially those marked by culturally marginalized race, gender, and class characteristics. However, it is also the encounter with public policies that ensures better living conditions for some, facilitating access to the university and the labor market. This research points out that, in the face of abandonment, young people become fireflies, producing luminosity amid the darkness and claiming the right to life.(AU)

Este artículo aborda el proceso de desconexión institucional justificado por la edad adulta de los jóvenes que residen en los servicios de acogida. Utilizamos una política sensible para hacer visibles las reuniones y los desajustes que tienen lugar entre los jóvenes y las políticas públicas brasileñas. Con este fin, se celebraron reuniones con los jóvenes que ya habían pasado por el proceso de desconexión institucional y también con los jóvenes que pronto cumplirían los 18 años y tendrían que abandonar las instituciones de acogida. Para hacer visibles estas existencias, se redactaron biografemas, inspirados en el trabajo de Roland Barthes. Los conceptos de necropolítica y vida precaria fueron fundamentales para comprender las omisiones del Estado en el momento de la desconexión. Se encontró que el Estado puede maximizar la precariedad de algunas vidas, principalmente de aquellas marcadas por características de raza, género y clase culturalmente marginadas. Sin embargo, el encuentro con las políticas también puede garantizar mejores condiciones de vida para algunos, facilitándoles el acceso a la universidad y al mercado laboral. Esta investigación señala que, ante el abandono, los jóvenes se convierten en luciérnagas, produciendo luminosidad en medio de la oscuridad y reclamando el derecho a la vida.(AU)

Escuta terapêutica no processo de atendimento à saúde do idoso / Therapeutic listening in the process of health care for the elderly / Escucha terapéutica en el proceso de atención médica anciana

Objetivo: descrever os efeitos da escuta terapêutica domiciliar junto a idosos com indicativo de depressão utilizando a técnica de solução de problemas. Método: estudo descritivo, intervencional de cunho qualitativo, com idosos de 60 anos ou mais e com indicativo de depressão. Os dados foram coletados entre outubro de 2017 a abril de 2018 e foi realizada em três etapas: seleção da amostra, intervenção domiciliar e avaliação final. Utilizou-se para análise o Discurso do Sujeito Coletivo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos. Resultados: foram elaborados três discursos utilizando as ideias centrais: acolhimento; crescimento pessoal e reflexão sobre a vida. Conclusão: a escuta terapêutica no domicílio favoreceu o acolhimento, fortalecimento do vínculo profissional/paciente e reforçou de modo positivo os mecanismos assertivos das idosas. A Técnica de Solução de Problemas possibilitou o desenvolvimento de uma estratégia sistematizada e adequada para a aplicação da escuta terapêutica.

Objective: to describe the effects of therapeutic listening, using the problem-solving technique, in home visits to elderly people with signs of depression. Method: this qualitative, descriptive, interventional study with elderly people aged 60 years and over with an indication of depression proceeded in three stages: sample selection, home intervention, and final evaluation. Data were collected between October 2017 and April 2018 and analyzed using Collective Subject Discourse. The study was approved by the human research ethics committee. Results: three discourses were formulated using the central ideas: reception; personal growth and reflection on life. Conclusion: therapeutic listening at home favored receptiveness, a stronger bond with the patients and reinforced the elderly women's assertive mechanisms positively. The Problem-Solving Technique made it possible to develop a systematic strategy suited to applying therapeutic listening.

Objetivo: describir los efectos de la escucha terapéutica domiciliaria junto a personas mayores con signos de depresión, utilizando la técnica de resolución de problemas. Método: estudio descriptivo, intervencionista, de tipo cualitativo, junto a personas mayores de 60 años y con indicios de depresión. La recolección de datos se realizó entre octubre de 2017 y abril de 2018 y se llevó a cabo en tres etapas: selección de la muestra, intervención domiciliaria y evaluación final. Para el análisis, se utilizó el Discurso del Sujeto Colectivo. El estudio fue sometido al Comité de Ética en Investigación con Seres Humanos. Resultados: se han elaborado tres discursos utilizando las ideas centrales: acogimiento; crecimiento personal y reflexión sobre la vida. Conclusión: la escucha terapéutica en el domicilio favoreció la recepción, fortaleció el vínculo profesional/paciente y reforzó positivamente los mecanismos asertivos de las ancianas. La Técnica de Resolución de Problemas permitió desarrollar una estrategia sistematizada y adecuada a la aplicación de la escucha terapéutica.

Rheumatological Adverse Events of Cancer Therapy with Immune Checkpoint Inhibitors.

Latin America is experiencing a demographic and epidemiological transition, with an increase in non-communicable diseases such as cancer. One of the greatest advances in the therapeutic approach to cancer has been the discovery of immunotherapy, and specifically of checkpoint inhibitors (CPIs). Since inhibition of CTLA-4 and PD-1/PD-L1 enhances the immune response, cancer immunotherapies are associated with a new class of toxicities of autoimmune and/or autoinflammatory origin. These immune-related adverse events (irAEs) result in a broad spectrum of clinical events including rheumatic clinical syndromes, which may resemble classic rheumatic diseases. The most common rheumatic manifestations include inflammatory arthritis, myositis, vasculitis, and sicca syndrome. Recognizing rheumatologic irAEs is challenging due to the wide spectrum of clinical presentations that often do not fulfill traditional classification criteria of rheumatic diseases. A delayed diagnosis and treatment can lead to long-term disability, and disorders may become chronic and require ongoing immunosuppressive therapy. The management of irAEs includes the prompt detection and appropriate grading since their management is dictated by their severity. The growing use of CPIs, and the ensuing increase in irAEs, warrants an increasing collaboration between rheumatologists and oncologists. Understanding the pathophysiology, diagnosis, grading, and therapeutic implications of irAEs in patients with cancer is thus a requirement for Latin American oncologists and rheumatologists alike.

Escutação: encontros entre crianças, assistência social e pandemia / "escucha-acción": encuentros entre niños, asistencia social y pandemia / "listening-action": encounters between children, social assistance and pandemic

Resumo: Neste artigo objetiva-se discutir questões relacionadas aos encontros das crianças com a assistência social a partir de um recorte da pesquisa de mestrado realizada em um Serviço de Convivência e Fortalecimento de Vínculos. Apostamos nos traçados singulares da metodologia cartográfica para o acompanhamento dos acontecimentos cotidianos do serviço e para o exercício epistêmico de descolonização do pensamento. Pretendemos, assim, contextualizar os discursos vinculados às crianças consideradas público prioritário do serviço e objetos da política pública e refletir sobre a pandemia da Covid-19 que escancara as desigualdades sociais. Entendemos que o olhar crítico desde uma perspectiva parcial potencializa a desconstrução de discursos totalizantes e universais sobre as infâncias e propomos a escutação como aposta ética-estética-política de uma escuta menor em tempos e sistemas maiores, que podem brutalizar o cotidiano de trabalho nas políticas públicas.

Resumen: Este artículo tiene como objetivo discutir cuestiones relacionadas con los encuentros de los niños con la asistencia social, a partir de un fragmento de una investigación de maestría realizada en un Servicio de Convivencia y Fortalecimiento de Vínculos. Apostamos por las huellas únicas de la metodología cartográfica para el seguimiento de los acontecimientos cotidianos del servicio y para el ejercicio epistémico de descolonización del pensamiento. Pretendemos, por tanto, contextualizar los discursos vinculados a los niños considerados público prioritario del servicio y objeto de la política pública y reflexionar sobre la pandemia de la Covid-19, que abre las desigualdades sociales. Entendemos que la mirada crítica desde una perspectiva parcial potencia la deconstrucción de discursos totalizadores y universales sobre la infancia y proponemos la "escucha-acción" como una apuesta ético-estética-política de una escucha más pequeña en tiempos y sistemas más grandes que puede embrutecer el trabajo cotidiano en las políticas públicas.

Abstract: This article aims to discuss issues related to children's encounters with social assistance, based on an excerpt from a master's research carried out in the Service for Coexistence and Strengthening of Bonds. We bet on the unique traces of the cartographic methodology for the monitoring of the daily events of the service and for the epistemic exercise of decolonization of thought. We intend, therefore, to contextualize the speeches linked to children considered a priority public of the service and objects of public policy and to reflect on the Covid-19 pandemic that opens up social inequalities. We understand that the critical look from a partial perspective enhances the deconstruction of totalizing and universal discourses about childhood. Besides, we propose listening-action as an ethical-aesthetic-political bet of a smaller listening in larger times and systems, which can brutalize the daily work in public policies.

Práticas cotidianas de judicialização da vida na assistência social: ensaio teórico / Daily practices of judicialization of life in social assistance: theoretical essay / Prácticas cotidianas de la judicialización de la vida de la asistencia social: ensayo teórico

Considerando que a judicialização é uma construção social recente, este ensaio teórico objetiva problematizar a noção de judicialização da vida nas políticas públicas de assistência social, a partir de fragmentos de obras da literatura brasileira (Vidas Secas, de Graciliano Ramos, e Conto de Escola, de Machado de Assis). Para analisar o processo de desqualificação e criminalização de vidas, a discussão se ampara nos conceitos foucaultianos de governo e vontade de saber, assim como autoras/es brasileiras/os que trabalham com o tema. Por judicialização entende-se o processo de regulação do viver, a partir de estratégias e normativas legais, que produz a normalização de práticas cotidianas. Essa tecnologia está intrinsecamente articulada com o governo da vida do outro, principalmente no campo das políticas públicas. Constituem-se em modos de punição que extravasam o âmbito legal, produzindo relações de poder assimétricas, caracterizadas pelo processo de judicialização, medicalização e patologização da vida. Finaliza-se o texto com algumas pistas para resistir à judicialização no cotidiano da assistência social, como ações micropolíticas e constituição de coletivos entre trabalhadores e usuárias/os.(AU)

Considering that judicialization is a recent social construct, this article aims to problematize the notion of life judicialization in social welfare policies based on fragments of two works of the Brazilian literature: Vidas Secas, by Graciliano Ramos, and Conto de Escola, by Machado de Assis. The process of life disqualification and criminalization is analyzed in the light of the Foucauldian concepts of government and the will to knowledge, as well as Brazilian authors addressing the theme. Judicialization is understood as the process of life regulation by legal strategies and provisions, normalizing daily practices. Such mechanism is intrinsically articulated with the government of others, especially in the field of Public Policy. Together, they constitute modes of punishment that go beyond the legal scope, producing asymmetrical power relations characterized by the process of life judicialization, medicalization, and pathologization. Finally, the discussion offers some propositions to resist life judicialization in social assistance, such as adopting micropolitical actions and forming collectives between workers and users.(AU)

Teniendo en cuenta que la judicialización es una construcción social reciente, en este ensayo teórico se pretende problematizar la noción de judicialización de la vida en políticas públicas para la asistencia social a partir de extractos de obras de la literatura brasileña (Vidas Secas, de Graciliano Ramos, y Conto de Escola, de Machado de Assis). Para analizar el proceso de descalificación y criminalización de la vida, la discusión parte de conceptos foucaultianos de gobernabilidad y voluntad de saber, así como de autoras/es brasileñas/os que trabajan con el tema. La judicialización se define como el proceso de regulación del vivir bajo estrategias y regulaciones legales, produciendo la normalización de la práctica diaria. Esta tecnología está intrínsecamente vinculada con el gobierno de la vida de otro, especialmente en el ámbito de las políticas públicas. Son modos de castigo que van más allá del marco legal, que ocasionan relaciones de poder asimétricas, caracterizadas por un proceso de legalización, medicalización y patologización de la vida. Se concluye con algunas pistas para resistir a la judicialización en el cotidiano de la asistencia social, como acciones micropolíticas y constitución de colectivos entre trabajadores y usuarias/os.(AU)

Concepções sobre Deficiência Importam? / Do Conceptions about Disability Matter?

RESUMO: A literatura indica que, em relação à deficiência, a concepção pode influenciar diretamente sobre as atitudes. Assim, este estudo objetivou analisar as concepções de deficiência de profissionais que atuam nas redes de serviços de prevenção e proteção à violência. Especificamente, objetivou-se verificar se há influência dos contextos, de oportunidades de formação e de atuação profissional na (des)construção de concepções de deficiência. Trata-se de uma pesquisa com delineamento multicaso, de caráter experimental, com análise quantitativa e qualitativa. Participaram da pesquisa 97 profissionais de quatro municípios do Estado de São Paulo, que responderam à Escala de Concepções de Deficiência (teste e reteste). A análise dos resultados indicou que: a) as concepções de deficiência divergem significativamente entre os municípios; b) as categorias profissionais não influenciam, necessariamente, sobre a concepção; c) há maior concordância com a concepção social da deficiência e menor concordância com a concepção metafísica, quando a análise não relaciona os participantes aos seus respectivos municípios. Assim sendo, identificar concepções de deficiência importa na medida em que as redes de prevenção e de proteção à violência precisam atravessar o processo de (des)construção das concepções, as quais podem potencializar ou minimizar atitudes discriminatórias frente a pessoas com deficiências.

ABSTRACT: Literature indicates that, in relation to people with disabilities, conception can influence directly on attitudes. Thus, this study aimed to analyze the conceptions of disability of professionals who work in networks of services for violence prevention and protection against it. Specifically, the objective was to verify whether there is an influence of contexts, training opportunities and professional performance in the (de)construction of disability conceptions. It is a multi-case design research, of experimental character, with quantitative and qualitative analysis. Ninety-seven professionals from four municipalities of the State of São Paulo, Brazil, participated in the research, who responded to the Disability Conceptions Scale (test and retest). The analysis results indicated that: a) conceptions of disability differ significantly among the municipalities; b) professional categories do not necessarily influence the conception; c) there is greater agreement with the social conception of disability and less agreement with the metaphysical conception, when the analysis does not relate the participants to their respective municipalities. Therefore, identifying conceptions of disability matters as the networks of violence prevention and protection against violence need to go through the process of (de)construction of conceptions, which can enhance or minimize discriminatory attitudes towards people with disabilities.

PesquisarCOM jovens: pistas metodológicas para narrativas ético-políticas / PesquisarCON jóvenes: pistas metodológicas para narrativas ético-políticas / ResearchWITH youngs: methodological clues to ethical policy narratives

Este artigo tem como proposta discutir pistas metodológicas para construções coletivas de pesquisas com jovens, afirmando as juventudes como coautoras e pesquisadoras desse processo. A partir de uma experiência de PesquisarCOM Jovens no Trabalho Educativo (TEd) - uma modalidade do Serviço de Convivência e Fortalecimento de Vínculos (SCFV) destinada a jovens de 14 a 18 anos incompletos -, emergiram as seguintes problematizações: como pesquisar junto com as jovens do Trabalho Educativo? Como expressar as intensidades e modos de experimentar as juventudes no Trabalho Educativo por meio de narrativas? Tendo como premissa sugestões dos jovens, foram confeccionados cadernos nos quais são narrados com ilustrações e textos as experiências coletivas e singulares das juventudes do TEd. Depois da produção dos cadernos e das narrativas, notou-se a importância de escutar e valorizar as experiências e os saberes dos jovens na construção das oficinas do TEd, principalmente o módulo de cidadania, para que o serviço não reproduza lógicas colonizadoras, racistas, epistemicidas e violentas.

This article aims to discuss methodological clues for collective construction of research with young people, affirming the youths as co-authors and researches of this process. From an experience of SearchingCOM young people in Educational Work - a modality of the Service of Living and Bonding (SCFV) aimed at young people from 14 to 18 years old incomplete - the following issues emerged: how to research together with young people in Educational Work? How to express the intensities and ways of experiencing youth in educational work through narratives? From the suggestions of the young, notebooks were made in which narratives with illustrations and texts are narrated the collective and singular experiences of the youth of TEd. After the production of notebooks and narratives, it was noted the importance of listening and valuing the experiences and knowledge of young people in the construction of TEd workshops, especially the citizenship module, so that the service does not reproduce colonizing, racist, epistemicidal logics and violent.

Este artículo tiene como objetivo discutir pistas metodológicas para la construcción colectiva de la investigación con los jóvenes, afirmando las juventudes como coautoras e investigadoras de este proceso. A partir de una experiencia de PesquisarCON jóvenes en el Trabajo Educativo - una modalidad del Servicio de Convivencia y Fortalecimiento de Lazos (SCFV) dirigida a jóvenes de 14 a 18 años - surgieron los siguientes problematizaciones: ¿cómo investigar junto con los jóvenes en el Trabajo Educativo? ¿Cómo expresar las intensidades y formas de experimentar la juventud en el trabajo educativo en narrativas? A partir de las sugerencias de los jóvenes, se hicieron cuadernos en los que se narran con ilustraciones y textos sobre las experiencias colectivas y singulares de los jóvenes de TEd. Después de la producción de cuadernos y narrativas, se señaló la importancia de escuchar y valorar las experiencias y el conocimiento de los jóvenes en la construcción de talleres de TEd, especialmente el módulo de ciudadanía, para que el servicio no reproduzca lógicas colonizadoras, racistas, epistemicidas y violentas.

Raça e Política de Assistência Social: produção de conhecimento em psicologia social / Race and Social Assistance Policy: production of knowledge in social psychology / Raza y Políticade Bienestar Social: producción de conocimiento en psicología social

Partimos da reflexão acerca das políticas públicas de Assistência Social e como as interfaces raça, racismo e branquitude emergem na produção de conhecimento. Inspiradas na ideia de pluriversalidade questionamos o universo conceitual branco, trazendo como reflexão as produções em Psicologia que se centram em um ideário eurocêntrico, masculinista e heterocentrado. Apresentamos uma discussão sobre o tema da raça e racismo, pensando como estes se articulam tanto na constituição e implementação das políticas públicas, quanto na sua precarização. Para finalizar, afirmamos a necessidade de descolonizar a produção em Psicologia Social, colocar a branquitude em jogo, dissolver a ideia de sujeito universal e assumir a necessidade de pensarmos e publicarmos a partir de uma perspectiva polirracional. Acreditamos que as políticas de produção de saberes e fazeres em Psicologia devem estar atentas à geopolítica do conhecimento, dialogando com diversidades epistêmicas espalhadas em distintas regiões do planeta, sobretudo aquelas do Sul Global....(AU)

This paper presents a reflection on public policies for Social Assistance and the way that interfaces such as race, racism and whiteness have appeared in knowledge production. Inspired by the idea of pluriversality, we have questioned the white conceptual universe by bringing reflections on psychology productions focused on a Eurocentric, masculinist, and heterocentered ideology. We present a discussion on race and racism, thinking about the way they have been articulated in the constitution and implementation of public policies as well as in their precariousness. Finally, we state the need to decolonize the production in Social Psychology, in order to bring whiteness into play, dissolve the idea of universal subject, and admit our need to think and publish from a multi-rational perspective. We believe that policies for the production of knowledges and actions in psychology should be attentive to the geopolitics of knowledge, in a dialogue with epistemic diversities spread in different regions over the world, particularly in the Global South....(AU)

Se parte de la reflexión sobre las políticas públicas de Bienestar Social e interfaces como la raza, el racismo y la blanquitud surgen en la producción de conocimiento. Inspirados en la idea de la pluriversidad, cuestionamos el universo conceptual blanco, trayendo como reflejo las producciones en psicología que se centran en una idea eurocéntrica, masculinista y heterocéntrica. Presentamos una discusión sobre el tema de la raza y el racismo, pensando cómo se articulan tanto en la constitución y la implementación de las políticas públicas, como en su precariedad.Finalmente, afirmamos la necesidad de descolonizar la producción en Psicología Social, poner en juego la blanquitud, disolver la idea del tema universal y asumir la necesidad de pensar y publicar desde una perspectiva múltiplemente racional. Creemos que la política de producción de conocimiento y las actividades en psicología deben estar atentas a la geopolítica del conocimiento, dialogando con diversidades epistémicas diseminadas en diferentes regiones del planeta, especialmente en las del Sur Global....(AU)

Psicologia, palhaçaria e psicodrama: construção coletiva de aprendizados e intervenções / Psychology, clowning and psychodrama: collective construction for learning and intervention purposes / Psicología, payasaría y psicodrama: construcción colectiva de aprendizajes e intervenciones

Este artigo tem como objetivo compartilhar a experiência do Grupo de Estudos e Práticas em Psicologia, Palhaçaria e Psicodrama (GEP), destacando-se as potencialidades de se trabalhar com metodologias ativas de aprendizagem na aproximação entre Psicodrama e Palhaçaria. O GEP – coordenado por psicólogas com formação em Psicodrama e Palhaçaria – visa pensar intervenções criativas que promovam a saúde e a expressão de questões sociais. Cada encontro mensal e aberto é construído junto aos participantes, estimulando seu protagonismo na construção coletiva e transdisciplinar dos conhecimentos.

This article aims to share the experience of the Psychology, Clowning and Psychodrama Study and Practice Group (GEP), highlighting the potential of working with active learning methodologies in binding Psychodrama and Clowning concepts. GEP, coordinated by psychologists with Psychodrama and Clowning degrees, promotes a reflection on health and social issues through creative interventions. Each monthly and open meeting is run together with the participants, encouraging their empowerment in the collective and transdiciplinary construction of knowledge.

Este artículo tiene como objetivo compartir la experiencia del Grupo de Estudios y Prácticas en Psicología, Payasaría y Psicodrama (GEP), destacándose las potencialidades de trabajar con metodologías activas de aprendisaje en la aproximación entre Psicodrama y Payasaría. El GEP, coordinado por psicólogas con formación en Psicodrama y Payasaría, pretende fomentar intervenciones creativas para la promoción de la salud y la expresión de problemas sociales. Cada encuentro mensual y abierto se construye junto a los participantes, estimulando su protagonismo en la construcción colectiva y transdisciplinaria de los conocimientos.

Navigating the Landscape of Tumor Extracellular Vesicle Heterogeneity.

The last decade has seen a rapid expansion of interest in extracellular vesicles (EVs) released by cells and proposed to mediate intercellular communication in physiological and pathological conditions. Considering that the genetic content of EVs reflects that of their respective parent cell, many researchers have proposed EVs as a source of biomarkers in various diseases. So far, the question of heterogeneity in given EV samples is rarely addressed at the experimental level. Because of their relatively small size, EVs are difficult to reliably isolate and detect within a given sample. Consequently, standardized protocols that have been optimized for accurate characterization of EVs are lacking despite recent advancements in the field. Continuous improvements in pre-analytical parameters permit more efficient assessment of EVs, however, methods to more objectively distinguish EVs from background, and to interpret multiple single-EV parameters are lacking. Here, we review EV heterogeneity according to their origin, mode of release, membrane composition, organelle and biochemical content, and other factors. In doing so, we also provide an overview of currently available and potentially applicable methods for single EV analysis. Finally, we examine the latest findings from experiments that have analyzed the issue at the single EV level and discuss potential implications.

Angioplastia coronaria percutánea en una mujer nonagenaria / Percutaneous coronary angioplasty in a nonagenarian woman

Resumen La esperanza de vida de las personas ha aumentado en los últimos años, como resultado, la prevalencia de octagenarios y nonagenarios con el diagnóstico de síndrome coronario agudo tipo infarto con elevación del segmento ST ha aumentado. La evidencia respecto al tratamiento con intervención coronaria percutánea (ICP) primaria en estos pacientes es poca y su prescripción es controvertida. Muchos estudios retrospectivos evaluaron el tratamiento con ICP primaria en adultos octogenarios, concluyendo que una ICP primaria exitosa puede reducir la mortalidad a corto y largo plazos. Con base en la evidencia actual, la decisión de realizar una ICP primaria a un paciente nonagenario no debe basarse solamente en la edad, debe evaluarse el beneficio de cada paciente de manera individual, asesorar si es apto a la revascularización y deben tomarse en cuenta las posibles complicaciones que pueden ocurrir durante y después del procedimiento. En este artículo se comunica el caso clínico de una paciente de 93 años de edad, que tuvo síndrome coronario agudo de tipo infarto con elevación del segmento ST, a quien se realizó intervención coronaria percutánea de manera exitosa.

Abstract The life expectancy of people has increased in the last years, as a result, the prevalence of octogenarians with the diagnosis of acute myocardial infarction with ST-segment elevation (STEMI) has augmented. The evidence about the treatment with primary percutaneous coronary intervention (PCI) in this group of patients is limited and its prescription is controversial. Many retrospective assays have studied primary PCI in octogenarians with STEMI, and conclude that successful primary PCI can result in a reduction of early and long-term mortality. Taking into account the current evidence, the decision to perform primary PCI in the elderly should not be based on chronological age alone, but rather on each patient's benefit and eligibility for revascularization, we should consider the possible complications during and after the procedure. This article reports a clinical case of a female patient of 93 years old, that presented with acute myocardial infarction with ST-segment elevation, in which primary percutaneous intervention was performed successfully.

Adesão ao tratamento: percepção de adolescentes dependentes químicos* / Adherence to treatment: perception of adolescents in chemical dependency / Adhesión al tratamiento: percepción de adolescentes dependientes químicos

OBJETIVO: descrever a percepção de adolescentes sobre a adesão ao tratamento da dependência química. MÉTODO: estudo descritivo, exploratório, com abordagem qualitativa. Participaram onze adolescentes atendidos no Centro de Atenção Psicossocial Álcool e Drogas (CAPS ad), no interior de Minas Gerais. Os dados foram coletados por meio de entrevistas, utilizando um instrumento semiestruturado, e após analisados através da técnica de análise de conteúdo. RESULTADOS: constatou-se que os vínculos estabelecidos, as atividades desenvolvidas e o apoio familiar facilitam a adesão ao tratamento, e a ordem judicial auxilia a frequência no serviço. CONCLUSÃO: conclui-se que a identificação e a compreensão dos fatores que interferem no processo de adesão ao tratamento possibilitam a elaboração de programas e abordagens terapêuticas adequadas e eficazes, pautadas nas necessidades dos adolescentes.

OBJECTIVE: the objective of this study was to describe the adolescents' perception about adherence to the chemical dependency treatment. METHOD: descriptive, exploratory study with a qualitative approach. Eleven adolescents attended the Psychosocial Care Center for Alcohol and Drugs (CAPS ad) in the interior of Minas Gerais. Data were collected through interviews, using a semi-structured instrument and then analyzed through the content analysis technique. RESULTS: it was found that the established links, the activities developed, the family support facilitates the adherence to the treatment and the court order assists in the frequency of service. CONCLUSION: it is concluded that the identification and understanding of the factors that interfere in the process of adherence to treatment allow the elaboration of adequate and effective therapeutic programs and approaches, based on the needs of adolescents.

OBJETIVO: el trabajo tuvo se objetivó describir la percepción de adolescentes sobre la adhesión al tratamiento de la dependencia química. MÉTODO: se trata de un estudio descriptivo, exploratorio, con abordaje cualitativo. Participaron del estudio once adolescentes atendidos en el grupo psicoterapéutico en el Centro de Atención Psicosocial Alcohol y Drogas (CAPS ad) en el interior de Minas Gerais. RESULTADOS: los datos fueron recolectados por medio de entrevistas, utilizando un instrumento semiestructurado y después de analizadas a través de la técnica de análisis de contenido. Se constató que los vínculos establecidos, las actividades desarrolladas, el apoyo familiar facilitan la adhesión al tratamiento y el orden judicial auxilia en la frecuencia al servicio. CONCLUSIÓN: se concluye que la identificación y la comprensión de los factores posibilitan la elaboración de programas y enfoques terapéuticos adecuados y eficaces.

Zika detection: comparison of methodologies

ABSTRACT Many countries in the Americas have detected local transmission of multiple arboviruses that cause febrile illnesses. Therefore, laboratory testing has become an important tool for confirming the etiology of these diseases. The present study aimed to compare the sensitivity and specificity of three different Zika virus detection assays. One hundred serum samples from patients presenting with acute febrile symptoms were tested using a previously reported TaqMan® RT-qPCR assay. We used a SYBR® Green RT-qPCR and a conventional PCR methodologies to compare the results. Of the samples that were determined to be negative by the TaqMan® RT-qPCR assay, 100% (Kappa = 0.670) were also found to be negative by SYBR® Green RT-qPCR based on Tm comparison; however, 14% (Kappa = 0.035) were found to be positive by conventional PCR followed by agarose gel electrophoresis. The differences between the ZIKV strains circulating worldwide and the low viremia period can compromise diagnostic accuracy and thereby the accuracy of outbreak data. Therefore, improved assays are required to improve the diagnosis and surveillance of arbovirus.

Extracellular RNAs: A New Awareness of Old Perspectives.

Extracellular RNA (exRNA) has recently expanded as a highly important area of study in biomarker discovery and cancer therapeutics. exRNA consists of diverse RNA subpopulations that are normally protected from degradation by incorporation into membranous vesicles or by lipid/protein association. They are found circulating in biofluids, and have proven highly promising for minimally invasive diagnostic and prognostic purposes, particularly in oncology. Recent work has made progress in our understanding of exRNAs-from their biogenesis, compartmentalization, and vesicle packaging to their various applications as biomarkers and therapeutics, as well as the new challenges that arise in isolation and purification for accurate and reproducible analysis. Here we review the most recent advancements in exRNA research.

Engagement of cellular prion protein with the co-chaperone Hsp70/90 organizing protein regulates the proliferation of glioblastoma stem-like cells.

BACKGROUND: Glioblastoma (GBM), a highly aggressive brain tumor, contains a subpopulation of glioblastoma stem-like cells (GSCs) that play roles in tumor maintenance, invasion, and therapeutic resistance. GSCs are therefore a promising target for GBM treatment. Our group identified the cellular prion protein (PrPC) and its partner, the co-chaperone Hsp70/90 organizing protein (HOP), as potential target candidates due to their role in GBM tumorigenesis and in neural stem cell maintenance. METHODS: GSCs expressing different levels of PrPC were cultured as neurospheres with growth factors, and characterized with stem cells markers and adhesion molecules markers through immunofluorescence and flow cytometry. We than evaluated GSC self-renewal and proliferation by clonal density assays and BrdU incorporation, respectively, in front of recombinant HOP treatment, combined or not with a HOP peptide which mimics the PrPC binding site. Stable silencing of HOP was also performed in parental and/or PrPC-depleted cell populations, and proliferation in vitro and tumor growth in vivo were evaluated. Migration assays were performed on laminin-1 pre-coated glass. RESULTS: We observed that, when GBM cells are cultured as neurospheres, they express specific stemness markers such as CD133, CD15, Oct4, and SOX2; PrPC is upregulated compared to monolayer culture and co-localizes with CD133. PrPC silencing downregulates the expression of molecules associated with cancer stem cells, upregulates markers of cell differentiation and affects GSC self-renewal, pointing to a pivotal role for PrPC in the maintenance of GSCs. Exogenous HOP treatment increases proliferation and self-renewal of GSCs in a PrPC-dependent manner while HOP knockdown disturbs the proliferation process. In vivo, PrPC and/or HOP knockdown potently inhibits the growth of subcutaneously implanted glioblastoma cells. In addition, disruption of the PrPC-HOP complex by a HOP peptide, which mimics the PrPC binding site, affects GSC self-renewal and proliferation indicating that the HOP-PrPC complex is required for GSC stemness. Furthermore, PrPC-depleted GSCs downregulate cell adhesion-related proteins and impair cell migration indicating a putative role for PrPC in the cell surface stability of cell adhesion molecules and GBM cell invasiveness, respectively. CONCLUSIONS: In conclusion, our results show that the modulation of HOP-PrPC engagement or the decrease of PrPC and HOP expression may represent a potential therapeutic intervention in GBM, regulating glioblastoma stem-like cell self-renewal, proliferation, and migration.

Saúde Mental na Infância: cuidado e cotidiano nas políticas públicas / Mental Health in Childhood: care and the everyday in public policies / Salud Mental en Infancia: cuidado y cotidiano en las políticas públicas

Este relato de experiência objetiva problematizar as possibilidades de constituição de cuidado em saúde mental tomando a criança e o adolescente como capaz de afetar-se e produzir afetos no outro. A narrativa, constituída em forma de relato de experiência, apoia-se na interface do cotidiano dos serviços de saúde e da assistência social, seja através de experiência profissional, bem como de forma indireta, como as supervisões locais e acadêmicas. Pensar saúde mental na infância e adolescência é partir da ideia de um sujeito integral, considerando sua subjetividade, singularidade e visão de mundo, a partir da constituição de rede de serviços, além de tencionar os mecanismos de cuidado que se estabelecem no contemporâneo para crianças e adolescentes.

This experience report aims to problematize the possibilities of providing mental health care, while considering the child and the adolescent as capable of being self-affecting and mutually productive of affects. The narrative, constituted as an experience report, relies on the daily interfacing of health services and social assistance either directly, through professional experience, or indirectly, through local and academic supervision. To think mental health in childhood and adolescence entails the idea of an integrated subject and consideration of its subjectivity, uniqueness and worldview through its constitution by a service network, in addition to examining the mechanisms of care established in the present for children and adolescents.

Esta experiencia en el informe discute las posibilidades de constitución del cuidado en la salud mental mediante la percepción de los niños y adolescentes como capaces de afectar y de producir afecto en demás. La narración, hecha en forma de informes de la experiencia, se basa en la interfaz cotidiana de los servicios de salud y asistencia social, ya sea a través de la experiencia profesional, así como de forma indirecta, como la supervisión local y académica. Pensar salud mental en la infancia y adolescencia empieza por la noción del sujeto integral, considerando susubjetividad, su singularidad y su punto de vista de mundo, a partir del establecimiento de la red de servicios. Bien como de tensionar los mecanismos de cuidado que se establecen en el contemporáneo para los niños y adolescentes.

Co-infection ofddengue virus by serotypes 1 and4 in patient from medium sized city from Brazil / Co-infeccao por virus dengue, sorotipos 1 e 4, em paciente de cidade de porte medio no Brasil

SUMMARY The natural co-infection with dengue virus can occur in highly endemic areas where different serotypes have been observed for many years. We report one case of DENV-1/DENV-4 co-infection in human serum detected by molecular tests. Phylogenetic analysis of the sequences obtained indicated the presence of genotype V and II for DENV-1 and DENV-4, respectively. .

RESUMO A co-infecção por dengue vírus pode ocorrer em áreas com circulação endêmica, nas quais diferentes sorotipos vêm circulando durante muitos anos. Neste trabalho relatamos um caso de co-infecção por DENV-1/DENV-4 em soro humano, detectado por testes moleculares. Análises filogenéticas das sequências obtidas indicaram a presença do genótipo V e II de DENV-1 e DENV-4, respectivamente. .

Identification of intracellular peptides in rat adipose tissue: Insights into insulin resistance.

Intracellular peptides generated by the proteasome and oligopeptidases have been suggested to function in signal transduction and to improve insulin resistance in mice fed a high-caloric diet. The aim of this study was to identify specific intracellular peptides in the adipose tissue of Wistar rats that could be associated with the physiological and therapeutic control of glucose uptake. Using semiquantitative mass spectrometry and LC/MS/MS analyses, we identified ten peptides in the epididymal adipose tissue of the Wistar rats; three of these peptides were present at increased levels in rats that were fed a high-caloric Western diet (WD) compared with rats fed a control diet (CD). The results of affinity chromatography suggested that in the cytoplasm of epididymal adipose tissue from either WD or CD rats, distinctive proteins bind to these peptides. However, despite the observed increase in the WD animals, the evaluated peptides increased insulin-stimulated glucose uptake in 3T3-L1 adipocytes treated with palmitate. Thus, intracellular peptides from the adipose tissue of Wistar rats can bind to specific proteins and facilitate insulin-induced glucose uptake in 3T3-L1 adipocytes.