Clinical and Epidemiological Characteristics of Mpox in HIV-Infected and Uninfected Men Who Have Sex with Men: A Retrospective Study in Lisbon.

The resurgence of Mpox, predominantly among men who have sex with men (MSM), has prompted an analysis of its clinical manifestations and epidemiological patterns, particularly in individuals living with human immunodeficiency virus (HIV). This retrospective study aims to delineate and compare the clinical presentations and epidemiological characteristics of Mpox among HIV-positive and HIV-negative individuals. A total of 58 confirmed Mpox cases from a dermatology department in Lisbon were analyzed, focusing on mucocutaneous manifestations, systemic symptoms, and laboratory parameters. Our findings indicate no significant difference in disease severity and presentation between HIV-positive and HIV-negative groups, suggesting that HIV status may not be a determinant of Mpox severity, but rather an indicator of increased sexual risk behaviors, a recognized risk factor for Mpox transmission.

Small Bowel Obstruction by a Phytobezoar in a Patient With Previous Antrectomy and Billroth II Reconstruction.

A phytobezoar is a conglomerate of improperly digested fruit and vegetable debris, and its development is associated, amongst other factors, with previous gastric surgery. Most phytobezoars remain asymptomatic and are incidentally found during imaging or interventional procedures. However, in some patients, they can cause small bowel obstruction, which can subsequently lead to severe complications. Although the clinical findings are similar to other causes of intestinal obstruction, there are some particular diagnostic and treatment features more specific to phytobezoars. We present a case of an 85-year-old man with a history of previous antrectomy and Billroth II reconstruction who came to the emergency department with bilateral aspiration pneumonia and intestinal obstruction due to a bezoar. The CT scan showed bilateral inferior lobe pulmonary consolidation, as well as a marked dilation of the small bowel with gas-fluid levels and a transition to normal caliber in the terminal ileum, where an oval mottled-appearing mass suggesting a bezoar was present. An urgent laparotomy confirmed the diagnosis, and an enterotomy with removal of the bezoar was performed. Phytobezoars must be considered as a cause of intestinal obstruction, particularly when patients have a history of previous gastric surgery. Its radiological findings, particularly in CT scans, are specific and should be appreciated to establish the diagnosis promptly. The treatment of small bowel obstruction due to a phytobezoar requires surgery most of the time, and the surgeon must bear in mind the need to look for the existence of other bezoars in the gastrointestinal tract to prevent reoccurrence.

Ischiopubic Ramus Resection as Treatment for Giant Cell Tumor of the Bone: Surgical Techniques in Two Clinical Cases.

Giant cell tumors (GCTs) of the ischium are rare and often diagnosed at an advanced stage. In fact, there is no defined treatment algorithm to treat this lesion. We present two case reports of Campanacci's stage three ischiopubic GCT confirmed with biopsy. They were effectively treated with excision of the ischiopubic ramus, aggressive curettage, drilling, and phenolization at the margins. The surgery was performed in a gynecological position with an approach over the ischiopubic ramus. Both cases present no recurrence (two and 10-year follow-up), and neither has a significant impact on the quality of life. A thorough plan and surgical technique were essential for the success of this intervention.

Trochanteric fractures: Tip-Apex distance, Calcar Tip-Apex distance, and Chang criteria-a multiple variable analysis.

Failure of osteosynthesis is a common complication of the nailing of trochanteric fractures which typically occurs through form of cut-out. Tip-Apex distance (TAD), Calcar Tip-Apex distance (CalTAD), and Chang criteria are validated variables to predict failure of cephalomedullary nailing. This is a retrospective study which analyzes treatment of trochanteric fractures from 2018 to 2020 (n = 296) evaluating postoperative radiographs and factors of mechanical failure. Our objective was to assess correlation among these variables and their influence on mechanical failure, either individually or creating a new score. Our results support the CalTAD and Chang's criteria as valid predictors of mechanical failure. Furthermore, they empathize the importance of fracture reduction and proper placement of cervical screw. To our knowledge, this is the first study performing multivariate analysis including these 3 variables.

Challenges in developmental psychology research during the COVID-19 pandemic / Desafios da pesquisa em psicologia do desenvolvimento durante a pandemia da COVID-19 / Desafíos de la investigación en psicología del desarrollo durante la pandemia de COVID-19

The COVID-19 pandemic brought a series of restructurings necessary for research in Developmental Psychology. The aim of the manuscript is to discuss adaptations we made in our research in this context during the COVID-19 pandemic and to present strategies to adequate research protocols originally designed to occur in person. Although some contexts do not allow the continuity of studies, research at this time can bring essential contributions in this extreme period. This article explores the strategies for adapting recruitment procedures, suggesting dissemination platforms, and using social networks for this purpose. Guidelines are suggested for conducting non-face-to-face interviews with caregivers, ways of assessing the interaction of the mother-child pairs, and problematizing ethical issues. The procedures for returning the results, an ethical researcher commitment, may be improved by resources such as automatic reports. Besides, strategies for better dissemination of the results for the participants are suggested. (AU)

A pandemia COVID-19 trouxe uma série de reestruturações necessárias à pesquisa em Psicologia do Desenvolvimento. O objetivo deste artigo é discutir as adaptações que realizamos em pesquisas neste contexto durante a pandemia de COVID-19 e apresentar estratégias para adequação de protocolos de pesquisa originalmente planejados para ocorrer de forma presencial. Embora alguns contextos não permitam a continuidade dos estudos, pesquisas nesse momento podem trazer importantes contribuições sobre este período ímpar. No presente artigo são exploradas estratégias de adaptação dos procedimentos de recrutamento, sugeridas plataformas de divulgação e como melhor usar as redes sociais para esse fim. Também são descritos procedimentos para realização de entrevistas não presenciais com responsáveis, formas de avaliação da interação das duplas mãe-criança e problematizadas questões éticas. Os procedimentos de devolução dos resultados, um compromisso ético dos pesquisadores, podem ser facilitados por recursos como relatórios automáticos. Além disso, sugerimos estratégias para melhor divulgação dos resultados ao público participante. (AU)

La pandemia del COVID-19 trajo una serie de reestructuraciones necesarias para la investigación en Psicología del Desarrollo. El objetivo de este artículo es discutir las adaptaciones realizadas en las investigaciones en este contexto durante la pandemia de COVID-19 y presentar algunas estrategias para la adaptación de los protocolos de investigación originalmente planeados para ser presenciales. Si bien algunos contextos no permitan la continuidad de los estudios, la investigación en este momento puede aportar importantes avances sobre estos tiempos de crisis. Este artículo explora las estrategias para adaptar los procedimientos de contratación, sugiriendo algunas plataformas de difusión y la mejor manera de utilizar las redes sociales para este fin. También se describen los procedimientos para la realización de entrevistas no presenciales con padres o tutores legales, las formas de evaluar la interacción madre-hijo y las cuestiones éticas. Los procedimientos para la devolución de los resultados, un compromiso ético de los investigadores, pueden verse facilitados por funciones como informes automáticos. Además, se recomienda estrategias para una mejor difusión de los resultados al público participante. (AU)

O medo da morte e do morrer em estudantes da saúde / Fear of death and dying in health students / El miedo a la muerte y a morir en estudiantes de la salud

A morte ainda causa aversão em alunos e profissionais da saúde e é enfrentada como fracasso desde a formação acadêmica. O estudo objetivou de forma geral, avaliar o medo da morte em estudantes da área da saúde. Aplicou-se um questionário sociodemográfico e a escala do medo da morte Collet-Lester em 366 estudantes de medicina, psicologia, enfermagem e fisioterapia. Os resultados indicaram que apenas o curso de medicina e fisioterapia apresentaram diferenças significativas nas subescalas referentes ao medo da morte, nas demais análises levantou-se hipóteses. Identificou-se que houve uma tendência dos estudantes de enfermagem apresentar maior medo em relação à própria morte e os de psicologia em medo do próprio processo de morrer. Concluiu-se que o medo da morte do outro surge como característica comum entre os estudantes dos quatro cursos, apontando diferenças no medo da morte entre os diferentes períodos dos cursos analisados.

Death still causes aversion in students and health professionals and is faced as a failure since academic training. The study aimed, in general, to assess the fear of death in health students. A sociodemographic questionnaire and the Collet-Lester fear of death scale were applied to 366 students of medicine, psychology, nursing and physiotherapy. The results indicated that only the medical and physical therapy courses showed significant differences in the subscales related to fear of death, in the other analyzes, hypotheses were raised. It was identified that there was a tendency for nursing students to be more afraid of their own death and those of psychology to be afraid of their own dying process. It was concluded that the fear of death of the other emerges as a common characteristic among students of the four courses, pointing out differences in fear of death between the different periods of the analyzed courses.

La muerte todavía causa aversión en estudiantes y profesionales de la salud y es enfrentada como un fracaso desde la formación académica. El estudio tuvo como objetivo, en general, evaluar el miedo a la muerte en estudiantes del área de la salud. Se aplicó un cuestionario sociodemográfico y la escala de miedo a la muerte de Collet-Lester a 366 estudiantes de medicina, psicología, enfermería y fisioterapia. Los resultados indicaron que sólo el curso de medicina y fisioterapia presentaron diferencias significativas en las subescalas relacionadas con el miedo a la muerte, en los otros análisis se plantearon hipótesis. Se identificó que los estudiantes de enfermería tenían una tendencia a tener más miedo a su propia muerte y que los estudiantes de psicología tenían miedo del proceso mismo de morir. Se concluyó que el miedo a la muerte del otro surge como una característica común entre los estudiantes de los cuatro cursos, señalando diferencias en el miedo a la muerte entre los diferentes períodos de los cursos analizados.

Escala McGill-UFRGS para avaliação dos grupos de amigos: adaptação e propriedades psicométricas / McGill-UFRGS Scale for evaluation of groups of friends: adaptation and psychometric properties / Escala McGill-UFRGS para la evaluación de los grupos de amigos: adaptación y propiedades psicométricas

O objetivo deste artigo é apresentar o processo de adaptação e as propriedades psicométricas da Escala McGill-UFRGS de avaliação das funções de amizade em grupos de amigos. Participaram do estudo 521 jovens adultos com idades entre 18 e 30 anos (M = 22,68; DP = +-3,21). A estrutura de seis fatores da escala apresentou bons índices de ajuste (CFI = 0,968, TLI = 0,965, RMSEA = 0,067, IC90% = 0,063-0,071) na análise fatorial confirmatória e demonstrou invariância de medida entre gêneros e grupos etários. Os coeficientes de confiabilidade dos fatores da escala foram bons, com alfas de Cronbach variando entre 0,875 e 0,912, e confiabilidade composta variando entre 0,956 e 0,966. A Escala McGill-UFRGS mostra-se uma adaptação válida e confiável para a avaliação das funções de amizade em grupo de amigos entre jovens adultos. (AU)

The purpose of this article was to present the adaptation process and psychometric properties of the McGill-UFRGS Scale for the assessment of friendship functions in peer groups. A total of 521 young adults aged 18 to 30 years (M = 22.68; SD = + 3.21) participated in the study. The six-factor structure of the scale had good fit indices (CFI = 0.968, TLI = 0.965, RMSEA = 0.067, CI90% = 0.063-0.071) in confirmatory factor analysis and demonstrated measurement invariance across sex and age groups. The reliability estimates of the factor scores were good, with Cronbach's alphas ranging from .875 to .912 and composite reliability ranging from .956 to .966. The McGill-UFRGS Scale proved to be a valid and reliable instrument for assessing friendship group functions among young adults. (AU)

El objetivo de este artículo es presentar el proceso de adaptación y las propiedades psicométricas de la Escala McGill-UFRGS para la evaluación de las funciones de amistad en grupos de amigos. Participaron del estudio un total de 521 adultos jóvenes de 18 a 30 años (M = 22,68; DS = +-3,21). La estructura de seis factores de la escala mostró buenos índices de ajuste en el análisis factorial confirmatorio (CFI = 0.968, TLI = 0.965, RMSEA = 0.067, IC90% = 0.063-0.071) y demostró invarianza de medición entre géneros y grupos de edad. Los coeficientes de confiabilidad de los factores de la escala fueron buenos, con alfa de Cronbach oscilando entre 0,875 e 0,912 y confiabilidad compuesta entre 0,956 e 0,966. La escala McGill-UFRGS se presenta como un instrumento válido y fiable para la evaluación de las funciones de amistad en un grupo de amigos entre adultos jóvenes. (AU)

When eating makes you sick - Gastric stump obstruction caused by a phytobezoar. A case report and literature review.

INTRODUCTION AND IMPORTANCE: Bezoars result from undigested material having an incidence of 0.4-1% (Gunner et al., 2012). Impaired gastrointestinal motility is one of the risk factors. The aim of this article is to highlight the importance of this commonly disregarded entity as well as the different treatment modalities available. CASE PRESENTATION: A 68-year-old female presented to our emergency department complaining of colicky lower left abdominal pain associated with vomiting and absence of bowel movements for the past 4 days. She had a previous history of a subtotal gastrectomy due to gastric cancer. The physical examination revealed a lower left quadrant palpable mass. Abdominopelvic CT scan showed distension of the gastric remnant with anastomotic obstruction caused by a bezoar. Attempted endoscopic dissolution of the bezoar was unsuccessful. The patient then underwent surgery enterotomy proximal to the obstruction with extraction of the mass. CLINICAL DISCUSSION: Bezoars are responsible for 0.4%-4% of cases of mechanical gastrointestinal obstruction (Dikicier et al., 2015). Contrast-enhanced CT scan is the best diagnostic test with a sensitivity and specificity of 90% and 57%, respectively (Kim et al., 2003). Treatment options differ according to the type, size and location of the bezoar as well as clinical presentation. Conservative measures such as chemical dissolution and endoscopic fragmentation and extraction can be used with surgery being usually required for a bezoar-induced gastrointestinal obstruction. CONCLUSION: The clinical findings of bezoar-induced ileus do not differ from the other different causes of mechanical intestinal obstruction. Hence, a high grade of suspicion and an early radiological exam are the keys for a prompt diagnosis and treatment.

Wilkie's Syndrome: An Unexpected Finding.

Wilkie's syndrome is a rare pathology caused by extrinsic compression of the third part of the duodenum by the superior mesenteric artery (SMA) at its origin. The symptoms are variable and non-specific consisting of postprandial abdominal pain, nausea and vomiting, early satiety, anorexia, and weight loss. A contrast-enhanced CT scan is the standard imaging modality. Surgery is reserved for severe cases or those unresponsive to pharmacological treatment. We present a case of a 66-year-old woman with a history of prolonged postprandial abdominal pain, nausea, and substantial weight loss (30 kg in four months). Laboratory tests revealed acute renal failure with hypokalemia due to severe dehydration. She underwent an abdominal-pelvic CT scan that showed enlargement of the second and third parts of the duodenum, without an identifiable cause, followed by an upper gastrointestinal (GI) endoscopy that showed a dilated duodenum until D2 and inability of progression to D3, without mucosal abnormalities. Her MRI revealed considerable gastric and proximal duodenum distension with compression of D3 by the SMA. The patient underwent a laparoscopic duodenojejunostomy with intra-operative findings consistent with the diagnosis. The procedure and the postoperative period were uneventful, and the patient was discharged on the ninth postoperative day. Gastrografin study made at day six postop showed normal progression of the oral contrast. At the outpatient reevaluation one month postop, she remained asymptomatic and with progressive weight gain. Wilkie's syndrome is a rare form of intestinal obstruction, which is commonly disregarded. Its non-specific symptoms make it a challenging diagnosis and imply a high clinical suspicion. Among the different surgical options, duodenojejunostomy presents the best outcomes.

Remaining kidney volume indexed to weight as a strong predictor of estimated glomerular filtration rate at 1 year and mid-term renal function after living-donor nephrectomy - a retrospective observational study.

The donors' estimated glomerular filtration rate (eGFR) after living nephrectomy has been a concern, particularly in donors with smaller kindeys. Therefore, we developed this retrospective observational study in 195 donors to determine the ability remaining kidney volume indexed to weight (RKV/W) to predict eGFR at 1 year through multivariate linear regression and to explore this relationship between annual eGFR change from 1 to 4 years postdonation evaluated by a linear mixed model. Comparing RKV/W tertiles (T1, T2, T3), RKV/W was a good predictor of 1-year eGFR which was significantly better in T3 donors. Gender, predonation eGFR, and RKV/W were independent predictors of eGFR at 1-year. In a subgroup with predonation eGFR < 90mL/min/1.73 m2 , a significant prediction of eGFR < 60mL/min/1.73 m2 was detected in males with RKV/W ≤ 2.51cm3 /kg. Annual eGFR (ml/min/year) change from 1 to 4 years was + 0.77. RKV/W divided by tertiles (T1-T3) was the only significant predictor: T2 and T3 donors had an annual eGFR improvement opposing to T1. RKV/W was a good predictor of eGFR at 1 year, independently from predonation eGFR. A higher RKV/W was associated with improved eGFR at 1 year. A decline in eGFR on the four years after surgery was only noticeable in donors with RKV/W ≤ 2.13cm3 /kg.

Tibialis Posterior Tendon Dislocation: A Case Report.

CASE: A 37-year-old man presented after a sudden snap followed by pain in the medial side of the ankle while playing football. Physical examination showed edema and pain posteriorly to the medial malleolus, and a longitudinal structure was palpable anteriorly. Ultrasound confirmed a dislocated tibialis posterior tendon (TPT). The patient underwent surgery, and the flexor retinaculum was repaired. Six months after the surgery, he was asymptomatic and had resumed his usual physical activity, with an AOFAS score of 100. CONCLUSION: TPT dislocation is rare and orthopaedic surgeons should be aware of this condition in patients with a sudden traumatic medial ankle pain.

Prostate biopsy evolution and the need for repeat biopsy - The role of image and new prostate cancer biomarkers. / Evolución de la biopsia prostática y de la necesidad de biopsias repetidas. Papel de las pruebas de imagen y de los nuevos biomarcadores de cáncer de próstata.

Prostate Cancer (PC) is the most common malignancy in men, and a diagnosis can only be confirmed following a prostate biopsy (PB). 10-12 cores ultrasound-guided PB is currently the state of the art in the primary diagnosis of PC, presenting clear advantages in terms of detection rate of clinically significant PC, pathology concordance, and both positive and negative predictive value, when compared with the former classical sextant biopsy. Persistent clinical suspicion of PC despite previous negative PB is a challenging topic, with several serum and urinary markers, as well as imaging techniques, aiming to help in the optimal management of these patients.Currently, the most accepted and used methods in clinical practice to reduce the number of unnecessary PBs in this subset of patients are Prostate Cancer Antigen 3 (PCA3) and multiparametric MRI (mpMRI). These methods have shown to improve the diagnostic accuracy of prostatic rebiopsy, but there still aren't clear guidelines defining the optimal strategy in this setting. New biomarkers have been proposed in recent years with the aim of increasing specificity and distinguishing aggressive from non-aggressive PC, highlighting the emerging role of the Prostate Health Index (PHI) and the Four Kallikrein (4k) score. The aim of this review is to demonstrate the evolution to the actual standard 10-12 core ultrasound-guided PB, the indications and controversies concerning repeated PB and to explore the data regarding the potential role of the leading methods affecting the decision to rebiopse - PCA3 and mpMRI -, as well as new PC biomarkers used in the clinical practice (PHI and 4K score).

OBJETIVO: El cáncer de próstata (CP) es el tumor maligno más frecuente en el varón y solo puede confirmarse después de una biopsia de próstata (BP). La BP guiada por ecografía con 10-12 muestras es actualmente el patrón de referencia en diagnóstico primario de CP, y presenta claras ventajas en términos de tasas de detección de CP clínicamente significativo, concordancia de la anatomía patológica, y valores predictivos positivo y negativo en comparación con la clásica biopsia sextante previa. La sospecha clínica persistente de CP con biopsias previas negativas es un desafio, en el que disponemos de varios marcadores séricos y urinarios, así como técnicas de imagen, que buscan ayudar en el manejo óptimo de estos pacientes.Actualmente, los métodos más aceptados y utilizados en la práctica clínica para reducir el número de BP innecesarias en este subgrupo de pacientes son el PCA3 (Antígeno de cáncer de próstata 3) y la RMN multiparamétrica (RMNmp). Estos métodos han mostrado que mejoran la precisión diagnóstica de la rebiopsia de próstata, pero todavía no hay guías claras definiendo cual es la estrategia óptima en este escenario. Se han propuesto nuevos biomarcadores en los últimos años con el objetivo de aumentar la especificidad y distinguir entre CP agresivo y no agresivo, destacando el papel emergente del índice de salud prostática (PHI Prostate health index9 y de la puntuación 4 K (4 Kalicreinas). El objetivo de esta revisión es demostrar la evolución del estándar actual de BP guiada por ecografía de 10- 12 muestras, las indicaciones y controversias en relación con las biopsias repetidas y la exploración de datos en relación con el rol potencial de los métodos predominantes que afectan a la decisión de repetir biopsia -- PCA3 y RMNmp--, así como los nuevos biomarcadores de CP utilizados en la práctica clínica (PHI y puntuación 4K).

"Viver dignamente": necessidades e demandas de saúde de homens trans em Salvador, Bahia, Brasil / "Living with dignity": health needs and demands of trans men in Salvador, Bahia State, Brazil / "Vivir dignamente": necesidades y demandas de salud de hombres transexuales en Salvador, Bahía, Brasil

Resumo: Este artigo discute as necessidades e demandas de saúde de homens trans, tema pouco estudado que, com frequência, interpela a construção de práticas de cuidado em saúde para esta população. Foi realizada uma pesquisa qualitativa composta de observação participante e entrevistas semiestruturadas com dez homens trans residentes em Salvador, Bahia, Brasil, em sua maioria negros, heterossexuais e com idades entre 20 e 43 anos. A análise foi baseada na antropologia interpretativa, articulada às críticas do pressuposto da interseccionalidade e da perspectiva decolonial. As necessidades e demandas de saúde dos homens trans são organizadas em três aspectos: a despatologização, a modificação corporal e os atendimentos ambulatoriais. Esses não são universais entre todos os homens trans e podem ser decorrentes de situações que assinalam conflitos e pressões grupais. A ausência do processo transexualizador no estado e as barreiras no acesso à rede de atenção à saúde intensificam o processo de mercantilização das suas demandas de saúde, em especial, as modificações corporais. Conclui-se que a transfobia estrutural faz disparar uma série de questões de saúde, ao mesmo tempo em que limita as possibilidades de obtenção de cuidado. A despatologização das vivências trans constitui o eixo central com base no qual o cuidado deve ser pensado, relacionando-a a mudanças culturais, políticas e sociais que impliquem a construção de uma sociedade não transfóbica e incidam no bem-estar e reconhecimento dos homens trans.

Abstract: This article discusses the health needs and demands of trans men, a topic that has received little attention and frequently calls for the development of specific health care practices for this population. A qualitative study was performed, consisting of participant observation and semi-structured interviews with trans men residing in Salvador, Bahia State, Brazil, the majority of whom were black, heterosexual, and 20 to 43 years of age. The analysis was based on interpretative anthropology, linked to critique of the assumption of intersectionality and the decolonial perspective. The health needs and demands of trans men are organized in three aspects: de-pathologization, body modification, and outpatient care. These aspects are not universal among trans men and may result from situations that indicate group conflicts and pressures. The absence of transsexualization process in the state of Bahia and barriers to accessing the health care network intensify the commodification of trans men's health demands and especially body modifications. The study concludes that structural transphobia triggers a series of health issues, while limiting the possibilities for obtaining care. The de-pathologization of trans experiences constitutes the central basis for conceiving care, relating it to cultural, political, and social changes that involve the construction of a non-transphobic society and foster the well-being and recognition of trans men.

Resumen: Este artículo discute las necesidades y demandas de salud de hombres transexuales, tema poco estudiado que, con frecuencia, requiere la construcción de prácticas de cuidado de salud para esta población. Se realizó una investigación cualitativa, compuesta de diez hombres transexuales residentes en Salvador, Bahia, Brasil, en su mayoría negros, heterosexuales y con edades entre 20 y 43 años. El análisis se basó en la antropología interpretativa, vinculada a críticas del presupuesto de la interseccionalidad y desde una perspectiva decolonial. Las necesidades y demandas de salud de los hombres transexuales se organizan en torno a tres aspectos: despatologización, modificación corporal y atención ambulatoria. Estos no son universales entre todos los hombres transexuales y pueden derivarse de situaciones que indican conflictos y presiones grupales. La ausencia del proceso transexualizador en el estado y las barreras en el acceso a la red de atención de la salud intensifican el proceso de mercantilización de sus demandas de salud, en especial, las modificaciones corporales. Se concluye que la transfobia estructural dispara una serie de cuestiones de salud, al mismo tiempo que limita las posibilidades de obtención de cuidado. La despatologización de las vivencias trans constituye el eje central, en base al cual se debe pensar el cuidado, relacionándolo con cambios culturales y políticas sociales que impliquen la construcción de una sociedad no transfóbica e incidan en el bienestar y reconocimiento de los hombres transexuales.

Adaptação Transcultural e Estrutura Fatorial da Versão Brasileira da Escala Right-Wing Authoritarianism / Adaptación Transcultural y Estructura Factorial de la Versión Brasileña de la The Right-Wing Authoritarianism / Cross-Cultural Adaptation and Factor Structure of the Brazilian Version of the Right-Wing Authoritarianism

Resumo A escala mais utilizada para avaliar autoritarismo é a Escala de Autoritarismo de Direita (EAD) originalmente denominada Right-Wing Authoritarianism (RWA). Ela avalia autoritarismo decorrente de crenças associadas à direita política, correlacionando-se com construtos como homofobia, oposição a direitos civis de transexuais, conformidade social e autodeclaração como partidário da direita política. Embora já tenha sido utilizada em contexto nacional assistematicamente, não foram feitos estudos de adaptação para o Brasil. O presente estudo buscou adaptar a EAD para a língua portuguesa e analisar suas propriedades psicométricas no contexto brasileiro através de análise fatorial exploratória. A versão adaptada da EAD apresentou estrutura de quatro fatores com bons índices de consistência interna: Autoritarismo (α = 0,936), Constestação à Autoridade (α = 0,858), Tradicionalismo (α = 0,871) e Submissão à Autoridade (α = 0,897). A medida também apresentou validade de critério entre grupos, bem como validade convergente e divergente. Por fim, conclui-se que ela é válida e confiável para investigação de autoritarismo na população brasileira.

Resumen El instrumento más utilizado para evaluar el autoritarismo es la Right-Wing Authoritarianism (RWA). El instrumento evalúa el autoritarismo relacionado con las creencias comúnmente asociadas a la ideología derechista, y se correlaciona con la homofobia, la oposición a los derechos civiles de transexuales, la conformidad social y la auto-categorización como un partidario de la derecha política. El instrumento fue utilizado en el contexto brasileño, pero no hay estudios que lo adapten al contexto nacional. Este estudio buscó adaptar la RWA a portugués brasileño y analizar sus propiedades psicométricas en el contexto brasileño mediante análisis factorial exploratorio. La versión culturalmente adaptada ha mostrado una estructura de cuatro factores y ótimos índices de consistencia interna: Autoritarismo (α = 0,936), Contestación a Autoridad (α = 0,858), Tradicionalismo (α = 0,871) y Sumisión a Autoridad (α = 0,897). El instrumento también muestra la validez de criterio entre grupos, así como la validez convergente y divergente. La medida es válida y fiable para la investigación del autoritarismo en la población brasileña.

Abstract The most widely used scale to assess authoritarianism is the Right-Wing Authoritarianism (RWA). It assesses authoritarianism related to thoughts commonly associated to the right-wing ideology, and it is correlated to homophobia, opposition to transsexuals' civil rights, social conformity and self-categorization as a right-wing partisan. Although it has already been used in Brazilian context, there are no studies adapting it to the national context. This study sought to adapt RWA to Brazilian Portuguese and analyze its psychometric properties in the Brazilian context through exploratory factor analysis. The cross-culturally adapted version displayed a four-factor structure and good internal consistency indexes: Authoritarianism (α= 0,936), Contestation to Authority (α= 0,858), Traditionalism (α= 0,871) and Submission to Authority (α = 0,897). The instrument also displayed criterion validity between groups, as well as convergent and divergent validity. Therefore, the measure is valid and reliable for the investigation of authoritarianism in the Brazilian population.

Invariância de medida e evidências de validade externa da Peer Aggressive Behavior Scale (PAB-S) / Measurement invariance and evidence of external validity of the Peer Aggressive Behavior Scale (PAB-S) / Invariancia de medida y evidencias de validez externa de la Peer Aggressive Behavior Scale (PAB-S)

Os comportamentos agressivos são comuns na infância, o que exige o uso de instrumentos adequados para mensurá-los. O objetivo deste estudo foi testar a invariância de medida da Peer Aggressive Behavior Scale (PAB-S) e investigar evidências de validade baseadas na relação com variáveis externas. Participaram 237 cuidadores (M=38,5; DP=7,02; 70,6% mães) e 1.370 crianças, com idades entre 7 e 13 anos (M=9,87; DP=1,28; 53,1% meninas), estudantes de escolas de ensino fundamental de três estados brasileiros. A Análise Fatorial Confirmatória Multigrupo demonstrou invariância configural escalar e métrica da PAB-S. Já a Modelagem de Equações Estruturais indicou evidências de validade concorrente e convergente. Os resultados apontam para as adequadas propriedades psicométricas da PAB-S, sugerindo sua adequação para uso no contexto brasileiro. Novos estudos deverão ser conduzidos para agregar outras evidências de validade e confiabilidade da PAB-S.

Aggressive behavior is common in childhood, which requires the use of appropriate instruments to measure them. The aim of this study was to test the measurement invariance of the Peer Aggressive Behavior Scale (PAB-S) and to investigate evidence of validity based on the association with other external variables. Participants were 237 caregivers (M=38.5; SD=7.02, 70.6% mothers) and 1,370 children, aged 7 to 13 years (M=9.87, SD=1.28, 53.1% girls), students from elementary schools in three Brazilian states. The Multigroup Confirmatory Factor Analysis demonstrated configural, scalar and metric invariance of the PAB-S. The Structural Equation Modeling indicated adequate evidence of concurrent and convergent validity. The results demonstrate adequate psychometric properties of the PAB-S, suggesting its adequacy for use in the Brazilian context. Further studies should be conducted to further evidence the validity and reliability of the PAB-S.

Los comportamientos agresivos son comunes en la infancia, lo cual exige el uso de instrumentos adecuados para evaluarlos. El objetivo de este estudio fue testar la invariancia de medida de la Peer Aggressive Behavior Scale (PAB-S) e investigar evidencias de validez baseada en la relación con otras variables externas. Participaron 237 cuidadores (M =38,5; DP=7,02; 70,6% mamás) y 1370 niños, con edades entre 7 y 13 años (M=9,87; DP=1,28; 53,1% niñas), estudiantes de colegios de primaria de tres estados brasileños. El Análisis Factorial Confirmatório Multigrupo demonstró la invariancia configural escalar y métrica de la PAB-S. Ya el Modelaje de Ecuaciones Estructurales indicó evidencias adecuadas de validez concurrente y convergente. Los resultados señalas que las propiedades psicométricas de la PAB-S son adecuadas, lo cual sugiere que esta escala es pertinente para el uso en el contexto brasileño. Nuevos estudios deberían ser conduzidos para agregar otras evidencias de validez y confiabilidad de la PAB-S.

Entre o especialismo e o apoio: psicólogos no Núcleo de Apoio à Saúde da Família / Between specialism and support: psychologists in Support Center for Family Health / Entre le spécialisme et le suport: Psychologues dans le "Núcleo de Apoio à Saúde da Família (Noyaux de Suport à la Santé de la Famille) / Entre el soporte y especialización: psicólogos en Centros de Apoyo a Salud de la Familia

A inserção do psicólogo em equipes multiprofissionais e interdisciplinares para suporte às equipes de saúde da família, a partir da criação dos Núcleos de Apoio à Saúde da Família em 2008, foi priorizada, ainda que sem um claro perfil para sua atuação. Isso levou ao questionamento das implicações de um trabalho voltado à atenção e gestão para a Psicologia. Objetivou-se analisar o processo de implantação do NASF e a prática dos psicólogos em dois municípios do estado do Rio Grande do Norte. Utilizou-se análise de documentos oficiais e roteiros de entrevistas semiestruturadas distintos, para psicólogos (um do município A e dois do município B) e coordenadores (dois, um de cada município). Pôde-se inferir que a atuação psicológica revela enfoques tradicionais e uma reprodução de atividades de outras instituições. Conclui-se que as diferenças nos processos de implantação dos serviços criam os próprios instrumentos para reversão dessa lógica.

The institution of Núcleo de Apoio a Saúde da Família (NASF) at 2008 structured multiprofessional and interdisciplinary teams, in which psychologists are considered main professional. Models related to psychological actions are not defined, raising questions about implications about a work that is health caring as much as managing service. This study aims to clarify the connection between NASF's deployment process and the effective practice of psychologist inserted at the service, at two cities of Rio Grande do Norte (RN). It was used analysis of official documents and different semi-structured interviews to psychologists (3) and coordinators (2). Through a comparison analysis may be infered that the psychological practice reveals a traditional approach and reproduces practices from different institutions. Also, the differences of services deployment process set a way to revert that logic.

L'insertion du psychologue en équipes multiprofessionnelles et interdisciplinaires pour le support aux équipes de santé de la famille, à partir de la création des NASFs (Núcleos de Apoio a Saúde da Família - Noyaux de Support à la Santé de la Famille) en 2008, a été priorisé, même sans un profil nette pour son action. Cela a provoqué le questionement des implications d'un travail destiné à l'attention et à la gestion pour la Psychologie. L'intention a été d'analyser le processus d'implantation du NASF et la pratique des psychologues dans deux villes de l'état du Rio Grande do Norte. On a utilisé l'analyse des documents officiels et des dialogues d'entretien semiestructurés distingués, pour des psychologues (1 de la ville A et 2 de la ville B) et des coordinateurs (2, un de chaque ville). On peut comprendre que l'actuation a eposé des mises au point plutôt traditionnels et une reproduction d'activités d'autres institutions. On peut conclure que les différences sur les processus d'implantation des services créent eux mêmes les instrument pour la reversion de cette logique.

La inclusión de psicólogos en equipos multidisciplinarios e interdisciplinarios para apoyar a los equipos de salud de la familia, desde la creación de Núcleos de Apoio a Saúde da Família en 2008, se dio prioridad, aunque sin un perfil claro para su actuación. Esto llevó al cuestionamiento de las implicaciones de un trabajo dirigido a la atención y gestión para la Psicología. Este estudio tuvo como objetivo analizar el proceso de implementación del NASF y la práctica de los psicólogos en dos municipios del estado de Rio Grande do Norte. Se utilizó el análisis de documentos oficiales y guiones diferentes de entrevistas semi-estructuradas a los psicólogos (uno de la ciudad A y dos de la ciudad B) y coordinadores (2, uno de cada ciudad). Resultó que la actuación psicológica revela enfoques tradicionales y una reproducción de actividades de otros contextos y se conclui que las diferencias en los procesos de implementación de servicio crean los instrumentos para revertir esta lógica.

Risk-benefit assessment of Bacillus Calmette-Guérin vaccination, anti-phenolic glycolipid I serology, and Mitsuda test response: 10-year follow-up of household contacts of leprosy patients

Abstract: INTRODUCTION: Despite multidrug therapy, leprosy remains a public health issue. The intradermal Bacillus Calmette-Guérin (BCG) vaccine, Mitsuda test (lepromin skin test), and anti-phenolic glycolipid I (PGL-I) serology are widely used in leprosy studies and have shown great epidemiological value. METHODS: This longitudinal study evaluated the relative risks and benefits of these three tools by comparing results observed in household contacts (HHCs) of leprosy patients who developed leprosy with those of HHCs who did not in a population of 2,992 individuals monitored during a 10-year period. RESULTS : Seventy-five (2.5%) new leprosy cases were diagnosed, including 28 (0.9%) co-prevalent cases. Therefore, for the risk-benefit assessment, 47 (1.6%) HHCs were considered as truly diagnosed during follow-up. The comparison between healthy and affected contacts demonstrated that not only did BCG vaccination increase protection, but boosters also increased to 95% relative risk (RR) reduction when results for having two or more scars were compared with having no scars [RR, 0.0459; 95% confidence interval (CI), 0.006-0.338]. Similarly, Mitsuda reactions >7mm in induration presented 7-fold greater protection against disease development compared to reactions of 0-3mm (RR, 0.1446; 95% CI, 0.0566-0.3696). In contrast, anti-PGL-I ELISA seropositivity indicated a 5-fold RR increase for disease outcome (RR, 5.688; 95% CI, 3.2412-9.9824). The combined effect of no BCG scars, Mitsuda reaction of <7mm, and seropositivity to anti-PGL-I increased the risk for leprosy onset 8-fold (RR, 8.109; 95% CI, 5.1167-12.8511). CONCLUSIONS: The adoption of these combined assays may impose measures for leprosy control strategies.