Sinais de mudança em autismo: prisma, um instrumento de pesquisa / Signs of change in autism: prisma, an instrument of research / Señales de cambio en autismo: prisma, un instrumento de investigación / Signes de changement en autisme: prisma, un outil de recherche

Neste trabalho, apresentamos o Protocolo de Investigação Psicanalítica de Sinais de Mudança em Autismo, elaborado a partir de um projeto de pesquisa, subsidiado inicialmente pela Associação Psicanalítica Internacional, que busca mapear o desenvolvimento emocional de crianças com transtornos autísticos e sua evolução no tratamento psicanalítico, a fim de demonstrar à comunidade a efetividade do tratamento psicanalítico para promover mudanças psíquicas e favorecer o diálogo com outros profissionais de saúde.

In this paper, we introduce to the reader the Protocol of Psychoanalytic Investigation of Signs Mapping Change in Autism (Prisma). The protocol was developed from a research project, which was first funded by the International Psychoanalytical Association. The purpose is to assess the emotional development in children who suffer from autism spectrum disorders and to evaluate their progress in psychoanalytic treatment. The idea is to demonstrate to the community the effectiveness of psychoanalytic treatment in promoting psychic changes, and to encourage dialogue with other health professionals.

En este trabajo presentamos el Protocolo de Investigación Psicoanalítica de Señales de Cambio en Autismo (Prisma), elaborado a partir de un proyecto de investigación, inicialmente con subsidio de la Asociación Psicoanalítica Internacional, que busca mapear el desarrollo emocional de niños con trastornos autísticos y su evolución en el tratamiento psicoanalítico, con el objetivo de demostrar a la comunidad la eficacia del tratamiento psicoanalítico para promover cambios psíquicos y favorecer el diálogo con otros profesionales de la salud.

Dans ce travail, nous présentons le Protocole de Recherche Psychanalytique de Signes de Changement en Autisme (Prisma), élaboré à partir d'un projet de recherche, subventionné initialement par l'Association Psychanalytique Internationale, qui vise à dessiner le développement émotionnel des enfants atteints de troubles autistiques et leur évolution dans la cure psychanalytique, pour démontrer à la communauté l'efficacité des soins psychanalytiques dans la promotion de changements psychiques, et de favoriser le dialogue avec d'autres professionnels de santé.

O autismo e a clínica dos estados autísticos

O conceito psicanalítico de estados autísticos concedeu à compreensão do autismo uma condição com possibilidade de mudança. Ainda que o diagnóstico identifique essas crianças como autistas, cada uma delas tem um mundo interno com diferentes oportunidades de evolução. A autoestimulação sensorial está associada à dispersão de sentido no autismo. O uso estereotipado dos objetos e do próprio corpo, destituídos de suas funções, mantém a dispersão, impedindo o reconhecimento e o contato com o não-eu. A autora demonstra através de exemplos clínicos que diferentes níveis de funcionamento mental estão em ação ainda que não possam ser percebidos inicialmente.(AU)

The psychoanalytic concept of autistic states allowed the understanding of autism as a condition with the possibility of changing. Even if the diagnosis identifies children as autists each of them has an internal world with different opportunities of evolution. The sensorial auto stimulation is associated to the dispersion of the senses in autism. The stereotyped use of objects and of its body deprived of their own functions keeps the dispersion and prevents the acknowledgement of and the contact with the not-me. The author describes through some clinical examples that different levels of mental activity are still working even if they are do not recognized initially.(AU)

Resection of the epileptogenic lesion abolishes seizures and reduces inflammatory cytokines of patients with temporal lobe epilepsy.

Persistent neuroinflammation is implicated in the pathogenesis of seizures and neuronal degeneration of temporal lobe epilepsy (TLE). Circulating level of inflammatory cytokines was determined during inter-ictal period of 25 non-operated and 10 patients (OP) submitted to anterior temporal lobectomy. OP patients showed marked reduction of IL-1ß, TNFα, MIP-1α, but not IL-6 and TGF-ß1. Paired analysis done before and after lobectomy showed reduction of inflammatory cytokines but increased TGF-ß1 levels, and lack of seizures for more than 6 months. Maintenance of high TGF-ß1 and IL-6 cytokines in both groups suggests a role in down-regulation of neuroinflammation and promotion of brain tissue remodeling for neuronal reorganization.

Intestinal helminthes and/or Toxocara infection are unrelated to anti-HBs titers in seven-year-old children vaccinated at birth with recombinant hepatitis B vaccine.

The aim of this investigation was to evaluate the possible effect of nematode infection on anti-HBs antibody levels in the serum of seven-year-old schoolchildren vaccinated at birth with the recombinant hepatitis B vaccine. Anti-HBs and anti HBc antibodies were evaluated in the sera of 100 schoolchildren with at least one intestinal nematode and/or a positive serological reaction for anti-Toxocara antibodies and in 95 schoolchildren without intestinal helminthiasis or serum anti-Toxocara antibodies. Both groups were from public elementary schools located on the urban periphery of Vitória, ES, Brazil. Among these 195 children, the median anti-HBs antibody titer was 31.3 IU/ml and the frequency of titers less than 10 IU/ml was 33.8% (95% CI: 27.1-40.4%). There were no significant differences between the medians of anti-HBs titers or the frequency of titers less than 10 IU/ml between the groups with or without helminthes (29.5 and 32.9 IU/ml and 33 and 34.7%, respectively; p>0.05). Even when the children with intestinal nematodes and/or anti-Toxocara antibodies and with blood eosinophil counts over 600/mm(3) were compared with children without infection from intestinal nematodes and without anti-Toxocara antibodies, with blood eosinophil counts less than 400 eosinophils/mm(3), these differences were not significant. None of the children presented anti-HBc antibodies. In conclusion, infections with intestinal nematodes and/or the presence of anti-Toxocara antibodies did not interfere with the anti-HBs antibody titers in seven-year-old children vaccinated at birth with the recombinant hepatitis B vaccine.

Intestinal helminthes and/or Toxocara infection are unrelated to anti-HBs titers in seven-year-old children vaccinated at birth with recombinant hepatitis B vaccine

The aim of this investigation was to evaluate the possible effect of nematode infection on anti-HBs antibody levels in the serum of seven-year-old schoolchildren vaccinated at birth with the recombinant hepatitis B vaccine. Anti-HBs and anti HBc antibodies were evaluated in the sera of 100 schoolchildren with at least one intestinal nematode and/or a positive serological reaction for anti-Toxocara antibodies and in 95 schoolchildren without intestinal helminthiasis or serum anti-Toxocara antibodies. Both groups were from public elementary schools located on the urban periphery of Vitória, ES, Brazil. Among these 195 children, the median anti-HBs antibody titer was 31.3IU/ml and the frequency of titers less than 10IU/ml was 33.8 percent (95 percent CI: 27.1-40.4 percent). There were no significant differences between the medians of anti-HBs titers or the frequency of titers less than 10IU/ml between the groups with or without helminthes (29.5 and 32.9IU/ml and 33 and 34.7 percent, respectively; p>0.05). Even when the children with intestinal nematodes and/or anti-Toxocara antibodies and with blood eosinophil counts over 600/mm³ were compared with children without infection from intestinal nematodes and without anti-Toxocara antibodies, with blood eosinophil counts less than 400 eosinophils/mm³, these differences were not significant. None of the children presented anti-HBc antibodies. In conclusion, infections with intestinal nematodes and/or the presence of anti-Toxocara antibodies did not interfere with the anti-HBs antibody titers in seven-year-old children vaccinated at birth with the recombinant hepatitis B vaccine.

O objetivo dessa investigação foi avaliar um possível efeito de infecções por nematóides sobre os níveis de anticorpos anti-HBs no soro de escolares de sete anos de idade, vacinados ao nascer com a vacina recombinante para hepatite B. Anticorpos anti-HBs e anti-HBc foram avaliados no soro de 100 escolares portadores de pelo menos um nematóide intestinal e/ou uma reação sorológica positiva para anticorpos anti-Toxocara e em 95 escolares sem helmintíases intestinais e sem anticorpos séricos anti-Toxocara, todos matriculados em escolas primárias públicas situadas na periferia urbana de Vitória, ES, Brasil. Nas 195 crianças, a mediana dos títulos dos anticorpos anti-HBs foi 31,3UI/ml, e a freqüência de títulos inferiores a 10UI/ml foi de 33,8 por cento (IC a 95 por cento:27,1- 40,4 por cento). Não houve diferença significativa entre as medianas dos títulos de anti-HBs ou da freqüência de títulos inferiores a 10 UI/ml entre as crianças com ou sem helmintos (29,5 e 32,9 UI/ml e 33 e 34,7 por cento, respectivamente; p >0.05). Mesmo quando comparadas crianças com nematóides intestinais e/ou anticorpos anti-Toxocara com eosinófilos circulantes acima de 600/mm³, com crianças sem infecção com nematóides intestinais e sem anticorpos anti-Toxocara, com menos de 400 eosinófilos/mm³, aquelas diferenças não foram significativas. Nenhuma das crianças apresentou anticorpos anti-HBc. Em conclusão, infecções com nematóides intestinais e/ou presença de anticorpos anti-Toxocara não interferem nos títulos de anticorpos anti-HBs em crianças de sete anos de idade, vacinadas ao nascer com a vacina recombinante para hepatite B.

[Synanthropic flies (Diptera: Cyclorrapha) and their microhymenoptera parasitoids (Insecta: Hymenoptera) at Monte Mor poultry production system, São Paulo, Brazil]. / Moscas sinantrópicas (Diptera: Cyclorrapha) e seus parasitóides microhimenópteros (Insecta: Hymenoptera) num plantel avícola de Monte Mor, São Paulo, Brasil.

A survey of synanthropic flies and their microhymenopteran parasitoids was conducted at the Capuavinha poultry farm, municipality of Monte Mor, State of São Paulo, Brazil, from 1991 to 1992. Bird manure samples were collected biweekly for examined and selected by the following methods: flotation in water, dissected pupae, and sentinel pupae. The species of flies more abundant were: Chrysomya putoria (Wiedeman) (41.2% - Calliphoridae), Muscidae: Muscina stabulans( Fallén) (27.3%), Musca domestica Linnaeus (23.9%), Fannia pusio (Stein) (5.3% - Fanniidae) e Sepsidae (2.3%). The pupal parasitoids were: Tachinaephagus zealandicus (Ashmead) (72.4% - Encyrtidae), Pteromalídeos: Spalangia gemina Boucek (9.2%), S. cameroni (Perkins) (7.3%), S. endius (Walker) (3.7%), Muscidifurax raptoroides (Kogan e Legner) (1.5%), Pachycrepoideus vindemiae (Rondani) (0.8%), Nasonia vitripennis Walker (0.06%). Trichopria sp. Nixon (Diapriídeo 5.5%) detected only in C. putoria pupae (t=-1,5269; P <0,1296). Some significant mean values were obtained for parasitoids in the collected hosts (t = 0.9540; Pr <0.0001), proportion of collected pupae and parasitoids with respect to the collecting site (F = 60.85; Pr <0.0001; F = 358.35; P <0.0001) and for the host species and parasitoid species (F = 2.58; Pr <0.0001; F = 9. 48; P <0.0001). The dissected host species was significant for proportion dissected pupae (F = 1.57; Pr <0.2053). These results concerning the insect fauna can be of help for an appropriate management of this poultry farm in terms of the control of synanthropic flies.

Curativo do grande queimado: oclusivo ou de exposiçäo? / Dressing of the severely burned one: occlusive or explosed?

As autoras discorrem sobre os dois tipos de curativos utilizados no tratamento do grande queimado, fazendo consideraçöes acerca de suas vantagens e desvantagens. Trata-se de um relato baseado em observaçöes efetuadas em dois serviços especializados.