Neisseria meningitidis aislada de muestras de hombres que tienen sexo con hombres / Neisseria meningitidis isolated from patients in men who have sex with men

Resumen En los períodos 2000-2004 y 2014-2015 se investigó la presencia de Neisseria meningitidis en 1.143 y 544 hombres que tienen sexo con hombres respectivamente, atendidos en el marco de un programa de enfermedades de transmisión sexual. Se determinó la prevalencia de este agente, su distribución en serogrupos y su sensibilidad a los antimicrobianos. Se obtuvieron hisopados faríngeos, rectales y uretrales, que se sembraron en medio selectivo Thayer Martin modificado. La identificación se realizó mediante pruebas bioquímicas convencionales y por espectrometría de masas (MALDI-TOF). En el segundo período estudiado, sobre 85 aislamientos procedentes de faringes se investigaron los serogrupos B, C, W e Y mediante PCR. Se determinó la CIM de penicilina, ceftriaxona, rifampicina, azitromicina y ciprofloxacina en 66 aislamientos obtenidos en el primer período y en 102 logrados en el segundo. La prevalencia de N. meningitidis fue del 17,8% en el primer período y del 28,1% en el segundo; este microorganismo se aisló más frecuentemente de fauces. Los serogrupos hallados fueron B (31,5%), Y (7,6%) y W (3,3%), con un 9,8% de aislamientos no capsulados; los restantes corresponderían a otros serogrupos. El 34,8% y el 63,7% de los aislados estudiados correspondientes al primer y segundo período, respectivamente, tuvieron sensibilidad intermedia a la penicilina, y un 11,8% de los evaluados en el segundo período fueron resistentes a dicho antibiótico. Todos los aislados estudiados fueron sensibles a ceftriaxona y a ciprofloxacina (excepto 3, con CIM entre 0,25 y 0,5(g/ml), el 3% fueron resistentes a rifampicina y el 2% fueron no sensibles a azitromicina. La portación de N. meningitidis en hombres que tienen sexo con hombres fue elevada y hubo un alto porcentaje de cepas no sensibles a penicilina. El serogrupo B fue prevalente.

Abstract During the periods 2000-2004 and 2014-2015, Neisseria meningitidis was investigated in men who have sex with men, 1143 and 544 respectively, who consulted in the sexually-transmitted disease program. Prevalence, serogroup distribution and susceptibility to antibiotics were determined. Pharyngeal, rectal and urethral swabs were cultivated on selective Thayer-Martin modified medium. The identification was performed by biochemical tests and mass spectrometry by MALDI-TOF. Serogroups B, C, W and Y were investigated by PCR in 85 isolates recovered from the pharynx belonging to the second period. MICs of penicillin, ceftriaxone, rifampicin, azithromycin and ciprofloxacin were determined for 66 and 102 isolates from periods 1 and 2 respectively, according to CLSI. The prevalence of N. meningitidis was 17.8% and 28.1%, in periods 1 and 2 respectively; the isolates were mainly recovered from the pharynx. The distribution of serogroups was B 31.5%; Y 7.6%; W 3.3% and 9.8% non-capsulated and the rest would belong to other serogroups. Isolates classified as intermediate to penicillin were 34.8% and 63.7% (first and second periods, respectively); moreover, 11.8% of the isolates from the second period were resistant. All isolates were susceptible to ceftriaxone, to ciprofloxacin (except 3 isolates with MIC values between 0.25 and 0.5(g/ml), 3% were resistant to rifampicin and 2% were not susceptible to azithromicin. The prevalence of N. meningitidis carriage in men who have sex with men was high with a high rate of penicillin non-susceptible isolates. B was the prevalent serogroup.

Incorporation of the rapid HIV test in a sexually-transmitted disease clinic in Buenos Aires: Dramatic increase in the frequency of HIV diagnosis.

Improving access to diagnosis constitutes a key step in the control of the Human immunodeficiency virus (HIV)/AIDS epidemic. Rapid testing is increasingly gaining interest as a powerful diagnostic tool to achieve this goal. The purpose of this study was to implement the rapid HIV test (RHT) in a clinical setting in order to evaluate its effectiveness in increasing HIV diagnosis and patient linkage to the healthcare system. The RHT was offered to all patients attending a sexually-transmitted disease clinic in the City of Buenos Aires between March and December 2015. A total of 593 RHT were performed. The implementation of the RHT yielded an increase in frequency of diagnosis from 6.9% to 31.4% (p<0.001). The first steps of the care cascade showed high retention rates around 90%. RHT yielded an HIV prevalence of 6.3% (95% CI: 4.2-8.5) in this population. HIV prevalence tended to be higher in individuals with no previous HIV testing (p=0.09). Linkage to the healthcare system was associated with a higher probability of having been tested for HIV (p=0.008). The incorporation of the RHT resulted in a high retention of patients and an increase in both frequency of diagnosis and results reception when compared to the classic methodology.

[Neisseria meningitidis isolated from patients in men who have sex with men]. / Neisseria meningitidis aislada de muestras de hombres que tienen sexo con hombres.

During the periods 2000-2004 and 2014-2015, Neisseria meningitidis was investigated in men who have sex with men, 1143 and 544 respectively, who consulted in the sexually-transmitted disease program. Prevalence, serogroup distribution and susceptibility to antibiotics were determined. Pharyngeal, rectal and urethral swabs were cultivated on selective Thayer-Martin modified medium. The identification was performed by biochemical tests and mass spectrometry by MALDI-TOF. Serogroups B, C, W and Y were investigated by PCR in 85 isolates recovered from the pharynx belonging to the second period. MICs of penicillin, ceftriaxone, rifampicin, azithromycin and ciprofloxacin were determined for 66 and 102 isolates from periods 1 and 2 respectively, according to CLSI. The prevalence of N. meningitidis was 17.8% and 28.1%, in periods 1 and 2 respectively; the isolates were mainly recovered from the pharynx. The distribution of serogroups was B 31.5%; Y 7.6%; W 3.3% and 9.8% non-capsulated and the rest would belong to other serogroups. Isolates classified as intermediate to penicillin were 34.8% and 63.7% (first and second periods, respectively); moreover, 11.8% of the isolates from the second period were resistant. All isolates were susceptible to ceftriaxone, to ciprofloxacin (except 3 isolates with MIC values between 0.25 and 0.5µg/ml), 3% were resistant to rifampicin and 2% were not susceptible to azithromicin. The prevalence of N. meningitidis carriage in men who have sex with men was high with a high rate of penicillin non-susceptible isolates. B was the prevalent serogroup.

Ideologia esportiva e formação do indivíduo: contribuições da Teoria Crítica do Esporte / Idéologie sportive et la formation de l'individu: contributions de la Théorie Critique du Sport / Ideología deportiva y la formación del individuo: las contribuciones de la Teoría Crítica de Deporte / Sports ideology and formation of the individual: contributions from the Critical Theory of Sports

Resumo Este ensaio apresenta o debate empreendido em meados da década de 1960, na França, pelo movimento teórico e político denominado Teoria Crítica do Esporte. Essa perspectiva ocorreu em meio ao clima cultural emergente naquele período, marcado pela crítica às instituições vigentes e propunha o desvelamento dos elementos subjacentes à hegemonia da ideologia esportiva na cultura, particularmente na mídia, nos clubes e escolas. O texto apresenta os principais argumentos de seus idealizadores, sobretudo os concebidos por Jean-Marie Brohm, aproximando suas inquietações com contribuições oriundas de autores que marcaram a primeira geração da Teoria Crítica da Sociedade, notadamente Theodor W. Adorno, Max Horkheimer e Hebert Marcuse. O ensaio incide sobre as críticas tecidas por esses autores com a finalidade de compreender os fundamentos do movimento esportivo, concebido como objeto cultural de ampla disseminação e importância para a formação do indivíduo sob a égide do capitalismo.

Résumé Cet article présente la discussion menée au milieu des années 1960 en France, le mouvement théorique et politique appelée la théorie critique Sport. Cette perspective est venu au milieu du nouveau climat culturel d'époque, marquée par la critique des institutions existantes et a proposé le dévoilement des éléments sous-jacents à l'hégémonie de l'idéologie de sport dans la culture, en particulier dans les médias, les clubs et les écoles. Le texte présente les principaux arguments de ses fondateurs, en particulier ceux conçus par Jean-Marie Brohm, apportant leurs préoccupations avec les contributions des auteurs qui ont marqué la première génération de la théorie critique de la société, notamment Theodor W. Adorno, Max Horkheimer et Herbert Marcuse. Le test se concentre sur les critiques formulées par les auteurs afin de comprendre les fondements du mouvement sportif, conçu comme un objet culturel de large diffusion et de l'importance à la formation de l'individu sous l'égide du capitalisme.

Resumen En este trabajo se presenta el debate llevado a cabo a mediados de la década de 1960 en Francia, el movimiento teórico y político llamado Teoría Crítica del Deporte. Esta perspectiva se produjo en medio del clima cultural que emerge de ese período, marcado por la crítica de las instituciones existentes y propuso la presentación de los elementos que subyacen a la hegemonía de la ideología de los deportes en la cultura, en particular en los medios de comunicación, clubes y escuelas. El texto presenta los principales argumentos de sus creadores, especialmente los diseñados por Jean-Marie Brohm, con lo que sus preocupaciones con contribuciones de autores que marcaron la primera generación de la teoría crítica de la sociedad, en particular Theodor W. Adorno, Max Horkheimer y Hebert Marcuse. La prueba se centra en las crítica de los autores con el fin de comprender los fundamentos del movimiento deportivo, concebido como un objeto cultural de amplia difusión e importancia a la formación de la persona bajo los auspicios del capitalismo.

Abstract This paper presents the debate undertaken in the mid-1960s in France, by the theoretical and political movement called Critical Theory of Sports. This perspective came amid the emerging cultural climate in that period, marked by criticism of existing institutions and proposed the unveiling of the elements underlying the hegemony of sports ideology in culture, particularly in the media, clubs and schools. The text presents the main arguments of its creators, especially those designed by Jean-Marie Brohm, bringing their concerns with contributions from authors that marked the first generation of Critical Theory of Society, notably Theodor W. Adorno, Max Horkheimer and Hebert Marcuse. The test focuses on the criticism leveled by the authors in order to understand the fundamentals of the sports movement, conceived as a cultural object of wide spread and importance to the formation of the individual under the aegis of capitalism.

Evaluation of the utility of a rapid test for syphilis at a sexually transmitted disease clinic in Buenos Aires, Argentina.

Even though syphilis can be easily diagnosed by simple and low-cost laboratory methods, it continues to be an important health problem. Rapid tests (RT) for the detection of treponemal antibodies can facilitate earlier diagnosis, access to treatment and linkage to care. The aim of this study was to analyse the usefulness of the incorporation of a RT in the detection of patients infected with T. pallidum in a sexually-transmitted disease (STD) clinic. Between March and December 2015, a syphilis RT was offered to patients who spontaneously attended the clinic. Conventional serology testing was additionally indicated to every participant. The RT for syphilis was offered to 1887 patients, of whom 31.1% agreed to get tested. VDRL test was performed in 84.0% of patients that were also tested with syphilis RT, with a significantly higher frequency observed among participants with reactive RT (94.3% vs. 79.8%, p < 0.001). These results showed that 33.7% of the participants were reactive for the RT and 27.0% were reactive for the VDRL test. Both tests were reactive in 24.9% and non-reactive in 64.3%. A high prevalence of active syphilis was detected in patients attending the clinic. The use of a syphilis RT had a positive impact, which in combination with the VDRL test increased the number of patients that were effectively diagnosed.

Molecular typing of Treponema pallidum isolates from Buenos Aires, Argentina: Frequent Nichols-like isolates and low levels of macrolide resistance.

A total of 54 clinical samples, including genital lesion swabs, whole blood and cerebrospinal fluid from patients diagnosed with syphilis were collected in 2006 and in 2013 in Buenos Aires, Argentina. Treponemal DNA was detected in 43 of the analyzed samples (79.6%) and further analyzed using Sequencing-based molecular typing (SBMT) and Enhanced CDC-typing (ECDCT). By SBMT, 10 different Treponema pallidum subsp. pallidum (TPA) genotypes were found, of which six were related to the TPA SS14 strain, and four to the TPA Nichols strain. The 23S rRNA gene was amplified in samples isolated from 42 patients, and in six of them (14.3%), either the A2058G (four patients, 9.5%) or the A2059G (two patients, 4.8%) mutations were found. In addition to Taiwan, Madagascar and Peru, Argentina is another country where the prevalence of Nichols-like isolates (26.8%) is greater than 10%.

Estado actual de la gonorrea / Current state of gonorrhea

La gonorrea es una infección de transmisión sexual conocida desde la antigüedad que se ha perpetuado en el tiempo. Su agente etiológico, Neisseria gonorrhoeae, fue adquiriendo resistencia a la mayoría de los antimicrobianos utilizados para su tratamiento empírico. Las resistencias emergentes en los últimos años son a fluorquinolonas, macrólidos y cefalosporinas orales y parenterales. Hay aislamientos multirresistentes que plantean un desafío para su tratamiento. En países donde estos hallazgos ocurrieron precedentemente, la experiencia de tratamientos con antibióticos no convencionales, por ejemplo aminoglucósidos, es limitada y también emergieron cepas resistentes. Una de las estrategias utilizadas frente a la sensibilidad disminuida a ceftriaxona es aumentar la dosis o utilizar tratamientos combinados. En el marco actual de la multirresistencia de este microorganismo es importante promover la prevención de la infección, realizar vigilancia epidemiológica y buscar nuevas estrategias para su tratamiento.

Gonorrhea is a sexually transmitted infection known since antiquity that has been perpetuated over time. Its etiologic agent, Neisseria gonorrhoeae, was becoming resistant to most antimicrobials agents used for empiric therapy. Emerging resistance in recent years are fluoroquinolones, macrolides, oral and parenteral cephalosporins. There are multiresistant isolates that represent a challenge for its treatment. In countries where these findings occurred previously, the experience with unconventional treatments such as aminoglycosides is limited and resistant strains have emerged. One of the strategies used against the reduced susceptibility to ceftriaxone is to increase the dose or use combined treatments. In the current context of multidrug resistance of this organism it is important to promote the prevention of infection, epidemiological surveillance and look for new strategies for treatment.

Educação inclusiva: escolha e rejeição entre alunos / Inclusive education: choice and rejection among students

Este artigo relata pesquisa sobre educação inclusiva; teve como objetivos comparar escolhas e rejeições dos alunos considerados em situação de inclusão pelas escolas com seus colegas e os motivos para essas escolhas e rejeições. Construiu-se uma Escala de Proximidade entre alunos, que foi aplicada em duas classes: uma do ensino público (um aluno considerado em situação de inclusão) e outra do ensino particular (três alunos considerados em situação de inclusão). Observou-se que não houve diferenças entre os dois grupos de alunos, em ambas as classes, no que se refere à frequência de escolha ou rejeição e em relação aos motivos. Os motivos dados para escolher ou não colegas para a execução de tarefas escolares denotam um ideal de produtividade e relações de competição; quanto às relações sociais como brincar ou ir à casa do colega, valorizou-se ser "legal" e "amigo".

This work reports a research about inclusive education which objective was to verify if there are differences in preferences and rejections made by students considered as an inclusive status by the schools and their classmates, as well as the reasons for the preferences and rejections. A Proximity Scale has been built among the students and was applied in two classrooms: in a public school (one student considered in an inclusive status) and in a private school (three students considered in an inclusive status). It was observed that there was no difference among students, in both classes, regarding the frequency of choice or rejection and the reasons therefore. Reasons presented for choosing or not choosing classmates for school assignments denote an ideal of productivity and competitive relations. In social relations like playing or visiting classmates, being "cool" or "friendly" was appreciated.

Neisseria gonorrhoeae. Resistencia a los antibióticos / Neisseria gonorrhoeae. Antibiotic resistance

Neisseria gonorrhoeae (Ng) adquirio a traves de los años mecanismos de resistencia, lo que provoco que los distintos esquemas de tratamiento que en un comienzo fueron exitosos en tiempos variables, generaran problemas no siempre faciles de resolver. El objetivo de este trabajo es evaluar el perfil de sensibilidad de los aislamientos de Neisseria gonorrhoeae (Ng) frente a siete antibióticos en el periodo 2005-2009. Este estudio se realizo en el Programa de Enfermedades de Transmision Sexual (PETS) del Hospital de Clinicas, Universidad de Buenos Aires, en el período comprendido entre enero de 2005 y diciembre de 2009. Los datos clinicos de este trabajo para la busqueda de Ng fueron tomados de 1.871 pacientes de sexo masculino, de los cuales 802 (43%) eran heterosexuales (HET) y 1.069 (57%) hombres que tenian relaciones sexuales con hombres (HSH). Se incluyeron pacientes con sintomatologia de descarga uretral y disuria. La recoleccion de muestras se realizo en aquellos pacientes que no habian recibido tratamiento antibiotico (ATB) durante las 48 horas previas, mediante hisopado uretral y tomas en region anal y faringea en los que tenian relaciones sexuales con hombres. El 23,7% de los aislamientos presento resistencia cromosómica a penicilina y el 12,6% fue productor de ß-lactamasa.Las primeras fallas de las fluorquinolonas a nivel mundial fue a principios de la decada del 90. La Argentina documento el primer hallazgo en 2000. Actualmente esta resistencia trepo al 31,2-52%. Las cefalosporinas de tercera generacion mantienen aun su efectividad, aunque se han detectado en nuestro medio aislamientos con sensibilidad disminuida a este antibiotico.

Relações entre preconceito, ideologia e atitudes frente à educação inclusiva / Relationships between prejudice, ideology and attitudes towards inclusive education

Este artigo analisa atitudes de alunos de um curso de pedagogia frente à educação inclusiva. Parte da hipótese de que o preconceito e a ideologia podem ser obstáculos à inclusão de crianças com deficiência na escola. Foram aplicadas quatro escalas: Manifestação de Preconceito, Atitudes Frente à Educação Inclusiva e Ideologia da Racionalidade Tecnológica, elaboradas por Crochík em 2000, 2003 e 2006, e a escala F, construída por Adorno, Frenkel-Brunswik, Levinson e Sanford em 1950. O estudo foi realizado com 188 estudantes de pedagogia. Os alunos desta amostra tenderam a ser mais favoráveis do que desfavoráveis à educação inclusiva, e foi possível verificar que o preconceito, a adesão à ideologia da racionalidade tecnológica e, implicitamente, ao fascismo, são variáveis que se relacionam às atitudes acerca desse tipo de educação.

This article studies the attitudes of pedagogy students towards inclusive/integrated education. It begins with the hypothesis that prejudice and ideology can be obstacles to the inclusion of children with intellectual disabilities at school. Four ranking scales were applied to 188 pedagogy students: manifestation of prejudice, attitudes towards inclusive/integrated education and the ideology of technological rationality, as created by Crochík (2000, 2003 and 2006), plus the F scale, created by Adorno et al. (1950). The students in this sample tended to be in favor of Inclusive/Integrated Education and we were able to ascertain that prejudice, subscribing to an ideology of technological rationality and inherent fascism are variables related to attitudes on inclusive/integrated Education.

Relações entre preconceito, ideologia e atitudes frente à educação inclusiva / Relationships between prejudice, ideology and attitudes towards inclusive education

Este artigo analisa atitudes de alunos de um curso de pedagogia frente à educação inclusiva. Parte da hipótese de que o preconceito e a ideologia podem ser obstáculos à inclusão de crianças com deficiência na escola. Foram aplicadas quatro escalas: Manifestação de Preconceito, Atitudes Frente à Educação Inclusiva e Ideologia da Racionalidade Tecnológica, elaboradas por Crochík em 2000, 2003 e 2006, e a escala F, construída por Adorno, Frenkel-Brunswik, Levinson e Sanford em 1950. O estudo foi realizado com 188 estudantes de pedagogia. Os alunos desta amostra tenderam a ser mais favoráveis do que desfavoráveis à educação inclusiva, e foi possível verificar que o preconceito, a adesão à ideologia da racionalidade tecnológica e, implicitamente, ao fascismo, são variáveis que se relacionam às atitudes acerca desse tipo de educação.(AU)

This article studies the attitudes of pedagogy students towards inclusive/integrated education. It begins with the hypothesis that prejudice and ideology can be obstacles to the inclusion of children with intellectual disabilities at school. Four ranking scales were applied to 188 pedagogy students: manifestation of prejudice, attitudes towards inclusive/integrated education and the ideology of technological rationality, as created by Crochík (2000, 2003 and 2006), plus the F scale, created by Adorno et al. (1950). The students in this sample tended to be in favor of Inclusive/Integrated Education and we were able to ascertain that prejudice, subscribing to an ideology of technological rationality and inherent fascism are variables related to attitudes on inclusive/integrated Education.(AU)

Atitudes de professores em relação à educação inclusiva / Teachers' attitudes towards inclusive education

Com a finalidade de analisar atitudes de professores em relação à educação inclusiva por meio da teoria crítica da sociedade, entrevistamos 14 professores do ensino fundamental. A maioria dos entrevistados se declarou favorável à educação inclusiva, propondo condições adequadas tais como: recursos humanos, diminuição de alunos em sala, restrição ao número de alunos com deficiência intelectual, necessidade de o professor ser especialista em educação inclusiva, participação de outros especialistas (médicos, psicólogos, fonoaudiólogos etc.) e apoio de outro professor em sala. No que se refere aos benefícios e prejuízos da educação inclusiva, verificou-se que a maioria dos professores julga que os alunos sem deficiência se consideram superiores àqueles que não têm deficiência, metade dos entrevistados julga que a presença dos alunos com deficiência não atrapalha a aprendizagem dos alunos sem deficiência, e, por fim, que a maioria dos professores considera que a educação inclusiva deve favorecer a socialização e a aprendizagem dos alunos com deficiência.(AU)

In order to analyze the attitudes of teachers towards inclusive education by means of the critical theory of the society, 14 elementary school teachers with and without experience with this type of education were interviewed; the teachers worked in public and private schools. The majority of the peopleinterviewed declared they were favorable to the inclusive education considering appropriate conditions such as: human resources, reduction of students in class, restriction to the number of students with intellectual disability, the necessity of the teacher to be an specialist in inclusive education and the presence of health professionals (such as doctors, psychologists and fonoaudiologists) in the school as well as the support of other teachers in class. As for the benefits and damages of the inclusive education, the results showed that the majority of the teachers thinks that the students without disability consider they are superior to the classmates with disability and half of the interviewed think that the presence of the students with disability does not disturb the apprenticeship of the students without disability; eventually, the majority of the teachers considers that the inclusive education favor both socialization and learning of the students with disability.(AU)

Atitudes de professores em relação à educação inclusiva / Actitudes de maestros con relación a la educación inclusiva / Teachers’ attitudes towards inclusive education

Com a finalidade de analisar atitudes de professores em relação à educação inclusiva por meio da teoria crítica da sociedade, entrevistamos 14 professores do ensino fundamental. A maioria dos entrevistados se declarou favorável à educação inclusiva, propondo condições adequadas tais como: recursos humanos, diminuição de alunos em sala, restrição ao número de alunos com deficiência intelectual, necessidade de o professor ser especialista em educação inclusiva, participação de outros especialistas (médicos, psicólogos, fonoaudiólogos etc.) e apoio de outro professor em sala. No que se refere aos benefícios e prejuízos da educação inclusiva, verificou-se que a maioria dos professores julga que os alunos sem deficiência se consideram superiores àqueles que não têm deficiência, metade dos entrevistados julga que a presença dos alunos com deficiência não atrapalha a aprendizagem dos alunos sem deficiência, e, por fim, que a maioria dos professores considera que a educação inclusiva deve favorecer a socialização e a aprendizagem dos alunos com deficiência.

In order to analyze the attitudes of teachers towards inclusive education by means of the critical theory of the society, 14 elementary school teachers with and without experience with this type of education were interviewed; the teachers worked in public and private schools. The majority of the peopleinterviewed declared they were favorable to the inclusive education considering appropriate conditions such as: human resources, reduction of students in class, restriction to the number of students with intellectual disability, the necessity of the teacher to be an specialist in inclusive education and the presence of health professionals (such as doctors, psychologists and fonoaudiologists) in the school as well as the support of other teachers in class. As for the benefits and damages of the inclusive education, the results showed that the majority of the teachers thinks that the students without disability consider they are superior to the classmates with disability and half of the interviewed think that the presence of the students with disability does not disturb the apprenticeship of the students without disability; eventually, the majority of the teachers considers that the inclusive education favor both socialization and learning of the students with disability.

[Ciprofloxacin resistance of Neisseria gonorrhoeae according to sexual habits]. / Resistencia de Neisseria gonorrhoeae a ciprofloxacina según hábitos sexuales.

The first isolates of Neisseria gonorrhoeae resistant to fluoroquinolones in Argentina were reported in 2000. Since January 2005 to June 2007 Neisseria gonorrhoeae was studied in 595 men who have sex with men (MSM) and 571 heterosexual men. The gonorrhea prevalence in MSM and heterosexual men was 0.091(91/1000) and the Neisseria gonorrhoeae ciprofloxacin resistant (CRNG) was 20% in MSM and 3.8% in heterosexual men (p: 0.0416). Thirteen out of 106 isolates from 11 MSM and 2 heterosexual men were CRNG. Six out of eleven MSM had urethritis, one also carried Neisseria gonorrhoeae in rectum and 5 patients were asymptomatic carriers (rectum 2, pharynx 2, urethra 1). No epidemiological relation was found among the patients. Two heterosexual men had urethritis. The 8 symptomatic men were treated with ciprofloxacin but treatment failed in all of them. These patients and the asymptomatic ones were treated with ceftriaxone, 500 mg IM. The post treatment microbiological controls were negative. The CRNG isolates had ciprofloxacin MIC between 2 and 32 (microg/ml), all were negative to penicillinase, 4 out of 13 were chromosomally resistant to penicillin (MIC: 1 microg/ml). The MICs (microg/ml) ranges for several antimicrobial agents were: penicillin: 0.016-1; tetracycline: 0.125-2; ceftriaxone: 0.004-0.008; erythromycin: 0.032-2; azithromycin: 0.032-0.5; spectinomycin: 8-32. Due to the high level of ciprofloxacin-resistant N. gonorrhoeae isolated from MSM in our hospital, another antimicrobial agent for empirical therapy should be used in these patients.

Resistencia de Neisseria gonorrhoeae a ciprofloxacina según hábitos sexuales / Ciprofloxacin resistance of Neisseria gonorrhoeae according to sexual habits

En la Argentina los primeros hallazgos de Neisseria gonorrhoeae resistentes a las fluorquinolonas se documentaron en el año 2000. Desde enero de 2005 hasta junio de 2007, se evaluaron 595 hombres que tienen sexo con hombres (HSH) y 571 varones heterosexuales para investigar la presencia de N. gonorrhoeae y la resistencia a los antimicrobianos. La prevalencia de gonorrea en HSH y varones heterosexuales fue 0.091(91/1000) en ambos grupos y el % de N. gonorrhoeae resistente a ciprofloxacina (NGRC) fue 20.0% y 3.8% respectivamente (p: 0.0416). Trece de 106 aislamientos fueron NGRC, correspondieron a 11 HSH y 2 varones heterosexuales. Seis HSH presentaron uretritis, uno de ellos con localización simultánea en recto y cinco pacientes fueron asintomáticos (recto, 2; faringe, 2; uretra, 1). No se pudo demostrar relación epidemiológica entre ellos. Dos varones heterosexuales presentaron uretritis. Los 8 pacientes sintomáticos fueron tratados empíricamente con ciprofloxacina y se documentó fracaso de tratamiento. Estos y los portadores de NGRC recibieron tratamiento con 500 mg de ceftriaxona IM. Los controles postratamiento demostraron la erradicación del microorganismo. Los aislamientos de NGRC presentaron CIM de ciprofloxacina entre 2 y 32 µg/ml, todos fueron beta-lactamasa negativos, 4/13 presentaron resistencia cromosómica a penicilina (CIM= 1 µg/ml), y los rangos de CIM (µg/ml) para los siguientes antibióticos fueron: penicilina: 0.016-1; tetraciclina: 0.125-2; ceftriaxona: 0.004-0.008; eritromicina: 0.032-2; azitromicina: 0.032-0.5; espectinomicina: 8-32. Dado el elevado porcentaje de aislamientos de NGRC en HSH en nuestro hospital, debería utilizarse otro antimicrobiano para el tratamiento empírico en estos pacientes.

The first isolates of Neisseria gonorrhoeae resistant to fluorquinolones in Argentina were reported in 2000. Since January 2005 to June 2007 Neisseria gonorrhoeae was studied in 595 men who have sex with men (MSM) and 571 heterosexual men. The gonorrhea prevalence in MSM and heterosexual men was 0.091(91/1000) and the Neisseria gonorrhoeae ciprofloxacin resistant (CRNG) was 20% in MSM and 3.8% in heterosexual men (p: 0.0416). Thirteen out of 106 isolates from 11 MSM and 2 heterosexual men were CRNG. Six out of eleven MSM had urethritis, one also carried Neisseria gonorrhoeae in rectum and 5 patients were asymptomatic carriers (rectum 2, pharynx 2, urethra 1). No epidemiological relation was found among the patients. Two heterosexual men had urethritis. The 8 symptomatic men were treated with ciprofloxacin but treatment failed in all of them. These patients and the asymptomatic ones were treated with ceftriaxone, 500 mg IM. The post treatment microbiological controls were negative. The CRNG isolates had ciprofloxacin MIC between 2 and 32 (µg/ml), all were negative to penicillinase, 4 out of 13 were chromosomally resistant to penicillin (MIC: 1 µg/ml). The MICs (µg/ml) ranges for several antimicrobial agents were: penicillin: 0.016-1; tetracycline: 0.125-2; ceftriaxone: 0.004-0.008; erythromycin: 0.032-2; azithromycin: 0.032-0.5; spectinomycin: 8-32. Due to the high level of ciprofloxacin-resistant N. gonorrhoeae isolated from MSM in our hospital, another antimicrobial agent for empirical therapy should be used in these patients.

As cicatrizes do corpo: a pedagogia esportiva nas aulas de educação física / The scars of the body: the sport pedagogy in the psysical education classes

O presente estudo tem por objetivo compreender os elementos que conformam as expressões da violência dentro do ambiente escolar. O interesse recai principalmente sobre qual é o papel que algumas das práticas pedagógicas da disciplina Educação Física ocupam no cotidiano escolar e quais as suas influências sobre a constituição das relações sociais entre os alunos. Para tanto analisa relatos orais de cinco adultos sobre suas experiências como alunos nas aulas de Educação Física durante seu processo de escolarização, nos anos 1970. O estudo propõe um diálogo entre a produção teórica da chamada 'Escola de Frankfurt', especialmente as obras de Adorno, e a 'Teoria Crítica do Esporte', especialmente as obras de Jean-Marie Brohum, visando um melhor entendimento dos elementos destacados dos relatos que auxiliem na compreensão sobre quais são os mecanismos envolvidos na formação de grupos de afinidades e nas atitudes de exclusão que se estabelecem no interior das aulas de Educação Física e nas instituições escolares. Sob essa perspectiva, analisa o papel do professor de Educação Física como mediador da cultura, os objetos de ensino postos em cena nas aulas e a formação da 'hierarquia paralela' no interior das escolas, na qual a habilidade corporal, a força fisica e todo um conjunto de atributos corporais assumem significados importantes na construção de dinâmicas sociais violentas no interior da escola (AU)

Linfangitis esclerosante no venérea del pene / Non venereal sclerosing lymphangitis of the penis

La linfangitis esclerosante no venérea del pene es una patología poco reportada que aparece en hombres sexualmente activos. Se manifiesta como un cordón firme, próximo al surco coronal del pene, asintomático y de resolución espontánea en pocas semanas. Se presenta el caso de un paciente de treinta años de edad, destacándose los hallazgos clínico-histológicos descriptos con escasa frecuencia

Linfangitis esclerosante no venérea del pene / Non venereal sclerosing lymphangitis of the penis

La linfangitis esclerosante no venérea del pene es una patología poco reportada que aparece en hombres sexualmente activos. Se manifiesta como un cordón firme, próximo al surco coronal del pene, asintomático y de resolución espontánea en pocas semanas. Se presenta el caso de un paciente de treinta años de edad, destacándose los hallazgos clínico-histológicos descriptos con escasa frecuencia (AU)