Esporotricose cutânea disseminada em paciente com imunossupressão secundária ao uso de corticoide: relato de caso / Disseminated cutaneous sporotrichosis in a patient with immunosuppression secondary to corticosteroid use: case report / Esporotricosis cutánea diseminada en paciente con inmunosupresión secundaria al uso de corticoides: reporte de un caso

Esporotricose é uma infecção ubíqua e cosmopolita com apresentação clínica diversificada, podendo acometer humanos por meio da inoculação traumática na pele. O diagnóstico é feito através da história clínica e do isolamento do fungo na cultura. Este artigo objetiva relatar um caso clínico de esporotricose cutânea disseminada, ocorrido em Campina Grande-PB, atendido no Hospital Universitário Alcides Carneiro, e realizar uma breve revisão de literatura a respeito dessa patologia e seus aspectos clínicos e laboratoriais. O paciente se encontrava imunossuprimido por uso de corticoide e apresentava lesões disseminadas pelo corpo. Ele não apresentou boa resposta a terapia inicial com Itraconazol.

Sporotrichosis is a ubiquitous and cosmopolitan infection with diverse clinical presentation, it can affect humans through traumatic inoculation in the skin. Diagnosis is accomplished through clinical history and isolation of the fungus in culture. This article aims to report a clinical case of disseminated cutaneous sporotrichosis, which occurred in Campina Grande-PB, treated at the Alcides Carneiro University Hospital. A brief literature review regarding this pathology and its clinical and laboratory aspects is conducted. The patient was immunosuppressed secondary corticosteroid use and presented disseminated lesions throughout the body. The initial therapy with Itraconazole did not yield a favorable response.

La esporotricosis es una infección ubicua y cosmopolita con una presentación clínica diversa, puede afectar a los seres humanos a través de la inoculación traumática en la piel. El diagnóstico se logra a través de la historia clínica y el aislamiento del hongo en cultivo. Este artículo tiene como objetivo reportar un caso clínico un caso clínico de esporotricosis cutánea diseminada, que ocurrió en Campina Grande-PB, tratado en el Hospital Universitario Alcides Carneiro. Se realiza una breve revisión de la literatura sobre esta patología y sus aspectos clínicos y de laboratorio. El paciente estaba inmunosuprimido debido al uso de corticosteroides y presentaba lesiones diseminadas en todo el cuerpo. La terapia inicial con Itraconazol no dio una respuesta favorable.

An alert from the present to the future: The impact of environmental disasters on health of children and adolescents.

Storms unleashed devastating tornadoes southern United States. National Weather Service maps revealed one supercell, which may have been a single tornado or a cluster. One of the most devastated sites is the southwestern Kentucky city of Mayfield. In Warren County, where about 12 people were killed, including several children, the process of identifying victims has been slowed because the people who could make those identifications are themselves recovering from injuries sustained in the storm. There's a lot of people injured and in hospitals. The death toll from the devastating tornado outbreak that ripped across six states last weekend held steady at 88 on Tuesday, including at least 13 children. Two-month-old baby was confirmed dead.

Pandemic of hunger: The severe nutritional deficiency that kills Yanomami ethnic children.

Chronic malnutrition is the painful reality that Yanomami children face in Brazil's largest Indigenous Land and is pointed out by specialists as one of the results of the federal government's "anti-indigenous policy". The lack, or scarcity, of medical care, together with the lack of environmental inspection, pushes the Yanomami into a desperate scenario. It is estimated that 20,000 illegal miners operate in the territory. Mining activity contaminates rivers with mercury and has caused deformities and illnesses in women and children. They live on the largest indigenous reserve in Brazil. There are nine million hectares within the Amazon Forest. Malaria has persistently advanced in Yanomami land: there are more than 16,000 cases this year alone. Several children are dying.

Molecular basis and clinical perspectives of deep brain stimulation for major depressive disorder.

It is possible to consider the stimulation of the cingulate gyrus in its portion below the corpus callosum (SCC, or subcallosal cingulate cortex) as an effective, promising, and safe alternative intervention for treatment-resistant depression. In studies with deep brain stimulation - DBS, when follow-on with functional magnetic resonance imaging and/or PET-CT (Positron emission tomography-computed tomography) is performed, it is observed an increase in the blood supply and glucose metabolism in this region, which is the anterior part of the limbic system. This same location has good experimental results also for the treatment of anorexia nervosa. The hypotheses suggest a greater activation of the reward system, a greater sense of well-being, and a consequent reduction in depressive symptoms, the objective of the treatment. Over the last 20 years, multicenter studies have shown symptomatic improvement in 50-60% of patients, and about a third even reach criteria for remission of the depressive disorder.

Echoes of Global Silence: Is there protection and safety for Venezuelan children and adolescents?

As the crisis in Venezuela deepens, an increasing number of children urgently needs shelter, protection, and access to basic services, including food, medicine, clean water, and sanitation. Children and young people in transit are particularly at risk of criminal activity or being separated from their families. The consequences of the humanitarian crisis for children could be devastating for the country's future. The child labor problem was fueled by a mass migration of more than five million Venezuelans that turned many children into livelihoods for their families. The pandemic has aggravated risk factors for child labor. The work ranges from working in dumps to agricultural fields, adding that children in rural areas are more likely to depend on public assistance and are at greater risk of being recruited by gangs. Some Venezuelan women and girls are traveling for hours or days to cross the Colombian border and earn money as sex workers. The complex and multifaceted reality of international migration reveals enormous challenges that directly affect the lives of children and adolescents, especially the most vulnerable, and demand urgent responses from the constituted powers and civil society in the face of countless human rights violations those people experience.

Victims of sexual exploitation and violence in Brazil.

At least 8.9% of Brazilian women have already suffered some type of sexual violence in their lives. Every hour, Brazil has 2.2 cases of sexual violence against children and adolescents. Of the approximately 35,000 cases of violence against children and adolescents in 2021, in around 12,000 ethnic groups were not identified, 10,064 were white, 9634 were brown, 2505 black, 141 yellow, and 61 indigenous. If compared to age groups, boys from zero to 6 years reach 30%, but when the age is 12 to 18, women reach 91% of the victims. The whistleblowers are almost always anonymous, unlike in the case of violence against women, which are usually the victims themselves who complain or when they are third parties, they are usually identified. According to official data, around 96% of sexual violence takes place at home. The data are frightening and prove that sexual violence is the result of a scenario of gender inequality because it affects the lives of girls and women in a much more profound way.

High maternal mortality rates: Racial, geographic, and socioeconomic disparities in Brazil.

What are the harsh consequences of racism and our country's slavery past in the life of every black woman today? How does the current federal government reinforce the reproduction of structural sexism and racism during a pandemic? Hunger, domestic violence, femicide, informal work, unemployment, and political under-representation are issues that are urgently presented by the need for an anti-racist social transformation. Black women remain vulnerable to social inequalities. And in the pandemic, these inequalities are not only related to its management (contamination, death, and vaccination), but also its economic and social consequences.

COVID-19 and HIV among children and adolescents: Current inequalities.

The HIV epidemic enters its fifth decade amid a global pandemic. The increasing poverty, mental health problems, and abuse are raising the risk of infection for children, adolescents, and women. The inequalities driving the HIV epidemic, which are now exacerbated by COVID-19, demonstrate the social and clinical inequalities of more children infected with HIV and more children losing their fight against AIDS. In this context, current evidence highlights that, alarmingly, two out of five children living with HIV worldwide are unaware of their status, and just over half of children with HIV are receiving antiretroviral treatment. Discrimination and gender inequalities permeate significant situations in HIV services due to COVID-19 in early 2020 and throughout 2021. It was observed in recent studies substantial reductions in births in health facilities, maternal HIV testing, and initiation of antiretroviral treatment for HIV. An AIDS-free generation should be possible, but we are not there yet. HIV remains a burden.