Who Is Seeking Help for Sleep? A Clinical Profile of Patients in a Sleep Psychology Clinic.

BACKGROUND: The present study outlines a clinical profile of an ecologically valid population consulting for sleep difficulties at the Sleep Psychology Clinic of the Consultation service of the School of Psychology of Université Laval . METHOD: Patients self-report to the sleep clinic. Following a phone screening interview, patients present to the clinic for a semi-structured clinical interview for sleep and psychopathology, which is conducted by psychologists and doctorate psychology students. A chart review of adult patients (56% female, Mage = 43.6 years) was conducted (between 2015 and 2018) to record diagnosed sleep, psychiatric, and medical conditions. RESULTS: There was a high level of comorbidity with an average of 2.85 diagnoses (any diagnosis combined) per patient (SD = 1.76), with 27% of the patients having at least four diagnoses. Reviewing specific types of disorders, 58.5% of patients presented with at least one comorbid psychiatric disorder, 27.5% with one medical comorbidity, or 39.5% with another sleep disorder alongside their primary sleep concern. Insomnia was the main sleep disorder (76%). Anxiety (77.8%) and depression (53.8%) were the predominant psychiatric disorders, while fibromyalgia (10.9%), hypertension (10.9%), and head trauma (9.1%) were the main medical conditions. Of patients with five diagnoses and more, 77.8% were taking on average 3.2 different types of medications. The number of diagnoses predicted the use of prescribed hypnotics and the use of any type of medications. CONCLUSION: This clinical profile emphasizes the reality of multiple morbidities, which may have implications for clinical decisions. Future research is required to evaluate transdiagnostic approaches for the sleep disorder patient with multiple morbidities.

GANT61 Reduces Hedgehog Molecule (GLI1) Expression and Promotes Apoptosis in Metastatic Oral Squamous Cell Carcinoma Cells.

Due to its importance in the pathogenesis of oral squamous cell carcinoma (OSCC), the Hedgehog (HH) pathway is considered a potential therapeutic target. We investigated the effects of GANT61, a GLI inhibitor, on HH gene expression, as well as on metastatic OSCC cell proliferation and death. Following culture in DMEM medium, cytotoxicity of GANT61 against different tumor and non-tumor cell types was assessed by alamarBlue assays. Cytotoxicity analysis revealed that the metastatic HSC3 cell line was the most sensitive (IC50: 36 µM) to the tested compound. The compound's effects on the expression of HH pathways components were analyzed by qPCR and Western blot; cell viability was analyzed by trypan blue assay and flow cytometry were used to investigate cell cycle phase, morphology, and death patterns in HSC3 cells. A significant reduction in mRNA levels of the GLI1 transcription factor was found after 12 h of treatment withGANT61. Protein expression levels of other HH pathway components (PTCH1, SHH, and Gli1) and HSC3 cell viability also decreased after 24 h of treatment. Cell cycle analysis and death pattern evaluations revealed significantly increased nuclear fragmentation in sub-G1 phase, as well as cell death due to apoptosis. In conclusion, the significantly reduced GLI1 gene expression seen in response to the GLI inhibitor indicates diminished downstream activation in HH pathway components. GANT61 significantly reduced cell viability in the metastatic cell line of OSCC and promoted a significant increase in nuclear fragmentation and cell death by apoptosis.

AI-driven convolutional neural networks for accurate identification of yellow fever vectors.

BACKGROUND: Identifying mosquito vectors is crucial for controlling diseases. Automated identification studies using the convolutional neural network (CNN) have been conducted for some urban mosquito vectors but not yet for sylvatic mosquito vectors that transmit the yellow fever. We evaluated the ability of the AlexNet CNN to identify four mosquito species: Aedes serratus, Aedes scapularis, Haemagogus leucocelaenus and Sabethes albiprivus and whether there is variation in AlexNet's ability to classify mosquitoes based on pictures of four different body regions. METHODS: The specimens were photographed using a cell phone connected to a stereoscope. Photographs were taken of the full-body, pronotum and lateral view of the thorax, which were pre-processed to train the AlexNet algorithm. The evaluation was based on the confusion matrix, the accuracy (ten pseudo-replicates) and the confidence interval for each experiment. RESULTS: Our study found that the AlexNet can accurately identify mosquito pictures of the genus Aedes, Sabethes and Haemagogus with over 90% accuracy. Furthermore, the algorithm performance did not change according to the body regions submitted. It is worth noting that the state of preservation of the mosquitoes, which were often damaged, may have affected the network's ability to differentiate between these species and thus accuracy rates could have been even higher. CONCLUSIONS: Our results support the idea of applying CNNs for artificial intelligence (AI)-driven identification of mosquito vectors of tropical diseases. This approach can potentially be used in the surveillance of yellow fever vectors by health services and the population as well.

Enhancing scaffold-free spheroid models: 3D cell bioprinting method for metastatic HSC3-Oral squamous carcinoma cell line.

3D in vitro systems offer advantages over the shortcomings of two-dimensional models by simulating the morphological and functional features of in vivo-like environments, such as cell-cell and cell-extracellular matrix interactions, as well as the co-culture of different cell types. Nevertheless, these systems present technical challenges that limit their potential in cancer research requiring cell line- and culture-dependent standardization. This protocol details the use of a magnetic 3D bioprinting method and other associated techniques (cytotoxicity assay and histological analysis) using oral squamous cell carcinoma cell line, HSC3, which offer advantages compared to existing widely used approaches. This protocol is particularly timely, as it validates magnetic bioprinting as a method for the rapid deployment of 3D cultures as a tool for compound screening and development of heterotypic cultures such as co-culture of oral squamous cell carcinoma cells with cancer-associated fibroblasts (HSC3/CAFs).

Arsenic Trioxide Triggers Apoptosis of Metastatic Oral Squamous Cells Carcinoma with Concomitant Downregulation of GLI1 in Hedgehog Signaling.

Given the lack of advances in Oral Squamous Cell Carcinoma (OSCC) therapy in recent years, pharmacological strategies to block OSCC-related signaling pathways have gained prominence. The present study aimed to evaluate the therapeutic potential of Arsenic Trioxide (ATO) concerning its antitumoral effects and the inhibition of the Hedgehog (HH) pathway in OSCC. Initially, ATO cytotoxicity was assessed in a panel of cell lines. Cell viability, cell cycle, death patterns, and cell morphology were analyzed, as well as the effect of ATO on the expression of HH pathway components. After the cytotoxic assay, HSC3 cells were chosen for all in vitro assays. ATO increased apoptotic cell death and nuclear fragmentation in the sub-G1 cell cycle phase and promoted changes in cell morphology. In addition, the reduced expression of GLI1 indicated that ATO inhibits HH activity. The present study provides evidence of ATO as an effective cytotoxic drug for oral cancer treatment in vitro.

Measuring mosquito control: adult-mosquito catches vs egg-trap data as endpoints of a cluster-randomized controlled trial of mosquito-disseminated pyriproxyfen.

BACKGROUND: Aedes aegypti and Culex quinquefasciatus are the main urban vectors of arthropod-borne viruses causing human disease, including dengue, Zika, or West Nile. Although key to disease prevention, urban-mosquito control has met only limited success. Alternative vector-control tactics are therefore being developed and tested, often using entomological endpoints to measure impact. Here, we test one promising alternative and assess how three such endpoints perform at measuring its effects. METHODS: We conducted a 16-month, two-arm, cluster-randomized controlled trial (CRCT) of mosquito-disseminated pyriproxyfen (MD-PPF) in central-western Brazil. We used three entomological endpoints: adult-mosquito density as directly measured by active aspiration of adult mosquitoes, and egg-trap-based indices of female Aedes presence (proportion of positive egg-traps) and possibly abundance (number of eggs per egg-trap). Using generalized linear mixed models, we estimated MD-PPF effects on these endpoints while accounting for the non-independence of repeated observations and for intervention-unrelated sources of spatial-temporal variation. RESULTS: On average, MD-PPF reduced adult-mosquito density by 66.3% (95% confidence interval, 95% CI: 47.3-78.4%); Cx. quinquefasciatus density fell by 55.5% (95% CI: 21.1-74.8%), and Ae. aegypti density by 60.0% (95% CI: 28.7-77.5%). In contrast, MD-PPF had no measurable effect on either Aedes egg counts or egg-trap positivity, both of which decreased somewhat in the intervention cluster but also in the control cluster. Egg-trap data, therefore, failed to reflect the 60.0% mean reduction of adult Aedes density associated with MD-PPF deployment. CONCLUSIONS: Our results suggest that the widely used egg-trap-based monitoring may poorly measure the impact of Aedes control; even if more costly, direct monitoring of the adult mosquito population is likely to provide a much more realistic and informative picture of intervention effects. In our CRCT, MD-PPF reduced adult-mosquito density by 66.3% in a medium-sized, spatially non-isolated, tropical urban neighborhood. Broader-scale trials will be necessary to measure MD-PPF impact on arboviral-disease transmission.

Effects of estrogen therapy on microalbuminuria in healthy post-menopausal women.

OBJECTIVE: To evaluate the impact of estrogen therapy on microalbuminuria levels in healthy post-menopausal women. METHODS: Sixty post-menopausal women were evaluated in a prospective, randomised, double-blind, placebo-controlled study. The patients were randomly allocated to one of two groups to take one pill orally per day containing either 1 mg of 17beta-estradiol (E(2) group) or placebo (placebo group). Prior to initiating treatment and at the end of the sixth treatment month, microalbumin was measured in a 12-h urine sample, and lipid profile (total cholesterol, HDL, LDL and triglycerides) and fasting glucose were evaluated. Comparative intra- and inter-group analyses between the initial and final laboratory parameters were performed using the t-test for paired samples and for independent samples, respectively. RESULTS: Microalbuminuria levels remained within normal limits throughout the study and no statistically significant differences were found in the intra- or inter-group analyses. With respect to lipid profile, alterations characteristically encountered during use of estrogen replacement therapy were found. No statistically significant variation in glucose levels occurred during the study period. CONCLUSION: Estrogen replacement therapy had no significant effect on microalbuminuria levels in healthy post-menopausal patients.

Estado nutricional, consumo de alimentos e (in) segurança alimentar de crianças assistidas pelo Programa Bolsa Família / Nutritional status, food consumption, and food (in) security of children assisted by the Bolsa Família Program

Populações que vivem em condições de desigualdade social e econômica são mais vulneráveis à ocorrência de problemas nutricionais, os quais impactam negativamente o crescimento, desenvolvimento e a saúde da criança. Nesse cenário, os Programas de Transferência Condicionada de Renda apresentam-se como estratégias importantes para atenuar a situação de insegurança alimentar dessas famílias. Todavia, ressalta-se que tal transferência monetária não representa garantia de alimentação adequada. Assim, esta pesquisa teve como objetivo avaliar o estado nutricional, o consumo qualitativo de alimentos e os níveis de (in) segurança alimentar de crianças assistidas pelo Programa Bolsa Família residentes no município de Nazária (PI). Trata-se de um estudo transversal envolvendo 134 crianças com sete a dez anos de idade. Um questionário foi aplicado aos pais/responsáveis para coletar as informações sobre as variáveis socioeconômicas. O estado nutricional das crianças foi avaliado a partir da aferição da estatura e peso corporal, sendo classificado conforme os parâmetros de índice de massa corporal-para-idade, peso-para-idade e estatura-para-idade. Para a avaliação do consumo alimentar, foi utilizado o questionário do Sistema de Vigilância Alimentar e Nutricional com marcadores sobre consumo alimentar para indivíduos acima de cinco anos de idade. A Escala Brasileira de Insegurança Alimentar foi aplicada para obtenção do nível de insegurança alimentar das famílias. As crianças beneficiárias do Programa Bolsa Família apresentaram, em sua maioria, estado nutricional adequado. Todavia, a prevalência de sobrepeso e obesidade identificada nesta população representa um fator preocupante à saúde. Associado a isso, as crianças realizavam ingestão diária de alimentos não saudáveis e consumo pouco frequente de alimentos nutritivos. Ademais, mesmo com o auxílio financeiro do programa, muitas famílias ainda se encontraram em situação de insegurança alimentar.

Populations living in conditions of social and economic inequality are more vulnerable to the occurrence of nutritional problems which negatively impact children's growth, development and health. In this scenario, the Conditional Cash Transfer Programs are important strategies to alleviate the food insecurity situation of these families. However, it should be noted that such monetary transfer does not represent a guarantee of adequate food. Therefore, this research aimed to evaluate the nutritional status, qualitative dietary intake, and levels of food (in) security of the children assisted by the Bolsa Família Program living in the municipality of Nazária (PI). A cross-sectional study was conducted with 134 children aged seven to ten years. A questionnaire was applied to parents/guardians to collect information on socioeconomic variables. Children's nutritional status was assessed by measuring height and body weight, and classified according to the parameters of body mass index-for-age, weight-for-age, and height-for-age. For the evaluation of dietary intake, the questionnaire with markers on food consumption for individuals over five years old of the Food and Nutrition Surveillance System was used. The Brazilian Food Insecurity Scale was applied to obtain the level of food insecurity of the families. The majority of children benefiting of the Bolsa Família Program has adequate nutritional status. However, the prevalence of overweight and obesity identified in this population represents a concerning health factor. Associated with this, children have a daily intake of unhealthy foods and infrequent consumption of nutritious foods. Furthermore, even with the financial support of the program, many families are still in a situation of food insecurity.

ß-Lapachone and its iodine derivatives cause cell cycle arrest at G2/M phase and reactive oxygen species-mediated apoptosis in human oral squamous cell carcinoma cells.

ß-Lapachone is a natural naphthoquinone originally obtained from the bark of the purple Ipe (Tabebuia avellanedae Lor, Bignoniaceae) and its therapeutic potential in human cancer cells has been evaluated in several studies. In this study, we examined the effects of ß-lapachone and its 3-iodine derivatives (3-I-α-lapachone and 3-I-ß-lapachone) on cell proliferation, cell death, and cancer-related gene expression in human oral squamous cell carcinoma cells. ß-Lapachone and its 3-iodine derivatives showed potent cytotoxicity against different types of human cancer cell lines. Indeed, treatment with these compounds induced cell cycle arrest at G2/M phase, followed by internucleosomal DNA fragmentation, and caused significant increases in phosphatidylserine externalization, caspase-8 and -9 activation, mitochondrial membrane depolarization, reactive oxygen species (ROS) production, and apoptotic cell death morphology. The apoptosis induced by the compounds was prevented by pretreatment with a pan-caspase inhibitor (Z-VAD-FMK) and an antioxidant (N-acetyl-l-cysteine). In vivo, ß-lapachone and its 3-iodine derivatives significantly reduced tumor burden and did not alter any of the biochemical, hematological, or histological parameters of the animals. Overall, ß-lapachone and its 3-iodine derivatives showed promising cytotoxic activity due to their ability to induce cell cycle arrest at G2/M phase and promote caspase- and ROS-mediated apoptosis. In addition, ß-lapachone and its 3-iodine derivatives were able to suppress tumor growth in vivo, indicating that these compounds may be new antitumor drug candidates.

Qualitative studies of insomnia: Current state of knowledge in the field.

Despite its high prevalence and burden, insomnia is often trivialized, under-diagnosed, and under-treated in practice. Little information is available on the subjective experience and perceived consequences of insomnia, help-seeking behaviors, and treatment preferences. The use of qualitative approaches (e.g., ethnography, phenomenology, grounded theory) may help gain a better understanding of this sleep disorder. The present paper summarizes the evidence derived from insomnia studies using a qualitative research methodology (e.g., focus group, semi-structured interviews). A systematic review of the literature was conducted using PsycINFO and Medline databases. The review yielded 22 studies and the quality of the methodology of each of them was evaluated systematically using the critical appraisal skills programme (CASP) appraisal tool. Selected articles possess at least a very good methodological rigor and they were categorized according to their main focus: "Experience of insomnia", "Management of insomnia" and "Medicalization of insomnia". The main findings indicate that: 1) insomnia is often experienced as a 24-h problem and is perceived to affect several domains of life, 2) a sense of frustration and misunderstanding is very common among insomnia patients, which is possibly due to a mismatch between patients' and health care professionals' perspectives on insomnia and its treatment, 3) health care professionals pay more attention to sleep hygiene education and medication therapies and less to the patient's subjective experience of insomnia, and 4) health care professionals are often unaware of non-pharmacological interventions other than sleep hygiene education. An important implication of these findings is the need to develop new clinical measures with a broader scope on insomnia and more targeted treatments that take into account the patient's experience of insomnia. Greater use of qualitative approaches in future research may produce novel and more contextualized information leading to a more comprehensive understanding of insomnia.

[Serological diagnosis of dengue and yellow fever infections in suspected cases from Pará State, Brazil, 1999]. / Diagnóstico sorológico de infecções por dengue e febre amarela em casos suspeitos no Estado do Pará, Brasil, 1999.

From June to December 1999, 785 serum samples were obtained from patients clinically suspected of having dengue or yellow fever. The patients were referred by public health centers distributed within the six mesoregions of Par State, Brazil. Serum samples were tested for Flavivirus antibodies by hemagglutination inhibition test and for dengue and yellow fever viruses by enzyme-linked immunosorbent assay for IgM detection. Of the sera collected, 563 (71.7%) were positive by HI test and out of these 150 (26.6%) were positive by ELISA-IgM. Dengue virus was responsible for most of the recent infections in all regions; yellow fever cases detected in the current study were restricted to the Maraj and Southeast regions.

Inserção profissional de Egressos da Licenciatura: avaliação quantitativa / Employability of teaching credential in nursing program alumni: a quantitative evaluation / Inserción profesional de Egresados de la Licenciatura: evaluación cuantitativa

Objetivos: Caracterizar os egressos da Licenciatura em Enfermagem da Escola de Enfermagem da Universidade de São Paulo e sua inserção no mercado de trabalho e conhecer as perspectivas sobre o curso. Trata-se de um estudo exploratório, de natureza descritiva e quantitativa. Resultados: Participaram da pesquisa 66 egressos do curso de Licenciatura, no período de 2002 a 2017. A coleta de dados foi realizada por meio de questionário eletrônico. Houve predominância do sexo feminino, solteiros, sem fi lhos, e de renda entre 7 a 10 salários mínimos. A maioria concluiu a licenciatura em 4 a 5 anos (69,7%). Parte dos egressos teve inserção profissional na Licenciatura (38%) e sete (10,6%) afirmaram exercer docência como atividade principal.Conclusão: Na fala dos participantes, percebeu-se algumas fragilidades em relação ao estágio curricular, bem como falta de articulação entre as disciplinas. A autonomia gerada durante o curso de licenciatura é citada como um fortalecedor da profissão. Foi possível observar que a docência é a segunda atividade mais exercida pelos egressos, contudo o curso é considerado fundamental para o crescimento pessoal e profissional.

Objective: To describe the alumni of the teaching credential in nursing program from the School of Nursing of the University of São Paulo and their employability, and to explore their perspectives about the course. This is an exploratory, descriptive, and quantitative study. Results: A total of 66 alumni from the teaching credential in nursing program who graduated between 2002 and 2017 participated in the study. Data collection were performed by using an electronic form. Participants were mainly female, single, childless, with an income between 7 to 10 minimum wages. The majority of the alumni concluded the course in 4 to 5 years (69.7%). Some of the alumni experienced teaching activities (38%) and seven (10.6%) participants described teaching as being their main current professional activity. Conclusion: Participants reported weaknesses regarding the clinical internship, as well as the lack of articulation among the disciplines. According to the alumni, the program generates professional autonomy, which empowers the profession. Although teaching was described as the second most commonly professional activity performed by the alumni, the program is considered fundamental for personal and professional development.

Objetivos: Caracterizar a los egresados de la Licenciatura en Enfermería de la Escola de Enfermagem da Universidade de São Paulo y su inserción en el mercado de trabajo, y conocer las perspectivas sobre el curso. Es un estudio exploratorio, de naturaleza descriptiva y cuantitativa. Resultados: Participaron de la investigación 66 egresados del curso de Licenciatura, en el periodo de 2002 a 2017. La recolección de los datos fue realizada por medio de un cuestionario electrónico. Hubo predominancia del sexo femenino, solteros, sin hijos, y de ingresos económicos entre 7 a 10 salarios mínimos (37,9%). La mayoría concluyó la licenciatura en 4 o 5anos (69,7%). Parte de los egresados tuvo inserción profesional en la Licenciatura (38%) y siete (10,6%) afirmaron ejercer la docencia como actividad principal.Conclusión: En el relato de los participantes se perciben algunas fragilidades con relación a la pasantía curricular, así como la falta de articulación entre las disciplinas. La autonomía generada durante el curso de licenciatura es citada como un fortalecedor de la profesión. Fue posible observar que la docencia es la segunda actividad más ejercida por los egresados, sin embargo, el curso es considerado fundamental para el crecimiento personal y profesional.

The impact of endoscopy on the treatment of cholesteatomas.

UNLABELLED: Recurrent cholesteatoma is relatively uncommon. Residual middle ear cholesteatomas account for most of the cases of recurrent disease. The limited role of microscopy in the visualization of tridimensional anatomic alterations of the temporal bone led to the use of endoscopic examination as an additional tool in the realm of ear surgery. Endoscopy has significantly aided in the management of chronic cholesteatomatous otitis media and in the prevention of recurrent disease. OBJECTIVE: To review the literature and assess the relevance of endoscopy in the surgical treatment of cholesteatomas and in the prevention of relapsing lesions. METHOD: Searches on databases MedLine and LILACS were carried out between March and June of 2011 to select studies in which endoscopy was used in the management of cholesteatomas. RESULTS: Three studies comparing surgery aided by endoscopy and surgery performed with the aid of a microscope met the inclusion criteria. CONCLUSION: Endoscopy has positively impacted the management of cholesteatomas and should be used in cholesteatoma surgery.

Impacto da endoscopia no tratameno do colesteatoma / The impact of endoscopy on the treatment of cholesteatomas

Com índices relativamente baixos de lesão recorrente, o colesteatoma residual de orelha média se mostra, hoje, um dos maiores responsáveis pelos altos índices de recidiva da doença. Dada a limitação em visualizar, sob microscopia, todos os acidentes anatômicos distribuídos tridimensionalmente no osso temporal, a endoscopia surgiu como uma ferramenta auxiliar em otocirurgia e está se mostrando uma grande aliada no manejo da otite media crônica colesteatomatosa e na prevenção de sua recidiva. OBJETIVO: Avaliar, por meio de revisão bibliográfica, a importância da otoendoscopia no tratamento cirúrgico do colesteatoma e seu papel na prevenção de lesões recidivadas. MÉTODO: Realizou-se uma busca eletrônica entre março a junho de 2011, nas bases de dados MedLine e LILACS, selecionando-se estudos que analisavam a endoscopia como método auxiliar no manejo do colesteatoma. RESULTADOS: Aplicados os critérios de inclusão e exclusão, restaram três estudos avaliando a endoscopia na cirurgia do colesteatoma frente ao método microcirúrgico tradicional. CONCLUSÃO: Parece que a endoscopia deve ser incorporada à prática diária da otologia, dado seu impacto positivo no manejo da referida enfermidade.

Recurrent cholesteatoma is relatively uncommon. Residual middle ear cholesteatomas account for most of the cases of recurrent disease. The limited role of microscopy in the visualization of tridimensional anatomic alterations of the temporal bone led to the use of endoscopic examination as an additional tool in the realm of ear surgery. Endoscopy has significantly aided in the management of chronic cholesteatomatous otitis media and in the prevention of recurrent disease. OBJECTIVE: To review the literature and assess the relevance of endoscopy in the surgical treatment of cholesteatomas and in the prevention of relapsing lesions. METHOD: Searches on databases MedLine and LILACS were carried out between March and June of 2011 to select studies in which endoscopy was used in the management of cholesteatomas. RESULTS: Three studies comparing surgery aided by endoscopy and surgery performed with the aid of a microscope met the inclusion criteria. CONCLUSION: Endoscopy has positively impacted the management of cholesteatomas and should be used in cholesteatoma surgery.

Impacto da endoscopia no colesteatoma residual / The endoscopy impact in the residual cholesteatoma

Introdução: Com índices relativamente baixos de lesão recorrente, o colesteatoma residual de orelha média se mostra hoje, um dos maiores responsáveis pelos altos índices de recidiva da doença. Dada a limitação em visualizar, sob microscopia, todos os acidentes anatômicos distribuídos tridimensionalmente no osso temporal, a endoscopia surgiu como uma ferramenta auxiliar em otocirurgia e está mostrando-se uma grande aliada no manejo da otite média crônica colesteatomatosa e na prevenção de sua recidiva. Objetivo: Avaliar, através de revisão bibliográfica, a importância da otoendoscopia no tratamento cirúrgico do colesteatoma e seu papel na prevenção de lesões recidivadas. Metodologia: Realizou-se uma busca eletrônica nas bases de dados Medline e Lilacs, selecionando-se estudos que analisavam a endoscopia como método auxiliar no manejo do colesteatoma. Conclusões: Parece que a endoscopia deve sim ser incorporada na prática diária da otologia, dado seu impacto positivo no manejo da referida enfermidade.

Immunization with heterologous flaviviruses protective against fatal West Nile encephalitis.

Prior immunization of hamsters with three heterologous flaviviruses (Japanese encephalitis virus [JEV] SA14-2-8 vaccine, wild-type St. Louis encephalitis virus [SLEV], and Yellow fever virus [YFV] 17D vaccine) reduces the severity of subsequent West Nile virus (WNV) infection. Groups of adult hamsters were immunized with each of the heterologous flaviviruses; approximately 30 days later, the animals were injected intraperitoneally with a virulent New York strain of WNV. Subsequent levels of viremia, antibody response, and deaths were compared with those in nonimmune (control) hamsters. Immunity to JEV and SLEV was protective against clinical encephalitis and death after challenge with WNV. The antibody response in the sequentially infected hamsters also illustrates the difficulty in making a serologic diagnosis of WNV infection in animals (or humans) with preexisting Flavivirus immunity.

Two new rhabdoviruses (Rhabdoviridae) isolated from birds during surveillance for arboviral encephalitis, northeastern United States.

Two novel rhabdoviruses were isolated from birds during surveillance for arboviral encephalitis in the northeastern United States. The first, designated Farmington virus, is a tentative new member of the Vesiculovirus genus. The second, designated Rhode Island virus, is unclassified antigenically, but its ultrastructure and size are more similar to those of some of the plant rhabdoviruses. Both viruses infect birds and mice, as well as monkey kidney cells in culture, but their importance for human health is unknown.

Sofrimento de Sávio: estigma de ser doente mental em Fortaleza / Sávio's suffering: stigma of being mental sick person in Fortaleza

Este artigo descreve um estudo de caso etnográfico realizado com Sávio, 20 anos, diagnosticado com transtorno somatoforme na Psiquiatria de um hospital público de Fortaleza. Durante o ano de 2005, foram realizadas visitas semanais ao seu bairro, com o objetivo de compreender a experiência vivida do estigma no seu cotidiano. A lente fenomenológica 'mundana' atuou na leitura de seu mundo vivido/lebenswelt. O conteúdo foi compreendido na perspectiva da Antropologia da Experiência; a etnografia foi o método de pesquisa. Os resultados mostraram que o estigma está presente no bairro e nas relações cotidianas de Sávio. O auto-estigma foi a marca mais relevante geradora de sofrimento psíquico.(AU)

This work describes an ethnographic case study with Sávio, 20-year-old, diagnosed with somatoform disorder at the Psychiatry of a public hospital in Fortaleza. During 2005, weekly visits were done in Sávio's community, aiming at the comprehension of the lived experience of stigma in his daily world, using the Merleau-Ponty's phenomenology on the reading of his lived world/lebenswelt. The content was understood under the Anthropology of Experience; Ethnography was the research method used. The results showed that the stigma is present in Sávio's community and daily relations. The auto-stigma was observed as the most relevant sign as generating of psychic suffering.(AU)

Sofrimento de Sávio: estigma de ser doente mental em Fortaleza / Sávio's suffering: stigma of being mental sick person in Fortaleza

Este artigo descreve um estudo de caso etnográfico realizado com Sávio, 20 anos, diagnosticado com transtorno somatoforme na Psiquiatria de um hospital público de Fortaleza. Durante o ano de 2005, foram realizadas visitas semanais ao seu bairro, com o objetivo de compreender a experiência vivida do estigma no seu cotidiano. A lente fenomenológica "mundana" atuou na leitura de seu mundo vivido/lebenswelt. O conteúdo foi compreendido na perspectiva da Antropologia da Experiência; a etnografia foi o método de pesquisa. Os resultados mostraram que o estigma está presente no bairro e nas relações cotidianas de Sávio. O auto-estigma foi a marca mais relevante geradora de sofrimento psíquico.

This work describes an ethnographic case study with Sávio, 20-year-old, diagnosed with somatoform disorder at the Psychiatry of a public hospital in Fortaleza. During 2005, weekly visits were done in Sávio's community, aiming at the comprehension of the lived experience of stigma in his daily world, using the Merleau-Ponty's phenomenology on the reading of his lived world/lebenswelt. The content was understood under the Anthropology of Experience; Ethnography was the research method used. The results showed that the stigma is present in Sávio's community and daily relations. The auto-stigma was observed as the most relevant sign as generating of psychic suffering.

Transtornos de aprendizagem na infância: uma revisão de literatura / Learning disorders in childhood: a literature review

Os transtornos de aprendizagem se definem como a dificuldade em alcançar metas educacionais básicas em crianças com inteligência normal e sem lesões neurológicas que os justifiquem e normalmente só são detectados quando a criança está em contato com a educação formal. Em torno de 15% a 20% das crianças apresentam dificuldade de aprendizado no primeiro ano de escolaridade, chegando até 30% a 50% nos primeiros seis anos, com prevalência do sexo masculino. Na consideração do seu diagnóstico é preciso ter em mente a tríade formada pela criança, sua família e a escola, além de considerar a existência de patologias orgânicas e psicológicas na origem do quadro. A forma de apresentação mais comum é a dislexia, ou seja, o transtorno de aprendizado específico da leitura e escrita. Outras formas de apresentação menos comuns são a discalculia e a disgrafia. A avaliação dessa disfunção é multiprofissional e seu tratamento inclui técnicas diferenciadas de ensino, acompanhamento psicológico e fonoaudiológico e, em algumas situações, tratamentos específicos de comorbidades que pioram o desempenho da criança (transtornos de humor, doenças auditivas, distúrbios obstrutivos do sono etc.). O diagnóstico diferencial é muito importante, pois, na maioria dos casos, trata-se de crianças normais e passíveis de recuperação...