Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: randomized, double-blind, and placebo-controlled clinical trial

Abstract Objective Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and social interaction and by restricted and repetitive patterns of behavior. Some studies have shown that substances derived from Cannabis sativa improve the quality of life of children with ASD without causing serious adverse effects, thus providing an alternative therapeutic option. The objective of this study was to evaluate the efficacy and safety of a cannabis extract rich in cannabidiol (CBD) in children with ASD. Methods In this randomized, double-blind, placebo-controlled clinical trial, 60 children, aged from 5 to 11 years, were selected and divided into two groups: the treatment group, which received the CBD-rich cannabis extract, and the control group, which received the placebo. They both used their respective products for a period of 12 weeks. Statistical analysis was done by two-factor mixed analysis of variance (two-way ANOVA). Results Significant results were found for social interaction (F1,116 = 14.13, p = 0.0002), anxiety (F1,116 = 5.99, p = 0.016), psychomotor agitation (F1,116 = 9.22, p = 0.003), number of meals a day (F1,116 = 4.11, p = 0.04), and concentration (F1,48 = 6.75, p = 0.01), the last of which was only significant in mild ASD cases. Regarding safety, it was found that only three children in the treatment group (9.7%) had adverse effects, namely dizziness, insomnia, colic, and weight gain. Conclusion CBD-rich cannabis extract was found to improve one of the diagnostic criteria for ASD (social interaction), as well as features that often co-exist with ASD, and to have few serious adverse effects.

Coparenting Intervention Programs: A Systematic Literature Review / Programas de intervención en coparentalidad: una revisión sistemática de la literatura / Programas de intervenção em coparentalidade: uma revisão sistemática da literatura / Coparenting Intervention Programs: A Systematic Literature Review

The coparenting relationship affects parents' and chil-dren's socioemotional well-being. Thus, we reviewed evidence in the scientific literature to describe the ob-jectives and organization of coparenting intervention programs, to examine the design of these studies and summarize evidence concerning the effectiveness of these programs. The following electronic databases were used: Bireme, Psycnet, Periódicoscapes, and IndexPsi Periódicos. The review was carried out in April 2020 with no restrictions involving the date of publication. The keywords used were "coparenting", combined with any of the following terms "training", "intervention", or "program", in Portuguese, English, and Spanish. Based on the study criteria 34 texts about 17 intervention programs were examined to gain in-formation about research design, program objectives and format, topics covered, intervention strategies, and evidence of program effectiveness. We observed that an experimental design was used in two-thirds of the studies with pretest, posttest, and follow-up evaluations. In many programs, parenting was also addressed. An array of psychoeducational intervention strategies was used to improve abilities such as emotional regula-tion, bidirectional communication, and joint decision-making. The programs were effective in helping parents to develop a more positive coparenting relationship (for example, by increasing support and reducing conflicts) and to improve their parenting (by reducing harsh pa-renting behaviors), with longitudinal studies indicating the stability of these effects. These findings indicate that coparenting can be improved and that working on the coparenting relationship is an important way of strengthening the socioemotional well-being of parents and their children.

La relación de coparentalidad afecta el bienestar socioemocional de padres e hijos. Dada su importancia, revisamos la evidencia en la literatura científica para describir los objetivos y la organización de los programas de intervención en coparentalidad que han sido evaluados, examinar el diseño de los estudios de evaluación y resumir la evidencia relativa a la eficacia de estos. Se utilizaron las bases de datos electrónicas Bireme, Psycnet, Periódicos capesy IndexPsi Periódicos. La revisión se realizó en abril del 2020, sin restricciones en la fecha de publicación. La palabra clave utilizada fue coparenting, combinada con cualquiera de los siguientes términos: training, intervention, o program. En portugués, inglés y español. Se identificaron 34 textos de 17 programas de intervención. Estos artículos fueron examinados para obtener información sobre el diseño de la investigación, los objetivos y el formato del programa, los temas tratados, las estrategias de in-tervención y la evidencia de la eficacia del programa. Observamos que en dos tercios de los estudios se utilizó un diseño experimental con evaluaciones previas, posteriores y de seguimiento. En muchos programas también se abordó la crianza de los hijos. Se utilizó una serie de estrategias de intervención psicoeducativas para mejorar habilidades como la regulación emocional, la comunicación bidireccional y la toma de decisiones conjunta. Los programas fueron eficaces para ayudar a los padres a desarrollar una relación de coparentalidad más positiva (por ejemplo, aumentando el apoyo y reduciendo los conflictos) y mejorar su crianza (por ejemplo, reduciendo las conductas de crianza duras), con estudios longitudinales que indican la estabilidad de dichos efectos. Estos resultados muestran que la coparentalidad puede mejorarse y que trabajar en esa relación es una forma de fortalecer el bienestar socioemocional de padres e hijos.

A relação coparental afeta o bem-estar socioemocional de pais e filhos. Dada a sua importância, revisamos as evidências na literatura científica para descrever os ob-jetivos e a organização dos programas de intervenção coparental que foram avaliados, examinamos o desenho dos estudos de avaliação e resumimos as evidências sobre sua eficácia. Foram utilizadas as bases de dados eletrônicas Bireme, Psycnet, Periódicos capes e Pe-riódicos IndexPsi. A revisão foi realizada em abril de 2020, sem restrições quanto à data de publicação. As palavras-chave utilizadas foram "coparenting", combi-nada com qualquer um dos seguintes termos: "training", "intervention" ou "program" em português, inglês e espanhol. Foram identificados 34 textos sobre 17 pro-gramas de intervenção. Esses artigos foram revisados para obter informações sobre o desenho da pesquisa, objetivos e formato do programa, tópicos abordados, estratégias de intervenção e evidências da eficácia do programa. Descobrimos que dois terços dos estudos usaram um desenho experimental com avaliações prévias, posteriores e de acompanhamento. A paren-talidade também foi abordada em muitos programas. Uma série de estratégias de intervenção psicoeducati-vas foram utilizadas para melhorar habilidades como a regulação emocional, comunicação bidirecional e tomada de decisão conjunta. Os programas foram efi-cazes em ajudar os pais a desenvolver uma relação de coparentalidade mais positiva (por exemplo, aumen-tando o apoio e reduzindo conflitos) e melhorar sua parentalidade (por exemplo, reduzindo comportamentos parentais severos), com estudos longitudinais indicando a estabilidade desses efeitos. Esses resultados indicam que a coparentalidade pode ser aprimorada e que tra-balhar a relação coparental é uma forma de fortalecer o bem-estar socioemocional de pais e filhos.

Cannabis and cannabinoid use in autism spectrum disorder: a systematic review

Abstract Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, associated with the presence of restricted and repetitive patterns of behavior, interests, or activities. Cannabis has been used to alleviate symptoms associated with ASD. Method We carried out a systematic review of studies that investigated the clinical effects of cannabis and cannabinoid use on ASD, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist). The search was carried out in four databases: MEDLINE/PubMed, Scientific Electronic Library Online (SciELO), Scopus, and Web of Science. No limits were established for language during the selection process. Nine studies were selected and analyzed. Results Some studies showed that cannabis products reduced the number and/or intensity of different symptoms, including hyperactivity, attacks of self-mutilation and anger, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, aggressiveness perseverance, and depression. Moreover, they found an improvement in cognition, sensory sensitivity, attention, social interaction, and language. The most common adverse effects were sleep disorders, restlessness, nervousness and change in appetite. Conclusion Cannabis and cannabinoids may have promising effects in the treatment of symptoms related to ASD, and can be used as a therapeutic alternative in the relief of those symptoms. However, randomized, blind, placebo-controlled clinical trials are necessary to clarify findings on the effects of cannabis and its cannabinoids in individuals with ASD. Systematic review registration International Prospective Register of Systematic Reviews (PROSPERO), code 164161.

Confirmed Invasive Pulmonary Aspergillosis and COVID-19: the value of postmortem findings to support antemortem management

Abstract We present postmortem evidence of invasive pulmonary aspergillosis (IPA) in a patient with severe COVID-19. Autopsies of COVID-19 confirmed cases were performed. The patient died despite antimicrobials, mechanical ventilation, and vasopressor support. Histopathology and peripheral blood galactomannan antigen testing confirmed IPA. Aspergillus penicillioides infection was confirmed by nucleotide sequencing and BLAST analysis. Further reports are needed to assess the occurrence and frequency of IPA in SARS-CoV-2 infections, and how they interact clinically.

Genomic and phylogenetic characterisation of an imported case of SARS-CoV-2 in Amazonas State, Brazil

A new coronavirus [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] is currently causing a life-threatening pandemic. In this study, we report the complete genome sequencing and genetic characterisation of a SARS-CoV-2 detected in Manaus, Amazonas, Brazil, and the protocol we designed to generate high-quality SARS-CoV-2 full genome data. The isolate was obtained from an asymptomatic carrier returning from Madrid, Spain. Nucleotide sequence analysis showed a total of nine mutations in comparison with the original human case in Wuhan, China, and support this case as belonging to the recently proposed lineage A.2. Phylogeographic analysis further confirmed the likely European origin of this case. To our knowledge, this is the first SARS-CoV-2 genome obtained from the North Brazilian Region. We believe that the information generated in this study may contribute to the ongoing efforts toward the SARS-CoV-2 emergence.

Molecular characterisation of the emerging measles virus from Roraima state, Brazil, 2018

Measles is a human infectious disease of global concern that is caused by the measles virus. In this study, we report the complete genome sequencing of one measles virus isolate, genotype D8, that was obtained directly from a urine sample in Boa Vista city, the capital of Roraima state in Brazil. Phylogenetic reconstruction grouped the genome described in this study with that of samples from Australia, South Korea, and Italy. To our knowledge, this is the first complete genome sequence of a wild-type measles virus reported from Latin America. Therefore, the present data strengthen the current knowledge on the molecular epidemiology of measles worldwide.

Ictus hemorrágico en los servicios clínicos del hospital José R López Tabrane: primer cuatrimestre del 2012 / Hemorrhagic ictus at the clinical services of the hospital José R. López Tabrane: First quarter of 2012

Se realizó un estudio descriptivo del seguimiento a 14 pacientes que ingresaron con el diagnóstico clínico y radiológico de enfermedad cerebrovascular hemorrágica en los servicios clínicos del hospital José Ramón López Tabrane de Matanzas, en el periodo de enero a abril del 2012. Se observa que el grupo de 66–75 años predominó con 6 casos para un 42,8 por ciento, siendo el sexo masculino el más afectado con 8 pacientes para un 57,1 por ciento. Se apreció una estrecha relación entre escala de Glasgow, evolución clínica y estado al egreso. Se observó con escala Glasgow 15/15 solo 1 paciente vivo, para un 7,1 por ciento; con escala de 9-14/15 hubo 9 pacientes para un 64,2 por ciento y dentro de estos 4 fallecidos para una letalidad de 44,4 por ciento, con Glasgow de menos de 8/15 se presentaron 4 pacientes que todos fallecieron para una letalidad del 100 por ciento. Se comprueba mediante estudios de neuroimagen que el 24,1 por ciento son hemorragias e infarto sin efecto de masa, el 57,1 por ciento son hemorragias con efecto de masa, el 14,2 por ciento son hemorragias subaracnoideas y el 7,1 por ciento corresponde a la hemorragia intraventricular. El 100 por ciento de los pacientes recibieron tratamiento convencional, la alimentación precoz se utilizó en 10 pacientes para un 71,4 por ciento. La estadía hospitalaria se comportó entre 2 y 15 días. Se muestra la presencia de factores de riesgo en los pacientes estudiados. Se concluye que la escala de Glasgow permite establecer un pronóstico de morbimortalidad de los pacientes que ingresan con enfermedad cerebrovascular hemorrágica.

We carried out a descriptive study of the follow up of 14 patients who entered the clinical services of the hospital José R. López Tabrane, of Matanzas, with the radiological and clinical diagnosis of hemorrhagic cerebral vascular disease, in the period form January to April 2012. We observed that there was a predominance of the 66-75-years-old age group with 6 cases for 42,8 percent, being the male genre the most affected with 6 patients for 57,1 percent. We found a tight relation among Glasgow scale, clinical evolution and health status at discharge. It was observed only one alive patient, 7,1 percent, with Glasgow scale 15/15; with Glasgow scale value 9-14/15 there were 9 patients for 64,2 percent, among them 4 passed away for 44,4 percent lethality; with Glasgow scale of less than 8/15 there were 4 patients; all of them died for 100 percent lethality. Through neuro-imaging studies we verified that 34,1 percent of the cases are hemorrhages and infarct without mass effect, 57,1 percent are hemorrhages with mass effect, 14,2 percent are sub-arachnoid hemorrhages, and 7,1 percent are intra-ventricular hemorrhages. 100 percent of the patients received conventional treatment, precocious feeding was used in 10 patients for 71,4. Hospital staying ranged between 2 and 15 days. It was showed the presence of risk factors in the studied patients. We arrived to the conclusion that the Glasgow scale allows to establish a morbimortality prognosis of the patients entering with hemorrhagic cerebral vascular disease.

Seudotumor pulmonar inflamatorio. Presentación de caso / Inflammatory pulmonary pseudo tumor. Presentation of a case

El seudotumor inflamatorio es un proceso no neoplásico poco frecuente, caracterizado por un crecimiento irregular de células inflamatorias. Puede originarse en cualquier lugar del organismo y, en la mayoría de los casos, presenta un asentamiento local único y de características benignas. Se presentó el caso de un varón de 51 años, en el que se manifestó el seudotumor inflamatorio de forma nodular en el pulmón derecho, con evolución a un empiema pleural.

The inflammatory pseudo tumor is a few frequent non neoplastic process, characterized by an irregular increase of inflammatory cells. It can be originated in any place of the organism, and in most of the cases it has only one local settlement with benign characteristics. We presented the case of a male patient, aged 51 years who had the inflammatory pseudo tumor of nodular form in the right lung, with evolution to a pleural empyema.

Eficacia del indacaterol como broncodilatador en un grupo de pacientes asmáticos / Effectiveness of Indacaterol as bronchodilator in a group of asthmatic patients

La búsqueda de nuevas opciones terapéuticas para tratar las enfermedades obstructivas bronquiales representa un reto permanente y los broncodilatadores constituyen unos de los fármacos más empleados para la atención de estos pacientes. En los últimos años han ido ganando fuerza los broncodilatadores de acción prolongada, pero el mayor efecto alcanzado era 12 h, superado por un broncodilatador nuevo salido al mercado en el año 2011, denominado indacaterol, del grupo de los beta agonistas, se diferencia de estos por la duración de su efecto que llega a alcanzar 24 h. Se realizó un estudio prospectivo, a ciego, tipo ensayo clínico, aleatorizado, con 90 pacientes asmáticos, entre 18 y 59 años de edad, que acudieron al departamento de pruebas funcionales respiratorias para estudiarles la función pulmonar. Todos recibieron de manera aleatoria indacaterol, salbutamol o placebo, y se les repitió la espirometría a los 15 min y a las 24 h de aplicado cada medicamento. Se evidenció que la respuesta broncodilatadora obtenida en los que usaron indacaterol, a las 24 h, fue muy superior a la respuesta de los que usaron otros fármacos. Se muestra además un discreto aumento de la frecuencia cardiaca y de la tensión arterial en los que usaron indacaterol y salbutamol, principalmente a los 15 min de empleados dichos medicamentos, pero dentro de los límites considerados como normales. No se evidenciaron efectos adversos

The search for new therapeutic options to treat bronchial obstructive diseases represents a permanent challenge and bronchodilators constitute one of the most used drugs in the treatment of these patients. In recent years, long acting bronchodilators have grown importance, but the greatest effect has been 12 h, superseded by a new bronchodilator that came on to the market in the year 2011 named Indacaterol, which belongs to the group of ß2-agonists and differentiates from the rest for its effect on the duration which lasts 24 hours. A randomized, essay-type, blind, prospective study was performed in 90 asthmatic patients, ranging from 18 to 59 years of age that presented to the department of respiratory functional tests for a study of their pulmonary functions. All the patients randomly received Indacaterol, Salbutamol or Placebo and spirometry was repeated 15 minutes and 24 hours after treatment. It was evidenced that the bronchodilator response obtained at the 24 hours in those patients that used Indacaterol, was higher than the response in the patients that used other drugs. The patients that used Indacterol and Salbutamol also showed a discrete increase of the cardiac frequency and blood pressure, mainly 15 minutes after receiving such drugs, but this increase is considered within the normal limits. Adverse effects were not evidenced

Conducta diagnóstica y pronóstico en pacientes con carcinoma pulmonar de células no pequeñas en estadios quirúrgicos / Diagnostic behavior and prognosis in patients presenting with non-small pulmonary cells carcinoma in surgical stages

Antecedentes: el cáncer de pulmón es la principal causa de muerte por cáncer en el mundo. La variedad histológica de células no pequeñas constituye el 70 porciento de todos los casos. Objetivos: describir el comportamiento del cáncer pulmonar no microcítico en los estadios I, II y IIIA. Métodos: se estudiaron 57 pacientes con diagnóstico de cáncer de pulmón de células no pequeñas en estadios I, II y IIIA del Hospital Clinicoquirúrgico Hermanos Ameijeiras desde enero de 2004 a diciembre de 2005. Se excluyeron los pacientes a los cuales fue imposible determinarles su estatus actual (vivo o fallecido). Resultados: el promedio de edad fue 62 años, la mayoría eran del sexo masculino y fumadores. El estadio clínico mayoritario fue el IB. La terapéutica quirúrgica se llevó a cabo en 51 pacientes. La insuficiencia respiratoria severa por EPOC fue la causa más frecuente de invalidación del tratamiento quirúrgico. Al culminar el estudio, la mitad de los pacientes había fallecido, principalmente, por metástasis. La supervivencia de los no operados a los 3 años fue 37,5 porciento y la media, 19,3 meses. No hubo sobrevivientes al cabo de los 5 años en este grupo. Mientras que la supervivencia de los pacientes operados a los 5 años fue 57,1 por ciento, con una media de 47,8 meses. Conclusión: se halló estrecha relación entre tabaquismo y cáncer pulmonar, la CAAF fue el método más utilizado para el diagnóstico. La probabilidad de vivir a los 5 años fue independiente del tipo histológico y el estadio clínico...

Introduction: the lung cancer is the leading cause of death at world scale. The non-small cells as a histological variety account for the 70 percent of all cases. Objectives: to describe the behavior of non-microcyte in I, II and IIIA stages. Methods: fifty seven patients were studied, diagnosed with non-small cells lung cancer in I, II, and IIIA stages in the Hermanos Ameijeiras Clinical Surgical Hospital from January, 2004 to December, 2005. Patients in whom it was impossible to determine its current status (live or dead) were excluded. Results: the mean age was of 62 years, most of them were of male sex and also smokers. The majority clinical stage was the IB. The surgical treatment was carried out in 51 of the total of patients. The severe respiratory failure due to the chronic obstructive pulmonary disease was the more frequent cause of invalidation of surgical treatment. At the end of study, half of patients died; the metastasis was the leading cause. The 3-years survival of the patients operated on was of 37,5 percent and the mean of 19,3 months. There was not survivors at 5 years in this group. Whereas the survival of the patients operated on at 5 years was of 57,1 percent, with a mean of 47,8 month Conclusion: there was a close relationship between smoking and lung cancer; CAAF was the more used diagnostic method. The 5-years life probability was independent of the histological type and of the clinical stage...

Neumomediastino secundario a efecto Macklin: presentación de caso / Pneumo-mediastinum secondary to Macklin effect: presentation of a case

El traumatismo torácico es un problema emergente de las grandes ciudades al aumentar los accidentes de tránsito. Se ha reportado neumomediastino hasta en 10 por ciento de los pacientes con contusión torácica, debiéndose este a lesiones traqueobronquiales en menos de 2 por ciento de los casos. A pesar de que la causa de enfisema mediastinal se desconoce en la mayoría de los pacientes, en muchos de ellos su etiología se puede deber al efecto Macklin. Esta presentación de caso trata sobre un paciente masculino de 40 años de edad con el antecedente de trauma complejo, presentando enfisema subcutáneo que afecta la cara anterior del tórax hasta los rebordes costales. En los estudios radiológicos se evidenció neumomediastino. Aunque la presencia del efecto Macklin representa un reto diagnóstico, una vez que este se ha establecido, el manejo debe basarse en el tratamiento de las lesiones asociadas. La presencia del efecto Macklin refleja el grado de severidad de la contusión torácica, por lo que estos pacientes deben ser monitorizados y manejados en el ambiente de la Unidad de Cuidados Intensivos. El objetivo de este trabajo fue reportar un caso de neumomediastino secundario a efecto Macklin, en un paciente con trauma cerrado de tórax, y revisar la fisiopatología de este mecanismo de fuga aérea.

The thoracic traumatism is an emergent problem from the big cities when increasing the traffic accidents. The pneumomediastinum it has been reported until 10 percent in patient with thoracic bruise, being due to Tracheobronchial lesions in less than 2 per cent of the cases. Although the cause of mediastinal emphysema is ignored in most of the patients, in many of them its etiologic could be by Macklin effect. This case tries on a 40 year-old masculine patient with the antecedent of complex trauma, presenting subcutaneous emphysema that affects the anterior part of the thorax until the ribs. In the radiological studies Neumomediastino is evidenced. Although the presence of the effect Macklin represents a challenge diagnosis, once this has settled down the handling it should be based on the treatment of the associate lesions. The presence of the Macklin effect show the degree of severity of the thoracic bruise, for these reason those patientes should be admited in ICU. The objective of this publication is to report a case of pneumomediastinum secundary to Macklin effect in a patient with closed trauma of thorax and take in considerations the fisiopatologic of this mechanism of air leak.

Hemorragia intraventricular. Presentación de caso / Intraventricular hemorrhage. Presentation of a case

En 1881, E. Sanders, considerado como el primer autor que describió la hemorragia intraventricular escribió: “A menudo sobreviene el ataque sin la existencia de síntomas premonitorios mientras que el paciente está en reposo o paseando, habitualmente de forma súbita, pero en ocasiones más o menos lenta; puede ser anunciado por síntomas aparentemente banales o puede sea tan violenta y arrolladora que conduzca rápida o incluso instantáneamente a la muerte”. Se realizó una revisión de la bibliografía actualizada sobre esta patología, para la mejor comprensión del caso.

In 1881, E. Sanders, considered as the first author who described the intraventricular hemorrhage, wrote: “The stroke often happens without premonitory symptoms while the patient is resting or walking, usually suddenly, but sometimes more or less slowly; it may be announced by apparently banal symptoms or may be so violent and devastating that leads quickly or even instantaneously to death”. We made a review of the updated bibliography on this pathology for a better understanding of the case.

Trombolisis en tromboembolismo pulmonar postoperatorio: presentación de caso / Thrombolysis in post-surgery pulmonary thromboembolism: presentation of a case

El presente caso plantea la utilidad de la estreptoquinasa en el manejo del tromboembolismo pulmonar, con gran repercusión hemodinámica. De mayor relevancia el hecho de tratarse de un paciente postoperatorio, período en el cual el riesgo de tromboembolismo pulmonar es más alto, y el temor de sangrado motiva al cirujano a ser reacio a la anticoagulación. Se presentó una revisión actualizada del tema y la experiencia de un paciente con tromboembolismo pulmonar tratado con estreptoquinasa en el Hospital Provincial Docente Clínico Quirúrgico José Ramón López Tabrane, de Matanzas, monitorizado con catéter de arteria pulmonar, lo cual evidenció una disociación entre la presión distólica pulmonar y la presión en cuña. Se le aplicó estreptoquinasa por infusión continua, con respuesta clínica y hemodinámica satisfactoria...

The current case states the utility of the streptokinase in the pulmonary thromboembolism, with a great hemodynamic repercussion. Of greatest relevance is the fact of being a post-surgery patient, period in which post-surgery pulmonary thromboembolism risk is higher, and fearing bleeding motivates surgeon to refuse anticoagulation. We presented an updated review of the theme and the experience of a patient with post-surgery pulmonary thromboembolism treated with streptokinase in the Clinical Teaching Provincial Hospital José Ramón Lopez Tabrane, of Matanzas , monitored with a catheter of pulmonary artery, evidencing a dissociation between pulmonary diastolic pressure and wedge pressure. He received streptokinase via continuous infusion, with a satisfactory clinical and hemodynamic answer...

Adolescentes em situação de rua: prostituição, drogas e HIV/AIDS em Santo André, Brasil / Street youth: prostitution, drugs and HIV/AIDS in Santo André-Brazil

O objetivo do estudo foi investigar as condições de vida de adolescentes do sexo feminino em situação de rua, envolvidas com o abuso de drogas e com a prostituição, visando orientar estratégias de prevenção às Doenças Sexualmente Transmissíveis - DST/AIDS. Foram entrevistadas sete adolescentes entre 14 e 19 anos, por meio de roteiro semi-estruturado com questões sobre escolaridade; desligamento da família; violência; histórico de uso de drogas, sexualidade e existência de DST/AIDS; vida na rua e futuro. Observou-se que os principais motivos que levaram essas adolescentes à rua foram violência doméstica; baixo nível sócio-econômico familiar e abuso de múltiplas drogas. As entrevistadas afirmaram conhecer medidas preventivas para as DST/AIDS, porém não as aplicaram aos clientes fixos e namorados. A análise dos resultados obtidos nesta pesquisa confirma a importância da criação de estratégias específicas para as DST/AIDS, além da adequação da rede educacional e de atenção psicossocial às necessidades das adolescentes para a garantia de seus direitos e conquista da emancipação.

The aim of this study was to investigate living conditions of female street adolescents, who are involved with illicit and licit drugs, and with prostitution, in the city of Santo André, as well as to tailor strategies for STD/AIDS prevention. We have interviewed seven adolescents, aged from 14 to 19 years old, using a semi-structured questionnaire with questions about education, family disaffection, violence, living on the streets, history of drug use, sexuality, level of information about STD/AIDS, and hopes for the future. We observed that among the reasons for these adolescents to live on the streets were domestic violence, low socioeconomic level, and drug abuse. They stated that they are aware of STD/AIDS preventive measures, but they do not bring them into effect with steady partners and boyfriends. The analysis of our results confirms the importance of creating well-defined strategies to STD/AIDS prevention, additionally to suitable educational system and psychosocial attention service. This will assure adolescents' rights and emancipation.

Adolescência e corpo: a prostituição e o abuso de droga como sintoma / Adolescence and the body: a prostitution and drug abuse as a symptom

O estudo propõe, com base na escuta das histórias de vida de dez jovens, entre 19 e 25 anos, que vivem na prostituição em boates da cidade de Santo André-SP, realizar uma discussão a respeito da prevenção das DST/AIDS e da toxicomania. A partir da fala de cada entrevistada sob o enfoque da psicanálise, evidenciou-se o fato de que as jovens, embora disponham de informações sobre medidas preventivas das DST/aids, vivenciam um conflito de identidade expresso em vários níveis de seu discurso que contribui para a vulnerabilidade dessas doenças, sobretudo nas relações que envolvem afetividade. Apoiando-se nesses discursos, foi possível pontuar a implicação dessa ambiguidade no cuidado de si e na necessidade de políticas públicas que abordem a prostituição, levando em conta esse aspecto.

The purpose of this study is to discuss the prevention of STDs/AIDS and drug adiction, starting from listening to ten life stories from youngsters, between 19 and 25 years old, who are involved in prostitution at nightclubs from the city of Santo André-SP. Through the speech of each and every one of them, under the psychoanalysis approach, it was possible to notice that, although having information on the prevention methods against STDs/AIDS, the youngsters live an identity conflict shown in many levels of their discourse, which contributes to their vulnerability towards these diseases, mainly in their affective relationships. Based on these discourses, it was possible to identify the implications of this ambiguity while caring for themselves and the need of public policies that take prostitution into account, regarding this aspect, from a woman's point of view.

Dieta mediterránea: ¿salud para el futuro? / Mediterranean diet. Is it health for the future?

Se realiza una revisión de los antecedentes históricos-sociales de la dieta de los países con costas en el mar Mediterráneo, motivado por los análisis estadísticos que demuestran la baja incidencia de cardiopatía isquémica, así como factores de riesgo coronario y cerebrovasculares en estas poblaciones. Valorando las actuales formas de comer de las culturas mediterráneas y el porque de su valor saludable...

Peter Safar, breve reseña de su vida / Peter Safar, a brief review of his life

Hijo de padre oftalmólogo y madre pediatra, tuvo acceso a la floreciente herencia cultural de la Viena de los años 30 (nace el 12 de abril de 1924). Todavía muy pequeño, contempla con asombro el mundo que su padre, Karl Safar, le muestra bajo la lente del microscopio: un mundo diminuto más benévolo que el que pudieron ver sus ojos de niño en aquella vieja Europa...

Actualización en la conducta a seguir en el trauma craneal / Up-Dating on the behavior to follow in craneal trauma

El trauma craneal se ha convertido en una epidemia. El manejo de los pacientes con trauma craneoencefálico depende de diferentes factores, incluyendo la presencia o no de traumas asociados, las condiciones clínicas del paciente antes y después del trauma y por supuesto, la severidad del traumatismo.El seguimiento estricto del accidentado desde el mismo momento en que tiene lugar el evento traumático, su imprescindible estabilización cardio-respiratoria y adecuadas condiciones de traslado, garantizan una disminución de la mortalidad y reducción considerable del deterioro secundario de la función neurológica relacionadas o agravadas por la hipotensión arterial y la hipoxia, fundamentalmente. El reconocimiento precoz de estos factores junto al tratamiento rápido y efectivo, son las únicas formas de reducir la morbimortalidad por trauma craneoencefálico.El objetivo de nuestro trabajo es repasar los principios a seguir en el tratamiento inicial de los pacientes con trauma craneal e intentar reducir la mortalidad por esta entidad en nuestra provincia...

Evidenciaçäo radiográfica de lesöes ósseas produzidas artificialmente em mandíbulas humanas secas / radiographic evidencing of bone lesions artificially produced in dry human mandibles

Este trabalho propöe-se a avaliar experimentalmente quando uma lise óssea de origem endodôntica torna-se discernível radiograficamente e, quando visível, se coincide com seu tamanho real. Desenvolvemos uma metodologia simulando situaçöes clínicas através de perfuraçöes ósseas produzidas artificialmente em mandíbulas humanas secas. Com brocas esféricas de números 2, 4, 6, 8 e 10, foram confeccionadas cavidades ósseas na regiäo periapical em osso esponjoso através de um alvéolo. Essas perfuraçöes seguiram uma ordem crescente, sempre no mesmo lugar. A cada aumento do diâmetro da broca, foi realizada uma radiografia. Os desgastes só eram aparentes radiograficamente quando a cortical estava envolvida, confirmando o fato de que as alteraçöes ósseas iniciam-se sem qualquer tipo de sinal radiográfico aparente e, quando discerníveis, näo coincidem com seu tamanho real