Perfil clínico-epidemiológico de felinos domésticos notificados com esporotricose no município de São Paulo no ano de 2020 / Clinical-epidemiological profile of domestic felines notified with sporotrichosis in the city of São Paulo in the year 2020

A esporotricose é uma dermatozoonose causada por fungos do gênero Sporothrix, que costumam estar presentes no meio ambiente, tanto no solo quanto na vegetação em decomposição. A infecção não zoonótica ocorre por meio da inoculação traumática do agente etiológico durante o manuseio de solo contaminado, plantas ou matéria orgânica. Atualmente, essa ainda é uma via de transmissão possível, porém a transmissão zoonótica vem se destacando crescentemente, e a esporotricose humana frequentemente está relacionada à arranhadura ou à mordedura de animais, em especial o gato doméstico (Felis catus). Em São Paulo, a Divisão de Vigilância em Zoonoses (DVZ) e as Unidades de Vigilância em Saúde (UVIS) são os órgãos da Prefeitura responsáveis pela vigilância, prevenção e controle dessa zoonose. O objetivo do presente trabalho é traçar o perfil epidemiológico de felinos domésticos com esporotricose no município de São Paulo entre os casos atendidos e/ou notificados no ano de 2020. Ao todo, foram avaliadas 1.050 fichas de felinos, dos quais 653 tinham diagnósticos confirmados; destes, 76% possuem livre acesso à rua. Felinos adultos, machos e não castrados, devido aos seus hábitos comportamentais e exploratórios, mostram-se mais expostos à infecção. Quanto à localização anatômica das lesões fúngicas, as regiões de maior ocorrência foram: cabeça (58,35%), membro torácico (34,76%), corpo (28,33%) e focinho (27,72%). Sendo assim, a domiciliação dos felinos domésticos é importante ponto na prevenção de novos casos. Sugerimos que futuras análises sejam realizadas, no mínimo, um ano após notificação/início do tratamento para melhor acompanhamento da coorte.

Principais manifestações clínicas oftalmológicas prevalentes em pacientes acometidos por fraturas orbitárias: revisão integrativa de literatura / The main ophthalmological clinical manifestations prevalent in patients affected by orbital fractures: an integrative literature review

RESUMO Um em cada quatro pacientes acometidos por trauma maxilofacial terão concomitantemente fraturas da órbita e lesão ocular. Por isso, uma avaliação oftalmológica minuciosa é recomendada para todos os pacientes que sofrem um trauma de face. Alguns exames oftalmológicos logo após o trauma podem ser decisivos para a preservação da acuidade visual. Sujeitos com achados de exame físico de acuidade visual deficitárias, defeito pupilar aferente e imagens radiográficas com alta profundidade da fratura da órbita estão em maior risco de perda de visão e justificam preocupação específica para avaliação de lesão ocular. O objetivo deste estudo foi reunir as manifestações clínicas oftalmológicas prevalentes em pacientes acometidos por fraturas orbitárias, com o intuito de adquirir melhor perspectiva e entendimento acerca das consequências que a patologia traz ao indivíduo, no que tange à oftalmologia e aos tratamentos mais adequados. Trata-se de estudo de revisão integrativa, utilizando as bases de dados Pubmed®/Medline®, SciELO, Biblioteca Virtual em Saúde e Lilacs, com um vocabulário controlado segundo a estratégia de busca em cada uma das bases de dados bibliográficas, por meio dos termos "ophthalmologic complications", "prevalence", "orbital fracture", em estudos publicados de 2013 a 2023. A qualidade dos artigos foi avaliada usando o Study Quality Assessment Tool from the Department of Health and Human Services. Foram encontradas 46 referências, sendo 20 no Pubmed®/Medline®, 17 na SciELO, 9 na Biblioteca Virtual em Saúde e nenhuma na Lilacs. Após excluir referências duplicadas, foram selecionadas 44 referências para avaliação de elegibilidade. Após leitura dos títulos e resumos (n=44), 36 estudos foram excluídos pelas seguintes razões: artigos que não respondiam a nossa pergunta científica (n=11) e publicação superior a 10 anos (n=25). Identificaram-se, nos oito artigos selecionados, o objetivo do estudo, a população estudada o nível de evidência. Os oito estudos tiveram como objetivo analisar traumas orbitais com alterações funcionais significativas oculares e visuais pelo prejuízo ao tecido ósseo, nervoso, vascular e até parenquimatoso cerebral na região do assoalho e paredes de cavidades orbital. Dentre as manifestações clínicas oftalmológicas mais importantes, listam-se manifestação de enoftalmia, diplopia, hifema traumático, hemorragia retiniana, amaurose, quemose, neuropatia óptica traumática e hematoma retrobulbar. Considerando os oito estudos analisados, verificou-se a presença unânime de manifestações clínicas oftalmológicas na totalidade dos pacientes acometidos, sendo predominantes a baixa acuidade visual e o hifema. No que tange aos achados de menor prevalência, ao equipará-los às manifestações clínicas oftalmológicas mais encontradas, verifica-se que possuem como fator principal o estado transitório, concluindo-se que, mesmo com toda a gravidade do quadro de fratura orbitária, sua tendência é não deixar sequelas permanentes em grande partes dos casos, ainda que não seja nítida a relação estabelecida pela ausência de sequelas permanentes, especulando-se que essa ausência se deve à identificação do quadro e à intervenção adequada em tempo hábil.

ABSTRACT One in four patients affected by maxillofacial trauma will have concomitant orbital fractures and ocular injuries; therefore, an ophthalmological evaluation is recommended for all patients who have been affected by facial trauma. Some ophthalmological exams soon after the trauma can be decisive for the preservation of visual acuity. Patients with physical examination findings of poor visual acuity, afferent pupillary defect, radiographic images with high depth of orbital fracture, are at greater risk of vision loss and specific concern for evaluation of ocular injury. The objective of this study was to gather the prevalent ophthalmologic clinical manifestations in patients affected by orbital fractures, to achieve a better perspective and understanding about the consequences that the pathology brings to the individual regarding ophthalmology and the most appropriate treatments. This is an integrative review study, using the Pubmed®/Medline®, SciELO, Virtual Health Library and Lilacs databases, with a controlled vocabulary according to the search strategy in each of the bibliographic databases, using the terms "ophthalmologic complications", "prevalence", "orbital fracture", in studies published from 2013 to 2023. The quality of the articles was assessed using the Study Quality Assessment Tool from the Department of Health and Human Services. A total of 46 references were found, 20 in Pubmed®/Medline®, 17 in SciELO, 9 in the Virtual Health Library and none in Lilacs. After excluding duplicate references, 44 references were selected for eligibility assessment. After reading the titles and abstracts (n=44), 36 studies were excluded for the following reasons: articles that did not answer our scientific question (n=11) and publication over 10 years (n=25). In the eight selected articles, the objective of the study, the population studied, and the level of evidence were identified. The eight studies aimed to analyze orbital trauma with significant ocular and visual functional changes due to damage to bone, nerve, vascular, and even brain parenchymal tissue in the region of the floor and walls of orbital cavities. Among the most important ophthalmologic clinical manifestations, there are enophthalmos, diplopia, traumatic hyphema, retinal hemorrhage, amaurosis, chemosis, traumatic optic neuropathy and retrobulbar hematoma. Considering the eight studies analyzed, there was a unanimous presence of ophthalmological clinical manifestations in all affected patients, with low visual acuity and hyphema being predominant. Regarding the findings of lower prevalence, when equating them to the most common ophthalmologic clinical manifestations, they have as main factor the transient state, which can be concluded that, even with all the severity of the orbital fracture, its tendency is not to leave permanent sequelae in most cases, although the relationship established by the absence of permanent sequelae is not clear, speculating that this absence is due to the identification of the condition and the appropriate intervention in a timely manner.

Tecnologia assistiva e políticas públicas no Brasil / Assistive technology and public policies in Brazil

Resumo A Tecnologia Assistiva é pouco disseminada no Brasil. Avanços têm ocorrido gradativamente por meio de conquistas na área jurídica e do fomento à pesquisa e desenvolvimento. A proposição de políticas nessa área pode contribuir para superar as desigualdades sociais de um significativo segmento da população que representa um mercado real e em expansão. No entanto, a baixa otimização desses recursos por seus usuários e a dificuldade em buscá-los no mercado e nos órgãos públicos são fatores preocupantes. Este estudo vem, portanto, abordar a repercussão da demanda por Tecnologia Assistiva nas políticas públicas brasileiras com o objetivo identificar a relação existente entre a otimização desses recursos e serviços e a formulação de políticas direcionadas no país. Por meio de pesquisa bibliográfica, com característica exploratória e abordagem qualitativa, foi realizado um levantamento da legislação brasileira e ações existentes na área da Tecnologia Assistiva, bem como a análise de políticas públicas brasileiras com base nos critérios da avaliação normativa, aplicando-se o método dedutivo e a técnica de análise de conteúdo de Bardin. Verificou-se na literatura científica que, apesar do avanço gradativo da legislação e das iniciativas de fomento a projetos nessa área, fatores de entrave ao acesso, utilização e aproveitamento dos produtos assistivos, como a escassez na oferta de tecnologias inovadoras, acarretam dificuldades para a formatação de políticas eficazes e a configuração adequada às ações de fomento na área de Tecnologia Assistiva - essenciais ao processo de inclusão social.

Abstract Assistive Technology is not widespread in Brazil. Advances have occurred gradually through achievements in the legal area and the promotion of research and development. The proposition of policies in this area can contribute to overcoming the social inequalities of a significant segment of the population that represents a real and expanding market. However, the low optimization of these resources by their users and the difficulty in finding them in the market and public agencies are worrying factors. This study addresses the impact of the demand for Assistive Technology on Brazilian public policies aiming to identify the relationship between the optimization of these resources and services and the formulation of targeted policies in the country. Through bibliographic, exploratory and qualitative research, a survey was conducted on the Brazilian legislation and the existing actions in the area of Assistive Technology, as well as an analysis of Brazilian public policies based on the normative evaluation criteria, applying the deductive method and the Bardin's content analysis technique. The scientific literature shows that, despite the gradual advancement in legislation and initiatives to promote projects in this area, factors that hinder the access, use, and application of assistive products, such as the scarcity of innovative technologies, entail difficulties for the formatting of effective policies and the adequate configuration of fostering actions in the area of Assistive Technology, which is essential to the process of social inclusion.

Prevalence of low back pain in Port of Santos workers.

INTRODUCTION: Low back pain is a common symptom among the general population and among manual workers, contributing to high rates of absenteeism and a decrease in overall quality of life. OBJECTIVES: To determine the prevalence of low back pain in Port of Santos workers, its influence on overall quality of life, physical activity level, and associated absenteeism rate. METHODS: This cross-sectional prevalence study was based on prospective data collection. RESULTS: Eighty-two port workers were interviewed, 97.6% were male, and mean age was 42.9 years. Ethnically, 37.8% reported being brown. Most had completed high school. Longshoreman was the most common occupation, followed by foreman, tallyman, and others. A 44-hour workweek was the most frequent (31.3%), and over 85% of workers reported not working overtime. Most of them were not paid on a production basis. Formal employment, according to Brazilian Labor Law, was 70.7%, and union membership was 64.6%. The mean time working at the port was 11.9 years (standard deviation ± 12.5). Occupational low back pain was reported by 17% of respondents, leading to an absenteeism rate of 19.7%. Physical activities helped improve the feeling of vitality for work performance. CONCLUSIONS: The prevalence of low back pain among respondents was 17%, not influencing their quality of life, with an absenteeism rate of 19.7%. Doing physical activities was common among respondents.

Prevalence of Rickettsia rickettsii in Ticks: Systematic Review and Meta-Analysis.

Background and Objectives:Rickettsia rickettsii is a pathogen that is known to cause spotted fever, a zoonosis that is endemic in several regions of the Americas. However, no systematic review and meta-analysis has been conducted to estimate the prevalence of this rickettsial disease in the Americas. Therefore, the objective of this study was to estimate the prevalence of R. rickettsii in ticks in the Americas. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and data were retrieved from four electronic databases: MEDLINE/PubMed, SciELO, ScienceDirect, and Directory of Open Access Journals. The pooled prevalence and heterogeneity were determined using a random-effects model and using Cochran's Q test and I2 index, respectively. Publication bias was assessed using a funnel plot and Egger's method. Results: The pooled prevalence of R. rickettsii in ticks was highest in Colombia (17.00%; confidence interval [95% CI]: 7.01-30.24), followed by Mexico (9.89%; 95% CI: 2.03-22.74), Panama (2.76%; 95% CI: 0.45-6.93), Brazil (2.03%; 95% CI: 0.66-4.14), and the United States (0.50%; 95% CI: 0.15-1.05). The tick species most frequently infected by R. rickettsii were Rhipicephalus sanguineus sensu lato (6.23%; 95% CI: 2.79-10.92) and Amblyomma mixtum (4.36%; 95% CI: 0.25-13.14). Interpretation and Conclusion: It can be suggested that studies aiming to identify the potential vectors of R. rickettsii should be conducted more intensively to better understand the epidemiology of spotted fever in the Americas.

Brazilian spotted fever: A spatial analysis of human cases and vectors in the state of São Paulo, Brazil.

Brazilian spotted fever (BSF) is a highly lethal disease caused by Rickettsia spp. and is transmitted by ticks of the genus Amblyomma. Understanding the epidemiology of BSF in each region can help direct health surveillance actions. The objective of this study was to determine the spatial distribution of vectors and the incidence of BSF in the state of São Paulo. Spatial analysis included confirmed BSF cases between 2009 and 2019; occurrences were registered by municipalities of the state. There were 752 confirmed BSF cases, with incidences ranging between 0.01 and 10.37/10,000 inhabitants. Moran's Global Index for BSF was 0.20 (p = .001), which was indicative of spatial dependence. Moran's map located a cluster of 20 high priority municipalities for BSF and showed that Amblyomma sculptum is the vector involved in Rickettsia rickettsii transmission in these locations. Spatial analysis identified clusters formed by 47, 20 and seven significant municipalities for the presence of A. sculptum, Amblyomma aureolatum and Amblyomma ovale vectors, respectively. Surveillance and prevention actions are necessary in areas that are at high risk for BSF and in areas where the presence of vectors was significant.

Acumuladores de animais: instrumento de vistoria técnica e perfil de casos no município de Guarulhos, SP, Brasil / Animal hoarders: Technical inspection instrument and profilein the city of Guarulhos, SP, Brazil

O transtorno de acumulação de animais, é uma psicopatologia caracterizada pela aquisição de muitos animais mantidos em espaços inadequados, onde os cuidados básicos de saúde, alimentação e bem-estar são negligenciados. O objetivo deste estudo foi caracterizar o perfil de acumuladores de animais no município de Guarulhos e elaborar um instrumento de coleta de dados para ser utilizado em vistoria técnica nestes casos. Foi realizado um levantamento e análise descritiva dos arquivos de casos de acumuladores de animais atendidos pelo serviço municipal. Dentre os 26 casos recebidos no período de 2012-2017, 12 (46,16%) eram referentes a casos de acumulação de animais. Estas ocorrências foram encaminhadas ao serviço de saúde como denúncias. Os dados obtidos, por meio das análises dos prontuários, foram refinados e, posteriormente, transcritos em planilhas considerando as variáveis de interesse, assim, facilitando o processo de interpretação. Para caracterizar o perfil dos casos de acumuladores, os dados adquiridos foram analisados por meio de cálculos de médias e frequências relativas. O perfil de acumuladores se caracterizou por mulheres, solteiras, idosas, desempregadas ou aposentadas, que residem sozinha em casa própria, portadoras de comorbidades ou fatores psicológicos associados, acumulando cães e gatos, especificamente, cães em sua maioria. O instrumento de vistoria em atenção a indivíduos em situação de acúmulo de animais proposto apresenta caracterização do indivíduo, ambiente, condições gerais dos animais e, ainda, indicadores de comprometimento de bem-estar animal ou maus-tratos.

Animal hoarding disorder is a psychopathy characterized by the acquisition of many animals that are kept in improper locations, in which the basic health care, feeding and well-being are neglected. The objective of this study was to characterize the profile of animal hoarders in the city of Guarulhos and to elaborate an instrument of data collection to be used in technical survey in cases of animal hoarding. Amongst the 26 cases analyzed, 12 (46,16%) were related to animal hoarding. These cases were sent to the health care service as denounces. Data obtained through analysis of medical records were refined and later transcribed into spreadsheets considering the variables of interest, thus facilitating the interpretation process. To characterize the profile of the hoarding cases, data were analyzed by means of calculations of means and relative frequencies. Hoarders profile is characterized as female, single, elderly, unemployed or retired, living alone at her own house, with associated comorbidities or psychological disorders, hoarding dogs and cats, specifically dogs in most cases. The proposed instrument presents characterization of the individual, environment, general conditions of the animals and also indicators of impairment of animal welfare or animal abuse.

Acumuladores de animais: instrumento de vistoria técnica e perfil de casos no município de Guarulhos, SP, Brasil / Animal hoarders: Technical inspection instrument and profile in the city of Guarulhos, SP, Brazil

O transtorno de acumulação de animais, é uma psicopatologia caracterizada pela aquisição de muitos animais mantidos em espaços inadequados, onde os cuidados básicos de saúde, alimentação e bem-estar são negligenciados. O objetivo deste estudo foi caracterizar o perfil de acumuladores de animais no município de Guarulhos e elaborar um instrumento de coleta de dados para ser utilizado em vistoria técnica nestes casos. Foi realizado um levantamento e análise descritiva dos arquivos de casos de acumuladores de animais atendidos pelo serviço municipal. Dentre os 26 casos recebidos no período de 2012-2017, 12 (46,16%) eram referentes a casos de acumulação de animais. Estas ocorrências foram encaminhadas ao serviço de saúde como denúncias. Os dados obtidos, por meio das análises dos prontuários, foram refinados e, posteriormente, transcritos em planilhas considerando as variáveis de interesse, assim, facilitando o processo de interpretação. Para caracterizar o perfil dos casos de acumuladores, os dados adquiridos foram analisados por meio de cálculos de médias e frequências relativas. O perfil de acumuladores se caracterizou por mulheres, solteiras, idosas, desempregadas ou aposentadas, que residem sozinha em casa própria, portadoras de comorbidades ou fatores psicológicos associados, acumulando cães e gatos, especificamente, cães em sua maioria. O instrumento de vistoria em atenção a indivíduos em situação de acúmulo de animais proposto apresenta caracterização do indivíduo, ambiente, condições gerais dos animais e, ainda, indicadores de comprometimento de bem-estar animal ou maus-tratos.

Animal hoarding disorder is a psychopathy characterized by the acquisition of many animals that are kept in improper locations, in which the basic health care, feeding and well-being are neglected. The objective of this study was to characterize the profile of animal hoarders in the city of Guarulhos and to elaborate an instrument of data collection to be used in technical survey in cases of animal hoarding. Amongst the 26 cases analyzed, 12 (46,16%) were related to animal hoarding. These cases were sent to the health care service as denounces. Data obtained through analysis of medical records were refined and later transcribed into spreadsheets considering the variables of interest, thus facilitating the interpretation process. To characterize the profile of the hoarding cases, data were analyzed by means of calculations of means and relative frequencies. Hoarders profile is characterized as female, single, elderly, unemployed or retired, living alone at her own house, with associated comorbidities or psychological disorders, hoarding dogs and cats, specifically dogs in most cases. The proposed instrument presents characterization of the individual, environment, general conditions of the animals and also indicators of impairment of animal welfare or animal abuse.

Meta-analysis of the prevalence and risk factors associated with bovine neosporosis.

Neospora caninum is one of the main infectious agents that cause reproductive disorders in cattle. However, knowledge about the prevalence and causal factors of bovine neosporosis is needed in order to establish control measures. The purpose of this study was to estimate the pooled prevalence and determine the risk factors of bovine neosporosis using meta-analytic methods. Searches for data on N. caninum seroprevalence and potential risk factors were conducted in the PubMed, LILACS, and SciElo databases. The random effects model was used for the meta-analysis of the included studies. The pooled prevalence of N. caninum in cattle was 24% (95% confidence interval (CI), 19-29) in North and Central America, 24% (95% CI, 20-28) in South America, 18% (95% CI, 14-21) in Asia, 15% (95% CI, 12-18) in Europe, 13% (95% CI, 11-16) in Africa, and 8% (95% CI, 4-14) in Oceania. A significant correlation was found between N. caninum infection and abortion in cows (odds ratio (OR) = 2.66, 95% CI, 1.97-3.59). The following risk factors were signicantly associated with N. caninum seroprevalence: presence of dogs on the farm (OR = 2.84; 95% CI, 1.40-5.80) and the type of cattle production system, with dairy cattle being more susceptible to bovine neosporosis (OR = 1.60; 95% CI, 1.16-2.19) than beef cattle. The adoption of measures to prevent the dissemination of N. caninum in cattle herds is suggested, aiming to reduce the economic losses incurred to the dairy and beef industry.

Profile and costs involved in long-term compulsory hospitalization of psychiatric patients

Objective: Involuntary hospitalization for acute psychiatry cases can be acceptable when there is potential harm. However, there are few reasons for a patient committed on these grounds to stay in an institution for a long period. The objective of the present study was to identify the profile and costs of compulsory hospitalizations over 20 days in a public psychiatric hospital in the coastal region of the state of São Paulo. Methods: Retrospective data were collected from the medical records of 1,064 patients admitted between July 2013 and June 2016 from an intensive mental healthcare unit in Santos, state of São Paulo, Brazil. Results: Records were found of 527 patients who had been hospitalized for at least 21 days during the study period. Long-term hospitalization related to judicial mandates represented 5.9% of the total sample. These patients stayed in the hospital for an average period of 142 days, while patients hospitalized for any other reason stayed an average period of 35 days (p < 0.001). The cost of a long-term court-ordered hospitalization averaged US$ 21,311 per patient. Conclusion: Judicial mandate has been an important reason for the long-term hospitalization of chronic psychiatric patients in Santos, Brazil.

Methicillin-Resistant Staphylococcus aureus in Poultry and Poultry Meat: A Meta-Analysis.

Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that colonizes and infects various host species and has been found in the poultry production chain, raising concerns about possible transmission from farm to fork. The objective of this study was to use meta-analytical methods to estimate the pooled prevalence of MRSA in chickens, turkeys, chicken meat, and turkey meat. Three electronic databases (PubMed, LILACS, and SciELO) were searched to establish MRSA prevalence from 51 studies published from 2003 through May 2017. The heterogeneity was assessed, and the pooled MRSA prevalence was calculated by using the random effects model according to the method of DerSimonian and Laird. Pooled MRSA prevalence (95% confidence interval [CI]) in turkeys, turkey meat, broilers, and chicken meat was 36% (1 to 78%), 13% (1 to 28%), 5% (2 to 9%), and 5% (3 to 8%), respectively. South America had the highest MRSA prevalence (27%; 95% CI, 17 to 37%), and North America had the lowest (1%; 95% CI, 0 to 2%). Livestock-associated MRSA has been isolated from poultry and poultry meat, indicating that this variant can spread from farm to fork. The presence of MRSA in poultry and poultry meat poses risks to public health, and steps should be taken to mitigate the contamination and spread of this bacterium along the poultry production chain.

Profile and costs involved in long-term compulsory hospitalization of psychiatric patients.

OBJECTIVE: Involuntary hospitalization for acute psychiatry cases can be acceptable when there is potential harm. However, there are few reasons for a patient committed on these grounds to stay in an institution for a long period. The objective of the present study was to identify the profile and costs of compulsory hospitalizations over 20 days in a public psychiatric hospital in the coastal region of the state of São Paulo. METHODS: Retrospective data were collected from the medical records of 1,064 patients admitted between July 2013 and June 2016 from an intensive mental healthcare unit in Santos, state of São Paulo, Brazil. RESULTS: Records were found of 527 patients who had been hospitalized for at least 21 days during the study period. Long-term hospitalization related to judicial mandates represented 5.9% of the total sample. These patients stayed in the hospital for an average period of 142 days, while patients hospitalized for any other reason stayed an average period of 35 days (p < 0.001). The cost of a long-term court-ordered hospitalization averaged US$ 21,311 per patient. CONCLUSION: Judicial mandate has been an important reason for the long-term hospitalization of chronic psychiatric patients in Santos, Brazil.

Dor crônica: manejo baseado nos mecanismos / Chronic pain: mechanism based management

A dor crônica (DC) é uma experiência sensorial e emocional desagradável e é definida por períodos contínuos ou persistentes de dor superior a três meses de duração. A classificação da DC, por seu mecanismo, permite um manejo mais adequado e eficiente. O presente trabalho objetiva revisar esta visão e analisar aspectos concernentes à essa questão.

Chronic pain (CP) is a multidimensional sensation with intrinsically unpleasant experiences. It is associated to uninterrupted or persistent periods of pain superior to e three months. CP is classified according to its mechanism, and this distinction is important to make the appropriate management of the condition. The goal of this assessment is to review such concept.

Primary isolated osteoma cutis of the face.

We report a healthy, 44-year-old woman presenting with an at least a 20-year history of hardened papules in the forehead region, extending to the scalp. The biopsy and histopathologic exam confirmed a diagnosis of osteoma cutis. We review the literature review and discuss the classification of the cutaneous ossification process presented, along with the results of the surgical treatment.

Determinantes ambientais e não-ambientais da transmissão do plasmódio na paisagem urbana amazônica e suas consequências clínicas: estudo de base populacional em Mâncio Lima, Acre / Environmental and non- environmental determinants of plasmodium transmission in the Amazonian urban ladscape and its clinical consequences: a population- based study in Mâncio Lima, Acre

Este estudo avaliou as mudanças ambientais da paisagem urbana de um município com alta incidência de malária na Amazônia brasileira (Mâncio Lima, Acre) e sua relação com a doença, com o objetivo de prover evidências de que a transmissão do Plasmódio é causada pelo modo como os seres humanos interagem com o meio-ambiente. Foram efetuados três estudos populacionais consecutivos, entre 2012 e 2013, com 1260 indivíduos, com identificação do plasmódio por microscopia e técnicas moleculares. Casos de malária foram analisados mediante um questionário clinico. O estudo entomológico envolveu 8 inquéritos transversais com coleta de formas imaturas em 90 corpos d’água, bem como avaliação espacial desses dados. Os resultados mostraram que a transmissão de malária na área deveu-se em grande parte a criação de tanques de piscicultura, que elevaram em cerca de 10 vezes a produtividade de imaturos de Anopheles darlingi, e à grande mobilidade da população, que se desloca para áreas de maior transmissão (como área ribeirinha e rural) e retorna infectada para a área urbana. Foram identificados casos de portadores assintomáticos do Plasmódio, embora em pequena quantidade. Os fatores associados a ausência de sintomas (infecção assintomática) foram o sexo e o tempo da última malária. Em pacientes sintomáticos, a frequência dos sintomas se relacionou com idade, número de malárias previas e parasitemia. A concentração geográfica dos casos deveu-se em parte a características socioeconômicas agregadas no espaço, em conjunto com fatores ambientais como presença do vetor, visto que o uso infrequente de mosquiteiro associouse com a incidência maior de malária.

This study evaluated the environmental changes of the urban landscape of a municipality with a high incidence of malaria in the Brazilian Amazon (Mâncio Lima, Acre) and its relation with the disease, in order to provide evidence that the transmission of Plasmodium is caused by the way humans interact with the environment. Three consecutive population studies were carried out between 2012 and 2013, with 1260 individuals, with plasmodium identification by microscopy and molecular techniques. Malaria cases were analyzed using a clinical questionnaire. The entomological study involved 8 cross-sectional surveys with collection of immature forms in 90 bodies of water, as well as spatial evaluation of these data. The results showed that the transmission of malaria in the area was largely due to the creation of fish tanks, which increased the immature productivity of Anopheles darlingi by around 10 times, and the great mobility of the population, which moves to areas of greater transmission (as riverside and rural area) and returns infected to the urban area. Cases of asymptomatic Plasmodium carriers have been identified, albeit in small numbers. Factors associated with absence of symptoms (asymptomatic infection) were the sex and time of the last malaria. In symptomatic patients, the frequency of symptoms was related to age, number of previous malaria and parasitemia. The geographic concentration of the cases was due in part to aggregate socioeconomic characteristics in space, together with environmental factors such as vector presence, since the infrequent use of mosquito nets was associated with a higher incidence of malaria.

Immunophenotyping of leukocytes in bovine placenta / Imunofenotipagem de leucócitos na placenta bovina

Lymphocytes and macrophages are the main white cells involved in fetal-maternal tolerance. Little is known about these leukocytes in bovine placenta, such as the quantity and location of these cells. Thus, the objective of this study was to identify lymphocyte and macrophage populations in bovine placenta using specific markers and flow cytometry. This study analyzed samples of placentomes and intercaruncular regions of cows in the three quarters of pregnancy. In the placentomes, during the first quarter of pregnancy, mean percentage of labeled CD3+ cells was 2.34%; CD8+, 1.28%; CD14+, 1.66%; and CD335+, 0.96%. For the intercaruncular region, percentage of CD3+ cells was 0.71%; CD8+, 1.63%; CD14+, 2.81%; and CD335+, 2.81%. In the second quarter, placentomes showed 0.94% CD3+ cells; 0.77% CD8+; 0.72% CD14+; and 0.51% CD335+. In the intercaruncular region, percentage of labeled CD3+ cells was 0.50%; CD8+, 1.81%; CD14+, 2.64%; and CD335+, 0.51%. In the third quarter, placentomes showed labeling of 0.88% CD3+; 0.66% CD8+; 1.06% CD14+; and 0.74% CD335+ cells. In the intercaruncular region, percentage of labeled CD3+ cells was 0.19%; CD8+, 2.23%; CD14+, 2.43%; and CD335+, 0.16%. The results showed that there was a greater immunomarking of leukocytes CD3+ and CD335+ in the placentome when compared to the intercaruncular region during the third trimester. It can be concluded that leukocytes populations in bovine placenta is reduced, probably because of the syndesmochorial characteristic of bovine placenta. This represents a significant barrier for the immunological system of the mother, sharply decreasing the exposure of the conceptus to the mother's immune system.(AU)

Linfócitos e macrófagos são os principais leucócitos envolvidos na tolerância materno-fetal. Pouco se sabe sobre esses leucócitos na placenta bovina, como por exemplo, a quantidade e localização dessas células. Assim, o objetivo desse estudo foi identificar populações de linfócitos e macrófagos na placenta bovina utilizando marcadores específicos e citometria de fluxo. Este estudo analisou amostras de placentônios da região intercaruncular de bovinos nos três trimestres da gestação. No primeiro trimestre, nos placentônios, a porcentagem média de células CD3+ foi 2,34%; CD8+, 1,28%; CD14+, 1,66%; e CD335+, 0,96%. Na região intercaruncular, a porcentagem de células CD3+ foi 0,71%; CD8+, 1,63%; CD14+, 2,81%; e CD335+, 2,81%. No segundo trimestre, os placentônios apresentaram 0,94% de células CD3+; 0,77% de CD8+; 0,72% de CD14+e 0,51% de CD335+. Na região intercaruncular, a porcentagem de células CD3+ foi 0,50%; CD8+, 1,81%; CD14+, 2,64%; e CD335+, 0,51%. No terceiro trimestre, os placentônios apresentaram 0,88% de células marcadas CD3+; 0,66% de CD8+; 1,06% de CD14+ e 0,74% de CD335+. Na região intercaruncular, a porcentagem de células CD3+ foi 0,19%; CD8+, 2,23%; CD14+, 2,43% e CD335+, 0,16%. Os resultados mostraram que a imunomarcação de leucócitos na região do placentônio foi maior do que na região intercaruncular no terceiro trimestre. Concluiu-se que a população de leucócitos CD3+ e CD335+ na placenta bovina está reduzida, provavelmente devido à sua característica sindesmocorial. Essa característica representa uma barreira significante para o sistema imunológico da mãe, o que diminui drasticamente a exposição do concepto ao sistema de defesa da mãe.(AU)

Etnozoologia e educação ambiental para escolas da amazônia: experimentação de indicadores quantitativos / Ethnozoology and environmental education for schools in the amazon: experimentation of quantitative indicators / Etnozoología y educación ambiental para escuelas de la amazonia: experimentación de indicadores cuantitativos

Resumo Desenvolvido em escolas públicas de diferentes contextos ambientais e educacionais de Belém, no Pará, o estudo apresentado objetivou criar uma abordagem metodológica possível de ser reproduzida por qualquer escola de ensino fundamental ou médio na Amazônia, gerando informações sobre as interações homem-animal-ambiente e a evolução da consciência ecológica do alunado. Testaram-se cinco indicadores quantitativos: ‘Diferenciação de animais silvestres e domésticos’, ‘Animais no prato’, ‘Proximidade aluno-animal’, ‘Sentimentos em relação à fauna’ e ‘Justificativas de falta dos alunos’. Obtiveram-se resultados significativos: na identificação do conhecimento prévio dos alunos sobre o conceito de animais silvestres-domésticos, verificou-se que em uma das escolas o avançar das séries não determinava maior capacidade de diferenciação dos animais; jacaré, tatu e tartaruga foram as espécies mais citadas pelos alunos nas duas escolas e constituíam o cardápio alimentar das famílias; foi comum a presença de animais domésticos e silvestres criados nos cômodos internos das casas, registrando-se altos percentuais de criações múltiplas de animais; sentimentos de ‘querer matar’ e ‘medo/nojo’ ainda foram bastante frequentes, principalmente para répteis, traduzindo a necessidade de maiores investimentos em educação ambiental; faltas por motivo de doença foram recorrentes e tinham estreita relação com animais. A metodologia é válida para etnozoologia e educação ambiental, adequando-se à realidade socioeconômica e ambiental das escolas.

Abstract Carried out in public schools in different environmental and educational contexts of Belém, state of Pará, Brazil, the study presented was designed to create a possible methodological approach to be reproduced by any primary or secondary school in the Amazon, generating information about the human-animal-environment interactions and the progress made in ecological awareness among the students. Five quantitative indicators were tested: ‘Distinction between wild and domestic animals,’ ‘Animals on the plate,’ ‘Student-animal proximity,’ ‘Feelings regarding the fauna,’ and ‘Student absence justifications.’ Significant results were obtained: In the identification of the students' prior knowledge about the concept of wild-domestic animals, it was found that at one of the schools, although students passed from one grade to the next, they were not necessarily more able to distinguish among the animals; alligators, armadillos, and turtles were the species students mentioned most frequently in the two schools, and they were on their families’ food menus; keeping domestic and wild animals in the homes was common, and keeping multiple animals was frequently recorded; feelings of ‘want to kill’ and ‘fear/disgust’ were still quite common, especially with regard to reptiles, reflecting the need for greater investments in environmental education; absences due to illness were recurrent and were closely related with animals. The methodology is valid for ethnozoology and environmental education, and is appropriate for the socioeconomic and environmental realities of the schools.

Resumen Desarrollado en escuelas públicas de diferentes contextos ambientales y educativos de Belém, en el estado de Pará, Brasil, el estudio presentado buscó crear un enfoque metodológico que se pudiera reproducir en cualquier escuela de la enseñanza fundamental o media, en la Amazonia, generando información sobre las interacciones hombre-animal-ambiente y la evolución de la conciencia ecológica del alumnado. Se probaron cinco indicadores cuantitativos: ‘Diferenciación de animales silvestres y domésticos’, ‘Animales en el plato’, ‘Proximidad alumno-animal’, ‘Sentimientos con relación a la fauna’ y ‘Justificativas de falta de los alumnos’. Se obtuvieron resultados significativos: en la identificación del conocimiento previo de los alumnos sobre el concepto de animales silvestres-domésticos, se observó que en una de las escuelas, el avanzar de grado no determinaba mayor capacidad de diferenciación de los animales; yacaré, tatú y tortuga eran las especies más citadas por los alumnos en las dos escuelas y constituían el menú familiar; era común la presencia de animales domésticos y silvestres criados en los cuartos de las casas, registrándose altos porcentajes de crías múltiples de animales; sentimientos de ‘querer matar’ y ‘miedo/asco’ todavía eran bastante frecuentes, principalmente para reptiles, lo que traduce la necesidad de mayores inversiones en educación ambiental; faltas por motivo de enfermedad eran recurrentes y guardaban estrecha relación con animales. La metodología es válida para la etnozoología y educación ambiental, adecuándose a la realidad socioeconómica y ambiental de las escuelas.

Alopecia secondary to anti-tumor necrosis factor-alpha therapy.

Biologic drugs represent a substantial progress in the treatment of chronic inflammatory immunologic diseases. However, its crescent use has revealed seldom reported or unknown adverse reactions, mainly associated with anti-tumor necrosis factor (anti-TNF). Psoriasiform cutaneous reactions and few cases of alopecia can occur in some patients while taking these drugs. Two cases of alopecia were reported after anti-TNF therapy. Both also developed psoriasiform lesions on the body. This is the second report about a new entity described as 'anti-TNF therapy-related alopecia', which combines clinical and histopathological features of both alopecia areata and psoriatic alopecia. The recognition of these effects by specialists is essential for the proper management and guidance of these patients.

Alopecia secondary to anti-tumor necrosis factor-alpha therapy

Biologic drugs represent a substantial progress in the treatment of chronic inflammatory immunologic diseases. However, its crescent use has revealed seldom reported or unknown adverse reactions, mainly associated with anti-tumor necrosis factor (anti-TNF). Psoriasiform cutaneous reactions and few cases of alopecia can occur in some patients while taking these drugs. Two cases of alopecia were reported after anti-TNF therapy. Both also developed psoriasiform lesions on the body. This is the second report about a new entity described as 'anti-TNF therapy-related alopecia', which combines clinical and histopathological features of both alopecia areata and psoriatic alopecia. The recognition of these effects by specialists is essential for the proper management and guidance of these patients.