Observatório em Saúde Mental como dispositivo de educação permanente na Atenção Primária em Saúde / Mental Health Observatory as a device of permanent education in Primary Health Care

O "Observatório em Saúde Mental" foi uma experiência de extensão universitária, que articulou ações com o ensino e a pesquisa, no objetivo de diminuir a distância entre a formação profissional, a realidade dos serviços e o trabalho em saúde, a partir das reformas sanitária e psiquiátrica. Para tanto, com base na pesquisa-ação, levantamos as demandas de saúde mental na atenção primária do município de Parnaíba-PI, a fim de realizar ações de educação permanente junto às equipes profissionais, gestores, usuários e estudantes extensionistas, por meio de rodas de cogestão. Como resultados, a partir do levantamento de indicadores em saúde mental e a discussão da realidade sanitária, ambiental e social dos territórios investigados, ampliou-se a capacidade de análise e intervenção dos atores envolvidos, especialmente dos estudantes, que tiveram a oportunidade de vivenciar uma formação voltada para o encontro com a vida e com os acontecimentos do cotidiano dos serviços.

The "Mental Health Observatory" was an experience of university extension, which articulated actions with teaching and research, aiming to reduce the distance between professional training, the reality of the services and the work in health, from the sanitary and psychiatric reforms. Therefore, based on action research, we surveyed the demands of mental health in the primary care in the city of Parnaíba-PI to carry out actions of continuing education with professional teams, managers, users and extension students, through co-management meetings. As a result, based on the survey of mental health indicators and the discussion of the sanitary, environmental and social reality of the investigated territories, the capacity of analysis and intervention of the involved actors was expanded, especially the students, who had the opportunity to experience a training focused on the encounter with life and with the events of everyday life in the services.

Oral myiasis: Analysis of cases reported in the English literature from 1990 to 2020.

Myiasis is an infection caused by the deposition of fly larvae in tissues, and its involvement in the human oral cavity is uncommon. Herein, we have performed a data analysis of published cases of oral myiasis. A search was performed in PubMed, Ovid, Web of Science, Scopus, and LILACS. Geographic distribution, demographic data, associated factors, clinical features, fly types, treatment, and presence of sequelae were analyzed. A total of 122 articles reported the cases of 157 infected individuals. The most affected countries were India (41%) and Brazil (29.5%). Male predominance (67.5%) and a mean of 41.9 years of age were observed. The gingiva (29%) was the most affected site, followed by palate (25%) and lip (21%). There were different forms and combinations of treatments: manual removal of larvae and surgical debridement, application of asphyxiating substances, antibiotic therapy, and use of ivermectin. The condition predominantly affects individuals with neurological and/or locomotor disabilities, of low socioeconomic status, with poor oral hygiene and chemical dependence and individuals with previous injuries or with the absence of lip sealing. The establishment of a standard treatment protocol, enabling comparison in future studies and providing uniformity in treatment strategies offered by health services is strongly recommended.

Comunidades tradicionais e conflitos socioambientais: e a psicologia com isso? / Traditional communities and socio-environmental conflicts: and psychology with it? / Comunidades tradicionales y conflictos socioambientales: ¿y psicología con esto?

Temos como preocupação central neste exercício teórico buscar trilhas de superação dos efeitos do sofrimento ético-político produzido nos/pelos conflitos socioambientais que atravessam a constituição do processo de exclusão/inclusão social das comunidades tradicionais no Brasil. Compreendemos que a defesa de um mundo comum habitável passa pelo fortalecimento das comunidades tradicionais e que a defesa de seus conhecimentos, territórios e práticas socioambientais é um ato político-ecológico estratégico para a humanidade. Assim, sem desacreditar na força do sentimento de pertença que configura identidades/singularidades, propomos a necessária ampliação de movimentos/ideias que contribuam para a composição de corpos mais permeáveis ao sentimento do comum. Este afeto tem como princípio ético o reconhecimento dos outros corpos como potência em ato indispensável a costura da vida e como princípio político a apropriação do interesse comum como interesse pessoal. Neste sentido, defendemos o aprimoramento das relações humanas como horizonte ético-político da psicologia social.

The central concern of this theoretical exercise is to seek ways of overcoming the effects of ethical-political suffering produced in the socio-environmental conflicts that go through the constitution of the social exclusion/ inclusion process of traditional communities in Brazil. We understand that the defense of a common habitable world involves strengthening traditional communities and that the defense of their socio-environmental knowledge, territories and practices is a strategic political-ecological act for humanity. Thus, without discrediting the strength of the “feeling of belonging” that configures identities/ singularities, we propose the necessary expansion of movements / ideas that contribute to the composition of bodies more permeable to the “feeling of the common”. This affection has, as its ethical principle, the recognition of other bodies as a powerful of life and transformation action, and as a political principle the appropriation of common interest as a personal interest. In this sense, we defend the improvement of human relations as the ethical-political horizon of social psychology.

Tenemos como preocupación central en este ejercicio teórico buscar senderos de superación de los efectos del sufrimiento ético-político producido en los conflictos socioambientales que atravesan la constitución del proceso de exclusión/inclusión social de las comunidades tradicionales en Brasil. Comprendemos que la defensa de un mundo común habitable pasa por el fortalecimiento de las comunidades tradicionales y que la defensa de sus conocimientos, territorios y prácticas socioambientales es un acto político-ecológico estratégico para la humanidad. Así, sin desacreditar en la fuerza del sentimiento de pertenencia que configura identidades/singularidades, proponemos la necesaria ampliación de movimientos/ideas que contribuyan a la composición de cuerpos más permeables al sentimiento del común, afecto que tiene como principio ético el reconocimiento de los otros cuerpos como potencia en acto indispensable la costura de la vida y como principio político la apropiación del interés común como interés personal. En este sentido, defendemos el perfeccionamiento de las relaciones humanas como horizonte ético-político de la psicología social.

Persistent Necrotizing Mediastinitis after Dental Extraction.

Mediastinitis is a rare, progressive, and destructive infectious process due to cervical or odontogenic infections, which, if not diagnosed early, may lead to several complications, including airway involvement and even an imminent risk of death. Herein, we report an unusual case of a 37-year-old male with a bilateral submandibular hard swelling after the left third molar extraction. After surgical intervention with submandibular drainage and antibiotic therapy, the infection persisted without explanation, since the patient was not hypertensive, did not have diabetes mellitus or sexually transmitted infections such as HIV or syphilis, and did not smoke or drink alcoholic beverages. A thoracic surgeon then intervened, treating the mediastinitis surgically by drainage, thus obtaining a significant improvement of the patient's health. Mediastinitis is a serious condition. Clinicians and maxillofacial surgeons should be alert to make an immediate diagnosis and select the appropriate treatment in order to prevent worsening of the patient's clinical condition.

Psicologia social e o estudo da desigualdade: reflexões para o debate / Social psychology and the study of inequality: reflections for a debate / Psicología social y estudio de la desigualdad: reflexiones para el debate

Este artigo reflete sobre a abordagem da desigualdade social no corpo teórico e nas pesquisas em Psicologia social, defendendo que esta deve passar do papel de variável independente a objeto de estudo. Apresenta os riscos epistemológicos e sociais do uso do conceito no plural e, nesse sentido, seguimos indagando sobre a concepção de desigualdade social e expondo algumas reflexões para que: a) ela não se torne um conceito bonde que facilite sua redução a diferenças e diversidades, favorecendo o relativismo e, ou, tornando-se elemento catalizador do ódio e da segregação; e b) para a (re)criação de conceitos e categorias analíticas que nos permitam alcançá-la em sua complexidade ético-política. Busca na filosofia monista de Espinosa e na dialética marxista pressupostos para orientar tais reflexões.

This paper deals with the approach of social inequality in the theoretical body and in social Psychology researches, arguing that it should move from the role of independent variable to object of study. It presents the epistemological and social risks of the use of the concept in the plural and in this sense we keep on asking about the concept of social inequality and exposing some reflections so that: a) it does not become a certain concept that facilitates its reduction to differences and diversities, favoring relativism and, or, becoming a catalyzing producer of hatred and segregation and b) for the (re) creation of concepts and analytical categories that allow us to achieve it in its ethical-political complexity. The study searches in Spinoza’s monistic philosophy and in the Marxist dialectic presuppositions to guide such reflections.

Este artículo reflexiona sobre el enfoque de la desigualdad social en el cuerpo teórico y en la investigación en Psicología Social, argumentando que debe pasar del papel de variable independiente al objeto de estudio. Presenta los riesgos epistemológicos y sociales de la utilización del concepto en plural y, en ese sentido, seguimos preguntando por el diseño de la desigualdad social y exponiendo algunas reflexiones que: a) no se convierta en un concepto de tranvía que facilita su reducción a las diferencias y a la diversidad, favoreciendo el relativismo y, o, se convirtiendo en un catalizador para el odio y la segregación y, b) para la (re) creación de conceptos y categorías analíticas que nos permitan alcanzarlo en su complejidad ético-política. Busca en la filosofía monista de Spinoza y en las presuposiciones dialécticas marxistas para guiar tales reflexiones.

Pseudoaneurysm in internal maxillary artery after gunshot wound: Critical review and case report.

INTRODUCTION: Pseudoaneurysm is a vascular injury typically caused by rupture of arteries with extravasation of blood. The involvement of this entity in facial arteries after firearm aggression is extremely rare, and they need treatment as early as possible, thus avoiding irreversible damage to patients. STUDY DESIGN: A 40-year-old male victim of gunshot attack with an entrance orifice in the right posterior cervical region with ascending trajectory, lodging in the ipsilateral zygomatic-orbitary complex, which was submitted to removal of the bone fragments and the bullet. In the intraoperative period, the patient developed profuse hemorrhage and, after complementary examinations, he was diagnosed with pseudoaneurysm of the internal maxillary artery, which was treated by selective endovascular embolization. RESULTS: The patient was hemodynamically stable, with no complaints and was discharged after 48 hours, without postoperative bleeding recurrences. He had no more complications after 8 months of follow-up. CONCLUSIONS: The main forms of treatment and diagnosis of vascular lesions are reviewed, and embolization is demonstrated as a technically safe procedure with few complications. Key words:Gunshot wound, pseudoaneurysm, maxillary artery, therapeutic embolization.

Orofacial clinical features in Arnold Chiari type I malformation: A case series.

BACKGROUND: Arnold Chiari malformation (ACM) is characterized by an anatomical defect at the base of the skull where the cerebellum and the spinal cord herniate through the foramen magnum into the cervical spinal canal. Among the subtypes of the condition, ACM type I (ACM-I) is particularly outstanding because of the severity of symptoms. This study aimed to analyze the orofacial clinical manifestations of patients with ACM-I, and discuss their demographic distribution and clinical features in light of the literature. MATERIAL AND METHODS: A case series with patients with ACM-I treated between 2012 and 2015 was described. The sample consisted of patients who were referred by the Department of Neurosurgery to the Oral and Maxillofacial Surgery Service of Hospital da Restauração in Brazil for the assessment of facial symptomatology. A questionnaire was applied to evaluate the presence of painful orofacial findings. Data are reported using descriptive statistical methods. RESULTS: Mean patient age was 39.3 years and the sample consisted mostly of male patients. A high prevalence of headache (50%) and pain in the neck (66.7%) and masticatory muscles (50%) was found. Only one patient reported difficulty in performing mandibular movements and two reported jaw clicking sounds. Mean mouth opening was 40.83 mm. CONCLUSIONS: ACM-I patients may exhibit orofacial symptoms which may mimic temporomandibular joint disorders. This study brings interesting information that could help clinicians and oral and maxillofacial surgeons to understand this uncommon condition and also help with the diagnosis of patients with similar physical characteristics by referring them to a neurosurgeon. Key words:Arnold-Chiari malformation, facial pain, diagnosis, orofacial.

Head and neck myiasis: a case series and review of the literature.

OBJECTIVE: This study describes 9 cases of myiasis affecting the head and neck region and discusses the demographic distribution, treatment, clinical characteristics, and sequelae of the disease in light of the literature. STUDY DESIGN: The study was performed in 2 steps. In the first part, 9 cases seen over a period of 10 years at the Emergency Department of Hospital da Restauração in Brazil were studied. In the second part, a literature search was performed in PubMed for articles on head and neck myiasis published from 1975 to March 2017. RESULTS: The case series mainly consisted of male patients in their 30s. The palate was the most commonly affected site. Myiasis was caused by Cochliomyia hominivorax in all patients, who were treated by mechanical removal of the larvae and debridement of necrotic tissue, followed by oral ivermectin. All patients had sequelae resulting from bone destruction. CONCLUSIONS: Head and neck myiasis generally affects individuals with poor hygiene habits, drug users, and individuals with neurologic and psychosocial disorders. The treatment of choice is mechanical removal of larvae and surgical debridement combined with oral ivermectin. This study provides information that could help clinicians in the diagnosis and management of this condition.

Antioxidant and Antihypertensive Effects of a Chemically Defined Fraction of Syrah Red Wine on Spontaneously Hypertensive Rats.

A particularly phenolic-rich fraction extracted from red wine from the São Francisco valley (Northeastern Brazil) was chemically characterized and its hypotensive and antioxidant effects on spontaneously hypertensive rats were studied both in vitro and in vivo. The liquid-liquid pH dependent fractionation scheme afforded a fraction with high content of bioactive phenolics such as flavonols, flavonol glycosides, phenolic acids and anthocyanins, whose identities were confirmed by liquid chromatography coupled to mass spectrometry analysis. Pretreatment of spontaneously hypertensive rats with this wine fraction at doses of 50 and 100 mg/kg by gavage. for 15 days was able to decrease mean arterial pressure and heart rate as well as decrease serum lipid peroxidation. The fraction at concentrations of 0.01-1000 µg/mL induced concentration-dependent relaxation of isolated rat superior mesenteric artery rings pre-contracted with phenylephrine and this effect was not attenuated by endothelium removal. Our results demonstrate it is possible for phenolic constituents of red wine that are orally bioavailable to exert in vivo hypotensive and antioxidant effects on intact endothelial function.

Cervical Necrotizing Fasciitis Caused by Dental Extraction.

Cervical necrotizing fasciitis is an unusual infection characterized by necrosis of the subcutaneous tissue and fascial layers. Risk factors for the development of necrotizing fasciitis include diabetes mellitus, chronic renal disease, peripheral vascular disease, malnutrition, advanced age, obesity, alcohol abuse, intravenous drug use, surgery, and ischemic ulcers. This report presents a case of necrotizing fasciitis in the cervical area caused by dental extraction in a 73-year-old woman. Cervical necrotizing fasciitis in geriatric patient is rare, and even when establishing the diagnosis and having it timely treated, the patient can suffer irreversible damage or even death. Clinical manifestations in the head and neck usually have an acute onset characterized by severe pain, swelling, redness, erythema, presence of necrotic tissue, and in severe cases obstruction of the upper airways. Therefore, the presentation of this clinical case can serve as guidance to dentists as a precaution to maintain an aseptic chain and be aware of the clinical condition of older patients and the systemic conditions that may increase the risk of infections.

Potential therapeutic effect of Allium cepa L. and quercetin in a murine model of Blomia tropicalis induced asthma.

BACKGROUND: Asthma is an inflammatory condition characterized by airway hyperresponsiveness and chronic inflammation. The resolution of inflammation is an essential process to treat this condition. In this study we investigated the effect of Allium cepa L. extract (AcE) and quercetin (Qt) on cytokine and on smooth muscle contraction in vitro and its therapeutic potential in a murine model of asthma. METHODS: AcE was obtained by maceration of Allium cepa L. and it was standardized in terms of quercetin concentration using high performance liquid chromatography (HPLC). In vitro, using AcE 10, 100 or 1000 µg/ml or Qt 3.5, 7.5, 15 µg/ml, we measured the concentration of cytokines in spleen cell culture supernatants, and the ability to relax tracheal smooth muscle from A/J mice. In vivo, Blomia tropicalis (BT)-sensitized A/J mice were treated with AcE 100, 1000 mg/kg or 30 mg/kg Qt. We measured cell influx in bronchoalveolar lavage (BAL), eosinophil peroxidase (EPO) in lungs, serum levels of Bt-specific IgE, cytokines levels in BAL, and lung histology. RESULTS: We observed a reduction in the production of inflammatory cytokines, a relaxation of tracheal rings, and a reduction in total number of cells in BAL and EPO in lungs by treatment with AcE or Qt. CONCLUSION: AcE and Qt have potential as antiasthmatic drugs, as they possess both immunomodulatory and bronchodilatory properties.

Diálogo entre Modo de Vida Comunitário dos Adolescentes em Regime de Liberdade Assistida e a Proposta de Inserção Comunitária do ECA / The Social Life of Teenagers in Assisted Freedom

A pesquisa de caráter qualitativo tem como objetivo geral conhecer o modo de vida comunitário dos adolescentes em regime de Liberdade Assistida-LA moradores do Lagamar a fim de estabelecer um diálogo com a aplicação da medida sócio-educativa de liberdade assistida realizada pela prefeitura Municipal de Fortaleza através do Projeto Raíz de Cidadania Para isso foram estabelecidos os seguintes objetivos específicos: identificar as atividades coletivas mais frequentes entre os adolescentes, compreender o processo de significação de comunidade e analisar a aplicação da LA a partir da vivência dos sócio-educandos Fundamentada nos construtos teóricos da Teoria histórico-cultural e da Psicologia Comunitária utilizou a análise temática ou análise por temas como instrumento para ordenar os dados colhidos através de entrevistas individuais e coletivas Ao final da pesquisa foi possível depreender que as ações que compõem o acompanhamento desses adolescentes não tem levado em conta a realidade comunitária objetiva e subjetiva desses sujeitos configurando-se como ações pontuais e desconectadas voltadas para o disciplinamento e inserção institucional ( escola, programas, projetos, cursos profissionalizantes) Não adota a política pedagógica emancipatória preconizada pelo ECA e por isso não consegue promover de forma satisfatória o processo de resignificação das vidas desses adolescentes A pesquisa aponta ainda a necessidade de diálogo entre a execução de políticas públicas e a realidade local onde está inserida como caminho para a efetiva participação popular e a possibilidade de superação das condições adversas para as quais estão destinadas...(AU)

This qualitative study sought to evaluate the relationships between the lifestyle of teenagers with criminal records and the social insertion program sponsored by the Estatuto da Criança e do Adolescente ECA Lagamar region one of the most violent and poorest areas of Fortaleza was studied The social insertion proposal is practically applied by the project Raíz de Cidadania, associated to the Prefeitura Municipal de Fortaleza and it is based upon the historic and cultural principles of social psychology using thematic analysis derived from directed individual and collective interviews Four male teenagers with age between fifteen and nineteen years constituted the subjects of this research Three specific objectives were established in order to evaluate the general objective i e to assess their social lifestyle These specific objectives are (1) to identify their most common social activities (2) to understand the process of attributing meaning to social interactions and (3) to analyze the application of the instrument of assisted freedom from the point of view of the subjects The results demonstrate some incongruence between the objectives of the assisted freedom mechanism and the measures leading to its application We have verified that these activities were rather exercises seeking to change habits reinforce discipline and rules observance than measures destined to create emancipation transformation of life and rebuilding of long term projects the primary objectives of the socio-educative instrument of assisted freedom It was also verified disarticulation between its application and the social life of the teenagers Thus such actions have revealed themselves as punctual disconnected and unassociated with the social scenarios...(AU)