Predisposing Factors to Medication Errors by Nurses and Prevention Strategies: A Scoping Review of Recent Literature.

Medication errors have serious consequences and high costs for the patient and the system. The treatment process and the care required for critically ill patients are complex, and these patients are more vulnerable to errors and potential consequences. A scoping review using the JBI methodology was conducted across PubMed, CINAHL, and MEDLINE databases and reported by the PRISMA-ScR guidelines to explore strategies that can mitigate medication errors by nurses. The search strategy focused on references published between January 2012 and April 2023. Sixteen studies were included, and the results were organized into thematic areas. Medication errors by nurses are in the areas of preparation, administration, and documentation; organizational, system-related, procedural, personal, and knowledge and training factors are predisposing factors for errors; educational intervention, verification and safety methods, organizational changes, and error reporting are the strategic areas to mitigate medication error. The organization of the data could be different, as it depends on the reviewers' experience. Knowledge of the factors that cause medication errors and interventions to mitigate them make it possible to outline strategies to minimize their occurrence and achieve health gains. The protocol preceding this review has been registered in the Open Science Framework and published.

Hookworm infection as a model for deepen knowledge of iron metabolism and erythropoiesis in anemia.

Over the years, there has been progress in understanding the molecular aspects of iron metabolism and erythropoiesis. However, despite research conducted both in laboratories and living organisms, there are still unanswered questions due to the complex nature of these fields. In this study we investigated the effects of hookworm infection on iron metabolism and how the hosts response to anemia is affected using hamsters infected with Ancylostoma ceylanicum as a model. Our data revealed interesting relationships between infection-induced anemia, erythropoiesis, iron metabolism, and immune modulation, such that the elevated production of erythropoietin (EPO) in renal tissue indicated intensified erythropoiesis in response to anemia. Additionally, the increased expression of the erythroferrone (ERFE) gene in the spleen suggested its involvement in iron regulation and erythropoiesis. Gene expression patterns of genes related to iron metabolism varied in different tissues, indicating tissue-specific adaptations to hypoxia. The modulation of pro-inflammatory and anti-inflammatory cytokines highlighted the delicate balance between immune response and erythropoiesis. Data derived from the investigation of changes induced in iron metabolism and stress erythropoiesis following anemia aid in our understanding of mechanisms related to blood spoliation and anemia, which could potentially be extrapolated or compared to other types or causes of anemia. These findings also contribute to our understanding of the pathophysiology of erythropoiesis in the context of blood loss.

Exploring Professional Practice Environments and Organisational Context Factors Affecting Nurses' Adoption of Evidence-Based Practice: A Scoping Review.

This scoping review, conducted within the Joanna Briggs Institute (JBI) framework, analysed the recent literature (January 2018 to March 2023) addressing factors inherent to professional practice environments and organisational contexts influencing nurses' adoption of evidence-based practice (EBP). This review included studies involving nurses regardless of sector, practice setting, and scope of practice. A systematic search was undertaken across the PubMed, Web of Science, CINAHL, and MEDLINE databases, as well as the EThOS, OATD, and RCAAP platforms. The extracted textual elements underwent a content analysis, resulting in a coding structure established through an inductive approach that categorised information into main categories and subcategories linked by similarity and thematic affinity. Forty-one studies were included, revealing four main categories of factors impacting EBP adoption by nurses: (1) organisational dynamics, (2) management and leadership, (3) teamwork and communication, and (4) resources and infrastructure. The study's limitations acknowledge the subjective nature of categorisation, recognising potential variations based on individual perspectives despite adopting procedures to minimise the risk of bias. The results provide a substantial foundation for developing interventions to cultivate environments conducive to EBP adoption by nurses, thereby enhancing the integration of evidence into nurses' professional practice contexts. This review was prospectively registered on the Open Science Framework (registration no. osf.io/e86qz).

A Psicanálise nos Conflitos Políticos: Clínica, Ciência e Coletivos / The Psychoanalysis in Political Conflicts: Clinic, Science and Collectives / El Psicoanálisis en los Conflictos Políticos: Clínica, Ciencia y Colectivos

O artigo desponta da construção de um amplo panorama que localiza afinidades estruturais e tensões problemáticas entre a psicanálise e os coletivos. Nossa revisão de literatura, sobre psicanálise e política, discerne o valor da análise do psicanalista na sustentação da tarefa de subversões políticas do divã às praças públicas. Na sequência, pensamos as repercussões da política da psicanálise frente aos debates que envolvem neurodiversidade/autismo, cientificismo psicoterápico e capitalismo. Pretendemos criticar uma versão alienante da política, versão protagonista dos diferentes temas que abordamos e veiculada pelo agente na função do semblante - a lei, o saber-todo ou o indivíduo hedonista servo de seus mais-de-gozar (discurso capitalista). Na contrapartida dessa versão, está a prática advinda de um Judeu - ou seja, de um corpo que viveu os efeitos do racismo dos discursos, antes mesmo da ascensão do Nazismo - e elaborada através da escuta de algo amordaçado na potencialidade da sexualidade feminina. A partir de tais fatos, argumentamos uma crucial chave de leitura à psicanálise nos conflitos políticos: interrogar a subjetividade de quem psicanalisa. Resultando no questionamento de modalizações conservadoras que marcaram a história da clínica psicanalítica e ainda ressoam no fazer teórico-prático.

The article emerges from the construction of a large panorama that locates structural affinities and problematic tensions between psychoanalysis and collectives. Our literature review on Psychoanalysis and Politics discerns the value of the psychoanalyst's analysis in sustaining the task of political subversions from the divan to the public space. In the sequence, we consider the repercussions of the politics of psychoanalysis in the face of debates involving neurodiversity/autism, psychotherapeutic scientificism and capitalism. We intend to criticize an alienating version of politics, a version that is the protagonist of the different themes we approach and which is conveyed by the agent in the function of the semblant - the law, the all-knowing or the hedonistic individual who is the servant of his own surplus-jouissance (capitalist discourse). The counterpart to this version is the practice coming from a Jew - that is, from a body that lived the effects of the racism of discourses, even before the rise of Nazism - and elaborated by listening to something muzzled in the potentiality of female sexuality. Based on these facts, we argue that there is a crucial key to psychoanalysis in political conflicts: questioning the subjectivity of those who psychoanalyze. This results in the questioning of conservative modalizations that have marked the history of the psychoanalytic clinic and still resonate in the doing of theoretical-practical.

El artículo surge de la construcción de un amplio panorama que localiza afinidades estructurales y tensiones problemáticas entre el psicoanálisis y los colectivos. Nuestra revisión bibliográfica, sobre Psicoanálisis y Política, discute el valor del análisis del psicoanalista para sostener la tarea de subversiones políticas del diván a las plazas públicas. En seguida, pensamos en las repercusiones de la política del psicoanálisis frente a los debates sobre neurodiversidad/autismo, cientificismo psicoterapéutico y capitalismo. Pretendemos criticar una versión alienante de la política, una versión que protagoniza en los diferentes temas que abordamos y que es vehiculada por el agente en el papel del semblante - la ley, el saber-todo o el individuo hedonista siervo de su propio más-de-gozar (discurso capitalista). En la contrapartida de esta versión está la práctica proveniente de un judío - es decir, de un cuerpo que vivió los efectos del racismo de los discursos, incluso antes del ascenso del nazismo - y elaborada al escuchar algo amordazado en la potencialidad de la sexualidad femenina. A partir de estos hechos, sostenemos que hay una clave de lectura crucial del psicoanálisis en los conflictos políticos: cuestionar la subjetividad de quienes psicoanalizan. Esto resulta en el cuestionamiento de las modalidades conservadoras que han marcado la historia de la clínica psicoanalítica y aún resuenan en el hacer teórico-práctico.

Molecular variability of the Ancylostoma secreted Protein-2 (Aca-asp-2) gene from Ancylostoma caninum contributes to expand information on population genetic studies of hookworms.

Hookworm infection is a major public health problem in many regions of the world. Given the high levels of host morbidity and even mortality of the host caused by these infections, it is crucial to understand the genetic structure of hookworm populations. This understanding can provide insights into the ecology, transmission patterns, mechanisms of drug resistance, and the development of vaccines and immunotherapeutic strategies. Previously, we examined presumably neutral molecular markers, such as microsatellites and COI (Cytochrome C oxidase subunit 1) in Brazilian populations of Ancylostoma caninum. Here we analyze the molecular variability of a genomic fragment of the Aca-asp-2 (Ancylostoma secreted protein-2) gene from Ancylostoma caninum. This gene is a highly expressed and activated following the infection of the L3 larvae in the host. We obtained individuals of A. caninum from five different geographic locations in Brazil, sequenced and analyzed parts of the gene. The results revealed extensive polymorphism at this fragment, especially in the intronic region, indicating low selective pressure acting on these sequences. However, we also observed irregular distributions of nucleotides and polymorphisms in the coding region of this gene, resulting in the identification of 27 alleles. The data presented here contribute to expanding the understanding of population genetic studies of hookworms.

Interventions to Minimize Medication Error by Nurses in Intensive Care: A Scoping Review Protocol.

Medication errors represent a concern for healthcare organizations due to their negative consequences. In the nursing context, these errors represent a threat to the quality of care and patient safety. Many factors have been identified as potential causes for these errors in intensive care units. A scoping review will be developed to identify interventions/strategies to minimize the occurrence of medication errors by nurses, considering the Joanna Briggs Institute (JBI) methodology. A search will be conducted in the EbscoHost (CINAHL Complete and MEDLINE), Embase and PubMed databases. Data analysis, extraction and synthesis will be carried out by two reviewers independently. This review will attempt to map which interventions are more specific to minimizing medication error by nurses in intensive care and to recognize which factors influence this type of error to mitigate practices that may lead to error. This protocol acts as the framework for a scoping review in the strategy to map the interventions and which factors contribute to the medication error by intensive care nurses. This study was prospectively registered with the Open Science Framework on 21 April 2023 with registration number DOI 10.17605/OSF.IO/94KH3.

From field to laboratory: isolation, genetic assessment, and parasitological behavior of Schistosoma mansoni obtained from naturally infected wild rodent Holochilus sciureus (Rodentia, Cricetidae), collected in Northeastern Brazil.

Wild rodent species are naturally infected by Schistosoma mansoni; however, the genetic characterization of the parasite, its parasitological features, and its role in human schistosomiasis are poorly understood. In this study, we isolated and characterized Schistosoma from naturally infected Holochilus sciureus, called HS strain, collected from a schistosomiasis endemic region in Maranhão State, Brazil. To isolate the parasite, miracidia obtained from the livers of H. sciureus were used to infect Biomphalaria glabrata of sympatric (called SB) and allopatric (called BH) strains, and the produced cercariae were subcutaneously inoculated into hamsters and/or BALB/c mice. Parasitological kinetics in experimentally infected hosts were evaluated, and the tRNACys-12S (referred to as 16S herein) and cox 1 regions of mtDNA from isolated worms were amplified and sequenced. Only miracidia obtained from infected mice, but not from hamsters, were capable of infecting B. glabrata, allowing maintenance of the isolated parasite. Cox1 and 16S mtDNA sequences showed 100% similarity with S. mansoni, and phylogenetic analysis showed that the HS strain of S. mansoni forms an assemblage with isolates from America and Kenya, confirming the conspecificity. Experimental infection of B. glabrata SB with S. mansoni HS resulted in two peaks of cercariae shedding at 45 and 70 days post-infection (dpi) and caused higher mortality than in B. glabrata BH. The worm recovery rate in mice was approximately 13%, and the peak of egg elimination occurred at the 10th week post-infection. Therefore, S. mansoni obtained from H. sciureus was successfully isolated, genetically characterized, and maintained in mice, allowing further study of this schistosome strain.

Incidence, lethality, and post-stroke functional status in different Brazilian macro-regions: The SAMBA study (analysis of stroke in multiple Brazilian areas).

Background: Stroke is the second leading cause of death in Brazil. The social and financial burden of stroke is remarkable; however, the epidemiological profile remains poorly understood. Objective: The aim of this study was to report the incidence, lethality, and functional status at 30 and 90 days post-stroke in the cities of different Brazilian macro-regions. Methods: This is an observational, prospective, and population-based study, led in Canoas (South), Joinville (South, reference center), Sertãozinho (Southeast), and Sobral (Northeast) in Brazil. It was developed according to the three-step criteria recommended by the World Health Organization to conduct population-based studies on stroke. Using different sources, all hospitalized and ambulatory patients with stroke were identified and the same criteria were kept in all cities. All first events were included, regardless of sex, age, or type of stroke. Demographic and risk factor data were collected, followed by biochemical, electrocardiographic, and radiological test results. Functional status and lethality were obtained using the mRankin scale through telephonic interview (validated Brazilian version). Results: In 1 year, 932 stroke cases were registered (784 ischemic stroke, 105 hemorrhagic stroke, and 43 subarachnoid hemorrhage). The incidence rates per 100,000 inhabitants, adjusted for the world population, were 63 in Canoas, 106 in Joinville, 72 in Sertãozinho, and 96 in Sobral. The majority (70.8%) were followed for 90 days. Kaplan-Meier curves showed that 90-day survival was different among cities. Sobral, which has the lowest socioeconomic indexes, revealed the worst results in terms of lethality and functional status. Conclusion: This study expands the knowledge of stroke epidemiology in Brazil, a middle-income country with enormous socioeconomic and cultural diversity. The discrepancy observed regarding the impact of stroke in patients from Joinville and Sobral highlights the need to improve the strategic allocation of resources to meet the health priorities in each location.

Phenotypic characterization and multiple resistance analysis in an experimentally selected albendazole-resistant hookworm isolate.

For some nematodes, alterations that leads to a resistance genotype may be accompanied by other modifications, causing changes in the biology of the parasite, although the exact mechanisms of this relationship are still not very clear. These alterations can have deleterious effects on their survival or even potentiate their pathogenicity. In this study a phenotypic characterization was carried out to compare two Ancylostoma ceylanicum isolates, a wild type one, kept in the laboratory and an albendazole selected resistant isolate (AceyBZR2). Differences in some analyzed parameters, between the two strains, were registered, as patency period, number and size of the recovered worms, including differences in the body structures. The AceyBZR2 isolate showed to be less adapted to the host, leading to a smaller number of recovered worms. However, no difference on the female egg content was observed between the two isolates. Concerning blood evaluation, no differences were found between the wild type and AceyBZR2 isolates, related to hemoglobin and hematocrit levels. However, animals in the group infected with the wild type isolate had lower serum iron concentrations than animals in the AceyBZR2 group. The possibility that the AceyBZR2 isolate might be resistant to other drugs was evaluated and it was demonstrated that it does not present cross-resistance to ivermectin and nitazoxanide. However, when animals infected with the AceyBZR2 were treated with another drug from the benzimidazoles group (mebendazole), the cross-resistance effect was observed. Morphometric analyses were performed comparing female and male adult worms from the two isolates. The results presented here allow a better understanding of the parasite-host relationship and may constitute a useful basis for establishing future control strategies for soil-transmitted helminths.

Detection of Benzimidazole Resistance-Associated Single-Nucleotide Polymorphisms in the Beta-Tubulin Gene in Trichuris trichiura from Brazilian Populations.

Preventive chemotherapy is recommended by the WHO as the main strategy for controlling infections caused by nematodes in humans, aiming to eliminate the morbidity associated with these infections. This strategy consists of routine periodic administration of benzimidazoles, among other drugs. Although these drugs decrease the intensity of infections, they have the potential to exert selection pressure for genotypes bearing mutations associated with drug resistance, which may result in the establishment of resistant worm populations. There is evidence in the literature of resistance to these drugs in nematodes that infect humans, including in the species Trichuris trichiura. Single-nucleotide polymorphisms (SNPs) in the beta-tubulin gene located at codons 167, 198, and 200 are associated with the mechanism of resistance to benzimidazoles in nematodes. Here, we standardized a molecular technique based on an amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) to analyze codons 167, 198, and 200 of T. trichiura. The ARMS-PCR methodology was successfully established to evaluate the codons of interest. A total of 420 samples of individual eggs were analyzed from populations obtained from five Brazilian states. A mutation in codon 198 was observed at a frequency of 4.8% (20/420), while for the other two codons, no polymorphism was observed. This is the first report of the presence of this mutation in populations of T. trichiura in Brazil. This fact and the emergence of the problem already observed in other species reinforces the need for regular monitoring of SNPs related to benzimidazole resistance using techniques that are highly sensitive and specific.

Development of allele-specific PCR methodology (AS-PCR) to screening A. lumbricoides and A. suum.

Ascaris lumbricoides and Ascaris suum are described as helminths that infect humans and pigs, respectively. It is estimated that infection by A. lumbricoides affects about 447 million individuals living in tropical regions of developing countries. However, there is an increasing number of cases of human ascariasis in countries with no recent history of autochthonous infection by A. lumbricoides. In these places, pigs have been incriminated as the main source of human infection. Conventional parasitological diagnosis does not allow species-specific identification, and the real epidemiological scenario of human and swine ascariasis is still uncertain. Therefore, this work presents the application of a species-specific molecular diagnosis, based on the allele-specific PCR methodology (AS-PCR), using the Internal Transcript Space 1 (ITS-1) of the ribosomal DNA, as a target for differentiating between the two species, using DNA obtained from eggs. To validate the methodology, stool samples positive for Ascaris spp, were obtained from 68 humans from seven Brazilian states and from six pigs from the state of Minas Gerais. All samples obtained from humans were genotyped as A. lumbricoides and all samples obtained from swine were genotyped as A. suum. These results are in agreement with the literature, which demonstrates that in most endemic regions, transmission cycles are separate. Therefore, the execution of this work allowed the availability of a useful methodology for the differential diagnosis of the species, which may contribute to the characterization of the real epidemiological profile of human and swine ascariasis, and to the implementation of future control strategies.

Bats as hosts of Leishmania (Leishmania) infantum in Minas Gerais, an endemic area for visceral leishmaniasis.

Bats are parasitized by a wide spectrum of ecto and endoparasites, but their role as a reservoir for some zoonoses is not fully understood. The objective of this work was to evaluate the presence of Leishmania DNA in the blood of bats from 30 municipalities in the state of Minas Gerais, Brazil. We analyzed samples of 120 bats, covering 29 species. The blood samples were used for DNA extraction and submitted to conventional PCR analysis with primers directed to the Leishmania ITS-1 region of the rRNA. In total, 1.67% (2/120 samples) were positive for Leishmania spp., detected in animals from the metropolitan region of Belo Horizonte, the state capital. Sequencing of the positive samples revealed that both bats were infected with Leishmania (Leishmania) infantum. Considering the adaptability of some bats species to synanthropic environments, the results of the present work can contribute to a better comprehension of the leishmaniasis cycle and epidemiology.

Moving beyond the state of the art of understanding resistance mechanisms in hookworms: confirming old and suggesting new associated SNPs.

Hookworms represent a serious problem for human and animal health in different parts of the world. One of the suggested control strategies for parasitosis caused by members of the Ancylostomatidae family is mass drug aministration with benzimidazole compounds. This strategy has been proven to lead to the establishment of resistant strains in several nematodes related to SNPs at codons 167, 198 and 200 of the beta-tubulin isotype-1 gene. Through bioassay and in vivo analysis, we successfully isolated an albendazole-resistant A. ceylanicum strain by drug selective pressure. We observed a strong correlation between the presence of SNPs at codon 198 and drug resistance. We also described for the first time, in hookworms, the presence of SNP A200L, already described at low frequencies in ruminant nematodes. The results presented here are important for updating the current knowledge about anthelmintic resistance in hookworms. The answers and the new questions raised may provide a basis for the establishment of more effective control strategies.

Awake Rhinology Surgery in Response to the COVID-19 Pandemic in Europe.

BACKGROUND: European health-care systems are faced with a backlog of surgical procedures following the suspension of routine surgery during the COVID-19 crisis. Routine rhinology surgery under general anaesthetic (GA) is now faced with significant challenges which include limited theatre capacity, the negative ramifications of surgical prioritization, reduced patient throughput in secondary care, and additional personal protective equipment requirements. Delayed surgery in rhinology, particularly with regards to chronic rhinosinusitis, has previously been shown to have poorer surgical outcomes, a detrimental effect on quality of life and long-term negative health socio-economic effects. Awake rhinology surgery under local anaesthetic (LA) provides an ideal alternative to GA. It provides a means of operating on patients in a setting alternative to currently oversubscribed main theatres, by utilizing satellite facilities, while ensuring identical surgical outcomes for patients who may otherwise have been forced to wait a long time for their procedure. It also confers additional benefits in terms of shorter recovery time and hospital stay for patients. OBJECTIVES: We have developed a set of recommendations that are intended to help support clinicians and managers to better adopt LA rhinology protocols and minimize the risk to the patient and health-care professionals involved. METHODOLOGY: International roundtable forums were conducted and supplemented by individual interviews. The international board consisted of 12 rhinologists experienced in awake rhinology surgery. Feedback was analysed and shared to develop a consensus of best practice. RECOMMENDATIONS: Local and national guidelines need to be adhered to with specific focus on patient and clinician safety. When performing awake rhinology procedures in the COVID-19 recovery process, consider implementing specific safety measures and workflow practices to safeguard patients and staff and minimize the risk of infection. CONCLUSION: Awake surgery potentially provides quicker access to routine rhinology surgery in the post-COVID-19 recovery phase, ensuring patients are treated in a timely matter, thereby avoiding higher downstream costs, and improving outcomes.

"Médico Disse que Era Só Psicológico": Analisando o Lugar da Psicologia no Campo da Saúde / "The Doctor Said it Was Psychological": Analyzing the Position of Psychology in the Health Field / "El Doctor Dijo que Era Solo Psicológico": Analizando el Lugar de la Psicología en el Campo de la Salud

As clínicas-escola de Psicologia vêm ocupando um lugar de centralidade nas regiões onde estão inseridas, pois acabam por dar suporte aos casos de "saúde mental" das redes de assistência social, educacional e, sobretudo, da saúde. Nesse sentido, nosso objetivo foi analisar os encaminhamentos da Atenção Primária à Saúde (APS) do município de Sobral-CE ao serviço-escola de Psicologia da Universidade Federal do Ceará (UFC). O estudo foi qualitativo e documental, uma vez que 293 prontuários, oriundos da APS, foram a fonte de pesquisa. Os dados foram analisados por meio da Análise de Discurso Crítica e a reflexão tomou como referência saber quem eram os profissionais que encaminhavam, o que "diziam" ao encaminhar e quais as sugestões de tratamentos consideravam mais adequadas. Constatamos que os psicólogos são os profissionais que mais encaminham ao serviço. Nos encaminhamentos feitos pelos médicos, percebemos a dificuldade de lidar e mesmo reconhecer o que não é palpável, com o que é "só psicológico". Por fim, consideramos que o que não pode ocorrer na atenção básica em saúde é a própria Psicologia, no entanto, as grandes filas de espera e os encaminhamentos massivos às clínicas-escola de Psicologia deflagrem o reconhecimento da importância da clínica, do atendimento individual. (AU)

The Psychology school clinics have a central importance in the regions where they are placed, because of the mental health support they give to cases from social assistance, educational and mainly health systems. Thus, our aim was to analyze the city of Sobral's Primary Health Care (PHC) referrals to the Psychology service of the Federal University of Ceará (UFC). This study was a qualitative and documentary research, using 293 medical records from PHC as source. The data were analyzed by means of the Critical Speech Analysis (CSA) and the reflection highlights to identify which professionals were referring, what "they said" when referring and what suggestions of treatments they considered more appropriate to the case. We found that psychologists are the professionals who most refer to the service. In the referrals made by the doctors, we realized the difficulty of medicine in dealing with and even recognize what is not touchable, what is "only psychological". Finally, we consider that what can not occur in the PHC is Psychology itself, however, the large waiting lines and the massive referrals to the school clinics of Psychology trigger the recognition of the importance of the clinic and of the individual care. (AU)

Las clínicas-escuela de Psicología vienen ocupando un lugar de centralidad en las regiones donde están insertadas, pues acaban por dar soporte a los casos de "salud mental" de las redes de asistencia social, educativa y, sobre todo, de la salud. En ese sentido, nuestro objetivo fue analizar las derivaciones de la Atención Primaria a la Salud (APS) del municipio Sobral-Ce. El estudio tuvo un enfoque cualitativo y documental, ya que 293 prontuarios, venidos de la APS, fueron la fuente de investigación. Los datos fueron analizados por medio del Análisis de Discurso Crítico y la reflexión tomó como referencia saber quién eran los profesionales que derivaban, lo que "decían" al derivar y cuáles las sugerencias de tratamientos consideraban más adecuadas. Constatamos que los psicólogos son los profesionales que más derivan al servicio. En los encaminamientos hechos por los médicos, percibimos la dificultad de tratar e incluso reconocer lo que no es palpable, con lo que es "solo psicológico". Por ultimo, consideramos que lo que no puede ocurrir en la APS es la Psicología misma, pero, las grandes colas de espera y los encaminamientos masivos a las clínicas-escuela de Psicología deflagran el reconocimiento de la importancia de la clínica, de la atención individual. (AU)

Réson: Ruído, ressonância e razão significante na clínica psicanalítica / Réson: Noise, resonance and significant reason in the psychoanalytic clinic / Réson: Ruido, resonancia y razón significante en la clínica psicoanalítica

Este artigo faz parte de uma pesquisa que busca articular a clínica psicanalítica com sujeitos ditos autistas com o estudo das noções de voz, vazio, silêncio, música e topologia. Aqui partimos de uma leitura do uso feito por Lacan, em suas aulas sobre o saber do psicanalista, da noção de ressonância para, enfim, abordar a questão da voz e da fala e sua articulação com conceitos provenientes do campo da teoria musical. O trabalho constitui uma investigação teórico-clínica no campo da psicanálise, com referência à experiência de extensão numa universidade brasileira. Além da incursão teórica na psicanálise e na teoria musical, faz-se referência a casos clínicos clássicos já publicados na literatura psicanalítica, como o caso Dick, descrito por Melanie Klein, o caso Marie-Françoise, abordado por Rosine e Robert Lefort, os casos Joey e Frank, de Bettelheim, e vinhetas provenientes de nossa experiência de trabalho. Relacionando as noções de ruído, ritmo e melodia com os registros do real, do simbólico e do imaginário, o artigo conclui sobre a importância clínica da dimensão musical da linguagem na constituição subjetiva e no enquadramento da voz como medida protetiva contra a invasão que alguns sujeitos sentem como ameaça.

This paper is part of a research that relates the psychoanalytic clinic with subjects deemed autist to the study of the concepts of voice, emptiness, silence, music and topology. In this study we start with a reading of Lacan's use of the notion of resonance in his classes about the knowledge of the psychoanalyst and the concept of resonance, in order to address the theme of voice and speech and their articulation with concepts from the field of music theory. This article constitutes a theoretical-clinical investigation in psychoanalysis, with reference to the experience of an extension project in a Brazilian university. In addition to the theoretical incursion into psychoanalysis and musical theory, a reference is made to classic clinical cases published in psychoanalytic literature, such as Dick's case, described by Melanie Klein, Marie-Françoise's case, by Rosine and Robert Lefort, and the cases of Joey and Frank, by Bettelheim. We also make use vignettes from our own experience. By relating the concepts of noise, rhythm and melody to the aspects of real, symbolic, and imaginary, the paper concludes on the clinical importance of the musical dimension of language in the subjective constitution and in the framing of the voice as a protective measure against the invasion that some subjects feel threatening.

Este artículo es parte de una investigación que busca articular la clínica psicoanalítica con sujetos dichos autistas y el estudio de las nociones de la voz, lo vacío, lo silencio, la música y la topología. Aquí comenzamos con una lectura del uso de Lacan, en sus clases sobre el saber del psicoanalista, de la noción de resonancia, para abordar el tema de la voz y la palabra y su articulación con conceptos del campo de la teoría musical. El trabajo constituye una investigación teórico-clínica en el campo del psicoanálisis, con referencia a la experiencia de extensión en una universidad brasileña. Además de la incursión teórica en el psicoanálisis y la teoría musical, se hace referencia a casos clínicos clásicos ya publicados en la literatura psicoanalítica, como el caso Dick, descrito por Melanie Klein, el caso Marie-Françoise, por Rosine e Robert Lefort, y los casos de Joey y Frank, de Bettelheim. Se hace referencia también a viñetas de nuestra experiencia. Relacionando los conceptos de ruido, ritmo y melodía con los registros de lo real, lo simbólico y lo imaginario, el artículo concluye sobre la importancia clínica de la dimensión musical del lenguaje en la constitución subjetiva y en el encuadre de la voz como medida protectora contra la invasión que algunos sujetos sienten tan amenazante.

Ketamine can be produced by Pochonia chlamydosporia: an old molecule and a new anthelmintic?

BACKGROUND: Infection by nematodes is a problem for human health, livestock, and agriculture, as it causes deficits in host health, increases production costs, and incurs a reduced food supply. The control of these parasites is usually done using anthelmintics, which, in most cases, have not been fully effective. Therefore, the search for new molecules with anthelmintic potential is necessary. METHODS: In the present study, we isolated and characterized molecules from the nematophagous fungus Pochonia chlamydosporia and tested these compounds on three nematodes: Caenorhabditis elegans; Ancylostoma ceylanicum; and Ascaris suum. RESULTS: The ethyl acetate extract showed nematicidal activity on the nematode model C. elegans. We identified the major substance present in two sub-fractions of this extract as ketamine. Then, we tested this compound on C. elegans and the parasites A. ceylanicum and A. suum using hamsters and mice as hosts, respectively. We did not find a difference between the animal groups when considering the number of worms recovered from the intestines of animals treated with ketamine (6 mg) and albendazole (P > 0.05). The parasite burden of larvae recovered from the lungs of mice treated with ketamine was similar to those treated with ivermectin. CONCLUSIONS: The results presented here demonstrate the nematicidal activity of ketamine in vitro and in vivo, thus confirming the nematicidal potential of the molecule present in the fungus P. chlamydosporia may consist of a new method of controlling parasites.

Genotypic profile of benzimidazole resistance associated with SNP F167Y in the beta-tubulin gene of Necator americanus helminths obtained from Brazilian populations.

Necator americanus is a worm that parasites the small intestine of humans and is highly prevalent in regions with poor sanitary conditions. The main strategy to control this helminth is by mass benzimidazole administration, however, periodic use of these drugs can select strains of parasites resistant to treatment. Single nucleotide polymorphisms (SNPs) in the beta-tubulin isotype 1 gene located at codons 167, 198 and 200 have been associated with benzimidazole resistance in some nematodes. Previously, our group detected the presence of some of these SNPs in populations of soil-transmitted helminths collected in different locations in Brazil. Here, we evaluated the SNP at codon 167, which has recently been shown to be associated with failure of benzimidazoles to treat N. americanus. Our ARMS-PCR analyses were performed using 524 single N. americanus eggs from 48 patients' feces collected in six Brazilian states; however, we did not detect any mutated samples at codon 167. This study builds on previous work, helping us monitor the presence of resistance-related genotypes in Brazilian helminth populations. The data presented here can assist in the implementation of future control strategies.

Sobre o que Ressoa e Faz Eco: Voz, Música e Lalíngua no Tratamento do Autismo / About what Resonates and Echoes: Voice, Music and Lalíngua in the Autism Treatment / Sobre lo que Resona y Hace Eco: Voz, Música y Lalíngua en el Tratamiento del Autismo

Esse artigo aborda a articulação entre os conceitos psicanalíticos de lalíngua e de voz, pensados a partir da clínica com sujeitos autistas. Com base nas vinhetas clínicas retiradas da literatura e da experiência de trabalho em serviços de Saúde Mental, busca-se investigar de que formas essas noções teóricas se apresentam primordialmente no ato de escuta e como estas podem indicar uma direção de tratamento no autismo a partir da música. A musicalidade da voz materna, por meio de uma ressonância que não se prende ao sentido, transmite uma invocação ao infans para que este advenha como sujeito, produzindo marcas a serem lidas. É necessário que tal invocação, para que possa ressoar no sujeito, ocorra primeiramente no campo do Outro, como forma de apelo. No autismo, no entanto, há impasses quanto à alienação aos significantes provenientes do Outro, sentidos como invasivos. Com isso, constatou-se que a introdução da musicalidade na clínica com esses sujeitos surge como possibilidade de deixar suas marcas, por se tratar de um elemento que permite mediação no âmbito da enunciação. (AU)

This article discusses the articulation between the psychoanalytic concepts of Lalíngua and speech, thought from the clinic with autistic subjects. Based on the clinical vignettes drawn from the literature and from the experience of working in Mental Health services, we seek to investigate in what ways these theoretical notions are presented primarily in the act of listening and how these can indicate a direction of treatment in autism from the music. The musicality of the mother's voice, through a resonance that does not attach to the sense, transmits an invocation to the infans so that it comes as subject, producing marks to be read. Such an invocation, so that it may resonate in the subject, must first occur in the field of the Other, as a form of appeal. In autism, however, there are impasses regarding the alienation to the signifiers from the Other, sensed as invasive. With this, it was verified that the introduction of musicality in the clinic with these subjects appears as a possibility to leave their marks, because it is an element that allows a mediation in the ambit of the enunciation. (AU)

Este artículo aborda la articulación entre los conceptos psicoanalíticos de lenguas y de voz, pensados a partir de la clínica con sujetos autistas. Con base en las viñetas clínicas retiradas de la literatura y de la experiencia de trabajo en servicios de Salud Mental, se busca investigar de qué formas esas nociones teóricas se presentan primordialmente en el acto de escucha y cómo éstas pueden indicar una dirección de tratamiento en el autismo a partir de la música. La musicalidad de la voz materna, por medio de una resonancia que no se prende al sentido, transmite una invocación al infans para que éste venga como sujeto, produciendo marcas a ser leídas. Tal invocación, para que pueda resonar en el sujeto, es necesario que ocurra primero en el campo del Otro, como forma de apelación. En el autismo, sin embargo, hay impases en cuanto a la alienación a los significantes provenientes del Otro, sentidos como invasivos. Con ello, se constató que la introducción de la musicalidad en la clínica con esos sujetos aparece como posibilidad de dejar sus marcas, por tratarse de un elemento que permite una mediación en el ámbito de la enunciación. (AU)

Gastrointestinal parasites in the opossum Didelphis aurita: Are they a potential threat to human health?

Currently, a great proportion of the emerging infectious human diseases are zoonotic, with most of the pathogens originated from wildlife. In this sense, synanthropic animals such as marsupials play important role in the dissemination of pathogens due to their proximity to human dwellings. These hosts are affected by many gastrointestinal parasites, including species with zoonotic potential. The aim of this study was to assess the diversity of gastrointestinal parasites infecting the black-eared opossum D. aurita captured in urban areas of Southeastern, Brazil. In addition, the potential risk for the human population based on the One Health perspective has been discussed. Forty-nine marsupial specimens were captured with Tomahawk live traps and fecal samples were collected. The samples were evaluated by parasitological procedures. Eggs and oocysts were analyzed at different magnifications (400 × and 1000 ×), and their identification, together with adult nematodes, was established on morphological and morphometric data. Forty-three hosts (87.76%) scored positive for at least one gastrointestinal parasite, being 83.67% (41/49) for helminths, and 65.30% (32/49) for protozoa. For Cryptosporidium sp., only 13 samples were evaluated due to insufficient amount of feces obtained of some animals. A prevalence of 23.08% (3/13) was reported for this parasite. PCR analysis revealed Ancylostomatidae eggs to belong to the genus Ancylostoma. Our results demonstrated that multiparasitism is frequently found in these animals and a high percentage of potentially zoonotic parasites are observed, implying that D. aurita may be involved in zoonotic cycles in urban environments.