Manejo das urgências subjetivas nas instituições: que lugar para o serviço-escola? / Maneuvering subjective urgency in institutions: what is the role of psychology school-service? / ¿Manejo de las urgencias subjetivas en las instituiciones: que lugar para el servicio-escuela?

Neste artigo pretende-se discutir a problemática do manejo da urgência subjetiva nas instituições, apoiando-se em uma investigação em andamento no serviço-escola de uma universidade pública. Interroga-se a urgência generalizada, marca de nossos tempos, para situar as coordenadas do manejo da angústia presente nas demandas por assistência em saúde mental dirigidas às instituições. Articula-se, a partir das referências teórico-clínicas dentro da psicanálise de orientação lacaniana, a prática do manejo das urgências em diversos dispositivos de saúde. Pretende-se circunscrever a partir dessa elaboração, o duplo pertencimento dos serviços-escola: lugar de formação e instituição que, de alguma forma, participa da rede de saúde mental. (AU)

This article intends to discuss the problem of maneuvering subjective urgency in institutions, based on ongoing research in development at the school-service of a public university. The widespread urgency is questioned, as a mark of our time, to locate thecoordinates of the management of anxiety present in demands for mental health assistance directed at institutions. It is articulated, through theoretical-clinical references within lacanian oriented psychoanalysis, the practical maneuvering of urgencies in several health devices. It is intended to circumscribe through this elaboration, the double belonging of school-services: place of formation and institution that, in some way, participates in the mental health network. (AU)

En este artículo se pretende discernir la problemática del manejo de la urgencia subjetiva en las instituciones, a partir de una investigación en desarrollo en el servicio-escuela de una universidad pública. Se interroga la urgencia generalizada, marca de nuestra época, para situar las coordinadas del manejo de la angustia presente en las demandas por asistencia en salud mental dirigidas a las instituciones. Desde las referencias teórico-clínicas se articula la práctica del manejo de las urgencias en diversos servicios de salud. Se pretende, a partir de esa discusión, circunscribir la doble pertenencia de los servicios-escuela: lugar de formación que, de alguna forma, participa de la redde salud mental. (AU)

Factors driving extensive spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals

The SARS-CoV-2 Gamma variant spread rapidly across Brazil, causing substantial infection and death waves. We use individual-level patient records following hospitalisation with suspected or confirmed COVID-19 to document the extensive shocks in hospital fatality rates that followed Gammas spread across 14 state capitals, and in which more than half of hospitalised patients died over sustained time periods. We show that extensive fluctuations in COVID-19 in-hospital fatality rates also existed prior to Gammas detection, and were largely transient after Gammas detection, subsiding with hospital demand. Using a Bayesian fatality rate model, we find that the geographic and temporal fluctuations in Brazils COVID-19 in-hospital fatality rates are primarily associated with geographic inequities and shortages in healthcare capacity. We project that approximately half of Brazils COVID-19 deaths in hospitals could have been avoided without pre-pandemic geographic inequities and without pandemic healthcare pressure. Our results suggest that investments in healthcare resources, healthcare optimization, and pandemic preparedness are critical to minimize population wide mortality and morbidity caused by highly transmissible and deadly pathogens such as SARS-CoV-2, especially in low- and middle-income countries. NoteThe following manuscript has appeared as Report 46 - Factors driving extensive spatial and temporal fluctuations in COVID-19 fatality rates in Brazilian hospitals at https://spiral.imperial.ac.uk:8443/handle/10044/1/91875. One sentence summaryCOVID-19 in-hospital fatality rates fluctuate dramatically in Brazil, and these fluctuations are primarily associated with geographic inequities and shortages in healthcare capacity.

Evaluation of ionizing radiation as a risk factor for the incidence of breast cancer: long-term analysis after the cesium-137 accident in Goiânia, Brazil. An ecological study.

BACKGROUND: The largest radiological accident to occur in any urban area happened in Goiânia, Brazil, in 1987. OBJECTIVE: To evaluate the association between breast cancer incidence and ionizing radiation levels. DESIGN AND SETTING: Ecological study among residents of the city of Goiânia, Brazil. METHODS: The central region of Goiânia, with seven major sources of contamination from cesium-137, was defined as the study area. The addresses of women diagnosed with breast cancer were identified between 2001 and 2010. The data were geographically referenced and, using census data, the annual averages of crude incidence rates were estimated. The existence of clusters of new cases was ascertained by means of the Moran index. Correlations of radiometric measurements with the incidence were assessed using unconditional linear regression. RESULTS: A total of 4,105 new cases were identified, of which 2,233 were in the study area, and of these, 1,286 (57.59%) were georeferenced. The gross rates of total and referenced cases were 102.91 and 71.86/100,000 women, respectively. These were close to the average for Brazilian state capitals, which is 79.37/100,000 women. The cluster analysis showed slight correlations in three small sets of census tracts, but these were far from the sources of contamination. The scatter plot of points and the R2 value close to zero indicated that there was no association between the variables. CONCLUSION: This study reinforces the hypothesis that the ionizing radiation levels to which women living in Goiânia are now exposed to are not associated with the onset of new cases of breast cancer.

Evaluation of ionizing radiation as a risk factor for the incidence of breast cancer: long-term analysis after the cesium-137 accident in Goiânia, Brazil. An ecological study

ABSTRACT BACKGROUND: The largest radiological accident to occur in any urban area happened in Goiânia, Brazil, in 1987. OBJECTIVE: To evaluate the association between breast cancer incidence and ionizing radiation levels. DESIGN AND SETTING: Ecological study among residents of the city of Goiânia, Brazil. METHODS: The central region of Goiânia, with seven major sources of contamination from cesium-137, was defined as the study area. The addresses of women diagnosed with breast cancer were identified between 2001 and 2010. The data were geographically referenced and, using census data, the annual averages of crude incidence rates were estimated. The existence of clusters of new cases was ascertained by means of the Moran index. Correlations of radiometric measurements with the incidence were assessed using unconditional linear regression. RESULTS: A total of 4,105 new cases were identified, of which 2,233 were in the study area, and of these, 1,286 (57.59%) were georeferenced. The gross rates of total and referenced cases were 102.91 and 71.86/100,000 women, respectively. These were close to the average for Brazilian state capitals, which is 79.37/100,000 women. The cluster analysis showed slight correlations in three small sets of census tracts, but these were far from the sources of contamination. The scatter plot of points and the R2 value close to zero indicated that there was no association between the variables. CONCLUSION: This study reinforces the hypothesis that the ionizing radiation levels to which women living in Goiânia are now exposed to are not associated with the onset of new cases of breast cancer.

A juventude universitária na contemporaneidade: a construção de um serviço de atenção em saúde mental para estudantes / The university youth in the contemporaneity: the construction of a mental health service for undergraduates / a juventud universitaria en la sociedad contemporánea: la construcción de un servicio de salud mental para los estudiantes

O presente estudo descreve a experiência de constituição de um serviço de atenção em saúde mental para estudantes universitários que se organiza a partir de sua porta de entrada, estabelecendo um mapa da clientela e realizando a caracterização de seu perfil contextual e subjetivo. São apresentados os pressupostos que sustentam o dispositivo de recepção dos estudantes, tomando como base as considerações psicanalíticas sobre urgência e crise e as questões relativas à abordagem dos jovens e de seus dilemas na atualidade. O manejo clínico é problematizado e discutido à luz do perfil do público atendido e do contexto da universidade, salientando a importância da constituição de um lugar de referência que relance a aposta na palavra e em seus efeitos. Ao sustentar ativamente uma postura inclusiva e aberta à diferença, espera-se contribuir para a criação de um espaço de reflexão que problematize o lugar da norma e do universal e fomente a construção de um laço solidário entre os estudantes.

This study describes the experience of setting up a mental health service for college students which is organized by the situations that happens in the first interview, creating a map of the clientele and establishing their subjective and contextual profile. The principles sustaining the student reception service are presented based on psychoanalytic urgency and crisis theories, as well as on issues concerning youth and its current dilemmas. The clinical approach is questioned and discussed considering the public’s profile and institutional context, and stressing the relevance of creating a place of reference that relaunches the wager on the word and its effects. By actively sustaining an attitude that is both inclusive and open to diversity, we hope to contribute in creating a place of reflection, where the norm and universal standards are questioned, and the creation of bonds based on solidarity among the students is fomented.

Este estudio describe la experiencia de formación de un servicio de salud mental para estudiantes universitarios que se organiza a partir de las situaciones que se presentan en las primeras entrevistas, construyendo un mapa de los utilizadores y una caracterización de su perfil contextual y subjetivo. Se presentan los presupuestos que sustentan el dispositivo de recepción de los estudiantes, a partir de las consideraciones psicoanalíticas sobre urgencia y crisis y de las teorizaciones sobre los dilemas con que se enfrentan los jóvenes en la actualidad. Se discute el método clínico y su funcionamiento a partir de la caracterización del público consultante en el contexto de la universidad, destacando la importancia de la creación de un lugar de referencia que tiene como objetivo relanzar la apuesta en la palabra y en sus efectos. Se sostiene una postura inclusiva e abierta a la diferencia, se espera que contribuya para la creación de un espacio de reflexión que problematice el lugar de la norma y del universal y fomente la construcción de un lazo solidario entre los estudiantes.

Atividade antineoplásica e tripanocida de Hovenia dulcis Thunb. cultivada in vivo e in vitro

Muitas são as substâncias do metabolismo vegetal que têm despertado grande interesse, principalmente no setor de fármacos. No presente estudo, foram avaliadas as atividades antineoplásica e tripanocida de extratos vegetais de Hovenia dulcis (Rhamnaceae) cultivada sob condições in vivo e in vitro. Extratos metanólicos das folhas de material jovem desenvolvido in vivo e in vitro, exibiram altas porcentagens na inibição do crescimento de todas as linhagens de células tumorais testadas, enquanto extratos etanólicos do pseudofruto mostraram seletividade com elevado percentual de inibição do crescimento celular nas linhagens SP2/0 e BW. Quanto à atividade tripanocida, os extratos aquoso do pseudofruto e metanólico das folhas das plantas germinadas in vivo, apresentaram percentual de inibição em 48 h, de 95 por cento e 100 por cento, respectivamente.

Plants produce a wide range of secondary metabolites, many of which are pharmaceutically important. In this paper were evaluated anti-cancer and trypanocidal activities from Hovenia dulcis (Rhamnaceae) in vivo and in vitro propagated plants. Methanolic extracts of young leaves from in vivo and in vitro material were remarkably active for all tumor cells lines tested, while ethanolic extracts of pseudofruit showed high degree of selectivity against to SP2/0 and BW cells in culture. Mortality of 95 and 100 percent (48 h) on Trypanosoma cruzi were observed on the aqueous extract of pseudofruit and methanolic extracts of leaves from seedlings.

Carcinoma de cisto tiroglosso / Carcinoma of thyroglossal cysts

Os remanescentes do ducto tiroglosso säo responsáveis pela maioria das massas congênitas encontradas no pescoço. Raramente estas sofrem processos infecciosos ou malignos, ou tornam-se autônomas, originando hipertireoidismo. O potencial embiológico para formar tecido tireoidiano explicaria o achado das células foliculares e os carcinomas primitivos destas. Näo é comum haver caracterizaçäo clínica de malignidade, critério dos autores para indicar a retirada cirúrgica de todos os cistos diagnosticados. A avaliaçäo cintilográfica anterior à cirurgia é fundamental para evitar a retirada do único tecido tireoidiano do paciente. O comportamento dos carcinomas dos cistos parece ser o mesmo dos da glândula tireóide, sendo que o diagnóstico precoce deve ser o determinante do melhor prognóstico dos primeiros. O achado de células tireoidianas nos cistos com tumores näo-diferenciados é importante para caracterizar um processo maligno dos remanescentes do ducto tiroglosso. É importante o controle periódico da tireóide após a excisäo do cisto, por possuírem suas células certamente o mesmo potencial carcinogênico. Alguns autores sugerem a supressäo do hormônio tireotrófico com hormônio tireoidiano (levotiroxina). Apresentam-se os casos de carcinoma de cisto tiroglosso encontrados no Hospital da Lagoa - INAMPS-RJ, nos últimos quatorze anos