Biosensing circulating MicroRNAs in autoinflammatory skin diseases: Focus on Hidradenitis suppurativa.

MicroRNAs (miRNAs) play a crucial role in the early diagnosis of autoinflammatory diseases, with Hidradenitis Suppurativa (HS) being a notable example. HS, an autoinflammatory skin disease affecting the pilosebaceous unit, profoundly impacts patients' quality of life. Its hidden nature, with insidious initial symptoms and patient reluctance to seek medical consultation, often leads to a diagnostic delay of up to 7 years. Recognizing the urgency for early diagnostic tools, recent research identified significant differences in circulating miRNA expression, including miR-24-1-5p, miR-146a-5p, miR26a-5p, miR-206, miR338-3p, and miR-338-5p, between HS patients and healthy controls. These miRNAs serve as potential biomarkers for earlier disease detection. Traditional molecular biology techniques, like reverse transcription quantitative-polymerase chain reaction (RT-qPCR), are employed for their detection using specific primers and probes. Alternatively, short peptides offer a versatile and effective means for capturing miRNAs, providing specificity, ease of synthesis, stability, and multiplexing potential. In this context, we present a computational simulation pipeline designed for crafting peptide sequences that can capture circulating miRNAs in the blood of patients with autoinflammatory skin diseases, including HS. This innovative approach aims to expedite early diagnosis and enhance therapeutic follow-up, addressing the critical need for timely intervention in HS and similar conditions.

[The digital workflow at the service of the practitioner's clinical learning] / Le workflow numérique au service de l'apprentissage clinique du praticien.

Our relationship to digital technologies will be a determining factor in building our identity as 21st century orthodontists. The digital workflow used in orthodontics can be summarized in four successive phases: diagnosis, treatment planning, computer Aid Manufacturing, therapeutic follow-up. According to Professor Stanislas Dehaene, cognitive neuroscience has identified four criteria on which learning success depends. Attention, active engagement, feedback and consolidation. Our article demonstrates that a good organization of the digital workflow, thought upstream and coherent, allows the practitioner to strengthen his learning from each treated clinical case by potentiating the four criteria of learning. This design which is a real challenge is part of an increase strategy.

Clínica em movimento: a cidade como cenário do acompanhamento terapêutico / Moving Clinic: the city as the setting to therapeutic follow-up care

O artigo aborda a prática do acompanhamento terapêutico em sua dimensão clínica-política. Pretende-se desenvolver uma reflexão a respeito da potência de se tomar a cidade como matéria da clínica a partir da prática do acompanhamento terapêutico. Para tanto, faremos uma incursão pelo modo a partir do qual se desenvolveu, na modernidade, a constituição dos discursos e medidas adotados com vistas a abarcar a experiência da loucura sob o estigma de doença mental. Em seguida, apresentaremos o contexto de revisionismo crítico acerca dos alicerces do saber médico-psiquiátrico, a partir da segunda metade do século XX, com o questionamento dos critérios utilizados para designar, delimitar e caracterizar os sujeitos alçados à categoria de alienados. O embasamento teórico está centrado em autores tais como Michel Foucault, Robert Castel e Franco Basaglia. O investimento nos espaços públicos faz com que esta estratégia de intervenção seja um importante ator no processo de Reforma psiquiátrica brasileira.(AU)

This article focus the therapeutical follow-up care practice in its clinical-political dimension. It is intended to develop a reflexion about the power of taking the city as a matter of the clinic from the practice of therapeutic follow-up. To achieve that, we shall make an incursion through the method from wich it has been developed, in modern times, the constitution of discourses and measures adopted in order to comprehend the experience of insanity under the stigma of a mental desease. Next, we present the context of critical revisionism about the foundations of medical-psychiatric knowledge, from the second half of the twentieth century, with the questioning of the criteria used to designate, delimit and characterize the subjects raised to the category of alienated. The theoretical basis is found in authors such as Michel Foucault, Robert Castel and Franco Basaglia. Investing in public spaces makes this intervention strategy to be an important agent in the Brazilian psychiatric reform process.(AU)

[Admission of a patient with psychosis to a nursing home and continuity of psychiatric care]. / Admission d'un sujet psychotique en Ehpad et continuité des soins psychiatriques.

The terms 'admission, solution and continuity' are the condensation of useful notions for describing the phenomenon of the referral of patients receiving psychiatric care to nursing homes. The extent of this trend and the concern for quality of life means that, in terms of the institutional, legal and ethical issues involved, the psychotic elderly patient must not remain marginal or invisible.

O acompanhamento terapêutico na cena urbana: transicionalidade e interjogo na arena sociocultural / The therapeutic follow-up care in the urban scene: transitionality and interplay in the sociocultural arena

O presente artigo visa refletir sobre o acompanhamento terapêutico, no intuito de articular as análises de Donald Winnicott acerca da importância das provisões ambientais primárias, à qualidade da relação que se estabelece entre o acompanhante terapêutico e o sujeito acompanhado. O acompanhamento terapêutico se inscreve no processo de Reforma Psiquiátrica brasileira, sendo uma de suas características mais marcantes a proposta de uma clínica ampliada, que acontece nos territórios de vida daqueles que são assistidos. A partir desta perspectiva, buscaremos esquadrinhar as questões clínicas decorrentes dessa abertura para o "fora" que caracteriza este tipo de acompanhamento. Constata-se com isso que, no acompanhamento terapêutico, as relações clínicas são estabelecidas no "aqui e agora" do cotidiano coletivo, domínio no qual a realidade só pode ser compartilhada, fazendo com que o vínculo seja distinto daquele que permeia os consultórios e clínicas de atendimento, promovendo outra qualidade de relação a qual precisa ser mais bem explorada pela literatura acerca do tema, exigindo a criação de conceitos que escapem às categorias clínicas tradicionais.(AU)

This article aims to reflect on the therapeutic follow-up care, with the intention to articulate Donald Winnicott analysis about the importance of the primary environmental provisions, and to the quality of the relation established between the therapeutic accompanist and the subject who is followed-up. The therapeutic follow-up care is part of the Brazilian Psychiatric Reform process, being one of the most striking features the proposal of san expanded clinic, which takes place in the living territories of those who are assisted. From this perspective, we will seek to analyze the clinical issues arising from this openness to the "outside" that characterizes this kind of followup. It can be observed that, in the therapeutic follow-up care, clinical relations are established in the "here and now" of collective everyday life, a domain in which reality can only be shared, making that the bond established be different from the one that permeates the clinics and consulting services, promoting another kind of relations quality, which needs to be more explored by literature regardin this theme, demanding the creation of concepts which get away from traditional clinical categories.(AU)

El presente artículo tiene por objeto reflexionar sobre el seguimiento terapéutico, con el fin de articular los análisis de Donald Winnicott sobre la importancia de las provisiones ambientales primarias, la calidad de la relación que se establece entre el acompañante terapéutico y el sujeto acompañado. El seguimiento terapéutico se inscribe en el proceso de Reforma Psiquiátrica brasileña, siendo una de sus características más marcantes la propuesta de una clínica ampliada, que ocurre en los territorios de vida de aquellos que son asistidos. A partir de esta perspectiva, buscaremos escudriñar las cuestiones clínicas derivadas de esa apertura hacia el "fuera" que caracteriza este tipo de acompañamiento. Se constata con ello que, en el acompañamiento terapéutico, las relaciones clínicas se establecen en el "aquí y ahora" del cotidiano colectivo, dominio en el cual la realidad sólo puede ser compartida, haciendo que el vínculo sea distinto del que permea los consultorios y clínicas de atención, promoviendo otra calidad de relación a la cual necesita ser mejor explotada por la literatura acerca del tema, exigiendo la creación de conceptos que escapen a las categorías clínicas tradicionales.(AU)

Which Lipids Should Be Analyzed for Diagnostic Workup and Follow-up of Patients with Hyperlipidemias?

PURPOSE OF REVIEW: To summarize and discuss the clinical use of lipid and apolipoprotein tests in the settings of diagnosis and therapeutic follow-up of hyperlipidemia. RECENT FINDINGS: The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently produced recommendations on the measurement of atherogenic lipoproteins, taking into account the strengths and weaknesses of analytical and clinical performances of the tests. Total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and calculated non-HDL cholesterol (= LDL + remnant cholesterol) constitute the primary lipid panel for hyperlipidemia diagnosis and cardiovascular risk estimation. LDL cholesterol is the primary target of lipid-lowering therapies. Non-HDL cholesterol or apolipoprotein B should be used as secondary therapeutic target in patients with mild-to-moderate hypertriglyceridemia, 2-10 mmol/l (175-880 mg/dl). Lipoprotein (a) is included in LDL cholesterol and should be measured at least once in all patients at cardiovascular risk, including to explain poor response to statin treatment.

Interest of fecal calprotectine dosage in inflammatory bowel diseases, state of the art and perspectives.

Inflammatory bowel diseases are chronic diseases that result from an inflammation of the intestinal wall. They are suspected in any patient presenting with intestinal symptoms. Until recently, diagnosis was mainly based both on clinical and endoscopic arguments. The use of an easy, fast, reliable, non-invasive and inexpensive test must not only assist in the diagnosis but also contribute to their evolutionary and therapeutic monitoring. To date, fecal calprotectin is the most documented in this perspective. This marker allows to discriminate between functional and organic bowel processes with good sensitivity and good specificity. The determination of the fecal calprotectin level in stools contributes to the evaluation of the degree of disease activity and monitoring of therapeutic response.

Preventive measures to prevent loss to follow-up in highly active antiretroviral therapy (HAART): implementing a strategy in Ziguinchor (Casamance, Senegal) in 2014.

Since 2010, the Pharmacie et Aide Humanitaire (PAH) in Casamance (Senegal) has been maintaining a software package (Tacojo) that allows monthly monitoring of the distribution of treatment to every patient with HIV infection receiving highly active antiretroviral therapy (HAART). We used this program to set up measures to prevent the loss to follow-up of patients receiving HAART. Our involvement focused on two main areas. First, each patient is routinely contacted after inclusion, to help us to understand the patient's experience of the disease and the treatment. This process aims to improve adherence to the treatment. Then, all patients who miss an appointment are routinely contacted by telephone within seven days of that appointment. The goal is to understand the reasons for the absence and to encourage patients to continue their treatment. Despite the lack of distance due to the relative newness of this program, these preventive measures have shown hopeful results (80% of the patients came back after a call). It would be interesting to apply it in a sustainable manner and in more medical facilities.

Optimal scheduling of post-therapeutic follow-up of patients treated for cancer for early detection of relapses.

Post-therapeutic surveillance is one important component of cancer care. However, there still is no evidence-based strategies to schedule patients' follow-up examinations. Our approach is based on the modeling of the probability of the onset of relapse at an early asymptotic or preclinical stage and its transition to a clinical stage. For that we consider a multistate homogeneous Markov model, which includes the natural history of relapse. The model also handles separately the different types of possible relapses. The optimal schedule is provided by the calendar visit that maximizes a utility function. The methodology has been applied to laryngeal cancer. The different follow-up strategies revealed to be more efficient than those proposed by different scientific societies.

Acompanhamento terapêutico: um dispositivo de desafios / Therapeutic follow-up: a dispositive of challenges

Este texto é parte de um estudo de especialização em Clínica e Saúde. Trazemos questionamentos das Políticas Públicas para infância e juventude, articulando as relações entre saúde e as redes de serviço, bem como práticas da Clínica Ampliada, enfatizando a função do acompanhante terapêutico e evidenciando o Acompanhamento Terapêutico como um dispositivo clínico, capaz de produzir mudanças e atravessamentos na transversalidade do campo da Saúde Coletiva. Para isso, utilizamos uma análise do campo social partindo da história de uma criança que é tomada como problemática por diversas instituições. Também apontamos a função do acompanhante terapêutico como um catalisador entre a criança, as instituições e a cidade, problematizando os modos de relação construídos pelo viés dos saberes e verdades instauradas nesses campos de subjetivação. Com isso, entendemos que as considerações finais ou conclusões não podem ser fechadas e apontamos alguns direcionamentos e mudanças como propulsores de novas práticas em Saúde.

This text is part of a study of specialization in Clinic and Health. In this article we bring questions about public policies for children and youth, articulating the relations between health and service networks as well as practices in Extended Clinic to emphasize the role of therapeutic follow-up and highlight the Therapeutic Follow-up as an efficient clinical dispositive in producing changes and crossings into the transversality of field of Collective Health. In order to do so, we used ananalysis of the social field based on the story of a child who is seen as problematic by several institutions. We also pointed out the role of therapeutic follow-ups as a catalyst between the child, the institutions and the city, questioning modes of relationship built by the bias of knowledge and truths brought into these fields of subjectivity, therewith we understood that the final considerations and conclusions cannot be closed and pointed out some directions and changes to be takenas a propeller of new practices in health.

Low-grade gliomas: the challenges of imaging.

WHO grade II gliomas are a major challenge for magnetic resonance imaging (MRI) due to their delayed anaplastic transformation. Today it is possible to individually characterize tumor progression from diagnosis to anaplastic transformation based on the many parameters identified in studies in the literature and the possibility of integrating these data into mathematical models. Early identification of negative morphological and metabolic factors, as well as treatment follow-up, help identify predictive factors of tumor progression, as well as determine treatment response to adapt management of this disease.

In vivo reflectance confocal microscopy assessment of the therapeutic follow-up of cutaneous T-cell lymphomas causing scalp alopecia.

Cutaneous T-cell lymphomas involving the scalp and determining scarring alopecias are difficult to be followed up during treatment because of the peculiar anatomical site of onset. In vivo reflectance confocal microscopy has already been reported to be useful for cutaneous T-cell lymphoma evaluation and for therapeutic follow-up in inflammatory skin conditions. We describe a case of a 26-year-old man affected by cutaneous T-cell lymphoma affecting the scalp in which reflectance confocal microscopy demonstrated to be useful for in vivo evaluation of the therapeutic response to topical and systemic treatment.

O acompanhamento terapêutico como estratégia de cuidado na atenção psicossocial / Therapeutic follow-up as a strategy for attention in the psychosocial care / El acompañamiento terapéutico como estrategia de cuidado en la atención psicosocial

O acompanhamento terapêutico constitui um importante instrumento de integração de projetos assistenciais centrados na atenção psicossocial. Suas ações se inserem como práticas opostas aos modelos asilares de tratamento, alinhando-se às propostas da reforma psiquiátrica e sanitária. Diante disso, questionase sobre a forma como a atenção psicossocial vem sendo desenvolvida dentro dos Centros de Atenção Psicossocial e buscam-se alternativas para a superação dos impasses da rede de saúde mental. O objetivo deste trabalho é refletir sobre as possibilidades de contribuição do acompanhante terapêutico dentro da atenção psicossocial. Assim, pode-se considerar que a atenção psicossocial ainda está em processo de construção como base assistencial dos atuais equipamentos da reforma psiquiátrica. Com isso, um ator que poderia atuar circulando nesses diferentes setores, nesses diferentes espaços, é o acompanhante terapêutico, promovendo a facilitação, a inserção e a construção conjunta do usuário ao seu universo cotidiano e em novas redes culturais/interacionais.(AU)

The therapeutic follow-up is an important tool for integrating service projects focused on psychosocial care. These actions are work practices as opposed to models of asylums treatment, aligning the proposed reform and psychiatric health. Therefore, it is uncertain how psychosocial care has been developed within the Psychosocial Care Centers, and alternatives to overcome the impasses of mental health network are sought. The objective of this paper is to discuss the possibility of the therapist contribution in psychosocial care. Thus, one can consider that psychosocial care is still in the building process as the basis of the current healthcare equipment of psychiatric reform. Thus, an actor who could act circulating in these different sectors, these different spaces is the therapist, promoting the user's facilitation, integration and joint construction in his/her everyday world and in new cultural /interactional networks.(AU)

El acompañamiento terapéutico constituye un importante instrumento de integración de proyectos asistenciales centrados en la atención psicosocial. Sus acciones se insieren como prácticas opuestas a los modelos asilares de tratamiento, alineándose a las propuestas de la reforma psiquiátrica y sanitaria. Ante eso, se cuestiona sobre la forma como la atención psicosocial viene siendo desarrollada dentro de los Centros de Atención Psicosocial y se buscan alternativas para la superación de los impases de la red de salud mental. El objetivo de este trabajo es reflexionar sobre las posibilidades de contribución del acompañamiento terapéutico dentro de la atención psicosocial. Así, se puede considerar que la atención psicosocial aún está en proceso de construcción como base asistencial de los actuales equipos de la reforma psiquiátrica. Con eso, un actor que podría actuar circulando en esos diferentes sectores, en esos diferentes espacios, es el acompañamiento terapéutico, promoviendo la facilitación, la inserción y la construcción conjunta del usuario a su universo cotidiano y en nuevas redes culturales/interaccionales.(AU)

O acompanhamento terapêutico como estratégia de cuidado na atenção psicossocial / Therapeutic follow-up as a strategy for attention in the psychosocial care / El acompañamiento terapéutico como estrategia de cuidado en la atención psicosocial

O acompanhamento terapêutico constitui um importante instrumento de integração de projetos assistenciais centrados na atenção psicossocial. Suas ações se inserem como práticas opostas aos modelos asilares de tratamento, alinhando-se às propostas da reforma psiquiátrica e sanitária. Diante disso, questionase sobre a forma como a atenção psicossocial vem sendo desenvolvida dentro dos Centros de Atenção Psicossocial e buscam-se alternativas para a superação dos impasses da rede de saúde mental. O objetivo deste trabalho é refletir sobre as possibilidades de contribuição do acompanhante terapêutico dentro da atenção psicossocial. Assim, pode-se considerar que a atenção psicossocial ainda está em processo de construção como base assistencial dos atuais equipamentos da reforma psiquiátrica. Com isso, um ator que poderia atuar circulando nesses diferentes setores, nesses diferentes espaços, é o acompanhante terapêutico, promovendo a facilitação, a inserção e a construção conjunta do usuário ao seu universo cotidiano e em novas redes culturais/interacionais...

The therapeutic follow-up is an important tool for integrating service projects focused on psychosocial care. These actions are work practices as opposed to models of asylums treatment, aligning the proposed reform and psychiatric health. Therefore, it is uncertain how psychosocial care has been developed within the Psychosocial Care Centers, and alternatives to overcome the impasses of mental health network are sought. The objective of this paper is to discuss the possibility of the therapist contribution in psychosocial care. Thus, one can consider that psychosocial care is still in the building process as the basis of the current healthcare equipment of psychiatric reform. Thus, an actor who could act circulating in these different sectors, these different spaces is the therapist, promoting the user's facilitation, integration and joint construction in his/her everyday world and in new cultural /interactional networks...

El acompañamiento terapéutico constituye un importante instrumento de integración de proyectos asistenciales centrados en la atención psicosocial. Sus acciones se insieren como prácticas opuestas a los modelos asilares de tratamiento, alineándose a las propuestas de la reforma psiquiátrica y sanitaria. Ante eso, se cuestiona sobre la forma como la atención psicosocial viene siendo desarrollada dentro de los Centros de Atención Psicosocial y se buscan alternativas para la superación de los impases de la red de salud mental. El objetivo de este trabajo es reflexionar sobre las posibilidades de contribución del acompañamiento terapéutico dentro de la atención psicosocial. Así, se puede considerar que la atención psicosocial aún está en proceso de construcción como base asistencial de los actuales equipos de la reforma psiquiátrica. Con eso, un actor que podría actuar circulando en esos diferentes sectores, en esos diferentes espacios, es el acompañamiento terapéutico, promoviendo la facilitación, la inserción y la construcción conjunta del usuario a su universo cotidiano y en nuevas redes culturales/interaccionales...

O acompanhamento terapêutico na internação hospitalar: inclusão social, resgate de cidadania e respeito à singularidade / Acompañamiento terapéutico en la internación hospitalaria: inclusión social, rescate de ciudadanía y respeto a la singularidad / Therapeutic follow-up during hospitalization: social inclusion, redemption of active citizenship and respect for singularity

Esta pesquisa foi realizada em unidade de internação psiquiátrica de crise, com objetivo de elaborar proposta de implementação do acompanhamento terapêutico (AT), para compor o programa terapêutico dessa unidade. Trabalhou-se com a concepção de acompanhamento terapêutico como recurso importante para integrar projetos de reabilitação psicossocial, tendo as seguintes finalidades: vincular o usuário em serviço extra-hospitalar, evitar as reinternações hospitalares e inclusão na rede social. A pesquisa constituiu um estudo de caso exploratório-descritivo, com abordagem qualitativa dos dados. Como técnica de coleta e registro dos dados, utilizou-se a observação participante e o diário de campo. As dificuldades vivenciadas relacionaram-se com esfera das redes sociais, família, relações institucionais e sociedade. Os resultados incluíram: acolhimento do sofrimento do portador e da família; inclusão dos usuários em redes sociais; serviços extra-hospitalares; e organizações comunitárias.

This study was carried out in a psychiatric crisis hospitalization unit, with the aim of drawing up a proposal for implementing therapeutic follow-up, as part of the therapeutic program at this unit. The concept of therapeutic follow-up was envisaged as an important resource to be included in psychosocial rehabilitation projects, with the following goals: linking users with extra-hospital services, avoiding rehospitalization and achieving inclusion in social networks. The study consisted of an exploratory-descriptive case study with a qualitative approach to the data. Participant observation and a field diary were the techniques used for data gathering and recording. The difficulties experienced were correlated with the spheres of social networks, family, institutional relationships and society. The results included heeding the patient's and the family's suffering and including users in social networks, extra-hospital services and community organizations.

Esta investigación se realizó en una unidad psiquiátrica de crisis, con objeto de elaborar propuesta de implemento de acompañamiento terapéutico (AT), para componer el programa terapéutico de esta unidad. Se ha trabajado con la concepción de acompañamiento terapéutico como recurso importante para integrar proyectos de rehabilitación psicosocial con las siguientes finalidades: vincular al usuario en servicio extra-hospitalario, evitar las internaciones repetidas en el hospital y en la red social. La investigación constituye un estudio de caso exploratorio-descriptivo con datos aproximados de calidad. Como técnica de colecta y registro de los datos se ha utilizado la observación participante y el diario de campo. Las dificultades afrontadas se relacionan con la familia, redes sociales e institucionales. Los resultados incluyen: acogida del sufrimiento del portador y de la familia, inclusión de los usuarios en redes sociales, servicios extra-hospitalarios y organizaciones comunitarias.