O ódio em três textos de Freud: reflexões sobre ambiguidade, hostilidade e identificação / Hate in three works of Freud: reflections on ambiguity, hostility and identification

Um estudo sobre a abordagem freudiana acerca do ódio em três textos clássicos. Reflexão acerca do pensamento freudiano sobre as bases da hostilidade, a ambivalência e identificação na constituição do sujeito. Tema candente diante da ascensão do discurso do ódio na sociedade contemporânea.(AU)

A study on the Freudian approach to hatred in three classic texts. Reflection on Freudian thought on the basis of hostility, ambivalence and identification in the constitution of the subject. Hot topic facing the rising of hate speech in contemporary society.(AU)

Salvage radiotherapy for biochemical recurrence after radical prostatectomy: does the outcome depend on the prostate cancer characteristics?

ABSTRACT Objective: To build a model to evaluate the impact of salvage radiotherapy (SRT) in men with PSA rise or persistent PSA after undergoing radical prostatectomy (RP). Materials and Methods: The study included 107 node-negative patients treated with SRT after RP at a single institution. Patients received SRT for either prostate-specific antigen (PSA) rising, or PSA persistence after RP. All patients received local radiation to the prostate / seminal vesicle bed. The primary measured outcome was the biochemical recurrence (BCR) free survival. Multivariable Cox regression analysis was used to develop a risk-stratification group to identify predictive factors associated with the probability of BCR at 5yr. Results: At a median follow-up of 52 months, the BCR free survival rate and overall survival in 5 years was 73% and 94%, respectively. At multivariable analysis, pre-SRT PSA level > 0.35ng / mL (p = 0.023), negative margins (p = 0.038), and seminal vesicles invasion (p = 0.001) were significantly associated with BCR free survival. Three risk groups using regression analysis for SRT administration was built. Low-, intermediate- and the high-risk groups had a BCR free survival in 5-years of 96%, 84%, and 44% (p = 0.0001), respectively. Conclusions: We developed a risk group stratification to show the impact of SRT based on prostate cancer characteristics. SRT showed to be extremely beneficial for patients with low- and intermediate-risk tumors. Moreover, the risk-group built could identify patients classified as high-risk who might benefit from more aggressive treatment for SRT.

Salvage radiotherapy for biochemical recurrence after radical prostatectomy: does the outcome depend on the prostate cancer characteristics?

OBJECTIVE: To build a model to evaluate the impact of salvage radiotherapy (SRT) in men with PSA rise or persistent PSA after undergoing radical prostatectomy (RP). MATERIALS AND METHODS: The study included 107 node-negative patients treated with SRT after RP at a single institution. Patients received SRT for either prostate-specific antigen (PSA) rising, or PSA persistence after RP. All patients received local radiation to the prostate / seminal vesicle bed. The primary measured outcome was the biochemical recurrence (BCR) free survival. Multivariable Cox regression analysis was used to develop a risk-stratification group to identify predictive factors associated with the probability of BCR at 5yr. RESULTS: At a median follow-up of 52 months, the BCR free survival rate and overall survival in 5 years was 73% and 94%, respectively. At multivariable analysis, pre-SRT PSA level > 0.35ng / mL (p = 0.023), negative margins (p = 0.038), and seminal vesicles invasion (p = 0.001) were significantly associated with BCR free survival. Three risk groups using regression analysis for SRT administration was built. Low-, intermediateand the high-risk groups had a BCR free survival in 5-years of 96%, 84%, and 44% (p = 0.0001), respectively. CONCLUSIONS: We developed a risk group stratification to show the impact of SRT based on prostate cancer characteristics. SRT showed to be extremely beneficial for patients with low- and intermediate-risk tumors. Moreover, the risk-group built could identify patients classified as high-risk who might benefit from more aggressive treatment for SRT.

Nijinsky: o sujeito psicótico no registro simbólico da arte / Nijinsky: the psychotic subject in the symbolic register of art

Apresentamos uma reflexão sobre os fenômenos psicóticos e os investimentos pulsionais possíveis na produção de Outra Cena no campo da linguagem, quando a ‘palavra-coisa-ação’ do sujeito psicótico denuncia a falência do simbólico. A partir de O diário de Nijinsky, escrito durante seus surtos psicóticos, é trabalhada a hipótese de que a produção em nome próprio no universo da arte permite a sustentação do sujeito psicótico no registro simbólico e sua permanência na potencialidade sem ser impelido à foraclusão.(AU)

Reflections on the psychotic phenomenon and the possible drive (trieb) investments in the production of Another Scene in the field of language when “word-thing-action” of the psychotic citizen determines the bankruptcy of the symbolic. From Nijinsky's diary, written during his psychotic episodes, is crafted the hypothesis that production in his own name in the world of art allows the support of the psychotic subject in the symbolic register and his/her stay in the potentiality without being driven to foreclosion.(AU)

Planning and treatment in oral rehabilitation with implant-supported prostheses using cephalometric analysis / Planejamento e tratamento em reabilitação oral com próteses sobre implantes usando análise cefalométrica

There are growing prosthetic and esthetic demands for Oral Rehabilitations on osseointegratable implants, requiring precise prosthetic-surgical planning. In edentulous patients planning may be done using cephalometric analysis to determine the position of the teeth in the dental prosthesis, and consequently, those of the implants. In this clinical case, the planning and treatment of an oral implant-supported rehabilitation is described, using cephalometry to optimize prosthetic success and patient comfort. The patient presented complete mandibular and partial maxillary edentulism, with unsatisfactory esthetics and function of the anterior teeth, with accentuated vestibular inclination. In order to determine the correct position of maxillary teeth it was necessary to use a Steiner cephalometric tracing to position the maxillary central incisor in the diagnostic wax-up. Therefore, the maxillary anterior teeth were extracted, osseointegratable implants were placed (Neodent(r), Curitiba, Brazil), and an immediate temporary fixed denture was inserted. After 30 days, surgery was performed for the placement of 4 osseointegratable implants (Neodent(r), Curitiba, Brazil) in the inter-mentonian region, on which a complete, temporary, implant-supported denture was placed. After the period of osseointegration, the definitive implant-supported dental prosthesis were fabricated.

Reabilitações orais sobre implantes osteointegráveis enfrentam crescentes exigências protéticas e estéticas, necessitando de um planejamento protético-cirúrgico preciso. O planejamento em pacientes edêntulos pode ser realizado usando análise cefalométrica para determinar o posicionamento dos dentes na prótese e conseqüentemente dos implantes. Esse caso clínico descreve o planejamento e tratamento de uma reabilitação oral sobre implantes usando análise cefalométrica para otimizar o sucesso protético assim como o conforto do paciente. Paciente apresentando edentulismo total mandibular e parcial maxilar com elementos anteriores insatisfatórios estética e funcionalmente, com inclinação vestibular acentuada. Para a determinação do correto posicionamento dos elementos superiores foi necessário a utilização de traçado cefalométrico de Steiner para o posicionamento do incisivo central superior no enceramento diagnóstico. Dessa forma, foi realizado exodontia dos elementos anteriores superiores, instalação de implantes osteointegraveis (Neodent(r), Curitiba, Brasil) e instalação de prótese fixa provisória imediata. Após 30 dias, foi realizada cirurgia para instalação de 4 implantes osteointegráveis (Neodent(r), Curitiba, Brasil) na região intermentoniana, sobre os quais foi instalada uma prótese total implanto-suportada inferior provisória. Após período de osteointegração, as próteses sobre implantes definitivas foram confeccionadas.

Atendimentos de emergência ocorridos no período de março de 2012 a fevereiro de 2013 no hospital de clínicas veterinária da universidade federal de pelotas / Emergency care occurred during march 2012 february 2013 in clinical veterinary hospital of university federal of pelotas

[...] O objetivo deste trabalho é descrever a casuística de pacientes considerados de emergência atendidos no Hospital de Clínicas Veterinária (HCV) da Universidade Federal de Pelotas (UFPel), no período de março de 2012 a fevereiro de 2013, contribuindo desta forma para um melhor entendimento dos casos e um melhor atendimento dos pacientes.

Ruptura de bexiga em um cão: relato de caso / Bladder rupture in a dog: case report

A ruptura de bexiga é uma das anomalias do trato urinário mais recorrente nos cães e nos gatos, e pode ser causada por diferentes fatores, como trauma, necrose ou alguma complicação durante uma cirurgia vesical. Como conseqüência, ocorre o uroperitônio que, em longo prazo, leva à uremia, desidratação, hipovolemia, hipercalemia e morte (FOSSUM, 2008). O objetivo deste trabalho é relatar um caso clínico-cirúrgico de uma ruptura de bexiga em um cão da raça Fila Alemão.

Pneumotórax e miocardite traumática em um cão / Pneumothorax and traumatic myocarditis in a dog

Cães que sofrem acidentes automobilísticos na grande maioria apresentam complicações pulmonares e da parede torácica, como contusão pulmonar, pneumotórax e miocardite traumática (FOSSUM, 2007). O pneumotórax é o acumulo de ar no espaço pleural e pode ser classificado em aberto ou fechado e pela etiologia. A miocardite traumática é um termo aplicado à síndrome de arritmias e ocorre por trauma não perfurante resultado de um impacto contra a parede do tórax e na grande maioria ocorrem taquiarritmias ventriculares (NELSON E COUTO, 2003). O objetivo deste trabalho é relatar um caso de pneumotórax e miocardite traumáticos em um cão.

Hipertermia por intermação em cão: relato de caso / Hyperthermia due to heat stroke in dogs: case report

O objetivo deste trabalho é relatar um caso de hipertermia por intermação em um cão da raça São Bernardo, destacando os procedimentos emergenciais realizados para o controle desta enfermidade.

Caspase-3 activation and increased procollagen type I in irradiated hearts.

The caspase-3-cleaved presence was evaluated in this study in the heart of irradiated rats, during the decline of ventricular function. Female Wistar rats were irradiated with a single dose of radiation (15 Gy) delivered directly to the heart and the molecular, histological and physiological evaluations were performed at thirteen months post-irradiation. The expressions of procollagen type I, TGF-ß1 and caspase-3-cleaved were analyzed using Western blotting. Cardiac structural and functional alterations were investigated by echocardiography and electron microscopy. In the irradiated group, the levels of procollagen type I, TGF-ß1 and caspase-3-cleaved are increased. Significant histological changes (degeneration of heart tissue and collagen deposition) and functional (reduced ejection fraction) were observed. Data suggest that the cardiac function decline after exposure to ionizing radiation is related, in part, to increased collagen and increased caspase-3-cleaved.

Investigating the role played by social support in the association between religiosity and mental health in low income older adults: results from the São Paulo Ageing & Health Study (SPAH).

OBJECTIVE: Religiosity has been associated with mental health, especially in the elderly. There is a shortage of studies on the factors that mediate this association, including social support. The aim of this study was to assess the association between the various dimensions of religiosity and the prevalence of common mental disorders among the elderly, and to verify whether social support can work as a mechanism that explains such mediation. METHOD: The sample consisted of an elderly population living in a low income region of the city of São Paulo (N = 1,980). Data on the socio-demographic profile of this population and on the prevalence of common mental disorders were collected, and indicators of religiosity and social support were identified. RESULTS: 90.7% of the sample considered themselves to be religious. In terms of denomination, 66.6% were Catholic. Forty-one per cent attended some kind of religious activity at least once or more times a week. The presence of common mental disorders was not associated with religious affiliation or subjective religiosity. The prevalence of common mental disorders in followers attending religious services was approximately half (OR between 0.43 and 0.55, p < 0.001) compared to those who never attend a religious service. Attending religious services was associated with higher levels of social support. The association between a higher attendance frequency and fewer common mental disorders did not change after the inclusion of relevant of social support variables. CONCLUSION: The study showed that subjects presented high levels of religiosity and that there is a strong association between religious attendance and the prevalence of common mental disorders, which could not be explained by social support.

Investigating the role played by social support in the association between religiosity and mental health in low income older adults: results from the São Paulo Ageing & Health Study (SPAH) / Investigando o papel do suporte social na associação entre religiosidade e saúde mental em idosos de baixa renda: resultados do São Paulo Ageing & Health Study (SPAH)

OBJECTIVE: Religiosity has been associated with mental health, especially in the elderly. There is a shortage of studies on the factors that mediate this association, including social support. The aim of this study was to assess the association between the various dimensions of religiosity and the prevalence of common mental disorders among the elderly, and to verify whether social support can work as a mechanism that explains such mediation. METHOD: The sample consisted of an elderly population living in a low income region of the city of São Paulo (N = 1,980). Data on the socio-demographic profile of this population and on the prevalence of common mental disorders were collected, and indicators of religiosity and social support were identified. RESULTS: 90.7 percent of the sample considered themselves to be religious. In terms of denomination, 66.6 percent were Catholic. Forty-one per cent attended some kind of religious activity at least once or more times a week. The presence of common mental disorders was not associated with religious affiliation or subjective religiosity. The prevalence of common mental disorders in followers attending religious services was approximately half (OR between 0.43 and 0.55, p < 0.001) compared to those who never attend a religious service. Attending religious services was associated with higher levels of social support. The association between a higher attendance frequency and fewer common mental disorders did not change after the inclusion of relevant of social support variables. CONCLUSION: The study showed that subjects presented high levels of religiosity and that there is a strong association between religious attendance and the prevalence of common mental disorders, which could not be explained by social support.

OBJETIVO: A religiosidade tem sido associada à saúde física e mental com especial importância na população idosa. Existe uma carência de estudos abordando os mediadores desta associação, dentre eles o suporte social. O objetivo deste trabalho é analisar a associação entre dimensões de religiosidade e prevalência de transtornos mentais comuns entre idosos e testar o suporte social como mecanismo de mediação desta suposta associação. MÉTODO: A amostra foi constituída pela população idosa de uma região de baixa renda de São Paulo (N = 1.980). Foram coletados dados sociodemográficos, suporte social, indicadores de religiosidade e prevalência de transtorno mental comum. RESULTADOS: 90,7 por cento da amostra considerou-se religiosa (66,6 por cento Católica); 41,2 por cento frequentam uma ou mais vezes alguma atividade religiosa semanalmente. A presença de transtorno mental comum não foi associada com filiação religiosa ou considerar-se religioso. A prevalência de transtorno mental comum para os que frequentam serviço religioso foi aproximadamente a metade (OR entre 0,43 e 0,55, p < 0,001) daqueles que nunca frequentam. Maior frequência a serviços religiosos também se associou a maiores níveis de suporte social. A associação entre maior frequência e menos transtorno mental comum não sofreu alterações relevantes após inclusão das variáveis de suporte social. CONCLUSÃO: A amostra apresentou altos níveis de religiosidade, forte associação entre freqüência religiosa e menor prevalência de transtornos mentais comuns, que não foi explicada pelo suporte social.

Investigating the role played by social support in the association between religiosity and mental health in low income older adults: results from the São Paulo Ageing & Health Study (SPAH).

OBJECTIVE: Religiosity has been associated with mental health, especially in the elderly. There is a shortage of studies on the factors that mediate this association, including social support. The aim of this study was to assess the association between the various dimensions of religiosity and the prevalence of common mental disorders among the elderly, and to verify whether social support can work as a mechanism that explains such mediation. METHOD: The sample consisted of an elderly population living in a low income region of the city of São Paulo (N = 1,980). Data on the socio-demographic profile of this population and on the prevalence of common mental disorders were collected, and indicators of religiosity and social support were identified. RESULTS: 90.7% of the sample considered themselves to be religious. In terms of denomination, 66.6% were Catholic. Forty-one per cent attended some kind of religious activity at least once or more times a week. The presence of common mental disorders was not associated with religious affiliation or subjective religiosity. The prevalence of common mental disorders in followers attending religious services was approximately half (OR between 0.43 and 0.55, p < 0.001) compared to those who never attend a religious service. Attending religious services was associated with higher levels of social support. The association between a higher attendance frequency and fewer common mental disorders did not change after the inclusion of relevant of social support variables. CONCLUSION: The study showed that subjects presented high levels of religiosity and that there is a strong association between religious attendance and the prevalence of common mental disorders, which could not be explained by social support.

Nutrição no paciente politraumatizado: parte 2: indicações e contra-indicações da nutrição enteral / Politrauma patient nutrition: part 2: indications and contraindication of enteral nutrition

Nesta segunda parte os autores discutem as indicações e contra-indicações da terapia de nutrição enteral, apresentando sua importância, seus riscos e seus benefícios diante de situações de extremo catabolismo, em que o adequado manejo clínico-cirúrgico pode influenciar diretamente na sobrevida do paciente politraumatizado

Avaliação morfológica de lesões ativas cutâneas humanas de leishmaniose tegumentar americana / Morphologic evaluation of active injuries cutaneous human beings of leishmaniasis diffuse cutaneous

O perfil celular no microambiente do granuloma tecidual de lesões cutâneas ativas de pacientes com LTA de áreas endêmicas do Estado do Rio de Janeiro, foi analisado por microscopia de luz convencional, aliada ao uso de técnicas de fluorescência (TUNEL), imunohistoquímica e microscopia eletrônica de transmissão convencional. A análise permitiu identificar alterações no perfil celular que variava de acordo com o tempo de infecção. Em lesões recentes (15 dias a 2 meses) de evolução, foi possível observar um número expressivo de neutrófilos, eosinófilos, linfócitos e alguns monócitos e macrófagos. Em lesões mais tardias (4-6 meses) de evolução, houve um aumento expressivo de células, particularmente e plasmócitos apresentando RER bem desenvolvido e algumas vesículas secretórias sugerindo intensa produção de imunoglobulinas e macrófagos. As lesões tardias com 6 meses de evolução apresentaram uma característica de destaque: grande quantidade de células em processo de morte celular como autofagia, necrose e apoptose. Por fluorescência (TUNEL), foi verificado um aumento crescente do número de células apoptóticas que variava de acordo com o tempo de infecção das lesões. A caracterização ultra-estrutural das lesões mostrou células como plasmócitos, em estágios progressivos de indicação de morte celular, sugerindo etapas iniciais de autofagia: (i) perda da arquitetura normal do RER, com arredondamento de suas cisternas, algumas vezes mostrando dilatação excessiva e ainda, aumento do espaço intermembranar do envoltório nuclear (ii) ausência de Golgi e grande quantidade de vesículas secretórias com conteúdo rarefeito. Essas lesões ainda mostraram macrófagos formando um granuloma desorganizado, corpúsculos residuais de amastigotas no interior de vacúolos parasitórofos de macrófagos e células intensamente vacuolizadas, sugerindo morte por autofagia. Morte celular por apoptose também pode ser evidenciada através da visualização de outras células apresentando cromatina altame

Nutrição no paciente politraumatizado: parte 1: aspectos fisiopatológicos do paciente politraumatizado / Nutrition in politrauma patient: part 1: phisiopathological aspects in politrauma patient

Devido ao grande número de acidentes, as vítimas de truma se tornaram uma constante nos hospitais. Com o objetivo de melhor entender e atender o paciente politraumatizado, os autores abordam, em duas partes, os aspectos nutricionais do politrauma. Na primeira parte, envolvendo a definição de trauma, revêem sua fisiopatologia e suas respostas endócrinometabólicas. Além disso, apresentam o conceito de desnutrição e as alterações na cicatrização no desnutrido politraumatizado. Na segunda parte serão abordados os conceitos, as indicações e as contra-indicações da terapia de nutrição enteral no paciente politraumatizado.

Colangite: um importante problema na clínica cirúrgica / Cholangitis: an important problem in clinic surgical

A colangite aguda é um importante desafio e uma condição grave encontrada na prática médica. Por isto, torna-se imprescindível um diagnóstico rápido, com conseqüente tratamento precoce. Os autores revisam as principais manifestações clínicas e as melhores abordagens terapêuticas desta condição.

Elemental composition of acidocalcisomes of Trypanosoma cruzi bloodstream trypomastigote forms.

The elemental composition of acidocalcisomes present in Trypanosoma cruzi bloodstream trypomastigotes was analyzed by X-ray microanalysis. Acidocalcisomes appear as electron-dense vesicles dispersed throughout the cytoplasm. X-ray microanalysis of whole cells adhered to Formvar-coated grids showed that they contained C, O, Na, Mg, P, S, Ca and Zn, although in some acidocalcisomes iron was also detected. However, in ultra-thin sections of parasites processed according to routine procedures, most elements were lost. Living parasites were incubated with gold-labeled holo-transferrin to test if the iron was taken up by receptor-mediated endocytosis. After incubation at 4 degrees C, labeling was observed only in the flagellar pocket membrane, showing that receptors to this protein are already present in bloodstream trypomastigotes. In parasites incubated at 28 degrees C no intracellular tracer was observed, despite the labeling in the flagellar pocket membrane. Our data show that some acidocalcisomes of T. cruzi bloodstream trypomastigotes contain iron and that this element was not taken up by receptor-mediated endocytosis.

Evidence for a perforin-mediated mechanism controlling cardiac inflammation in Trypanosoma cruzi infection.

CD8+ T lymphocytes are considered an important cell population involved in the control of parasitaemia and mortality after Trypanosoma cruzi infection. However, despite recent developments in this field, the mechanism whereby this control is exerted is still not completely understood. Here we have used perforin knockout (-/-) mice infected with Y strain T. cruzi in order to evaluate specifically the participation of the perforin-based cytotoxic pathway in the destruction of cardiomyocytes, cellular inflammatory infiltration, and control of parasitaemia and mortality. We observed that although parasitaemia was equivalent in perforin (+/+) and (-/-) groups, survival rate and spontaneous physical performance were significantly lower in the perforin deficient mice. The cardiac inflammatory cell infiltration, mostly composed of CD8+ cells, was more evident in perforin (-/-) mice. Ultrastructural and immunofluorescence analysis, as well as plasma creatine kinase activity, revealed cardiomyocyte damage and necrosis, more evident in perforin (-/-) mice. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) assays performed in heart samples revealed similar and modest levels of apoptosis in both perforin (+/+) and (-/-) mice. These results indicate that perforin does not play a pivotal role in the control of parasitaemia and direct lysis of cardiomyocytes, but seems to be an important molecule involved in the control of cardiac inflammation and pathology induced by a highly virulent strain of T. cruzi.

Estudo da estrutura fatorial, fidedignidade e validade da traduçäo e adaptaçäo para o português da Escala de Avaliaçäo Psiqui trica Breve (BPRS) modificada / A study of the reliability, validity and factor structure of a Portuguese translation and adaptation of the modified Bried Psychiatric Rating Scale

Investigou-se a estrutura fatorial, a fidedignidade e a validade preditiva da traduçäo e adaptaçäo para o português da escala Brief Psychiatric Rating Scale(BPRS), modificada por BECH e Col. (1986), num grupo heterogêneo de pacientes psiqui tricos internados numa unidade de internaçäo breve em hospital geral universit rio (n = 34). Os pacientes foram avaliados, simultaneamente, por dois psiquiatras, uma vez por semana, durante as três primeiras semanas de internaçäo, produzindo um total de 93 pares de avaliaçöes. A an lise fatorial revelou seis fatores, que reproduzem os da escala original, acrescido de um fator referente a "preocupaçöes som ticas". Verificou-se que a escala possui fidedignidade significativa, estimada pelo coeficiente de correlaçäo intraclasse dos itens individuais dos fatores e dos escores totais. A validade preditiva dos escores totais da BPRS mostrou-se adequada, uma vez que eles discriminaram os pacientes que tiveram alta precoce. Assim, esta traduçäo da BPRS é compatível com a BPRS original