Alexitimia e teatro playback: Um ensaio aleatório controlado

Dissertação de Mestrado realizada sob a orientação do Prof. Doutor António José Gonzalez, apresentada no ISPA – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica.Sendo a alexitimia associada a diversas perturbações psicológicas, psiquiátricas e até doenças físicas, esta pode diminuir a qualidade e o tempo de vida dos indivíduos, sendo por isso importante a investigação sobre como a diminuir. A sua diminuição está associada à utilização de técnicas que aumentem a consciência emocional e a atividade imaginativa dos indivíduos (através da promoção da comunicação não verbal) e à presença de imaginação espontânea. No Teatro Playback dá-se uma maior importância ao uso de uma linguagem não verbal, metafórica e simbólica do que a uma linguagem verbal e literal, em que ao participar numa performance deste formato teatral os atores e a audiência são convidados a “ser aventureiros, espontâneos e criativos”. Encontramos assim uma ligação conceptual entre as formas de diminuição da alexitimia e o Teatro Playback. Este estudo propõe-se a investigar, através da realização de um ensaio controlado aleatório, se uma intervenção de Teatro Playback de 12 sessões semanais durante três meses consecutivos, pode diminuir os níveis de alexitimia nos seus participantes. Uma amostra de 32 participantes (13 do grupo experimental e 19 do grupo de controlo), com idades compreendidas entre os 19 e os 58 anos, respondeu à Escala de Alexitimia de Toronto (TAS-20) antes e depois da realização da intervenção. Os resultados obtidos não nos permitirem inferir qualquer relação entre o Teatro Playback e a diminuição da alexitimia. São discutidas limitações metodológicas e possíveis enviesamentos deste estudo, assim como propostas para estudos futuros.Since alexithymia is associated with a variety of psychological, psychiatric and even physical disorders, it may decrease the quality and life span of individuals, so research on how to reduce it is important. Its decrease is associated with the use of techniques that increase the emotional awareness and imaginative activity of individuals (through the promotion of nonverbal communication) and the presence of spontaneous imagination. In Playback Theater, the use of nonverbal, metaphorical, and symbolic language is given more importance than verbal and literal language, in which by participating in a performance of this theatrical format actors and audience are invited to “be adventurous, spontaneous and creative”. Thus, we find a conceptual link between the forms of diminishing alexithymia and the Playback Theater. This study aims to investigate, by conducting a randomized controlled trial, whether a 12-session weekly Playback Theater intervention for three consecutive months can decrease the levels of alexithymia in its participants. A sample of 32 participants (13 from the experimental group and 19 from the control group), aged 19 to 58 years, responded to the Toronto Alexithymia Scale (TAS-20) before and after the intervention. The results obtained do not allow us to infer any relationship between Playback Theater and the decrease in alexithymia. Methodological limitations and possible biases of this study are discussed, as well as proposals for future studies

The emergence of arboviruses changes the profile of viral meningitis in Salvador, Bahia: A case series

Background: Recently, different arboviruses became endemic in Brazil mostlycausing acute febrile illnesses, however, neurological manifestations have alsobeen reported. This study aimed to investigate which viruses were involved inthe meningitis etiology and the contribution of the circulating arboviruses inSalvador, Bahia, Brazil.Methods: From June 2014 to February 2016, 170 patients with suspected viralmeningitis were identified in Couto Maia Hospital, Salvador-BA, Brazil. TheirCSF samples were investigated for possible viral etiology by reversetranscription-PCR (RT-PCR) for different arboviruses: DENV, ZIKV and CHIKV;and for the EV; and by PCR for the HHV1-5 complex (HSV1-2, VZV, EBV andCMV). Also, ELISA was carried out in a subgroup of remaining samples fordetection of DENV IgM and NS1 antigen, CHIKV IgM and ZIKV IgM.Results: Thirty-seven patients were PCR or ELISA positive for at least one of thestudied viruses (overall positivity 21.8%). EV was the agent most frequentlydetected (10 cases; 27.0%), along with all four DENV serotypes (10 cases;27.0%); followed by CHIKV (6 cases; 16.2%), ZIKV (6 cases; 16.2%), and Varicellazoster virus (VZV) (1 case; 2.7%). Four cases (10.8%) presented viral co-infectiondetected: DENV1 + CHIKV, DENV1 + EV, DENV4 + ZIKV, and CHIKV + ZIKV.Arboviruses (DENV, CHIKV and ZIKV) accounted for the great majority of cases(26 cases; 70.3%) of all single and co-infections: DENV has been the mostfrequently detected arbovirus (13 cases; 35.1%). Among non-arboviralmeningitis,the most common etiology was the EV (11 cases; 29.7%).Conclusions: Arboviruses accounted for the majority of identified virusesamong patients with suspected viral meningitis. In areas where they areendemic it is crucial to increase viral surveillance and consider them in thedifferential diagnosis of meningitis.Fil: Dias, Tamiris T.. Fundación Oswaldo Cruz; BrasilFil: Tauro, Laura Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Puerto Iguazú | Universidad Nacional de Misiones. Instituto de Biología Subtropical. Instituto de Biología Subtropical - Nodo Puerto Iguazú; ArgentinaFil: Macêdo, Lara E. N.. Fundación Oswaldo Cruz; BrasilFil: Brito, Liz O.. Fundación Oswaldo Cruz; BrasilFil: Ribeiro, Victor H. O.. Fundación Oswaldo Cruz; BrasilFil: Santos, Cleiton S.. Fundación Oswaldo Cruz; BrasilFil: Jacob-Nascimento, Leile C.. Fundación Oswaldo Cruz; BrasilFil: Vilas-Boas, Letícia S.. Fundación Oswaldo Cruz; BrasilFil: Amado, Caio. Fundación Oswaldo Cruz; BrasilFil: Barbosa, Paula S.. Fundación Oswaldo Cruz; BrasilFil: Reis, Joice N.. Fundación Oswaldo Cruz; BrasilFil: Soares Campos, Gubio. Fundación Oswaldo Cruz; BrasilFil: Ribeiro, Guilherme S.. Fundación Oswaldo Cruz; BrasilFil: Siqueira, Isadora C.. Fundación Oswaldo Cruz; BrasilFil: Silva, Luciano K.. Fundación Oswaldo Cruz; BrasilFil: Reis, Mitermayer G.. Fundación Oswaldo Cruz; Brasi

The influence of Amazonian and Atlantic flora in the vegetation of cerrado sensu stricto

A contribuição das floras Atlântica e Amazônica foi analisada em doze localidades no bioma do cerrado. Um total de 290 espécies de arbustos e árvores foram registradas nas localidades de cerrado. Deste total 41,1% ocorreram apenas no cerrado, sendo provavelmente endêmicas e 58,9% ocorreram nas florestas Atlântica e Amazônica. Para as espécies não endêmicas, a contribuição da floresta Atlântica foi maior (44,8%) do que a da floresta Amazônica (1,4%), com as 12,7% de espécies restantes ocorrendo nos dois biomas florestais. A proporção de espécies com centro de distribuição na floresta Atlântica e Amazônica mostraram um pequeno decréscimo em direção ao centro do bioma do cerrado. Para o primeiro, a distância explicou apenas 30% da variação na proporção de espécies, por um modelo polinomial ajustado aos dados e, para o último, um modelo linear explicou 78% da variação. A proporção de espécies com centro de distribuição na floresta Atlântica mostrou um pequeno aumento com a altitude, mas um modelo polinomial explicou apenas 18% dessa variação. Inversamente, ocorreu um decréscimo linear na proporção de espécies com a altitude para aquelas com centro de distribuição na floresta Amazônica; o modelo explicou 31% da variação. As diferenças na contribuição das floras da floresta Atlântica e Amazônica para a fisionomia de cerrado é discutida com relação às mudanças climáticas durante o Quaternário e diferenças na tolerância entre espécies às queimadas e baixas temperaturas no bioma do Cerrado.The contribution of Amazonian and Atlantic floras was analyzed in twelve localities in the cerrado biome. A total of 290 tree and shrub species were recorded in those localities. Of these, 41.1% occurred only in cerrado and are probably endemic, and 58.9% also occurred in Atlantic and/or Amazonian forest. For non-endemic species the contribution of Atlantic forest was greater (44.8%) than Amazonian ones (1.4%), with the remaining 12.7% species found in both forest biomes. The proportions of species with centers of distribution in Atlantic and Amazonian forest showed a slight decrease toward the center of cerrado biome. For the former, the distance explained only 30% of variation in proportions by a polynomial model fit to the data, and for the latter a significant linear model explained 78% of variations. The flora of Amazon forest and Atlantic forest showed a segregation with altitude. The proportions of species with centers of distribution in the Atlantic forest showed a slight increase with altitude, but a polynomial model explained only 18% of this variation. Inversely, there was a linear relationship between the proportions of species with centers of distribution in Amazonian forest and altitude that explained 31% of variation. The differences in contribution patterns of the Atlantic and Amazonian forest flora to the cerrado physiognomy is discussed with respect to climatic changes during the Quaternary and to differences in plant species tolerance to fire and low temperature in the cerrado biome

Study of Urbanization in Areas of Landsline Risk at the Recreio São Jorge and Novo Recreio Neighborhoods, of the Cabuçu Region, in the Guarulhos Township, State of São Paulo, Brazil

Este artigo, desenvolvido a partir de dissertação de mestrado em Análise Geoambiental da Universidade Guarulhos, apresenta um estudo de urbanização em áreas de risco a escorregamentos dos loteamentos do Recreio São Jorge e Novo Recreio, localizados no município de Guarulhos, São Paulo, Brasil. O estudo adotou a microbacia Taquara do Reino como unidade de planejamento urbano e considerou a carta de zoneamento de risco e suscetibilidade a escorregamentos, assim como a cartografia de restrições legais ao uso do solo. O resultado obtido foi a elaboração de uma alternativa de urbanização como ensaio prático de aplicação dos critérios estudados, considerando a necessidade de melhorar-se as condições ambientais do uso do solo nessa microbacia.This article, developed at the Master´s Program in Geoenvironmental Analysis of the Guarulhos University, presents an urbanization study in areas under landslide risk at the Recreio São Jorge and Novo Recreio neighborhoods, in the city of Guarulhos, State of São Paulo, Brazil. This study adopted the Taquara do Reino watershed as an urban planning unit and considered the zoning map of landslide risk restrictions to land use. This study resulted in the elaboration of an urbanization alternative as a practical test for the studied criteria, considering the need to improve environmental conditions of land use in that watershed

Analytical Performance of a Multiplex Real-Time PCR Assay Using TaqMan Probes for Quantification of Trypanosoma cruzi Satellite DNA in Blood Samples

Background: The analytical validation of sensitive, accurate and standardized Real-Time PCR methods for Trypanosoma cruzi quantification is crucial to provide a reliable laboratory tool for diagnosis of recent infections as well as for monitoring treatment efficacy. Methods/Principal Findings: We have standardized and validated a multiplex Real-Time quantitative PCR assay (qPCR) based on TaqMan technology, aiming to quantify T. cruzi satellite DNA as well as an internal amplification control (IAC) in a single-tube reaction. IAC amplification allows rule out false negative PCR results due to inhibitory substances or loss of DNA during sample processing. The assay has a limit of detection (LOD) of 0.70 parasite equivalents/mL and a limit of quantification (LOQ) of 1.53 parasite equivalents/mL starting from non-boiled Guanidine EDTA blood spiked with T. cruzi CLBrener stock. The method was evaluated with blood samples collected from Chagas disease patients experiencing different clinical stages and epidemiological scenarios: 1- Sixteen Venezuelan patients from an outbreak of oral transmission, 2- Sixty three Bolivian patients suffering chronic Chagas disease, 3- Thirty four Argentinean cases with chronic Chagas disease, 4- Twenty seven newborns to seropositive mothers, 5- A seronegative receptor who got infected after transplantation with a cadaveric kidney explanted from an infected subject. Conclusions/Significance: The performing parameters of this assay encourage its application to early assessment of T. cruzi infection in cases in which serological methods are not informative, such as recent infections by oral contamination or congenital transmission or after transplantation with organs from seropositive donors, as well as for monitoring Chagas disease patients under etiological treatment.Fil: Duffy, Tomas. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones En Ingeniería Genética y Biología Molecular; ArgentinaFil: Cura, Carolina Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular; ArgentinaFil: Ramírez, Juan C.. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular; ArgentinaFil: Abate, Teresa. Universidad Central de Venezuela. Instituto de Medicina Tropical; VenezuelaFil: Cayo, Nelly M.. Universidad Nacional de Jujuy. Instituto de Biologia de la Altura; ArgentinaFil: Parrado, Rudy. Universidad San Simón; BoliviaFil: Diaz Bello, Zoraida. Universidad Central de Venezuela. Instituto de Medicina Tropical; VenezuelaFil: Velazquez, Elsa Beatriz. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; ArgentinaFil: Muñoz Calderón, Arturo. Universidad Central de Venezuela. Instituto de Medicina Tropical; VenezuelaFil: Juiz, Natalia Anahí. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular; ArgentinaFil: Basile, Joaquín. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular; ArgentinaFil: Garcia, Lineth. Universidad San Simón; BoliviaFil: Riarte, Adelina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; ArgentinaFil: Nasser, Julio Rubén. Universidad Nacional de Salta. Facultad de Ciencias Naturales; ArgentinaFil: Ocampo, Susana B.. Universidad Nacional de Jujuy. Instituto de Biologia de la Altura; ArgentinaFil: Yadon, Zaida E.. Pan-American Health Organization; Estados UnidosFil: Torrico, Faustino. Universidad San Simón; BoliviaFil: Alarcón de Noya, Belkisyole. Universidad Central de Venezuela. Instituto de Medicina Tropical; VenezuelaFil: Ribeiro, Isabela. Drugs and Neglected Diseases Initiative; SuizaFil: Schijman, Alejandro Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular; Argentin

Needle visualization during ultrasound-guided puncture: image optimization

Abstract Background Obtaining an adequate image of the needle by ultrasound reduces complications resulting from punctures, increasing patient safety and reducing hospitalization costs. Objectives To verify human perception in relation to number of pixels, while also identifying the best puncture angle and which needle should be used, and to evaluate whether there is a difference if needle visualization software is used. Methods 20 images were analyzed by 103 students who classified them as being sufficient or insufficient and were compared with the quality observed using photoshop. We evaluated whether there were differences between puncture angles of less than 45º and more than 45º, between IV catheter and introducer needles, and between images obtained with and without visualization software. Results There was a higher percentage of sufficient ratings for images those that had more than 60 pixels and when the puncture angle was less than 45º, with significant associations between students’ evaluations and each of these groups (p < 0.001). The percentages of images classified as sufficient were higher for images in which a IV catheter was used and also higher for those using the needle visualization software, with significant associations between the results for students’ classifications and each of these groups (p < 0.001). Conclusions The human eye classifies an image as sufficient according to higher numbers of pixels. Images of punctures at angles smaller than 45º in relation to the surface, of punctures performed with a IV catheter, and when using specific visualization software are also better detected by the human eye

Proteases of haematophagous arthropod vectors are involved in blood-feeding, yolk formation and immunity : a review

Ticks, triatomines, mosquitoes and sand flies comprise a large number of haematophagous arthropods considered vectors of human infectious diseases. While consuming blood to obtain the nutrients necessary to carry on life functions, these insects can transmit pathogenic microorganisms to the vertebrate host. Among the molecules related to the blood-feeding habit, proteases play an essential role. In this review, we provide a panorama of proteases from arthropod vectors involved in haematophagy, in digestion, in egg development and in immunity. As these molecules act in central biological processes, proteases from haematophagous vectors of infectious diseases may influence vector competence to transmit pathogens to their prey, and thus could be valuable targets for vectorial control

Genome of the Avirulent Human-Infective Trypanosome—Trypanosoma rangeli

Background: Trypanosoma rangeli is a hemoflagellate protozoan parasite infecting humans and other wild and domestic mammals across Central and South America. It does not cause human disease, but it can be mistaken for the etiologic agent of Chagas disease, Trypanosoma cruzi. We have sequenced the T. rangeli genome to provide new tools for elucidating the distinct and intriguing biology of this species and the key pathways related to interaction with its arthropod and mammalian hosts.  Methodology/Principal Findings: The T. rangeli haploid genome is ,24 Mb in length, and is the smallest and least repetitive trypanosomatid genome sequenced thus far. This parasite genome has shorter subtelomeric sequences compared to those of T. cruzi and T. brucei; displays intraspecific karyotype variability and lacks minichromosomes. Of the predicted 7,613 protein coding sequences, functional annotations could be determined for 2,415, while 5,043 are hypothetical proteins, some with evidence of protein expression. 7,101 genes (93%) are shared with other trypanosomatids that infect humans. An ortholog of the dcl2 gene involved in the T. brucei RNAi pathway was found in T. rangeli, but the RNAi machinery is non-functional since the other genes in this pathway are pseudogenized. T. rangeli is highly susceptible to oxidative stress, a phenotype that may be explained by a smaller number of anti-oxidant defense enzymes and heatshock proteins.  Conclusions/Significance: Phylogenetic comparison of nuclear and mitochondrial genes indicates that T. rangeli and T. cruzi are equidistant from T. brucei. In addition to revealing new aspects of trypanosome co-evolution within the vertebrate and invertebrate hosts, comparative genomic analysis with pathogenic trypanosomatids provides valuable new information that can be further explored with the aim of developing better diagnostic tools and/or therapeutic targets

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation