32 research outputs found
Case report: respiratory failure – don’t forget myasthenia!
A miastenia gravis (MG) Ă© uma doença autoimune rara na qual os anticorpos se ligam aos receptores de acetilcolina na membrana pĂłs-sináptica da junção neuromuscular. Pacientes com MG associado ao anticorpo mĂşsculo quinase especĂfico (MuSK) freqĂĽentemente apresentam sintomas graves, incluindo disfunção bulbar, insuficiĂŞncia respiratĂłria e atrofia dos mĂşsculos faciais e da lĂngua. O caráter flutuante e a semelhança dos sintomas com os de outras doenças tornam a MG um dos diagnĂłsticos mĂ©dicos mais desafiadores. O diagnĂłstico incorreto de MuSK-MG pode levar ao agravamento dos sintomas. O diagnĂłstico Ă© confirmado por resultados positivos em testes farmacolĂłgicos, testes de eletrodiagnĂłstico e análise de anticorpos sĂ©ricos. As abordagens sintomáticas, imunoativas e terapias de supeorte tĂŞm um efeito positivo na sintomatologia e o prognĂłstico Ă© melhorado com intervenções precoces
OcorrĂŞncia de sorotipos exĂłticos de Salmonella encontrados em cĂŁes assintomáticos nos distritos do municĂpio de IlhĂ©us / BA - Brasil
Fecal samples from dogs residing in areas of poor living conditions in IlhĂ©us city / BA were examined for Salmonella spp from June 2001 to April 2002. Eighteen (9.47%) of 190 animals were found to be positive. 66.6% of those samples were taken from one year old puppies, 56% of the positive animals were fed by table scrap, 66% did not drink treated water and 67% had a domiciliary behavior. Symptoms of salmonellosis were not present in 83% of all positive animals. S. Gafsa represented the most prevalent serovar (38.9%), followed by S. Rubislaw (27.8%), S. Carrau (16.7%) and S. enterica subsp. Houtenae (11.1%). One sample could not be identified. Gentamicin was the most potent in vitro drug for the treatment of salmonelosis, followed by ampicilin. Our results confirmed that dogs represent an important reservoir of exotic Salmonella serovars and that there are different patterns of sensitivity to drugs among them.Amostras fecais de cĂŁes provenientes de distritos carentes do MunicĂpio de IlhĂ©us / BA foram analisadas para a presença de Salmonella spp durante o perĂodo de junho de 2001 a abril de 2002. Dezoito (9,47%) dos 190 animais foram considerados positivos sendo que 66,6% destes casos ocorreram com animais atĂ© 1 ano de idade, 56% se alimentavam com comida caseira, 66% tinham acesso Ă fonte de água nĂŁo tratada e 67% possuĂa comportamento domiciliar. A sintomatologia da doença nĂŁo foi percebida em 83,3% dos animais. A S. Gafsa representou o sorotipo mais prevalente (38,9%), seguido pela S. Rubislaw (27,8), S. Carrau (16,7%) e S. enterica subsp. Houtenae (11,1%). Uma cepa nĂŁo pĂ´de ser identificada. O antibiograma revelou a gentamicina como sendo a droga mais potente, in vitro, para o tratamento das salmonelas encontradas na regiĂŁo de IlhĂ©us, seguida pela ampicilina. Nossos resultados confirmam que cĂŁes representam um importante reservatĂłrio de sorotipos exĂłticos de Salmonella e que ocorre padrões diferentes de sensibilidade a antibiĂłticos entre eles
Ideação suicida, ansiedade e depressão em pacientes com esclerose múltipla
Transtornos psiquiátricos frequentemente ocorrem em pacientes com esclerose mĂşltipla (EM). No entanto, os artigos sobre estas comorbidades sĂŁo limitados. Pretendemos investigar as relações entre EM, ansiedade, depressĂŁo e ideação suicida. MĂ©todos: Cento e trinta e dois pacientes com EM remitente-recorrente foram avaliados usando a Escala de Estado de Incapacidade Expandida, Inventário de DepressĂŁo de Beck-II (IDB-II), Escala de Beck para Ideação de SuicĂdio (BSI) e Escala de Ansiedade e DepressĂŁo. Resultados: Uma análise de regressĂŁo hierárquica foi realizada para avaliar as variáveis. A equação de regressĂŁo previu significativamente o escore BSI (R2 = 0,306; R2 ajustado = 0,273; F (9,125) = 9,18; p < 0,0005) e o escore no IDB-II foi a Ăşnica variável que contribuiu significativamente para este modelo (p < 0,0005). Conclusões: Uma alta prevalĂŞncia de depressĂŁo e ansiedade e uma maior taxa de ideação suicida foram identificadas em pacientes com EM em comparação com a população em geral. A presença de sintomas depressivos pareceu ter uma influĂŞncia direta no risco de suicĂdio.Psychiatric disorders frequently occur in patients with multiple sclerosis (MS); however, limited reports are available on these comorbidities. We aimed to investigate the relationships among MS, anxiety, depression, and suicidal ideation. Methods: One hundred and thirty two patients with relapsing-remitting MS were evaluated using the Expanded Disability Status Scale, Beck Depression Inventory-II (BDI-II), Beck Scale for Suicide Ideation (BSI), and Hospital Anxiety and Depression Scale. Results: A hierarchical regression analysis was performed to evaluate the variables. The regression equation significantly predicted the BSI score (R2 = 0.306; adjusted R2 = 0.273; F (9, 125) = 9.18; p < 0.0005), and the BDI-II score was the only variable that contributed significantly to this model (p < 0.0005). Conclusions: A high prevalence of depression and anxiety, and a higher rate of suicidal ideation were identified in MS patients compared to the general population. The presence of depressive symptoms appeared to have a direct influence on the risk of suicide
Consenso brasileiro para o tratamento da esclerose mĂşltipla : Academia Brasileira de Neurologia e ComitĂŞ Brasileiro de Tratamento e Pesquisa em Esclerose MĂşltipla
O crescent arsenal terapĂŞutico na esclerose mĂşltipla (EM) tem permitido tratamentos mais efetivos e personalizados, mas a escolha e o manejo das terapias modificadoras da doença (TMDs) tem se tornado cada vez mais complexos. Neste contexto, especialistas do ComitĂŞ Brasileiro de Tratamento e Pesquisa em Esclerose MĂşltipla e do Departamento CientĂfico de Neuroimunologia da Academia Brasileira de Neurologia reuniram-se para estabelecer este Consenso Brasileiro para o Tratamento da EM, baseados no entendimento de que neurologistas devem ter a possibilidade de prescrever TMDs para EM de acordo com o que Ă© melhor para cada paciente, com base em evidĂŞncias e práticas atualizadas. Por meio deste documento, propomos recomendações práticas para o tratamento da EM, com foco principal na escolha e no manejo das TMDs, e revisamos os argumentos que embasam as estratĂ©gias de tratamento na EM.The expanding therapeutic arsenal in multiple sclerosis (MS) has allowed for more effective and personalized treatment, but the choice and management of disease-modifying therapies (DMTs) is becoming increasingly complex. In this context, experts from the Brazilian Committee on Treatment and Research in Multiple Sclerosis and the Neuroimmunology Scientific Department of the Brazilian Academy of Neurology have convened to establish this Brazilian Consensus for the Treatment of MS, based on their understanding that neurologists should be able to prescribe MS DMTs according to what is better for each patient, based on up-to-date evidence and practice. We herein propose practical recommendations for the treatment of MS, with the main focus on the choice and management of DMTs, as well as present a review of the scientific rationale supporting therapeutic strategies in MS
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4
While the increasing availability of global databases on ecological communities has advanced our knowledge
of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In
the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of
Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus
crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced
environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian
Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by
2050. This means that unless we take immediate action, we will not be able to establish their current status,
much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost
Psicanálise e Educação: um tratamento possĂvel para as queixas escolares
This paper presents a theoretical reflection on a study conducted with elementary school teachers in a public school. It was applied Psychoanalytic orientation on conversations as a work methodology, supported by ethics of desire and accountability. The conversations had a main theme, which consisted on the difficulties confronted by teachers in their teaching practice. Teachers have elected three main deadlocks over their educational practice: family, sexuality and public policies. Based on Speech Theory and Temporal Triad proposed by Lacan – instant of seeing, time of understanding and moment of concluding – the author brings up a reflection on speech offer effects on elementary school teachers in a public school.Este artigo apresenta uma reflexĂŁo teĂłrica decorrente de um trabalho realizado com professores do ensino fundamental em uma escola pĂşblica. Foi utilizada, como metodologia de trabalho, a conversação de orientação psicanalĂtica, apoiada pela Ă©tica do desejo e da responsabilização. As conversações tiveram como tema central as dificuldades encontradas pelos professores em suas práticas docentes. Os professores elegeram trĂŞs principais impasses para a sua prática educativa: a famĂlia, a sexualidade e as polĂticas pĂşblicas. Com base na teoria dos discursos e na trĂade temporal proposta por Lacan: o instante de ver, o tempo de compreender e o momento de concluir, o artigo apresenta uma reflexĂŁo sobre os efeitos da oferta da palavra aos professores na escola
Psicanálise e Educação: um tratamento possĂvel para as queixas escolares
This paper presents a theoretical reflection on a study conducted with elementary school teachers in a public school. It was applied Psychoanalytic orientation on conversations as a work methodology, supported by ethics of desire and accountability. The conversations had a main theme, which consisted on the difficulties confronted by teachers in their teaching practice. Teachers have elected three main deadlocks over their educational practice: family, sexuality and public policies. Based on Speech Theory and Temporal Triad proposed by Lacan – instant of seeing, time of understanding and moment of concluding – the author brings up a reflection on speech offer effects on elementary school teachers in a public school.Este artigo apresenta uma reflexĂŁo teĂłrica decorrente de um trabalho realizado com professores do ensino fundamental em uma escola pĂşblica. Foi utilizada, como metodologia de trabalho, a conversação de orientação psicanalĂtica, apoiada pela Ă©tica do desejo e da responsabilização. As conversações tiveram como tema central as dificuldades encontradas pelos professores em suas práticas docentes. Os professores elegeram trĂŞs principais impasses para a sua prática educativa: a famĂlia, a sexualidade e as polĂticas pĂşblicas. Com base na teoria dos discursos e na trĂade temporal proposta por Lacan: o instante de ver, o tempo de compreender e o momento de concluir, o artigo apresenta uma reflexĂŁo sobre os efeitos da oferta da palavra aos professores na escola