O sofrimento infantil: ouvindo crianças no serviço de saúde

Este trabalho parte, desde 1997, da observação de uma equipe multiprofissional no Ambulatório de Pediatria do Hospital Universitário Cassiano Antonio de Moraes( Hucam). Observa o número crescente de crianças consideradas com dificuldades de aprendizagens e com depressão encaminhadas para atendimento clínico, questionando quem é a criança com diagnóstico de depressão, como se relaciona com a própria família e com a escola, como compreende os acontecimentos que a envolvem. Diante disso, esta pesquisa tem como objetivo analisar como a criança com diagnóstico de depressão compreende e elabora os acontecimentos que vão compondo sua vida em diferentes espaços pelos quais circula, sobretudo no ambiente escolar. Parte de uma visão que entende o homem em uma perspectiva de totalidade, inserido em um dado contexto histórico e cultural e sendo constituído por esse contexto. O estudo busca afastar-se de um modelo medicalizante, que trabalha prioritariamente com fatores biofisiológicos, minimizando a influência de aspectos sociais e históricos na saúde e bem-estar da criança. Para esta pesquisa foi realizado estudo de casos de crianças com diagnóstico de transtorno depressivo, que foram encaminhadas ao Serviço de Saúde pela escola ou por suas famílias. Os sujeitos da pesquisa foram duas crianças com diagnóstico de depressão, na faixa etária de 10 a 12 anos, período próximo à adolescência e considerado de risco em relação à eclosão de transtornos mentais, em algumas teorias. Na análise dos dados dos dois sujeitos, constatou-se a presença de modos de ser complexos, constituições subjetivas marcadas por múltiplos acontecimentos e pela participação de outras pessoas. Compõem a vida dessas crianças aspectos, como: ser filho adotivo, ter sofrido doenças e perdas no ambiente familiar, maus-tratos no ambiente familiar, ter vivenciado nascimento de um irmão mais novo e ter limitação em relação às possibilidades de fazer as próprias escolhas. Embora se possam estabelecer relações com o espaço escolar, nesse contexto, sobressai o ambiente familiar, com suas contradições e também possibilidades no desenvolvimento e expansão na vida dessas crianças. Ressalta-se, neste trabalho, a importância do intercâmbio entre educação e saúde para responder às demandas de garantia de vida e saúde da criança em processo de sofrimento psíquico

Multicentric Castleman's disease: a case report

Castleman's disease is a clinicopathological entity associated with lymphoproliferation. We report a case of a 71 year old gentleman who was initially clinically suspected to have lymphoma (owing to clinical features at presentation), but was later histologically confirmed to have Castleman's disease. This case report underlines the importance of definitive histological diagnosis in patients with lympadenopathic presentation associated with systemic symptoms and the distinctiveness of multicentric Castleman's disease from malignant lymphoma. In this report we also attempt to provide new insight (through the review of medical literature) into the clinical features, pathogenesis, diagnosis and treatment of this rare and relatively benign disorder

Primary breast lymphomas

The diagnosis, prognostic factors, and optimal management of primary breast lymphomas (PBL) is difficult. Seven patients recorded at the Geneva Cancer Registry between 1973–1998 were reviewed. Five patient had diffuse large B-cell lymphoma, one a follicular lymphoma and one a MALT-lymphoma. All patients had clinical and radiological findings consistent with breast cancer and underwent mastectomy, which is not indicated in PBL. Diagnosis should be established prior to operative interventions, as fine needle aspiration missed the diagnosis for one patient and intra-operative frozen sections for 3 patients in our study. Five-year and 10-year overall survivals were 57% and 15%, respectively. Of the 3 patients who died from PBL, 2 had tumors that were Bcl-2 positive but Bcl-6 negative. All 3 surviving patients have positive Bcl-2 and Bcl-6 immunostaining, which could be important prognostic factors if confirmed by a larger study

Epstein-Barr virus myelitis and Castleman's disease in a patient with acquired immune deficiency syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Few cases of Epstein-Barr virus myelitis have been described in the literature. Multi-centric Castleman's disease is a lymphoproliferative disorder that is well known for its associations with the human immunodeficiency virus, human herpes virus 8, and Kaposi's sarcoma. The concurrent presentation of these two diseases in a patient at the same time is extremely unusual.</p> <p>Case Presentation</p> <p>We describe the case of a 43-year-old Caucasian man with acquired immune deficiency syndrome who presented with fever, weight loss and diffuse lymphadenopathy, and was diagnosed with multi-centric Castleman's disease. He presented three weeks later with lower extremity weakness and urinary retention, at which time cerebrospinal fluid contained lymphocytic pleocytosis and elevated protein. Magnetic resonance imaging demonstrated abnormal spinal cord signal intensity over several cervical and thoracic segments, suggesting the diagnosis of myelitis. Our patient was ultimately diagnosed with Epstein-Barr virus myelitis, as Epstein-Barr virus DNA was detected by polymerase chain reaction in the cerebrospinal fluid.</p> <p>Conclusion</p> <p>To the best of our knowledge, this is the first case of multi-centric Castleman's disease followed by acute Epstein-Barr virus myelitis in a human immunodeficiency virus-infected patient. Clinicians caring for human immunodeficiency virus-infected patients should be vigilant about monitoring patients with increasing lymphadenopathy, prompting thorough diagnostic investigations when necessary.</p

An unusual presentation of Castleman's Disease:a case report

BACKGROUND: Castleman's disease (CD), a rare condition of uncertain etiology, involves a massive proliferation of lymphoid tissues and typically presents as mediastinal masses. We describe a patient with CD who presented with diffuse adenopathy involving the inguinal, paratracheal, retroperitoneal, axillary, and pelvic regions. CASE PRESENTATION: Case report describing presentation, work-up, management and clinical course of a patient with Castleman's disease in the setting of a county hospital in metropolitan area. Patient was treated with chemotherapeutic agents. CONCLUSIONS: To our knowledge, this represents the first case of CD involving an HIV-positive patient with a negative Human Herpes Virus (HHV-8) viral panel. Because patients with similar clinical histories are at high risk for the development of non-Hodgkin's lymphoma and Kaposi sarcoma, regular medical surveillance is recommended

Soybean oil increases SERCA2a expression and left ventricular contractility in rats without change in arterial blood pressure

<p>Abstract</p> <p>Background</p> <p>Our aim was to evaluate the effects of soybean oil treatment for 15 days on arterial and ventricular pressure, myocardial mechanics and proteins involved in calcium handling.</p> <p>Methods</p> <p>Wistar rats were divided in two groups receiving 100 μL of soybean oil (SB) or saline (CT) i.m. for 15 days. Ventricular performance was analyzed in male 12-weeks old Wistar rats by measuring left ventricle diastolic and systolic pressure in isolated perfused hearts according to the Langendorff technique. Protein expression was measured by Western blot analysis.</p> <p>Results</p> <p>Systolic and diastolic arterial pressures did not differ between CT and SB rats. However, heart rate was reduced in the SB group. In the perfused hearts, left ventricular isovolumetric systolic pressure was higher in the SB hearts. The inotropic response to extracellular Ca²⁺and isoproterenol was higher in the soybean-treated animals than in the control group. Myosin ATPase and Na⁺-K⁺ATPase activities, the expression of sarcoplasmic reticulum calcium pump (SERCA2a) and sodium calcium exchanger (NCX) were increased in the SB group. Although the phosfolamban (PLB) expression did not change, its phosphorylation at Ser¹⁶was reduced while the SERCA2a/PLB ratio was increased.</p> <p>Conclusions</p> <p>In summary, soybean treatment for 15 days in rats increases the left ventricular performance without affecting arterial blood pressure. These changes might be associated with an increase in the myosin ATPase activity and SERCA2a expression.</p

A Standardized Morpho-Functional Classification of the Planet’s Humipedons

It was time to take stock. We modified the humipedon classification key published in 2018 to make it easier and more practical. This morpho-functional taxonomy of the topsoil (humipedon) was only available in English; we also translated it into French and Italian. A standardized morphofunctional classification of humipedons (roughly the top 30–40 cm of soil: organic and organomineral surface horizons) would allow for a better understanding of the functioning of the soil ecosystem. This paper provides the founding principles of the classification of humipedon into humus systems and forms. With the recognition of a few diagnostic horizons, all humus systems can be determined. The humus forms that make up these humus systems are revealed by measuring the thicknesses of the diagnostic horizons. In the final part of the article, several figures represent the screenshots of a mobile phone or tablet application that allows for a fast recall of the diagnostic elements of the classification in the field. The article attempts to promote a standardized classification of humipedons for a global and shared management of soil at planet level

A standardized morpho-functional classification of the planet’s humipedons

It was time to take stock. We modified the humipedon classification key published in 2018 to make it easier and more practical. This morpho-functional taxonomy of the topsoil (humipedon) was only available in English; we also translated it into French and Italian. A standardized morphofunctional classification of humipedons (roughly the top 30–40 cm of soil: organic and organomineral surface horizons) would allow for a better understanding of the functioning of the soil ecosystem. This paper provides the founding principles of the classification of humipedon into humus systems and forms. With the recognition of a few diagnostic horizons, all humus systems can be determined. The humus forms that make up these humus systems are revealed by measuring the thicknesses of the diagnostic horizons. In the final part of the article, several figures represent the screenshots of a mobile phone or tablet application that allows for a fast recall of the diagnostic elements of the classification in the field. The article attempts to promote a standardized classification of humipedons for a global and shared management of soil at planet level

Co-limitation towards lower latitudes shapes global forest diversity gradients

The latitudinal diversity gradient (LDG) is one of the most recognized global patterns of species richness exhibited across a wide range of taxa. Numerous hypotheses have been proposed in the past two centuries to explain LDG, but rigorous tests of the drivers of LDGs have been limited by a lack of high-quality global species richness data. Here we produce a high-resolution (0.025° × 0.025°) map of local tree species richness using a global forest inventory database with individual tree information and local biophysical characteristics from ~1.3 million sample plots. We then quantify drivers of local tree species richness patterns across latitudes. Generally, annual mean temperature was a dominant predictor of tree species richness, which is most consistent with the metabolic theory of biodiversity (MTB). However, MTB underestimated LDG in the tropics, where high species richness was also moderated by topographic, soil and anthropogenic factors operating at local scales. Given that local landscape variables operate synergistically with bioclimatic factors in shaping the global LDG pattern, we suggest that MTB be extended to account for co-limitation by subordinate drivers