Psychosocial care center: convergence between mental and collective health

This paper aimed to discuss the existence of converging points between mental and collective health practices from the perspective of the professionals of a Psychosocial Care Center (CAPS) in Campinas, SP. The study conducted was both descriptive and qualitative and the data obtained were analyzed according to the theoretical basis coming from phenomenology and discourse analysis. The results showed the existence of factors that hinder the structuring of the health care network, such as: lack of physical resources, inadequate physical space and lack of knowledge regarding CAPS's role as well as the development of a work based on users embracement, on the development of individualized therapeutic projects, on matrix support and team meetings, enhancing a sense of collective and dialogical work.Este artículo tuvo como propuesta discutir la existencia de puntos de convergencia entre el trabajo de salud mental y la salud pública, desde la perspectiva de los profesionales que trabajan en un Centro de Atención Psicosocial (CAPS) en Campinas, SP. Este estudio es cualitativo y descriptivo, y la base teórica de la fenomenología y el análisis de contenido del discurso motivado el análisis de los datos obtenidos. Los resultados mostraron tanto factores que dificultan la articulación de la red de atención como la escasez de recursos materiales, espacio físico inadecuado y la falta de papel de CAPS, como también el desarrollo de un trabajo dirigido a la recepción, a la construcción de proyectos de tratamiento singulares, al apoyo matricial y a las reuniones de equipo, evidenciando acciones que potencian el trabajo colectivo y dialógico.Este trabalho teve por objetivo discorrer sobre a existência de pontos de convergência entre o trabalho de saúde mental e o de saúde coletiva, a partir da percepção de profissionais que atuam em um Centro de Atenção Psicossocial (CAPS) do município de Campinas, SP. Trata-se de estudo de natureza qualitativa e descritiva em que os referenciais teóricos relativos à fenomenologia e à análise do conteúdo do discurso fundamentaram a análise dos dados obtidos. Os resultados mostraram tanto fatores que dificultam a articulação da rede de cuidados - como escassez de recursos materiais, espaço físico inadequado e desconhecimento do papel do CAPS, quanto fatores que dificultam o desenvolvimento de um trabalho dirigido ao acolhimento, à construção de projetos terapêuticos singulares, ao matriciamento e às reuniões de equipe, evidenciando ações que potencializam o trabalho coletivo e dialógico.60361

Histopathology of tumor-like masses present in the nasal cavity of equids from Brazil

Este estudo foi realizado com o objetivo de analisar os aspectos microscópicos e enfatizar a importância do exame histopatológico na determinação do diagnóstico de lesões tumoriformes na cavidade nasal de eqüídeos. Para tanto, foram estudados microscopicamente cortes de tecido de 11 eqüídeos com lesões tumoriformes na cavidade nasal. Essas amostras foram enviadas ao Serviço de Anatomia Patológica da Faculdade de Medicina Veterinária da Universidade Federal Fluminense, Niterói, Rio de Janeiro, no período de 2000 a 2004. Foram diagnosticados três casos de rinosporidiose, um de amiloidose, seis de pólipos nasais e um de hematoma etmoidal progressivo.The purpose of the present study was to analyze the microscopic aspects of tumor-like masses present in the nasal cavity of equids and also to emphasize the importance of histopathological examination for determining the diagnosis. Tissue sections of tumor-like masses from the nasal cavity of 11 equids were microscopically examined. These samples were sent to the Anatomic Pathology Service of the Veterinary Medicine College from the Fluminense Federal University, Niterói, Rio de Janeiro, from 2000 to 2004. Three cases of rhinosporidiosis, one of amyloidosis, six of nasal polyps and one of progressive ethmoid hematoma were diagnosed

Sodium Iodide: an Alternative Treatment Option for Feline Sporotrichosis?

Background: Sporotrichosis is caused by pathogenic fungi of the genus Sporothrix. The clinically relevant species are S. schenckii, S. globosa and S. brasiliensis. In Brazil, S. brasiliensis is the most prevalent etiological agent among humans and cats. In cats with sporotrichosis, skin lesions are mainly characterized by nodules and ulcers, usually located in the head, nasal region and limbs. The presence of respiratory signs concomitantly with cutaneous lesions is frequent, especially sneezing, and may be associated with lesions located in the nasal mucosa. Ketoconazole (KTZ), itraconazole (ITZ), potassium iodide (KI), sodium iodide (NaI), terbinafine (TRB), fluconazole (FLZ) and amphotericin B (AMB) are the drugs currently available for treating feline sporotrichosis. ITZ remains the drug of choice. ITZ combined with KI has been successfully used in the treatment of naïve cats (especially cases with lesions in the nasal region), cases of recurrence and refractory to ITZ. Clinical cure with NaI has been described in some cases, but its use has been limited by adverse reactions. The conventional formulation is the saturated solution and the recommended dose in the treatment of feline sporotrichosis is 10 mg/kg every 12 h. Cats are sensitive to iodide preparations and should be carefully monitored for clinical evidence of iodism, such as apathy, anorexia, vomiting, diarrhea, hypothermia, hyperthermia, cardiomyopathy, hyperexcitability, muscular spasms and ptyalism. The purpose of this study was to evaluate the therapeutic response of NaI capsules in feline sporotrichosis.Materials, Methods & Results: An observational cohort study was conducted in cats with sporotrichosis at the Laboratory of Clinical Research in Dermatozoonoses in Domestic Animals (Lapclin-Dermzoo), Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil. Twenty-eight cats with sporotrichosis confirmed by isolation of Sporothrix spp. in culture, no previous systemic antifungal therapy, and weight above 3.0 kg, were included in the study. The treatment consisted of NaI oral capsules (5 mg/kg/once daily). In cats without clinical improvement after one month of treatment, the dose was increased (10 mg/kg/once daily). The cats were followed up monthly by clinical examination, complete blood count and biochemical analysis (urea, creatinine, alanine aminotransferase - ALT, aspartate aminotransferase - AST, alkaline phosphatase - FA). All procedures were approved by the Animal Ethics Committee (CEUA/Fiocruz), number LW 56/13, and the informed consent term was obtained from all tutors. Clinical cure was achieved in six (21.4%) cases and treatment failure was observed in 13 (46.4%) animals. Seven (25%) cats were lost during follow up, and unknown causes of death occurred in two cases (7.1%). Ten animals (35.7%) presented clinical adverse reactions at some point during treatment. Hyporexia and weight loss were the most frequent ones. Three cats presented alteration in renal function.Discussion: Treatment of feline sporotrichosis in epizootic areas has been a challenge for veterinarians and tutors. Additionally, there are few studies evaluating treatment regimens for this mycosis in animals. In this study, NaI was compounded in capsules, because it is easier to administer when compared to the solution, as previously described for KI. Despite the low cost and the convenient administration of the capsule, NaI presented a low cure rate with the dose used. The study of new pharmaceutical forms and lower doses of low-cost drugs is necessary in a scenario of epizootic sporotrichosis, where investments for the development of new antifungal agents are scarce

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

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

Avaliação da resposta inflamatória in vivo e in vitro na esporotricose felina em diferentes apresentações clínicas

Made available in DSpace on 2014-12-05T18:38:22Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) luisa_miranda_ipec_dout_2013.pdf: 2382714 bytes, checksum: d55b4e803e3fb5de09cd228382c4aa44 (MD5) Previous issue date: 2014-11-18Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas, Rio de Janeiro, RJ, BrasilA ocorrência de formas graves de esporotricose felina, aliada a lesões sem granulomas e ricas em estruturas leveduriformes, evidencia a suscetibilidade destes animais para a doença e enfatiza a importância do estudo da sua patogenia. O objetivo deste estudo foi descrever o processo inflamatório e a carga fúngica das lesões em diferentes apresentações clínicas, e sua relação com o perfil de leucócitos no sangue periférico de gatos com esporotricose por meio da técnica de citometria de fluxo (CF) e com a infecção pelo Vírus da Imunodeficiência Felina (FIV) e/ou pelo Vírus da Leucemia Felina (FeLV). Gatos com lesões cutâneas com isolamento de Sporothrix sp. foram incluídos no estudo, separados nos grupos L1, L2 e L3 (lesões em um, dois e três ou mais locais, respectivamente) e submetidos a coleta de sangue e de fragmentos de lesão. O estado geral dos animais foi classificado como bom, regular ou ruim. Ao exame histopatológico, as lesões foram agrupadas de acordo com o processo inflamatório (granulomatoso ou inespecífico), grau de ativação de fagócitos predominantes nos granulomas (macrófagos ou células epitelióides), organização do granuloma (bem formado ou mal formado) e intensidade dos tipos celulares no infiltrado A carga fúngica foi verificada pelas técnicas de impregnação pela prata de Grocott (IPG) e imuno-histoquímica (IHQ). A CF foi aplicada no sangue periférico, utilizando anticorpos monoclonais para os marcadores CD4, CD8, CD21, CD14 e granulócitos. Cento e um animais foram incluídos no estudo: 20 do grupo L1, 22 do grupo L2 e 59 do grupo L3. O processo inflamatório granulomatoso supurativo (PIGS) foi observado em 99 casos. A maioria das lesões, sobretudo no grupo L3, apresentavam granulomas mal formados (pvalor= 0,032) e com predomínio de macrófagos (p-valor=0,010). A IPG e a IHQ evidenciaram estruturas leveduriformes (EL) em 94 casos cada uma, sendo a concordância entre as duas observada em 92 casos. As duas técnicas associadas apresentaram sensibilidade de 98,0%. A carga fúngica de mais de 400 EL/ campo (400x) ocorreu em 48,5% dos casos com PIGS e foi predominante nos animais do grupo L3. Houve correlação entre granulomas mal formados e com predomínio de macrófagos e a carga fúngica superior a 100 EL/ campo (p-valor<0,01). A CF foi realizada em 33 casos de esporotricose e cinco animais não infectados (Grupo controle). O percentual de linfócitos T CD8+ foi maior nos animais dos grupos L2 e L3 (p-valor=0,01) O maior percentual de células CD4+ esteve associado ao grupo L1 e ao estado geral bom (pvalor= 0,04 e 0,03, respectivamente). A expressão CD8low ocorreu em 20 animais com esporotricose, sendo predominante no grupo L3 (p-valor=0,01), e não ocorreu no grupo controle. Esta expressão foi associada a granulomas com predomínio de macrófagos (p-valor=0,01) e ocorreu em 76,2% dos casos com carga fúngica acima de 100 EL/campo. Três animais foram positivos para FIV, quatorze para FeLV e dois para os dois testes. Não houve correlação entre estes testes e os demais achados. Estes resultados sugerem associação entre a resposta bem organizada, menor carga fúngica e aumento de linfócitos CD4+ com o controle da doença, manutenção do estado geral bom e lesões localizadas. No estado geral ruim, as lesões disseminadas e alta carga fúngica estavam relacionadas a existência de um padrão de resposta com aumento de células CD8+ e aumento da expressão de CD8lowThe occurrence of severe forms of feline sporotrichosis, along with lesions without granulomas and rich in yeast-like forms, demonstrate the su sceptibility of these anim als to the disease and emphasizes the importance of the study of its pathogenesis. The aim of this study was to describe the inflammatory changes and fungal load at different clinical presentations and its relationship with the profile of leukocytes in peripheral blood of cats with sporotrichosis by means of flow cytometry (FC) technique and with Feline Immunodeficiency Virus (FIV) and / or Feline Leukemia Virus (FeLV). Cats presenting cutaneous lesions with isolation of Sporothrix sp. in culture were included. They were separated in groups L1, L2 and L3 (lesions in one, two and three or more sites, respectively) and were subjected to blood sample collection and to biopsy of the lesion. The general condition of the animal s was classified as good, fair or poor. Histologically, the lesions were described according to the inflammatory process (granulomatous or nonspecific), degree of activation of predominant phagocytes within the granulomas (macrophages or epithelioid cells), granulomas organization (well-formed or poorly formed) and intensity of cell types within the inflammation. The fungal lo ad was assessed by Grocott silver stain (GSS) technique and immunohistochemistry (IHC). The FC was applied to peripheral blood by means of monoclonal antibodies to target CD4, CD8, CD21, CD14 and granulocytes. One hundred and one animals were included: 20 in group L1, 22 in group L2 and 59 in group L3. Histologically, 99 lesions showed suppurative granulomatous inflammation (SGI). Most lesions, specially in the group L3, showed poorly formed granulomas (p-value=0.032) and predominantly macrophages (p-value=0.010). The GSS and IHC s howed yeast-like forms (YF) in 94 cases each one and their concordance was noted in 92 cases. Together, the two techniques showed sensivity of 98.0%. The fungal load of more than 400 YF/Field (400x) occurred in 48,5% of cases by GSS and was predominant in group L3. There was a correlation between poorly formed granulomas with macrophages predominance and the fungal load exceeding 100 YF/Field (p-value<0.01). The CF was performed in 33 cases of sporotrichosis and five uninfected cats (control group). The percentage of CD8 + T cells was greater in the groups L2 and L3 (p-value=0.001). The higher percentage of CD4 + T cells was correlated to group L1 and to good general condition (p- value=0.04 and 0.03, respectively). The reduced expression of the CD8 molecule (CD8low) occurred in 20 animals with sporotrichosis, being predominat in group L3 (p-value=0.01), and was not observed in control group. This expression was associated with granulomas with macrophage predominance (p-value=0.01) and occurred in 76.2% of cases with fungal load above 100 YF/field. Three animals were positive to FIV, four teen to FeLV and two to both tests. There was no correlation between these tests and the other findings. These results suggest an association of the well-organized response, the lower fungal load and increased CD4 + T lymphocytes with the control of the disease, al ong with the good general condition and localized lesions. At the poor general condition, the dissem inated lesions and high fungal load were related to a response patter n with and increase of CD8 + T lymphocytes and particulary of the CD8 low expression

Cryptococcus in Wildlife and Free-Living Mammals

Cryptococcosis is typically a sporadic disease that affects a broad range of animal species globally. Disease is a consequence of infection with members of the Cryptococcus neoformans or Cryptococcus gattii species complexes. Although cryptococcosis in many domestic animals has been relatively well-characterized, free-living wildlife animal species are often neglected in the literature outside of occasional case reports. This review summarizes the clinical presentation, pathological findings and potential underlying causes of cryptococcosis in various other animals, including terrestrial wildlife species and marine mammals. The evaluation of the available literature supports the hypothesis that anatomy (particularly of the respiratory tract), behavior and environmental exposures of animals play vital roles in the outcome of host–pathogen–environment interactions resulting in different clinical scenarios. Key examples range from koalas, which exhibit primarily C. gattii species complex disease presumably due to their behavior and environmental exposure to eucalypts, to cetaceans, which show predominantly pulmonary lesions due to their unique respiratory anatomy. Understanding the factors at play in each clinical scenario is a powerful investigative tool, as wildlife species may act as disease sentinels

O processo de envelhecimento e a problematização das práticas de saúde no Brasil

RESUMO Este artigo teve como objeto discorrer sobre o processo de envelhecimento, problematizando as práticas em saúde destinadas à população idosa no Brasil. Para isso, a partir da metodologia de revisão bibliográfica, elaborou-se um texto que inicialmente discute algumas definições e termos conceituais do campo da Gerontologia, a partir do diálogo entre diferentes perspectivas teórico-conceituais. Em seguida, são apresentados alguns dados históricos, epidemiológicos e socioculturais sobre o processo de envelhecimento, para, posteriormente, realizar possíveis articulações entre os dados apresentados e as práticas de cuidado em saúde na atualidade