Jogo educativo sobre drogas para cegos: construção e avaliação

Estudo realizado com o objetivo de construir e avaliar um jogo educativo sobre drogas psicoativas acessível a pessoas cegas, desenvolvido em três etapas: construção do jogo educativo, avaliação por três especialistas em educação especial e doze cegos. Foi construído um jogo de tabuleiro denominado Drogas: jogando limpo . Na Versão Alfa os especialistas fizeram sugestões em relação às e instruções e ao tabuleiro: textura das casas, peças do jogo e escrita em Braille. Na Versão Beta, procedeu-se à avaliação pelos cegos, os quais sugeriram alterações na textura das casas e colocação de velcro para fixação do pino no tabuleiro. Passou-se, então, à Versão Gama, jogada pelas últimas três duplas de cegos e considerada adequada. Na avaliação dos juízes, o jogo revelou-se adequado, pois permite o acesso à informação sobre drogas psicoativas de maneira lúdica

Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature

The resurgence of the malaria eradication agenda and the increasing number of severe manifestation reports has contributed to a renewed interested in the Plasmodium vivax infection. It is the most geographically widespread parasite causing human malaria, with around 2.85 billion people living under risk of infection. The Brazilian Amazon region reports more than 50% of the malaria cases in Latin America and since 1990 there is a marked predominance of this species, responsible for 85% of cases in 2009. However, only a few complicated cases of P. vivax have been reported from this region. A systematic review of the Brazilian indexed and non-indexed literature on complicated cases of vivax malaria was performed including published articles, masters' dissertations, doctoral theses and national congresses' abstracts. The following information was retrieved: patient characteristics (demographic, presence of co-morbidities and, whenever possible, associated genetic disorders); description of each major clinical manifestation. As a result, 27 articles, 28 abstracts from scientific events' annals and 13 theses/dissertations were found, only after 1987. Most of the reported information was described in small case series and case reports of patients from all the Amazonian states, and also in travellers from Brazilian non-endemic areas. The more relevant clinical complications were anaemia, thrombocytopaenia, jaundice and acute respiratory distress syndrome, present in all age groups, in addition to other more rare clinical pictures. Complications in pregnant women were also reported. Acute and chronic co-morbidities were frequent, however death was occasional. Clinical atypical cases of malaria are more frequent than published in the indexed literature, probably due to a publication bias. In the Brazilian Amazon (considered to be a low to moderate intensity area of transmission), clinical data are in accordance with the recent findings of severity described in diverse P. vivax endemic areas (especially anaemia in Southeast Asia), however in this region both children and adults are affected. Finally, gaps of knowledge and areas for future research are opportunely pointed out

Single-Site Video Endoscopic Inguinal Lymphadenectomy: Initial Report

Techniques that attempt to further reduce the morbidity and improve cosmesis of laparoscopic surgery have particularly generated interest. Since its initial urologic description in 2007, there has been a surge of interest in laparoendoscopic single-site surgery, which is now an emerging technique within the field of minimally invasive urologic surgery. This report describes a preliminary experience with single-site video endoscopic inguinal lymphadenectomy (SSVEIL) compared with conventional video endoscopic inguinal lymphadenectomy (VEIL) on inguinal nodes management in a 45-year-old man with pT(2) grade 2 squamous cell penile carcinoma and impalpable inguinal nodes. VEIL with saphenous vein preservation in the left leg and SSVEIL on the other side presented no difference concerning operative time (100 vs 120 min), blood loss (50 mL), drainage volume, number of nodes retrieved (8), pain, and oncologic outcome. The patient had an uneventful postoperative course, was discharged 12 hours after the procedure, and preferred the aesthetic result of SSVEIL. Further refinements in technology will likely alleviate many of the persistent technical problems. Additional rigorous comparison studies are needed to evaluate the true benefits of the technique and the extent of its clinical application, mainly oncologic results, before the widespread adoption of SSVEIL. Ultimately, advance breakthroughs in fields of in-vivo instrumentation, robotics, and purpose-built robotic platforms will bring its potential to full clinical realization.o TEXTO COMPLETO DESTE ARTIGO, ESTARÁ DISPONÍVEL À PARTIR DE AGOSTO DE 2015.25460761

Androgen Deprivation Therapy And Morbid Obesity: Do They Share Cardiovascular Risk Through Metabolic Syndrome?

Background: Although the use of androgen deprivation therapy (ADT) has resulted in improved survival in men with advanced prostate cancer, the resulting hypogonadism is associated with profound adverse effects comparable to those found in morbid obesity, being cardiovascular risk among the most lethal. Objectives: Evaluate metabolic syndrome, metabolic abnormalities and cardiovascular risk in patients with prostate cancer under ADT, not under ADT and morbid obese men. Methods: This is a cross-sectional study that involves 79 men presenting prostate cancer, of whom 54 under ADT and 25 not under ADT and 91 morbidly obese patients paired by sex and age. To define metabolic syndrome, we used the International Diabetes Federation (IDF) criteria. Metabolic abnormalities, metabolic markers and Framingham score to predict the ten year coronary heart disease risk were compared among patients under ADT, not under ADT and morbid obese. Results: Patients under ADT presented significantly greater occurrence of diabetes and central obesity and higher levels of total cholesterol and low density lipoprotein (LDL) compared to eugonadal men. The mean cardiovascular risk was significantly higher in patients under ADT (39.97 +/- 12.53% vs. 26.09 +/- 14.80%; p = 0.021). Morbidly obese subjects had increased ten year coronary heart disease risk; comparable to patients under ADT (p = 0.054). Conclusion: This study suggests that patients under ADT show higher prevalence of metabolic abnormalities and cardiovascular risk similar to those found in morbidly obese subjects. It is possible that both processes share cardiovascular risk through metabolic syndrome. (C) 2010 AEU. Published by Elsevier Espana, S.L. All rights reserved.35525926

The meanings of death and dying: the perspective of crack users Los significados de la muerte y el morir: la perspectiva de los consumidores de crack Os significados da morte e do morrer: a perspectiva de usuários de crack

The consumption of crack can constitute in an inauthentic form of the existence that leads a person to live improperly the being-toward-death. Given this reality, this study aimed to comprehend the significance of death and dying for the user of crack and to unveil the meanings attributed to this significance. This qualitative study was conducted, based on the phenomenological method, with 12 crack users, in the therapeutic process, in a Psychosocial Care Center - Alcohol and Drugs (CAPSad), in the period from February to April 2011, in Teresina, Piauí. The results show that death is signified, ontically, as a companion, a partner, a passage, a journey and as the crack itself. It was concluded that this significance expressed an inauthentic experience, directed toward the incessant interaction with crack, accompanied by a feeling of nullity and relational disengagement.<br>El consumo de cocaína puede estar en un modo auténtico de la existencia que lleva la persona a vivir mal ser-para-la-muerte. Ante esta realidad se tuvo como objetivo comprender el significado de la muerte y el morir para los consumidores del crack revelar los significados atribuidos a estos significados. Se realizó un estudio cualitativo sobre el método fenomenológico con 12 usuarios de crack en el proceso terapéutico en un Centro de Atención Psicosocial de alcohol y otras drogas en el período de febrero a abril de 2011 en Teresina, Piauí. Los resultados muestran que la muerte se entiende, onticamente por socio, asociación, entradas, viajes y el propio crack. Se concluye que el sentido es expresado en una experiencia inauténtica dirigido a la convivencia de la grieta incesante acompañada por un sentimiento de la nada y la retirada relacional.<br>O consumo de crack pode constituir-se em forma inautêntica da existência que leva a pessoa a viver de forma imprópria o ser-para-a-morte. Diante dessa realidade, objetivou-se compreender o significado da morte e do morrer para o usuário de crack e desvelar os sentidos atribuídos a esses significados. Realizou-se pesquisa qualitativa, fundamentada no método fenomenológico, com 12 usuários de crack, em processo terapêutico, em um Centro de Atenção Psicossocial - Álcool e Drogas (CAPSad), no período de fevereiro a abril de 2011, em Teresina, Piauí. Os resultados mostram que a morte é significada, onticamente, por companheira, parceira, passagem, viagem e pelo próprio crack. Conclui-se que esse significado expressa uma vivência inautêntica, direcionada ao convívio incessante do crack, acompanhada por sentimento de nulidade e descompromisso relacional