Las imágenes de Juan. Análisis de un caso de negativismo desafiante

We present a case of oppositional defiant disorder, in school. The student had learning difficulties and severe difficulties in social relationships. The overall objectives of art therapy process include (a) improving the levels of attention in the tasks and the autonomy, and (b) incorporation of socially appropriate behavior in conflict situations. In the sessions, techniques were used to promote communication and expression of feelings. Finally, we discuss the progress in understanding social situations and positive strides in the construction of identity in adolescencePresentamos un caso de trastorno negativista desafiante en el ámbito escolar. El alumno presentaba dificultades de aprendizaje y graves dificultades en las relaciones sociales. Los objetivos generales del proceso de arteterapia fueron (a) la mejora de los niveles de atención en las tareas y el incremento de la autonomía, y (b) la incorporación de comportamientos socialmente adecuados en situaciones de conflicto. En las sesiones, se utilizaron técnicas para favorecer la comunicación y la expresión de sentimientos. Finalmente, se discuten los progresos en la comprensión de las situaciones sociales y los avances para la construcción positiva de la identidad en la adolescenci

Revisiting the Mona Lisa of the Louvre, The Prado and Isleworth: Leonardo, in the company of others

Actualmente existen tres versiones de la Gioconda de alta calidad, una en el Louvre, otra en el Prado y la tercera en la colección Isleworth. Tras la restauración de 2010 realizada en el Museo del Prado, se ha discutido mucho su autoría. En este trabajo, analizamos el estilo de los principales candidatos propuestos por la historiografía, centrándonos en Fernando Yáñez de la Almedina y Salai. Revisamos el modo de colaboración en el taller de Leonardo, apoyándonos en La Virgen del huso. Nuestras conclusiones apuntan a Fernando Yáñez como autor de la Mona Lisa de Isleworth, por su concordancia con obras conocidas de este pintor; y realizada en colaboración con Leonardo, por la calidad de su diseño, manos y rostro. La Gioconda del Prado sería obra de Salai, si bien su alta calidad nos sugiere una participación importante de Leonardo en su diseño y ejecución. Un análisis informatizado de los colores presentes en las dos versiones de la Gioconda y su comparación con obras de Yáñez y Salai podría confirmar estas hipótesis en el futuro.There are currently three high-quality versions of the Mona Lisa, in Louvre Museum, Prado and the Isleworth collection. After the 2010 restoration carried out in the Prado Museum, its authorship has been much discussed. In this work, we analyze the style of the main candidates proposed by historiography, focusing on Fernando Yáñez de la Almedina and Salai. We reviewed the mode of collaboration in Leonardo’s workshop, relying on The Madonna of the Yarnwinder. Our conclusions point to Fernando Yáñez as the author of the Mona Lisa of Isleworth, due to its concordance with known works by this painter; and made in collaboration with Leonardo, for the quality of its design, hands and face. The Prado´s Gioconda would be the work of Salai, although its high quality suggests an important participation of Leonardo in its design and execution. A computerized analysis of the colors present in the two versions of the Mona Lisa and their comparison with works by Yáñez and Salai could confirm these hypotheses in the future.Facultad de Arte

Arteterapia, Trastorno Negativista Desafiante, Adolescencia.

We present a case of oppositional defiant disorder, in school. The student had learning difficulties and severe difficulties in social relationships. The overall objectives of art therapy process include (a) improving the levels of attention in the tasks and the autonomy, and (b) incorporation of socially appropriate behavior in conflict situations. In the sessions, techniques were used to promote communication and expression of feelings. Finally, we discuss the progress in understanding social situations and positive strides in the construction of identity in adolescenc

Diferencias de género en el reconocimiento de caras emocionales: ¿son los hombres menos eficientes?

As research in recollection of stimuli with emotional valence indicates, emotions influence memory. Many studies in face and emotional facial expression recognition have focused on age (young and old people) and gender-associated (men and women) differences. Nevertheless, this kind of studies has produced contradictory results, because of that, it would be necessary to study gender involvement in depth. The main objective of our research consists of analyzing the differences in image recognition using faces with emotional facial expressions between two groups composed by university students aged 18-30. The first group is constituted by men and the second one by women. The results showed statistically significant differences in face corrected recognition (hit rate - false alarm rate): the women demonstrated a better recognition than the men. However, other analyzed variables as time or efficiency do not provide conclusive results. Furthermore, a significant negative correlation between the time used and the efficiency when doing the task was found in the male group. This information reinforces not only the hypothesis of gender difference in face recognition, in favor of women, but also these ones that suggest a different cognitive processing of facial stimuli in both sexes. Finally, we argue the necessity of a greater research related to variables as age or sociocultural level.Como indican las investigaciones sobre recuerdo de estímulos con valencia emocional, las emociones influyen sobre la memoria. Muchos estudios sobre reconocimiento de caras y expresiones faciales emocionales se han centrado en diferencias entre grupos de edad (jóvenes y mayores) o diferencias sexuales (hombres y mujeres). No obstante, este tipo de estudios ha arrojado resultados contradictorios, por lo que sería necesario profundizar en la implicación del género. El objetivo principal de nuestra investigación consiste en analizar las diferencias en el reconocimiento de fotografías de caras con expresiones faciales emocionales entre dos grupos, el primero compuesto por hombres y el segundo por mujeres, formados por estudiantes universitarios entre 18 y 30 años. Los resultados mostraron diferencias estadísticamente significativas en el reconocimiento de caras, presentando las mujeres un mejor reconocimiento corregido (probabilidad de aciertos menos probabilidad de falsas alarmas) que los hombres. Sin embargo, otras variables analizadas, como el tiempo o la eficiencia, no ofrecen resultados concluyentes. Además, en el grupo de varones se encontró una correlación negativa significativa entre el tiempo empleado y la eficiencia en la tarea. Estos datos proporcionan apoyo tanto a la hipótesis de la diferencia de género en el reconocimiento de caras, a favor de las mujeres, como a las que proponen un procesamiento cognitivo diferenciado de estímulos faciales en ambos sexos. Finalmente, se argumenta la necesidad de mayor investigación, relacionada con variables como la edad o el nivel social-cultural

Soluble interleukin-2 receptor, intercellular adhesion molecule-1 and interleukin-10 serum levels in patients withelanoma

Serum soluble interleukin-2 receptor (sIL-2R), intercellular adhesion molecule-1 (sICAM-1) and interleukin-10 (IL-10) have each been reported as useful markers for melanoma progression. To evaluate the clinical relevance of these three markers, we simultaneously analysed their serum levels in patients with melanoma. A longitudinal study with a 3-year follow-up was performed and different stages of the disease were considered. Mean values of sIL-2R were significantly higher than in normal controls in all stages and correlated with the disease progression. The prognosis of patients with levels > 529 U/ml of sIL-2R was significantly poorer than in patients with sIL-2R levels < 529 U/ml. Levels of sICAM-1 were also elevated in melanoma patients, specially at the time of the metastatic disease. Serum IL-10 levels were more frequently detectable in the patients that developed metastasis during follow-up, and the prognosis of patients with detectable IL-10 levels was significantly poorer than in those patients with IL-10 undetected levels. Statistical analysis based on Logistic and Cox regression models showed that only sex, stage and sIL-2R value are factors significantly associated with metastatic progression. Moreover, high levels of sIL-2R could be a risk factor for malignant progression in melanoma. © 2000 Cancer Research Campaig

Tumor-derived interleukin-10 as a prognostic factor in stage III patients undergoing adjuvant treatment with an autologous melanoma cell vaccine.

OBJECTIVES: Interleukin-10 (IL-10) downregulates T-cell-mediated immune responses. We studied the association between IL-10 production by freshly isolated melanoma cell suspensions in vitro and overall survival in patients undergoing adjuvant treatment with a vaccine prepared from the same autologous melanoma cells modified with a hapten, dinitrophenyl (DNP). METHODS: Forty-four patients with cutaneous melanoma (29 stage III and 15 stage IV) were prospectively evaluated. Tumor cells were extracted from metastatic deposits for production of DNP-modified autologous melanoma cell vaccine. Small aliquots of the melanoma cell suspensions were separated prior to vaccine processing and cultured overnight for IL-10 production. Based on a blind assessment of the distribution of IL-10 levels in the culture supernatants, a cutoff of 200 pg/ml was used to define high versus low IL-10 producers. Cox regression model was used for multivariate analysis. Overall survival was calculated using the Kaplan-Meier method, and survival curves were compared with the log-rank test. RESULTS: Out of 44 patients, 29 were low and 15 were high IL-10 producers. The median OS was significantly worse for high compared with low IL-10 producers (10.5 months vs. 42 months; P = 0.022). In stage III patients, the multivariate hazard ratio for high versus low IL-10 producers was 2.92 (95% CI, 1.04-8.20; P = 0.041). The corresponding hazard ratio in stage IV patients was 0.92 (95% CI, 1.04-8.20; P = 0.888). CONCLUSIONS: High IL-10 production in the tumor microenvironment could be a determinant of clinical outcomes in stage III melanoma patients receiving autologous melanoma cell vaccine

Laboratorial approach in the diagnosis of food allergy

OBJCTIVE: Review the available laboratory tests used to assist in the diagnosis of IgE-mediated and non-IgE-mediated food allergy. DATA SOURCES: Papers in English and Portuguese published in PubMed and Embase, in the last ten years. Terms searched were food allergy, diagnose and laboratory, isolated and/or associated. DATA SYNTHESIS: The diagnostic approach to food allergy reactions includes a good medical history, laboratory studies, elimination diets and blinded food challenges. More recently, the use of a quantitative measurement of food-specific IgE antibodies has been shown to be more predictive of symptomatic IgE-mediated food allergy. Food-specific IgE serum levels exceeding the diagnostic values indicate that the patient is greater than 95% likely to experience an allergic reaction if he/she ingests the specific food. Such decision point values have been defined just for some foods and inconsistent results were obtained when allergy to the same food was studied in different centers. Food challenges, in particular the double-blind placebo-controlled food challenge (DBPCFC), represent the most reliable way to establish or rule out food hypersensitivity. CONCLUSIONS: A number of recent developments are improving the predictive value of some laboratory tests for the diagnosis of food allergies. However, to date, no in-vitro or in-vivo test shows full correlation with clinical food allergy and the DBPCFC remains the gold standard for the definitive diagnosis of specific food allergies. There is an urgent need for new and fundamentally improved diagnostic approaches, which must be validated in patients with food allergy confirmed by a positive DBPCFC.OBJETIVO: Revisar os exames laboratoriais disponíveis utilizados no diagnóstico da alergia alimentar mediada ou não por IgE. FONTES DE DADOS: Artigos publicados em base de dados PubMed e Embase (língua inglesa e portuguesa) nos últimos dez anos. As palavras-chave utilizadas como fonte de busca foram alergia alimentar, diagnóstico e laboratório, isolados e/ou associados. SÍNTESE DOS DADOS: A abordagem diagnóstica das reações alérgicas a alimentos inclui história clínica completa, estudos laboratoriais, dietas de eliminação e desencadeamentos cegos com alimentos. Recentemente, a medida quantitativa de anticorpos IgE específicos a alimentos tem mostrado ser mais preditiva de alergia alimentar sintomática mediada por IgE. Níveis séricos de IgE específica a alimento que excedam os valores diagnósticos indicam que o paciente tem chance maior que 95% de apresentar uma reação alérgica se ingerir o alimento em questão. Estes valores de decisão foram definidos para alguns alimentos e resultados inconsistentes são obtidos ao se estudar diferentes populações. Os desencadeamentos com alimento, especialmente o duplo-cego controlado por placebo (DADCCP), representa a maneira mais confiável de estabelecer ou descartar o diagnóstico de hipersensibilidade alimentar. CONCLUSÕES: Número crescente de aquisições tem melhorado o valor preditivo de alguns testes laboratoriais empregados no diagnóstico de alergias alimentares. Entretanto, até hoje, não há teste in vitro ou in vivo que mostre correlação completa com a clínica da alergia alimentar. O DADCCP continua sendo o padrão-ouro no diagnóstico definitivo de alergia alimentar específica. São necessárias, urgentemente, novas abordagens diagnósticas válidadas em pacientes com alergia alimentar confirmada por DADCCP positivo.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PediatriaUNIFESP-EPM Departamento de PediatriaUniversidade de São Paulo Faculdade de Medicina Departamento de PediatriaUniversidade Federal da Bahia Departamento de PediatriaUNIFESP-EPMUniversidade Federal do Paraná Departamento de PediatriaUNIFESP, EPM, Depto. de PediatriaUNIFESP, EPM Depto. de PediatriaUNIFESP, EPMSciEL

Justified Concern or Exaggerated Fear: The Risk of Anaphylaxis in Percutaneous Treatment of Cystic Echinococcosis—A Systematic Literature Review

Percutaneous treatment (PT) emerged in the mid-1980s as an alternative to surgery for selected cases of abdominal cystic echinococcosis (CE). Despite its efficacy and widespread use, the puncture of echinococcal cysts is still far from being universally accepted. One of the main reasons for this reluctance is the perceived risk of anaphylaxis linked to PTs. To quantify the risk of anaphylactic reactions and lethal anaphylaxis with PT, we systematically searched MEDLINE for publications on PT of CE and reviewed the PT-related complications. After including 124 publications published between 1980 and 2010, we collected a total number of 5943 PT procedures on 5517 hepatic and non-hepatic echinococcal cysts. Overall, two cases of lethal anaphylaxis and 99 reversible anaphylactic reactions were reported. Lethal anaphylaxis occurred in 0.03% of PT procedures, corresponding to 0.04% of treated cysts, while reversible allergic reactions complicated 1.7% of PTs, corresponding to 1.8% of treated echinococcal cysts. Analysis of the literature shows that lethal anaphylaxis related to percutaneous treatment of CE is an extremely rare event and is observed no more frequently than drug-related anaphylactic side effects