LA SALUD MENTAL DE PACIENTES DERMATOLÓGICOS EN ATENDIMENTO HOSPITALAR

Delimitando e protegendo a individualidade, a pele é o principal meio de contato do sujeito com o mundo exterior. Conflitos e emoções podem se manifestar através do corpo e da pele, tornando-se visíveis e suscetíveis às reações sociais que muitas vezes são de preconceito e discriminação. O impacto dessas relações pode intensificar sintomas psicossomáticos e desencadear comorbidades como ansiedade e depressão, interferindo diretamente na qualidade de vida dos pacientes dermatológicos. Mesmo que as manifestações dermatológicas não sejam desencadeadas por fatores psíquicos, podem ser agravadas por estes, alterando a resposta do organismo a tratamentos. Há que se considerar ainda, que algumas doenças podem resultar da pobreza e prevalecer nestas condições, ou ainda gerar pobreza, colaborando para a manutenção da desigualdade social. Uma revisão bibliográfica foi realizada com o intuito de compreender o impacto psicológico das dermatoses na qualidade de vida dos acometidos. Considerando o cuidado que estes pacientes devem receber para que tenham uma melhora em sua relação consigo e com o meio social, contribuindo para a melhoria da sua qualidade de vida, a revisão bibliográfica abrangeu os métodos de intervenção psicossocial de Cinematerapia e de Rodas de Conversa, como estratégia terapêutica complementar dentro do ambiente hospitalar. Por meio de filmes que são ferramentas acessíveis, é possível propor reflexões sobre o tema, com debates sobre autoimagem, autoestima e aceitação, permitindo espaço para acolhimento e troca de vivências.Delimiting and protecting the individuality, the skin is the main means of contact of the subject with the outside world. Conflicts and emoticons may manifest themselves through the body and skin, becoming visible and susceptible to social reactions that are often of prejudice and discrimination. The impact of these relations can intensify psychosomatic symptoms and trigger comorbidities such as anxiety and depression, directly interfering in the quality of life of dermatological patients. Even if the dermatological manifestations are not triggered by psychic factors, they can be aggravated by these, altering the body's response to treatments. It should also be considered that some diseases may arise from poverty and prevail in these conditions, or even generate poverty, contributing to the maintenance of social inequality. A literature review was carried out in order to understand the psychological impact of dermatosis on the quality of life of those affected. Considering the care these patients should receive to improve their relationship with themselves and with the social environment, contributing to the improvement of their quality of life, the literature review covered the psychosocial intervention methods of Cinematherapy and Dialogue circles, as complementary therapeutic strategies within the hospital environment. Through films that are accessible tools, it is possible to propose reflections on the theme, with debates about self-image, self-esteem and acceptance, allowing space for welcoming and exchanging experiences.Delimitando y protegiendo la individualidad, la piel es el principal medio de contacto del sujeto con el mundo exterior. Conflictos y emociones pueden manifestarse a través del cuerpo y de la piel, tornándose visibles y susceptibles a reacciones sociales en muchos casos prejuiociosas y discriminatorias. El impacto de estas relaciones puede intensificar síntomas psicossomáticos y desencadenar comorbilidades como ansiedad y depresión, de esta forma impactando directamente en la calidad de vida de los pacientes dermatológicos. Aun en los casos en que las manifestaciones dermatológicas no tengan como causa factores psíquicos, pueden ser agravadas por los mismos, alterando la respuesta del organismo a los tratamientos.  Se debe considerar también que algunas enfermedades pueden ser resultado de condiciones de pobreza y prevalecer en estas condiciones, o en algunos casos intensificar estas condiciones de vulnerabilidad, colaborando para el mantenimiento de la desigualdad social. Fue realizada una revisión de bibliografía con la intención de comprender el impacto psicológico de las dermatosis en la calidad de vida de los afectados. Considerando el cuidado que estos pacientes deben recibir para que evidencien una mejora en su relación consigo e con su medio social, contribuyendo para una mejora de su calidad de vida, la revisión bibliográfica abarcó los métodos de intervención psicosocial de Cinematerapia y Rondas de conversación, como estrategia terapéutica complementar dentro del ambiente hospitalar. A través de películas, que son recursos accesibles, es posible proponer reflexiones sobre el tema, incluyendo debates sobre auto-imagen, autoestima y aceptación, promoviendo un espacio de acogida e intercambio de vivencias

Naturally acquired humoral immunity against malaria parasites in non-human primates from the Brazilian Amazon, Cerrado and Atlantic forest

Non-human primates (NHPs) have been shown to be infected by parasites of the genusPlasmodium, the etiological agent of malaria in humans, creating potential risks of zoonotic transmission.Plasmodium brasilianum, a parasite species similar toP. malariaeof humans, have been described in NHPs from Central and South America, including Brazil. The merozoite surface protein 1 (MSP1), besides being a malaria vaccine candidate, is highly immunogenic. Due to such properties, we tested this protein for the diagnosis of parasite infection. We used recombinant proteins ofP. malariaeMSP1, as well as ofP. falciparumandP. vivax, for the detection of antibodies anti-MSP1 of these parasite species, in the sera of NHPs collected in different regions of Brazil. About 40% of the NHP sera were confirmed as reactive to the proteins of one or more parasite species. A relatively higher number of reactive sera was found in animals from the Atlantic Forest than those from the Amazon region, possibly reflecting the former more intense parasite circulation among NHPs due to their proximity to humans at a higher populational density. The presence ofPlasmodiumpositive NHPs in the surveyed areas, being therefore potential parasite reservoirs, needs to be considered in any malaria surveillance program

Ações extensionistas e o diálogo com as comunidades contemporâneas.

As possibilidades que o tema desta segunda edição da Coleção Extensão e Sociedade oportuniza são muitas, porque o diálogo é a condição essencial da Extensão Universitária, a ponto de ser um princípio determinante. Portanto, quando a chamada foi lançada para que os autores submetessem textos oriundos de ações extensionistas, já se esperava que as submissões desenhassem um quadro de diversidade ampla. A expectativa foi cumprida. O que se poderá observar nesta coletânea é como o princípio do diálogo ocorre em campos diversos. Sobre tal aspecto, há de se observar que para a extensão, o diálogo deve ocorrer entre diferentes grupos. A Universidade é, de modo geral, um grupo e a sociedade, abarca todos os demais. Isto, diga-se logo, sob um ponto de vista amplo, porque quanto mais o olhar se aproxima dos fatos, encontram-se no primeiro grupo, muitos outros, tão diversos entre si quanto o são aqueles que se resolveu reunir em uma categoria imensa: a sociedade. Portanto, os influxos desejáveis no processo dialógico são esperados dentro e entre os grupos e é, possivelmente, a maior energia que uma atividade extensionista possa gerar: a ebulição de ideias (nem sempre convergentes) que o diálogo entre os diversos, internos e externos, acaba gerando no processo de interação. E como não há extensão sem interação, vamos aceitar que quando os dois universos, o acadêmico e a sociedade, aproximam-se, nem sempre é possível saber quais os planetas, de cada dimensão, que orbitarão no processo interativo

Clinical manifestations of intermediate allele carriers in Huntington disease

Objective: There is controversy about the clinical consequences of intermediate alleles (IAs) in Huntington disease (HD). The main objective of this study was to establish the clinical manifestations of IA carriers for a prospective, international, European HD registry. Methods: We assessed a cohort of participants at risk with <36 CAG repeats of the huntingtin (HTT) gene. Outcome measures were the Unified Huntington's Disease Rating Scale (UHDRS) motor, cognitive, and behavior domains, Total Functional Capacity (TFC), and quality of life (Short Form-36 [SF-36]). This cohort was subdivided into IA carriers (27-35 CAG) and controls (<27 CAG) and younger vs older participants. IA carriers and controls were compared for sociodemographic, environmental, and outcome measures. We used regression analysis to estimate the association of age and CAG repeats on the UHDRS scores. Results: Of 12,190 participants, 657 (5.38%) with <36 CAG repeats were identified: 76 IA carriers (11.56%) and 581 controls (88.44%). After correcting for multiple comparisons, at baseline, we found no significant differences between IA carriers and controls for total UHDRS motor, SF-36, behavioral, cognitive, or TFC scores. However, older participants with IAs had higher chorea scores compared to controls (p 0.001). Linear regression analysis showed that aging was the most contributing factor to increased UHDRS motor scores (p 0.002). On the other hand, 1-year follow-up data analysis showed IA carriers had greater cognitive decline compared to controls (p 0.002). Conclusions: Although aging worsened the UHDRS scores independently of the genetic status, IAs might confer a late-onset abnormal motor and cognitive phenotype. These results might have important implications for genetic counseling. ClinicalTrials.gov identifier: NCT01590589

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (&gt;59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P &lt;.001). Overall motor and cognitive performance (P &lt;.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P &lt;.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P &lt;.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P &lt;.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients

Reduced Cancer Incidence in Huntington's Disease: Analysis in the Registry Study

Background: People with Huntington's disease (HD) have been observed to have lower rates of cancers. Objective: To investigate the relationship between age of onset of HD, CAG repeat length, and cancer diagnosis. Methods: Data were obtained from the European Huntington's disease network REGISTRY study for 6540 subjects. Population cancer incidence was ascertained from the GLOBOCAN database to obtain standardised incidence ratios of cancers in the REGISTRY subjects. Results: 173/6528 HD REGISTRY subjects had had a cancer diagnosis. The age-standardised incidence rate of all cancers in the REGISTRY HD population was 0.26 (CI 0.22-0.30). Individual cancers showed a lower age-standardised incidence rate compared with the control population with prostate and colorectal cancers showing the lowest rates. There was no effect of CAG length on the likelihood of cancer, but a cancer diagnosis within the last year was associated with a greatly increased rate of HD onset (Hazard Ratio 18.94, p < 0.001). Conclusions: Cancer is less common than expected in the HD population, confirming previous reports. However, this does not appear to be related to CAG length in HTT. A recent diagnosis of cancer increases the risk of HD onset at any age, likely due to increased investigation following a cancer diagnosis