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Stoke is a growing public health problem in the developed world resulting in more hospitalization and mortality. In young adults stroke is the third most common cause of death world wide and the fourth leading cause of disease burden.
The aim was to describe a case of recovery after two hemorrhagic strokes in a young adult patient.
It was presented a clinical case and review the current literature showing the pathway of recovery.
A 38-years-old man presented two episodes of hemorrahgic strokes with a lack of 6 months. With history of hypertension, smoking habits and consume of cannabinoid. The first hemorrhagic stroke had sequels of right hemiparesis. It was diagnosed with frontal arteriovenous malformation. In the second episode was submeted to frontoparietal craniotomy with total dissection of the arteriovenous malformation. After surgery he had convulsive crises that remited with valproic and levetirazetan. It did intensive rehabilitation and two months later he recovered totally. In this momente he is functional for daily lactivities, maintained the same treatment and cognitive stimulation.
It is necessary to accomplish for healthy habits in order to prevent strokes in young people. A better prognoses may be related to a urgent and prolonged intervention and reabilitation.
Olfactory hallucinations have been described since the 19th century as a particular, often unpleasant smell at the beginning or during the spell. The olfactory cortex are involved in temporal lobe epilepsy.
The aim was analyze the relationship between the olfactory hallucinations and the previus diagnosis of epilepsy.
In this study, we present a clinical case and review the current literature showing the relationship between smell and epilepsy.
A 69-years-old woman, with a medical history of epilepsy, went to the emergency department describing a recent episode of seizure, self-limited in time, after a sensation of an unpleasant smell in bed. A medical history of osteoarthritis, cholecystectomy and essential tremor is described. No unknown drug allergies. The neurological examination shows dysarthric speech, tremor in the right upper limb, isochoric and reactive pupils, preserved sensitivity and strength, and a positive Romber’s sign. The physical examination, blood test and vital signs were normal. The head CT scan showed signs of ischemic leukoencephalopathy, without acute ischemic or hemorrhagic lesions. The patient was medicated with 1000 mg of valproate daily, which was suspended a month ago due to an alteration in liver transaminases. Treatment with diazepam 10 mg daily was prescribed and referred for consultation. The sense of smell changes over time for anormal aging process, affecting abilitiesto detect, identify and discriminate odors.Several neurodegenerative diseases presentcertain alterations that help us determine yourorigin and progression (Vaughan and Jackson, 2014).
Olfactory auras occurs before a seizure of the temporal lobe. Repeated stimuli in limbic regions can produce changes in the piriform cortex, with increased excitability and in epileptic discharges.
Static stretching provides benefits to the range of motion, modulates intramuscular connective tissue, and is incorporated into warm-up exercises. In this study, we present the effects in the motor endplate and belly muscle resulting from previous static stretching to climbing training. Twenty-four adult male Wistar rats were divided into four groups (n = 6 each): Sedentary (Sed), Climbing (Clb), Static stretching (Ss), and Static stretching prior to climbing (Ssc). The animals (Clb, Ss, and Ssc groups) were subjected to a training protocol 3×/week for 8 weeks, and the Ssc group was subjected to the Ss and Clb protocols in the same session. Samples from the animals were processed for immunostaining, histochemistry, and light microscopy. The Clb group presented a higher motor endplate; the Ss group presented no changes in the motor endplate; and the Ssc group demonstrated a higher compactness. We concluded that static stretching prior to the climbing protocol maintained the density of the motor endplate and increased the compactness of the neuromuscular junction structure. Also, there was a reduction in the myofibers’ diameter (Type I and IIa), an increase in myofibrillar densities (Type I and IIx, and total), and the reorganization of the myonuclei and the interstitium.
To estimate the cost of metastatic prostate cancer (mPC) treatment using the time-driven activity-based costing (TDABC) method from the perspective of a philanthropic hospital in the Brazilian public health system (PHS) and to identify determinants of costs.
We used data from patients who received docetaxel chemotherapy in the Brazilian PHS from September 2012 to May 2017. Direct medical costs were estimated with the TDABC microcosting method, taking into account the multiple departments and services the patients interacted with during their oncological treatment.
The median overall survival of the forty-three patient sample was 1.8 years (95% CI 1.45–2.30), and the total cost of the sample was BRL 917.005 (USD 250,878). The median monthly cost per patient was BRL 20.201 (USD 5,526). The end-of-life cost per patient using the TDABC method was BRL 5.151 (USD 1,409). Patients who had received previous treatment at the center registered the lowest cost for hospitalizations and exams, suggesting an opportunity to better manage healthcare resources.
This is the first study on the economic burden of mPC in the Brazilian PHS using the TDABC costing evaluation method. Accurate cost information obtained with the TDABC can be helpful in guiding disease management to guarantee better use of ever-scarcer resources.
The objectives of this study were to evaluate the cross-cultural measurement equivalence of the Healthy Eating Index (HEI) for children aged 1–2 years and to analyse the quality of nutrition of preterm infants. This was a cross-sectional study with 106 premature infants attended in two specialised outpatient clinics of university hospitals. The quality of the diet was analysed through an adapted HEI to meet the dietary recommendations of Brazilian children aged 1–2 years. Food consumption was measured by 24-h recalls. The reliability of the instrument was evaluated by internal consistency analysis and inter-observer reliability using Cronbach’s α coefficient and κ with quadratic ponderation. The construct validity was evaluated by principal component analysis and by Spearman’s correlation coefficient with total energy and consumption of some groups’ food. The diet quality was considered adequate when the total HEI score was over 80 points. Cronbach’s α was 0·54. Regarding inter-observer reliability, ten items showed strong agreement (κ > 0·8). The item scores had low correlations with energy consumed (r ≤ 0·30), and positive and moderate correlation of fruit (r 0·67), meat (r 0·60) and variety of diet (r 0·57) with total scores. When analysing the overall quality of the diet, most patients need improvement (median 78·7 points), which can be attributed to low total vegetable intake and the presence of ultraprocessed foods in the diet. The instrument showed auspicious psychometric properties, being promising to evaluate the quality of the diet in children aged 1–2 years.
The fibrous scaffolds for bone tissue engineering that mimic the extracellular matrix with bioactive and bactericidal properties could provide adequate conditions for regeneration of damaged bone. Electrospun ultrathin fiber covered with nano-hydroxyapatite is a favorable fibrous scaffold design. We developed a fast and reproducible strategy to produce polyvinylidene fluoride (PVDF)/nano-hydroxyapatite (nHAp) nanofibrous scaffolds with bactericidal and bioactive properties. Fibrous PVDF scaffolds were obtained first by the electrospinning method. Then, their surfaces were modified using oxygen plasma treatment followed by electrodeposition of nHAp. This process formed nanofibrous and superhydrophilic PVDF fibers (133.6 nm, fiber average diameter) covered with homogeneous nHAp (202.6 nm, average particle diameter) crystals. Energy-dispersive X-ray spectrometry demonstrated the presence of calcium phosphate, indicating a Ca/P molar ratio of approximately 1.64. X-ray diffraction, Fourier transform infrared spectroscopy, and Raman spectroscopy spectra identified β-phase of nHAp. Thermal analysis indicated a slight reduction in stability after nHAp electrodeposition. Bactericidal assays showed that nHAp exhibited 99.8% efficiency against Pseudomonas aeruginosa bacteria. The PVDF/Plasma and PVDF/nHAp groups had the highest cell viability, total protein, and alkaline phosphatase activity by 7 days after exposure of the scaffolds to MG63 cell culture. Therefore, the developed scaffolds are an exciting alternative for application in bone regeneration.
This is a cross-sectional analysis of data obtained in the baseline of the Longitudinal Study on the Lifestyle and Health of University Students (n 685) carried out in a public Brazilian university. Food intake was assessed using a 24-h dietary recall. Dietary patterns (DP) for breakfast, lunch and dinner were identified using principal component analysis. Generalised linear models were used to analyse the variables associated with each DP. Three DP were extracted for each meal: breakfast: ‘White bread and butter/margarine’, ‘Coffee and tea’ and ‘Sausages, whole wheat bread and cheese’; lunch: ‘Traditional’, ‘Western’ and ‘Vegetarian’ and dinner: ‘Beans, rice and processed juice’, ‘White bread and butter/margarine’ and ‘White meat, eggs and natural juice’. Students who had meals at the campus showed greater adherence to the ‘White bread and butter/margarine’ (exp (βadj) = 1·15, 95 % CI 1·11, 1·19) and ‘Coffee and tea’ (exp (βadj) = 1·06, 95 % CI 1·02, 1·10) breakfast patterns; ‘Western’ lunch pattern (exp (βadj) = 1·04, 95 % CI 1·01, 1·08) and to the ‘Beans, rice and processed juice’ dinner pattern (exp (βadj) = 1·10, 95 % CI 1·06, 1·14). Having meals at the campus was associated with lower adherence to the ‘Sausages, whole wheat bread and cheese’ breakfast pattern (exp (βadj) = 0·93, 95 % CI 0·89, 0·97), ‘Traditional’ lunch pattern (exp (βadj) = 0·96, 95 % CI 0·93, 0·99) and to the ‘White bread and butter/margarine’ (exp (βadj) = 0·96, 95 % CI 0·93, 0·99) and ‘White meat, eggs and natural juice’ (exp (βadj) = 0·96, 95 % CI 0·93, 0·99) dinner pattern. The food environment at campus may influence students’ DP. Recognising meal eating patterns is important to support healthy eating promotion strategies on campus. Adjustments in the University Canteen menu could contribute to healthier eating choices among students.
The production of beef cattle in the Atlantic Forest biome mostly takes place in pastoral production systems. There are millions of hectares covered with pastures in this biome, including degraded pasture (DP), and only small area of the original Atlantic Forest has been preserved in tropics, implying that actions must be taken by the livestock sector to improve sustainability. Intensification makes it possible to produce the same amount, or more beef, in a smaller area; however, the environmental impacts must be assessed. Regarding climate change, the C dynamics is essential to define which beef cattle systems are sustainable. The objectives of this study were to investigate the C balance (t CO2e./ha per year), the intensity of C emission (kg CO2e./kg BW or carcass) and the C footprint (t CO2e./ha per year) of pasture-based beef cattle production systems, inside the farm gate and considering the inputs. The results were used to calculate the number of trees to be planted in beef cattle production systems to mitigate greenhouse gas (GHG) emissions. The GHG emission and C balance, for 2 years, were calculated based on the global warming potential (GWP) of AR4 and GWP of AR5. Forty-eight steers were allotted to four grazing systems: DP, irrigated high stocking rate pasture (IHS), rainfed high stocking rate pasture (RHS) and rainfed medium stocking rate pasture (RMS). The rainfed systems (RHS and RMS) presented the lowest C footprints (−1.22 and 0.45 t CO2e./ha per year, respectively), with C credits to RMS when using the GWP of AR4. The IHS system showed less favorable results for C footprint (−15.71 t CO2e./ha per year), but results were better when emissions were expressed in relation to the annual BW gain (−10.21 kg CO2e./kg BW) because of its higher yield. Although the DP system had an intermediate result for C footprint (−6.23 t CO2e./ha per year), the result was the worst (−30.21 CO2e./kg BW) when the index was expressed in relation to the annual BW gain, because in addition to GHG emissions from the animals in the system there were also losses in the annual rate of C sequestration. Notably, the intensification in pasture management had a land-saving effect (3.63 ha for IHS, 1.90 for RHS and 1.19 for RMS), contributing to the preservation of the tropical forest.
Accurate estimates of methane (CH4) production by cattle in different contexts are essential to developing mitigation strategies in different regions. We aimed to: (i) compile a database of CH4 emissions from Brazilian cattle studies, (ii) evaluate prediction precision and accuracy of extant proposed equations for cattle and (iii) develop specialized equations for predicting CH4 emissions from cattle in tropical conditions. Data of nutrient intake, diet composition and CH4 emissions were compiled from in vivo studies using open-circuit respiratory chambers, SF6 technique or the GreenFeed® system. A final dataset containing intake, diet composition, digestibility and CH4 emissions (677 individual animal observations, 40 treatment means) obtained from 38 studies conducted in Brazil was used. The dataset was divided into three groups: all animals (GEN), lactating dairy cows (LAC) and growing cattle and non-lactating dairy cows (GCNL). A total of 54 prediction equations available in the literature were evaluated. A total of 96 multiple linear models were developed for predicting CH4 production (MJ/day). The predictor variables were DM intake (DMI), gross energy (GE) intake, BW, DMI as proportion of BW, NDF concentration, ether extract (EE) concentration, dietary proportion of concentrate and GE digestibility. Model selection criteria were significance (P < 0.05) and variance inflation factor lower than three for all predictors. Each model performance was evaluated by leave-one-out cross-validation. The Intergovernmental Panel on Climate Change (2006) Tier 2 method performed better for GEN and GCNL than LAC and overpredicted CH4 production for all datasets. Increasing complexity of the newly developed models resulted in greater performance. The GCNL had a greater number of equations with expanded possibilities to correct for diet characteristics such as EE and NDF concentrations and dietary proportion of concentrate. For the LAC dataset, equations based on intake and animal characteristics were developed. The equations developed in the present study can be useful for accurate and precise estimation of CH4 emissions from cattle in tropical conditions. These equations could improve accuracy of greenhouse gas inventories for tropical countries. The results provide a better understanding of the dietary and animal characteristics that influence the production of enteric CH4 in tropical production systems.
Lysmata vittata is considered an invasive shrimp in the Atlantic Ocean and some characteristics might have contributed to its invasive success, such as its larval nutritional vulnerability during the early stages of development. The objective of this study was to evaluate the early larval stages of the shrimp L. vittata. Ovigerous specimens were captured in an estuarine region of north-eastern Brazil. Zoeae were assigned to two experiments: (1) the point of no return (PNR), consisting of treatments with an increasing number of days of starvation and subsequent days of feeding; and (2) the point of reserve saturation (PRS), consisting of treatments with an increasing number of days of feeding and subsequent days of starvation. Two control groups were considered: continuous starvation (CS) and continuous feeding (CF). Nutritional vulnerability was estimated by the time when 50% of the initially starved larvae (PNR50) lost the ability to moult to the next stage, when 50% of the initially fed larvae (PRS50) were capable of moulting to the next stage. In the CF, the mean development time (±SD) of the larvae that reached stage III was 4.36 ± 0.74 days with a mortality of 70%, and the mean carapace length (±SD) was 0.61 ± 0.04 mm CL. The PNR50 and PRS50 were 2.42 ± 0.14 and 1.32 ± 0.83 days, respectively. The nutritional vulnerability index (PRS50/PNR50 = 0.54) indicates that L. vittata presents intermediate dependence on exogenous food during the early larval stages, which might help our understanding of the invasive potential of this species in the Atlantic Ocean.
Acupuncture is a low-risk intervention that is increasingly used. Some studies examined the potential effects of acupuncture on anxiety and the bispectral index of the EEG (BIS), used as an objective and indirect measure of anxiolysis. Those studies used the same acupuncture point and achieved conflicting results.
To objectively assess the effects of acupuncture on anxiety and the BIS on a clinically relevant population.
To evaluate the impact of alternative, low risk interventions, such as acupuncture in anxiety.
15 anxious volunteers were recruited for this prospective, controlled, blinded, crossover study with random allocation. Acupuncture was performed at the experimental point He7 (Heart 7) and at a control point Lu 9 (Lung 9). BIS was evaluated at 3 different stages, rest state, during electro-acupuncture and post acupuncture.
BIS mean values and minimums means were significantly reduced by acupuncture on He7 compared to acupuncture on Lu9 (means: 90,7 ± 4,3 to 86,5 ± 7,2; p = 0,009 | minimums: 80,6 ± 9,6 to 71,9 ± 12,3; p = 0,011). None of the groups had a significant decrease in BIS comparing acupuncture to the rest state, however acupuncture on He7 was related to a relevant (but statistically nonsignificant) decrease in BIS mean compared to the rest state.
Acupuncture on He7 was superior over acupuncture on Lu9 to decrease BIS in anxious volunteers and showed objective and measurable cerebral effects.
In order to establish an individual plan of care for the patient for promote their psychosocial rehabilitation, was conducted a multidisciplinary assessment protocol. This protocol aims to characterize the patients admitted in DH, through the analysis of sociodemographic and clinical data at moment of clinical admission and discharge of the unit. Another objective is to assess the degree of satisfaction with the services provided, and also quality of life (QOL) (The Short Form Health Survey SF-36), psychopathological state (Brief Symptom Inventory - BSI) and functionality (Occupational Self Assessment - OSA).In a sample of 168 individuals, (assessment between January 2009 and June 2011) 48% were male (n = 80). The average age of participants was 44.4 (SD = 11.9), the average age of onset of 29.7 (SD = 13.3). The most frequent diagnoses were the Group of Schizophrenia, Schizotypal and Delusional Disorders at 38.7%, followed by mood disorders with 30.4%.In regard to QOL, it was found out that patients scored significantly higher on some dimensions on discharge, corresponding to a better QOL. The BSI dimensions on exit are generally lower than the results of the entrance, which means that patients have less psychopathological symptoms. The results of OSA indicate that aspects of functionality, chosen by their patients for psychosocial rehabilitation are: self care and problem-solving ability.
The authors intend to characterize the population of foreign patients admitted to Department L of Centro Hospitalar Psiquiátrico de Lisboa, Portuguese biggest Psychiatric hospital, and compare it with published data on the subject.
The authors identified all foreigner patients hospitalized in the Inpatient Clinic from 01/01/2010 to 30/06/2011. Clinical information was obtained from the case notes and statistically treated. Relevant literature collected from PubMed was reviewed.
A great heterogeneity of nationalities was found including 21 countries, the majority of which are a part of CPLP (Community of Portuguese Language Countries). Nearly all of the patients (91%) were in Portugal as immigrants, most being single and unemployed. Housing conditions are unstable. Psychiatric diagnoses show that schizophrenia is the pathology with more expression (27%), followed by major depression (16%) and bipolar disorder (15%). A significant number of patients have disorders due to psychoactive substance use (19%). After discharged from the hospital 77% where referred to outpatient services, but only half of those are still being followed-up.
Social and familial stability is an important factor influencing mental health. Most patients covered by this study experience familiar, professional and housing instability, making them a risk group. Schizophrenia and affective disorders are the most prevalent pathologies, which agrees with the prevailing idea that social distress is a risk factor to them.
Further studies should be held in order to characterise foreigner populations admitted to psychiatric clinics so that better therapeutic and follow-up measures can be carried out.
The full etiology of transsexualism is still unknown. However many factors, like biological and environmental, are being suggested as possible explanations to the cause of this entity.
We intend to revisit the major etiological theories of transsexuality, based on the description of two cases occurring in first-degree relatives.
A mother and her daughter both diagnosed with Gender Identity Disorder are followed at Multidisciplinary Clinical Sexology Group in our facilities since 2011.
This case is related to a young girl who in her childhood felt and behaved himself as a boy by adopting male gender stereotypes. She has lived with distress during the development of female secondary sexual characteristics, and the age of 17, after identifying his problem decided to tell his mother. However our patient founded that her mother, with 38 years old, was already resigned by living with a sex gender that didn't recognize as her own. In the end they decided to confront the social and family environment, joining both in the process of sexual reassignment.
The transsexualism is a complex phenomenon. The occurrence of two cases of transsexualism in a mother and daughter highlights the importance of consider and extend the knowledge about the biological aspects of gender identity disorder.
It is relevant to communicate the cases occurring within the same family to contribute to the etiology investigation in this area. In the literature the rare cases described of family transsexuals are among brothers, which makes this case between mother and daughter special.
Nutrient requirements in cattle are dependent on physiological stage, breed and environmental conditions. In Holstein × Gyr crossbred dairy heifers, the lack of data remains a limiting factor for estimating energy and protein requirements. Thus, we aimed to estimate the energy and protein requirements of Holstein × Gyr crossbred heifers raised under tropical conditions. Twenty-two crossbred (½ Holstein × ½ Gyr) heifers with an average initial BW of 102.2 ± 3.4 kg and 3 to 4 months of age were used. To estimate requirements, the comparative slaughter technique was used: four animals were assigned to the reference group, slaughtered at the beginning of the experiment to estimate the initial empty BW (EBW) and composition of the animals that remained in the experiment. The remaining animals were randomized into three treatments based on targeted rates of BW gain: high (1.0 kg/day), low (0.5 kg/day) and close to maintenance (0.1 kg/day). At the end of the experiment, all animals were slaughtered to determine EBW, empty body gain (EBG) and body energy and protein contents. The linear regression parameters were estimated using PROC MIXED of SAS (version 9.4). Estimates of the parameters of non-linear regressions were adjusted through PROC NLIN of SAS using the Gauss–Newton method for parameter fit. The net requirements of energy for maintenance (NEm) and metabolizable energy for maintenance (MEm) were 0.303 and 0.469 MJ/EBW0.75 per day, respectively. The efficiency of use of MEm was 64.5%. The estimated equation to predict the net energy requirement for gain (NEg) was: NEg (MJ/day) = 0.299 × EBW0.75 × EBG0.601. The efficiency of use of ME for gain (kg) was 30.7%. The requirement of metabolizable protein for maintenance was 3.52 g/EBW0.75 per day. The equation to predict net protein requirement for gain (NPg) was: NPg (g/day) = 243.65 × EBW−0.091 × EBG. The efficiency of use of metabolizable protein for gain (k) was 50.8%. We observed noteworthy differences when comparing to ME and protein requirements of Holstein × Gyr crossbred heifers with other systems. In addition, we also observed differences in estimates for NEm, NEg, NPg, kg and k. Therefore, we propose that the equations generated in the present study should be used to estimate energy and protein requirements for Holstein × Gyr crossbred dairy heifers raised in tropical conditions in the post-weaning phase up to 185 kg of BW.
Research has shown that PTSD is prevalent among firefighters and police forces and that Quality of Life (QoL) is seriously compromised in individuals suffering from PTSD. However, QoL studies with these professionals are scarce. This study results from a screening program held by the Portuguese Red Cross (PRC) aiming to analyze predictors of QoL. Participants were 95 firefighters and municipal police officers. They answered the Posttraumatic Stress Disorder Checklist (PCL-5) in order to evaluate the prevalence of PTSD symptoms, as well as measures of social support (3-Item Oslo Social Support Scale) and QoL (EUROHIS-QOL-8). From the results, there were no group differences regarding total PTSD, social support or QoL and 10% of participants reported enough symptoms to PTSD diagnostic. Social Support and PTSD explained 25% of QoL variance, PTSD symptoms explaining 10% (negative beta) and, in the second step, social support explained 15%. The results suggest that it would be important to include QoL as an outcome measure in clinical and research work in these populations, with special attention to PTSD and social support.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Bipolar disorder (BD), along with schizophrenia, is one of the most severe psychiatric conditions and is correlated with attentional deficits and emotion dysregulation. Bipolar patients appear to be highly sensitive to the presence of emotional distractors. Yet, no study has investigated whether perceptual load modulates the interference of emotionally distracting information. Our main goal was to test whether bipolar patients are more sensitive to task-irrelevant emotional stimulus, even when the task demands a high amount of attentional resources.
Fourteen participants with BD I or BD II and 14 controls, age- and gender-matched, performed a target-letter discrimination task with emotional task-irrelevant stimulus (angry, happy and neutral facial expressions). Target-letters were presented among five distractor-letters, which could be the same (low perceptual load) or different (high perceptual load). Participants should discriminate the target-letter and ignore the facial expression. Response time and accuracy rate were analyzed.
showed a greater interference of facial stimuli at high load than low load, confirming the effectiveness of perceptual load manipulation. More importantly, patients tarried significantly longer at high load. This is consistent with deficits in control of attention, showing that bipolar patients are more prone to distraction by task-irrelevant stimulus only when the task is more demanding. Moreover, for bipolar patients neutral and angry faces resulted in a higher interference with the task (longer response time), compared to controls, suggesting an attentional bias for neutral and threating social cues. Nevertheless, a more detailed investigation regarding the attentional impairments in social context in BD is needed.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The nurse practice model at the family health strategy is characterized by direct involvement in the patient's health-disease recovery process, deconstruction of social stigma involving mental health disorders, and the restoration of patient autonomy their social ties. This descriptive study follows a qualitative approach to document and analyse practices performed by mental health nurses at the family health strategy (FHS) in Rio das Ostras, Brazil. The study identifies practices implemented by Mental Health Nurses at FHS and the nurses’ own reflection and analysis on these mental health practices. Data was collected through semi-structured interviews. All interviewed nurses had worked in the primary mental health care for at least one year at the FHS units in Rio das Ostras. Data was analysed, grouped, and coded according to two categories: 1) The nurses’ professional practices in mental health at the FHS, and 2) The nurses’ view on mental health practices at the FHS. Results show that the main activities in mental health at FHS involve working with the matricial team, continuing education, reception, home visits, referrals, therapeutic workshops and community therapy. Nurse perspectives on professional practices involve prevention, establishment of bonds with patient, and nurses’ training to deliver care to patients who are suffering. The bond with and care for the patient, family and community, is one of the FHS differentiators. In that vein, the study looks at the link between health care delivery, territory and population attended. The health care based on territoriality, allows increased patient and family confidence.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Sensory processing is the individual's ability to receive, process and integrate sensory information from the environment and body movement in the central nervous system, in order to produce adaptive responses. Sensory processing disorders (SPD) are associated to difficulties in regulating emotions and behaviours as well as motor abilities in response to sensory stimulation that lead to impairment in development and functioning. It is estimated that SPD affect 5–16% of school-aged children. Although these diseases constitute a primary diagnostic category in the Diagnostic Classification of Mental Health and Development Disorders of Infancy and Early Childhood: DC0-3, they have not yet been validated by the Diagnostic and Statistical Manual of Mental Disorders-DSM. In the latest edition of DSM, SPD were only included as one of the diagnostic criteria of autism-spectrum disorders. However, several studies have suggested that SPD may present themselves solely or coexist with other clinical conditions.
The aim of this study was to review systematically the relationship between SPD and psychopathology.
Articles indexed in the Pubmed database were analyzed.
Although sensory processing problems are well known to occur in association with autism, their relationship with other mental disorders is not a well studied area. Some studies have related them with ADHD, behavioural disorders and learning disorders. Some studies also comproved that SPD are a valid diagnosis and that there are individuals with SPD who do not meet the criteria for other known disorder. One study found an abnormal white matter microstructure in children with SPD. Despite these findings SPD need to be further studied.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The relative contribution of imported vs. locally acquired infections to urban malaria burden remains largely unexplored in Latin America, the most urbanised region in the developing world. Here we use a simple molecular epidemiology framework to examine the transmission dynamics of Plasmodium vivax in Mâncio Lima, the Amazonian municipality with the highest malaria incidence rate in Brazil. We prospectively genotyped 177 P. vivax infections diagnosed in urban residents between June 2014 and July 2015 and showed that local parasites are structured into several lineages of closely related microsatellite haplotypes, with the largest genetic cluster comprising 32% of all infections. These findings are very unlikely under the hypothesis of multiple independent imports of parasite strains from the rural surroundings. Instead, the presence of an endemic near-clonal parasite lineage circulating over 13 consecutive months is consistent with a local P. vivax transmission chain in the town, with major implications for malaria elimination efforts in this and similar urban environments across the Amazon.