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Objetivo: Desvelar as especificidades do acesso do usuário de drogas à Atenção Psiscossocial pela Atenção Básica. Método: Utiliza-se a técnica de entrevista semi-estruturada junto aos profissionais de saúde que atuam neste cenário, realizando-se a análise dos dados através de uma perspectiva crítica e reflexiva. Resultados: O enfoque do acesso dos usuários de drogas tem se pautado, sobretudo, na lógica do acolhimento. Pôde-se elencar pontos de tensão que se estabelecem nos diferentes modos de abordagem da Atenção Básica para o acolhimento dos usuários de drogas, considerando-se as propostas da Ética do Cuidado através da Redução de Danos. Conclusão: Acredita-se que os profissionais de saúde envolvidos devam buscar pistas nas propostas do Sistema Único de Saúde e da Reforma Psiquiátrica para que as redes de saúde qualifiquem as respostas que têm oferecido a estes indivíduos.Objetivo: Desvelar as especificidades do acesso do usuário de drogas à Atenção Psiscossocial pela Atenção Básica. Método: Utiliza-se a técnica de entrevista semi-estruturada junto aos profissionais de saúde que atuam neste cenário, realizando-se a análise dos dados através de uma perspectiva crítica e reflexiva. Resultados: O enfoque do acesso dos usuários de drogas tem se pautado, sobretudo, na lógica do acolhimento. Pôde-se elencar pontos de tensão que se estabelecem nos diferentes modos de abordagem da Atenção Básica para o acolhimento dos usuários de drogas, considerando-se as propostas da Ética do Cuidado através da Redução de Danos. Conclusão: Acredita-se que os profissionais de saúde envolvidos devam buscar pistas nas propostas do Sistema Único de Saúde e da Reforma Psiquiátrica para que as redes de saúde qualifiquem as respostas que têm oferecido a estes indivíduos.

Con la reapertura de los juicios por los crímenes cometidos en la última dictadura cívico- militar en Argentina (1976-1983) se suscitaron debates sobre la calificación de los hechos como delitos de lesa humanidad o genocidio y sus distintos efectos en la sociedad. A partir del análisis de un conjunto representativo de sentencias, este artículo se propone analizar los debates jurídicos en relación a la calificación, los modos en que los tribunales comprenden el fenómeno histórico- social en cuestión y la relación entre ambas variables.

Este trabalho analisa a inserção do enfermeiro na prática de atenção ao usuário de álcool e outras drogas através da revisão sistemática de artigos em periódicos científicos. Foi realizada uma revisão sistemática de literatura nas bases de dados virtuais BDENF, SCIELO, LILACS e BIREME no período de 2001 a 2006. Foram encontrados 29 artigos relacionados com a temática. Os dados foram agrupados nas seguintes categorias: formação do enfermeiro para lidar com usuários de álcool e outras drogas; dificuldades encontradas pelos enfermeiros na atenção aos usuários de álcool e outras drogas e estratégias para promoção à saúde. Conclui-se que a Enfermagem ainda carece de profissionais qualificados para atender às necessidades dos usuários de álcool e outras drogas, fato que pode ser modificado com a inclusão da temática nas disciplinas da graduação e com a realização de treinamento dos enfermeiros dos diferentes serviços de saúde.Ese estudio analiza el inserción de la enfermería en la práctica desde atención a los usuarios de alcohol y otras drogas vía una revisión sistemática de artículos de periódico científico. Fue realizada una revisión sistemática de la literatura en las bases de datos virtuales BDENF, SCIELO, LILACS y BIREME en lo periodo de 2001 hasta 2006. Fueran encontrados 29 artículos relativos a la temática. Los datos fueran agrupados en las siguientes categorías: formación del enfermero para tratar a los usuarios de alcohol y otras drogas; límites para atención a los usuarios y estrategias de intervención y promoción. Se puede concluir que la enfermería todavía carece de profesionales cualificados para atender a las necesidades de los usuarios de alcohol y otras drogas, facto que puede ser cambiado con la inclusión de la temática en las disciplinas de la graduación y con la realización de entrenamiento de los enfermeros de los distintos servicios de salud.This paper analyses the insertion from the nurse attention in practice to the user as of alcohol and other drugs in the review systematic as of articles into periodic scientific. It was realized a literature review at the virtual data bases BDENF, SCIELO, LILACS e BIREME from the year of 2001 to 2006. It was found 29 articles. The data were put in groups by the following categories: nurse's knowledge about how to deal with user as of alcohol and other drugs; limits for patient care and intervention, such as strategies promoting the good health. It had been concluded that nursing still needs qualified professionals to assist the necessities of the alcohol and drugs users, fact that can be modified by the inclusion of the theme on the graduation disciplines and the realization of nurses' training to the several health services of this care.

A evolução do relevo está associada às formações superficiais nas vertentes e vales, envolvendo os diferentes níveis de organização da cobertura pedológica. Nesse sentido, este estudo objetivou realizar a caracterização micropedológica de coberturas na borda oeste do Planalto do Espinhaço, buscando verificar a existência de indicadores que traduzam a evolução da paisagem em escala regional. A partir de uma compartimentação da área em três superfícies geomórficas (SG1, SG2 e SG3), foram selecionados quatro perfis derivados do mesmo material de origem. As descrições micromorfológicas foram feitas a partir da caracterização das microestruturas (agregados e porosidade associada), do fundo matricial e das feições pedológicas. A partir delas, foram selecionados indicadores capazes de traduzir o grau evolutivo das coberturas em cada superfície. Dentre os indicadores, destacam-se: i) a presença de microagregados granulares de origem termítica; ii) a mineralogia e distribuição (do topo à base e dentro ou fora dos agregados) dos grãos grossos; iii) a cor e mineralogia da micromassa, bem como as transformações ao longo do perfil das tramas birrefringentes e iv) a presença, distribuição, grau evolutivo e composição (mineral) de nódulos. A partir do que foi observado por tais indicadores, a SG1 é mais antiga, a SG2 possui coberturas mais recentes que a SG1, o que pode indicar uma exposição mais recente de tais rochas à alteração e pedogênese; e a SG3 sugere ser, em razão das características da cobertura, a superfície mais recente e mais sujeita à deposição de materiais. Em conjunto, tais observações refletem uma íntima associação entre o grau evolutivo dos compartimentos do relevo, das coberturas pedológicas neles contidas e dos atributos micropedológicos dessas coberturas.

Ecología Austral, 24:94-102 (2014) La declinación en la diversidad y abundancia de polinizadores relacionada a diversos tipos de disturbios de origen antrópico es un tema de debate en el contexto del cambio en el uso de la tierra. Se ha enfatizado la importancia de los remanentes de hábitats naturales y semi-naturales como reservorios de polinizadores para cultivos dependientes de ellos. El sudeste de la Provincia de Buenos Aires constituye una zona agrícolo-ganadera con un alto grado de uso y alteración del uso de la tierra. Sin embargo, los márgenes de cultivos asociados a los bordes de caminos pueden proveer recursos florísticos y sitios de nidificación para una gran diversidad de polinizadores, los que podrían, eventualmente, incrementar la polinización y la productividad de muchos cultivos aledaños dependientes de ellos. Evaluamos el efecto de la diversidad floral de los bordes de cultivos sobre la riqueza y abundancia de los visitantes florales en 17 lotes de girasol en la zona de Balcarce y Lobería. La diversidad floral del borde tuvo un efecto positivo sobre la riqueza y abundancia de visitantes florales nativos en el cultivo adyacente. En consecuencia, los servicios de polinización en estos agroecosistemas podrían ser promovidos por un incremento en la cantidad y diversidad de estos hábitats marginales.

O presente artigo problematiza a noção de ciberespaço enquanto lócus ocupado pelo social a partir da consideração dos aspectos imaginários e simbólicos presentes na atribuição de valores tradicionalmente associados à concepção de espaço ou, mais notadamente, ao conceito a ele vinculado de lugar. Trata-se de uma reflexão teórica que aproxima pensadores da cibercultura (Francisco Rüdiger, André Lemos) a autores das áreas da psicologia cultural (James Hillman), da etnologia (Marc Augé), da geografia humana (Yi-Fu Tuan) e da história das religiões (Mircea Eliade).

Interactions between species form complex networks that vary across space and time. Even without spatial or temporal constraints mutualistic pairwise interactions may vary, or rewire, across space but this variability is not well understood. Here, we quantify the beta diversity of species and interactions and test factors influencing the probability of turnover of pairwise interactions across space. We ask: 1) whether beta diversity of plants, pollinators, and interactions follow a similar trend across space, and 2) which interaction properties and site characteristics are related to the probability of turnover of pairwise interactions. Geographical distance was positively correlated with plant and interaction beta diversity. We find that locally frequent interactions are more consistent across space and that local flower abundance is important for the realization of pairwise interactions. While the identity of pairwise interactions is highly variable across space, some species-pairs form interactions that are locally frequent and spatially consistent. Such interactions represent cornerstones of interacting communities and deserve special attention from ecologists and conservation planners alike.

O artigo investiga a repercussão da personagem de animação Shrek, considerando sua natureza imaginária e as relações que os meios de comunicação estabelecem entre imaginário e consumo. Pensando no processo de espelhamento e na centralidade dos processos miméticos para a constituição da identidade social, o artigo busca investigar não apenas a repercussão da personagem Shrek, mas também possíveis efeitos que o tratamento dado à personagem possa ter, como o hiperconsumo e a infantilização.

Pollinators for animal pollinated crops can be provided by natural and semi-natural habitats, ranging from large vegetation remnants to small areas of non-crop land in an otherwise highly modified landscape. It is unknown, however, how different small- and large-scale habitat patches interact as pollinator sources. In the intensively managed Argentine Pampas, we studied the additive and interactive effects of large expanses (up to 2200 ha) of natural habitat, represented by untilled isolated "sierras", and narrow (3-7 m wide) strips of semi-natural habitat, represented by field margins, as pollinator sources for sunflower (Helianthus annus). We estimated visitation rates by feral honey-bees, Apis mellifera, and native flower visitors (as a group) at 1, 5, 25, 50 and 100 m from a field margin in 17 sunflower fields 0-10 km distant from the nearest sierra. Honey-bees dominated the pollinator assemblage accounting for >90% of all visits to sunflower inflorescences. Honey-bee visitation was strongly affected by proximity to the sierras decreasing by about 70% in the most isolated fields. There was also a decline in honey-bee visitation with distance from the field margin, which was apparent with increasing field isolation, but undetected in fields nearby large expanses of natural habitat. The probability of observing a native visitor decreased with isolation from the sierras, but in other respects visitation by flower visitors other than honey-bees was mostly unaffected by the habitat factors assessed in this study. Overall, we found strong hierarchical and interactive effects between the study large and small-scale pollinator sources. These results emphasize the importance of preserving natural habitats and managing actively field verges in the absence of large remnants of natural habitat for improving pollinator services.

A partir de alguns diagnósticos da cultura e da comunicação contemporâneas sugerimos que se torna perceptível uma crescente dissolução da alteridade nas mediações provocada pelos chamados novos media, construídos a partir de plataformas tecnológicas cada vez mais distantes da corporeidade e seus requisitos. As experiências de encantamento se transferem do sentido para os aparatos, dissolvendo a temporalidade presente e a percepção de si mesmo, em favor de suportes ou imagens geradas por ou para tais suportes tecnológicos. A tecnologia torna-se autônoma, gerando em torno de si sujeitos e objetos hipnógenos.

El melanoma cutáneo es el cáncer cuya incidencia presenta la mayor tasa de crecimiento en el mundo. Su tasa de mortalidad no ha disminuido pese a las terapias costosas empleadas para su diagnóstico y tratamiento. Puede presentarse bajo dos formas: esporádica y hereditaria. Esta última incluye a individuos con alto riesgo de desarrollar melanoma, variando su frecuencia según la población estudiada. El objetivo general del presente trabajo es contribuir al conocimiento de la predisposición hereditaria de padecer melanoma en Uruguay. Mediante la aplicación de un formulario de tamizaje se identificaron 14 familias con alto riesgo de padecer melanoma hereditario. Diecisiete pacientes integrantes de ellas dieron su consentimiento informado para investigar mutaciones de línea germinal en CDKN2A y CDK4. La detección de cambios genéticos se realizó mediante PCR-SSCP (Polymerase Chain Reaction - Single Stranded Conformational Polymorphism). Los fragmentos con un patrón de bandas de SSCP atípicos fueron analizados mediante secuenciación. Se identificaron dos mutaciones: una en el exón 2 de CDKN2A (E88X) en dos pacientes familiares de primer grado portadoras de melanomas múltiples y síndrome familiar de nevos atípicos (SFNA) y con historia familiar de melanoma y cáncer de páncreas. Esta mutación de línea germinal no ha sido descripta previamente en familias con melanoma. La otra mutación identificada (G101W) es una de las más frecuentes a nivel mundial. Ambas mutaciones fueron identificadas en pacientes con SFNA y múltiples melanomas en sus familias. La frecuencia de mutaciones encontrada concuerda con la documentada en estudios previos que utilizaron criterios de selección similares.

O número de autores e obras que se dedicam à compreensão dos fenômenos relacionados com a visualidade e sua exacerbação nas últimas décadas do século XX tem crescido e consequentemente vem se acirrando a polêmica em tomo deste campo de saber. As contribuições da neurologia, da psicologia, das ciências sociais e das ciências da linguagem sobre o tema têm se mostrado imprescindíveis para uma maior compreensão dos significados e dos usos da imagem para o campo da comunicação. Alguns desses aportes são tratados aqui, notadamente aqueles que transitam pelas áreas da teoria da cultura em suas interfaces com as ciências da comunicação; dentre eles, autores como A. Damásio, B. Cyrulnik, E. Morin, D. Linke e H. Belting recebem atenção privilegiada por transporem as fronteiras da monodisciplinaridade, oferecendo perspectivas mais complexas e processuais para o estudo da imagem no campo da comunicação, fugindo das tipologizações classificatórias.

O presente artigo propõe uma reflexão sobre a presença de recursos míticos na produção e no fazer publicitário de nossa sociedade. Aponta relações entre comunicação e cultura, situando a produção publicitária no universo dessas relações e apontando para o uso que a publicidade realiza de conteúdos míticos e de práticas de ritualização para evocar padrões de indentificação com o consumidor. Ressalta a distinção existente entre dois usos distintos para a palavra "mito", mostrando as diferenças básicas de sentido, natureza e intenção de cada uma dessas acepções. Sugere ainda a necessidade de uma maior seriedade no tratamento dado até então à questão de que as práticas publicitárias atuais ignoram, ou preferem ignorar, a dimensão ética no uso que fazem desses recursos míticos e rituais.

Background and Objectives: Clinical and experimental data have shown that differences in nephron endowment result in differences in renal mass and predisposition to chronic renal failure, hypertension, and proteinuria. We hypothesized that a significant proportion of the variance in GFR, as estimated by serum creatinine, is attributable to differences in renal size in normal children., Design, Setting, Participants, & Measurements: A total of 1748 normal renal ultrasounds that were performed in children older than 6 months were reviewed. For each ultrasound, serum creatinine, serum blood urea nitrogen, and systolic and diastolic office BP were recorded. Renal size was evaluated as a function of renal length and thickness. All data were normalized for height, weight, age, and gender., Results: When expressed as SD scores, a significant correlation was found between kidney size and serum creatinine (P < 0.0001) and between kidney size and serum blood urea nitrogen (P < 0.002). When dividing kidney size data per quintiles, a difference of 0.51 SD score in serum creatinine was observed between the lowest and highest quintile. No significant correlation was found with office BP measurements., Conclusions: These data show that, even in the normal pediatric population, differences in renal function are significantly explained by differences in renal mass. Methodologic limitations of this study are likely to underestimate this relationship.

Horseshoe lung is a rare malformation that is often associated with lung hypoplasia and/or vascular anomalies. We describe a 10-year-old girl with horseshoe lung and unique left pulmonary vein. This is the first reported case with this vascular feature. The patient presented with signs and symptoms of severe pulmonary hypertension and was treated with sildenafil.

Autism is a developmental disorder characterized by social deficits, impaired communication, and restricted and repetitive patterns of behaviour. Emerging theories indicate interregional functional and anatomical brain connectivity as a likely key feature in autism pathophysiology. Corpus callosum (CC) represents a natural target of autism connectivity research, being the expression of interhemispheric communication. In this paper, a novel method for a robust morphometric analysis of CC data is presented. The standard morphometric approach is based on the analysis of the size and shape of the CC midsagittal cross-section. As there are no gross anatomical landmarks that clearly delimit anatomically or functionally distinct CC regions, several geometric partitioning schemes have been proposed in the literature for morphometric analysis, subdividing CC into subregions whose fiber topography is expected to target different hemispheric cortical regions. A novel tool of morphometric analysis, based on the automated subdivision of a high number of partitions from a CC centroid and on the consequent determination of the CC anatomical landmarks is presented, allowing an automated analysis of CC volumes, shapes and curvatures, suitable for an automated application in clinical environment. Moreover the proposed tool can be used for original post-processing and visualization techniques that may help in the analysis of possible alterations of CC and in the correlations with autism-related diseases. The proposed morphometric tool has been validated and applied for clinical investigation on brain morphometry in children (age 3-11 years) with autism or with other autism spectrum disorders (DSA) and on healthy control subjects who underwent volumetric MRI T1 weighted acquisitions.

Background: Pleuropulmonary blastoma (PPB) is a rare, aggressive dysontogenetic neoplasm affecting children. It was identified as a distinct entity by Manivel in 1988 and later subdivided into three types on the basis of the histological pattern, with increasing malignancy from type I (cystic) through type II (solid/cystic) to type III (solid)., Objective: To report on the imaging findings, clinical presentation, and differential diagnosis, mainly cystic malformations., Materials and Methods: We evaluated three children, age 2-4 years, with PPB., Results: One patient presented with unresolving pneumothorax and a multicystic mass, another with a mixed fluid/solid lesion, and the last with a solid heterogeneous mass., Conclusion: Despite its rarity, PPB should be considered in the evaluation of cystic or solid masses in children with respiratory distress. Plain film radiography alone is unable to distinguish between PPB and cystic malformations. CT represents the gold standard, although MRI can show the imaging features of solid enhancing nodules inside fluid-filled cavities, a mass causing lung compression, mediastinal shift, frequent pleural effusion, and no chest wall invasion. No preoperative imaging can reliably differentiate between congenital cystic lesions and PPB type I.

A case report of a neonate with pulmonary arteriovenous malformation is described. The anomaly was prenatally diagnosed, and family history was positive for Rendu-Osler-Weber syndrome. Because neurologic symptoms developed during the second week of life, surgical resection was deemed the best curative option to avoid further embolic events and reoccurrence of the lesion. Previous reports detailing coil embolization therapy for pulmonary arteriovenous malformation are discussed.

Ultrasonography is useful and effective in the evaluation of renal diseases in pediatric age. Sonography is well established as a screening tool to evaluate the kidney for the presence of renal obstruction. Distinction of the obstructed from the non obstructed dilated collecting system is a difficult problem. Doppler Ultrasonography offers potential advantages in the evaluation of childhood genitourinary tract abnormalities.

A case of simultaneous heart and kidney transplantation is presented in a 12 years old girl. The patient suffered from dilated cardiomyopathy and end-stage kidney disease. Bilateral vesico-renal refluxes were corrected at the same time of the duplex transplantation. A multiorgan harvesting from a pediatric 8 years old donor was utilized. Follow-up is 40 months. Cytomegalovirus (CMV) infection and acute tubular necrosis from haemoglobinuria were transient complications. Hemolysis from bypass and extracorporeal circulation was involved as pathogenetic factor of the acute tubular necrosis. Cardiac and renal function remain excellent and the child is fully recovered and resumed a normal and active life. Combined heart and kidney transplantation may be of benefit in selected patients, also in pediatric age.

Previous publications attempted to define normal and abnormal ranges in the measurement of pyloric length (L), breadth (D), muscle thickness (S), volume (V) and muscle index (MI). We examined with US 286 patients with suspected hypertrophic pyloric stenosis and investigated all the above diagnostic criteria. Normal and abnormal ranges were in agreement in all five measurements, though less apparent for pyloric volume and muscle index. The patients with borderline values were 46 (16%) for pyloric muscle thickness, 98 (34%) for breadth, 52 (18%) for length, but only 22 (7.7%) for pyloric volume and muscle index. Borderline patients received medical therapy with the antispasmodic drug metaclopramide hydrochloride and they were examined with US after 15 days. Only 8 of 22 borderline patients (36%) developed a typical hypertrophic pyloric stenosis. In the others, pyloric volume was reduced and the symptoms subsided. Pyloric parameters cannot be always measured accurately, but pyloric volume and muscle index measures better distinguish normal from abnormal findings. The formula for pyloric volume calculation is simpler than that for pyloric muscle index calculation and easier to memorize, also because no correction for body weight is necessary.

We performed serial cranial ultrasonography in four newborns affected by maple syrup urine disease. Symmetric increase of echogenicity of periventricular white matter, basal ganglia (mainly pallidi), and thalami was detected in the acute stage. The degree of ultrasonography abnormalities paralleled the clinical course of the disease.

We report a case of a child who was first seen for acute renal failure and periarteritis nodosa. Angiography findings confirmed this diagnosis. Ultrasound scan revealed large tricuspid valve vegetation, as well as minute vegetation on the right ventricular wall. All vegetation disappeared after 12 months of immunosuppressive therapy. Serology findings for lupus were negative. All clinical and laboratory findings strongly support the hypothesis that this previously undescribed heart involvement is caused by PAN.

The Authors report their experience dealing with 21 patients affected by lymphoproliferative disorders with renal lesions. In 4 cases renal ultrasound allowed such a diagnosis, previously unsuspected.

Fourteen cases are reported of monolateral adrenal hemorrhage in newborns who were submitted to US exam at 1 week, 2 weeks, 3 weeks, and 3 months of age. The variability is emphasized of US and pathologic findings according to the patients' age. A concise terminology is suggested allowing the description of morphological and echo-structural patterns in adrenal hemorrhage. Being familiar with US spectrum of neonatal adrenal hemorrhage appearances can provide useful data in the cases with atypical clinical features. Moreover, the differential diagnosis becomes easier of neonatal adrenal hemorrhage and other diseases such as neonatal neuroblastoma, adrenal abscess, cystic neuroblastoma, cortical renal cyst, and obstructed upper cortical renal cyst, and obstructed upper excretory tract in duplicated kidney. The most effective criterion for US differential diagnosis is probably the chronological variability of US findings. Sonography is stressed as an useful and effective imaging modality in the diagnosis and follow-up of adrenal hemorrhage which helps avoid X-ray investigations and unnecessary laparotomies.

Non parasitic splenic cysts are an uncommon clinical and pathologic entities, out of these, epitelias splenic cysts (ESC) occurred in 10% of cases. Until recently the treatment of choice for the large ESC consisted of splenectomy. Splenic preservation, for avoiding risks of sepsis, is a modern concept uniformly accepted for treating childhood splenic injury and benign pathology. The Authors report a case of prenatal diagnosis of large left upper quadrant mass that was apparent at Ultrasonography (US) at 32th week of gestational age. Laparotomy at 3rd day of life: a large cyst splenic mass was found (7 x 7 cm), it was situated all in lower pole. Partial splenectomy was performed; cysts were not found in other organs. Histology of specimen: ESC. The postoperative course was uneventful. Postoperative (6 months) Scintigraphy demonstrated the good vascularization of the spleen.

We have studied 47 children (58 ears) with external and middle-ear malformations. Tomography was useful and effective in the pre-operative evaluation of anatomical patterns. We have divided our cases into four groups and described the most characteristic tomographic findings in each. We also discuss problems concerning patients immobilization and X-ray protection.