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SummaryThe maturation of genomic surveillance in the past decade has enabled tracking of the emergence and spread of epidemics at an unprecedented level. During the COVID-19 pandemic, for example, genomic data revealed that local epidemics varied considerably in the frequency of SARS-CoV-2 lineage importation and persistence, likely due to a combination of COVID-19 restrictions and changing connectivity. Here, we show that local COVID-19 epidemics are driven by regional transmission, including across international boundaries, but can become increasingly connected to distant locations following the relaxation of public health interventions. By integrating genomic, mobility, and epidemiological data, we find abundant transmission occurring between both adjacent and distant locations, supported by dynamic mobility patterns. We find that changing connectivity significantly influences local COVID-19 incidence. Our findings demonstrate a complex meaning of ‘local’ when investigating connected epidemics and emphasize the importance of collaborative interventions for pandemic prevention and mitigation.

Among older adults, age-related macular degeneration (AMD) is a prevalent disabling condition that begins as subtle visual disturbances and can progress to permanent loss of central vision. In its late neovascular form, AMD is treatable with inhibitors of vascular endothelial growth factor, the key driver of exudative disease. In the atrophic form, treatment remains elusive. This review addresses the natural history of AMD – through early, intermediate, and advanced disease stages – and concentrates on diagnosis and risk stratification, deficiencies of current treatments, and the promising findings of emerging therapies.

PURPOSE To correlate drusen morphology and outer retinal status with autofluorescence (AF) imaging in patients with intermediate age-related macular degeneration. METHODS Drusen type and morphology were analyzed using color fundus photography and spectral-domain optic coherence tomography, whereas fundus AF was used for drusen AF evaluation. Additional structural changes on spectral-domain optic coherence tomography, such as disruption of external limiting membrane, ellipsoid zone, and retinal pigment epithelium/Bruch membrane complex, as well as the presence of choroidal hypertransmission at correspondent locations were also evaluated and correlated with fundus AF findings. Spearman's correlation coefficient was used to analyze the correlation between spectral-domain optic coherence tomography morphological characteristics of drusen and AF appearance of the corresponding drusen. Strength of correlation was calculated (r), and a P value < 0.05 was considered statistically significant. RESULTS Two hundred and twenty-eight drusen from 53 eyes of 53 patients were analyzed, 130 soft drusen (57.02%) and 98 cuticular drusen (42.98%). Sixty percent of the drusen were isoautofluorescent (n = 136), 35% hyperautofluorescent (n = 80), and 5% hypoautofluorescent (n = 12). We found positive correlation between drusen AF and hyperreflective foci (r = 0.4). Outer retinal layers morphology (external limiting membrane and ellipsoid zone status and hypertransmission) also correlates with autofluorescent findings (r = 0.3). CONCLUSION Multimodal imaging reveals a broad spectrum of ultrastructural changes, which may reflect different stages in the evolution of drusen. Our results suggest that drusen morphological characteristics and autofluorescent findings are correlated but other factors or cofactors may be involved. The described correlations will help us understand new progression biomarkers of nonexudative age-related macular degeneration.

Luteal angiogenesis is regulated by pro-angiogenic hormones including fibroblast growth factor 2 (FGF2) and angiopoietin 1 (Ang1), which are regulated by the adipokine leptin during development. Another adipokine, adiponectin, exhibits an inverse relationship with leptin and has been identified in the CL. Therefore, it is hypothesized that adiponectin will influence pro-angiogenic hormones in the developing porcine CL. Crossbred sows were randomly allocated to one of two days of the estrous cycle, day 5 (D5; n = 4) or day 7 (D7; n = 5) for CL collection. Tissue was processed for immunohistochemical localization of adiponectin receptor 2 (AdipoR2), gene expression of FGF2, Ang1, leptin, AdipoR2, and cell culture for adiponectin treatment. The expression of AdipoR2 tended (p = 0.09) to be higher in D7 lutea and was more prevalently localized to the cell surface of large and small luteal cells than in D5 tissue. Adiponectin influenced (p ≤ 0.05) FGF2, leptin, and AdipoR2 gene expression relative to the dose and day (D5 or D7). Collectively, the evidence supports the supposition that adiponectin influences angiogenic factors in the developing CL.

Introduction: This post hoc analysis applies a fixed dosing stratification approach to patient-level brolucizumab data from the phase III HAWK and HARRIER trials to determine the proportion of patients who would have been assigned to fixed dosing regimens with treatment intervals of 8, 12, or 16 weeks (q8w, q12w, or q16w) based on the presence/absence of disease activity (DA) following the loading phase. The analysis also simulates central subfield thickness (CSFT) data to estimate the anatomical outcomes if the patients had been thus assigned. Of note, the limitations of this analysis include the post hoc nature of the work and the inability to directly compare HAWK and HARRIER with TENAYA and LUCERNE due to the differences in design. Design: This study was a post hoc modelling analysis of patient-level data. Methods: Using patient-level data from HAWK and HARRIER, patients (n = 730) were allocated to a fixed q16w, q12w, or q8w regimen based on assessment of DA at weeks 16 and 20. Two definitions of DA were used: DA 1, based on a phase II study of faricimab, and DA 2, a definition derived from common clinical consideration including visual acuity and anatomical changes. CSFT simulations were performed using a pharmacokinetic/pharmacodynamic model describing CSFT response to anti-VEGF treatment. Outcome measures were modelled patient allocation to fixed regimens and mean CSFT reduction. Results: Using DA definitions 1 and 2, respectively, 78% and 76% of patients in the brolucizumab arm were allocated to a greater than or equal to q12w regimen, and 56% and 52% were allocated to a q16w regimen. Mean reduction in CSFT was similar between the two study drugs with both DA definition assumptions. Conclusions: This analysis demonstrates the potential durability of action and effectiveness of brolucizumab.

This article presents a study that identifies the variables with greatest impact on the biogas and methane production over a process with thermal pretreatment, to accelerate anaerobic digestion process in sewage sludge in a water treatment plant, for a poultry processing factory, by using fuzzy logic. The designed fuzzy logic model includes 688 inference rules, with a correlation of 99.3% between prediction data against experimental data, for the biogas variable; and 97% for the methane variable. The predictions of the fuzzy logic model were analyzed with response surface models, and it is concluded that the temperature and operating time variables are mutually determining in the biogas and methane production. Likewise, this research provides a methodology for the design of an expert decision support system that allows to evaluate and optimize a mesophilic anaerobic digestion process through a previous thermal treatment in order to improve the yields of biogas and methane in the treatment of effluent sludge from agroindustry. These results propose to diffuse logic as a reliable tool to make comparisons, and predictions for operation variables management on the treatment of residual sludge with thermal pretreatment on anaerobic digestion.

Extension outreach professionals are searching for new methods to target the growing population of Latino students. Oklahoma State University faculty in the Animal Science department and the 4-H Youth Development program partnered to sponsor a 4-H STEM Institute designed to promote science, technology, engineering, and math to Latino students in the Unidos Se Puede program. The STEM Institute was designed to introduce the Latino youth to college life and STEM based career opportunities. The program was evaluated utilizing the 4-H Common Measures Science instruments. The results indicate a positive impact on the youth’s perception of STEM as a career option. The students increase in self-efficacy predicts the students will increase their persistence in the subjects of science and math (Simpkins, Davis-Kean, & Eccles, 2006). Increased persistence in science and math leads to increased success in post secondary STEM studies and occupations.

AIM: To evaluate and compare the quality of life of patients submitted to XEN® implant or trabeculectomy and the relationship with potentially involved variables. METHODS: A cross-sectional study of patients with advanced open-angle glaucoma who underwent implantation of XEN® (group 1) and trabeculectomy (group 2) between October 2015 and February 2017. The studied variables were: age, gender, follow-up time, need of topical anti-hypertensive therapy, visual acuity and intraocular pressure (IOP). The quantification of the quality of life was attained through the Glaucoma Symptom Scale (GSS) questionnaire. RESULTS: Totally 34 eyes (34 patients) were included, 17 in each group. The mean GSS scores for group 1 were 42.6±6.8 (median, 47; p25, 36.5; p75, 48.5) and for group 2 it was 41.6±7.0 (median, 43; p25, 36.5; p75, 47.0; P=0.34). There was a strong negative correlation between the need for topical anti-hypertensive drugs and the GSS result in both groups (r=-0.88, P

Subretinal fluid accumulation in a patient with systemic lupus erythematosus (SLE) may represent a diagnostic challenge. We present a case of a 43-year-old man with baseline diagnosis of SLE and hydroxychloroquine-associated maculopathy who reported progressive vision loss on the right eye, associated with corticosteroids use for an arthritic crisis. Ophthalmological examination did not reveal any acute finding. On optical coherence tomography, subretinal fluid in the perifoveal area was visible on the right eye, with corresponding enlargement of the visual field defect. An increased choroidal thickness was also visible. Fluorescein angiography revealed, on the right eye, two pinpoint areas of leakage and indocyanine green angiography signs of choroidal vascular hyperpermeability. Considering a diagnosis of a non-central central serous chorioretinopathy, corticosteroids use was interrupted, with resolution of the subretinal fluid. This case illustrates the relevance of a multimodal imaging approach to guide the diagnosis of patient with an SLE with subretinal fluid.

This article focuses on the analysis of the behavior patterns of the variables involved in the anaerobic digestion process. The objective is to predict the impact factor and the behavior pattern of the variables, i.e., temperature, pH, volatile solids (VS), total solids, volumetric load, and hydraulic residence time, considering that these are the control variables for the conservation of the different groups of anaerobic microorganisms. To conduct the research, samples of physicochemical sludge were taken from a water treatment plant in a poultry processing factory, and, then, the substrate was characterized, and a thermal pretreatment was used to accelerate the hydrolysis process. The anaerobic digestion process was analyzed in order to obtain experimental data of the control variables and observe their impact on the production of biogas. The results showed that the thermal pre-hydrolysis applied at 90°C for 90 min accelerated the hydrolysis phase, allowing a significant 52% increase in the volume of methane produced. An artificial neural network was developed, and it was trained with the database obtained by monitoring the anaerobic digestion process. The results obtained from the artificial neural network showed that there is an adjustment between the real values and the prediction of validation based on 60 samples with a 96.4% coefficient of determination, and it was observed that the variables with the major impact on the process were the loading rate and VS, with impact factors of 36% and 23%, respectively.

Purpose Retinal vein occlusion (RVO) is an important cause of visual disability in the modern world. We aim to evaluate the real-world outcomes of patients with RVO treated with anti-vascular endothelial growth factor (VEGF) in Portugal. Methods We performed a retrospective, observational, multicenter study including 8 centers across Portugal and 200 patients treated with either ranibizumab or bevacizumab. Data were collected at 3 time points: time of diagnosis (0 time point) and 6 and 12 months after initiating treatment. Demographic and clinical data were collected. Results Median visual acuity (VA) and central macular thickness (CMT) improved in the branch RVO (BRVO), central RVO (CRVO), bevacizumab, and ranibizumab groups at 6 and 12 months compared to baseline, with CMT improving further only in the CRVO and ranibizumab groups between 6 and 12 months (p = 0.002 and p = 0.001, respectively). The CMT was lower in the ranibizumab group compared to the bevacizumab group both at 6 and 12 months (pConclusions Both treatments were effective, although less effective than results reported in clinical trials. The morphologic response was better with ranibizumab compared to bevacizumab, although functionally there were no differences.

Purpose To study structural chorioretinal changes in tamoxifen-treated patients. Methods Cross-sectional case-control study comparing structural chorioretinal aspects in tamoxifen-treated patients and healthy controls. Enhanced depth spectral domain optic coherence tomography with choroidal binarization and optic coherence tomography angiography were performed. Individual retinal layer thickness and chorioretinal vascular components were compared. Subgroup analysis regarding history of chemotherapy was performed. Results Two hundred eyes of 100 TAM-treated patients (Group 1) and 80 eyes of 40 healthy controls (Group 2) were included. Of the 200 spectral domain optic coherence tomography scans from patients, 2 showed structural changes attributable to tamoxifen. Group 1 showed significantly lower values in choroidal parameters and in total retinal, ganglion cell layer, inner plexiform layer, outer nuclear layer, and retinal pigment epithelial thicknesses as well as an increased thickness in the outer plexiform layer. The subgroup not submitted to chemotherapy maintained significant reductions in total retinal thickness, ganglion cell layer, retinal pigment epithelium, outer nuclear layer, outer retinal layer, choroidal parameters, as well as an increased thickness in the outer plexiform layer, in comparison with Group 2. Conclusion Subclinical structural retinal changes could indicate early retinal pigment epithelial and photoreceptor damage. The new finding of choroidal thinning could point toward another important pathophysiologic process in tamoxifen-induced toxicity.

Anti-vascular endothelial growth factor therapy has revolutionized the treatment of wet age-related macular degeneration; however, it is important to monitor actual use of ranibizumab and related treatment outcomes in routine practice.This was a retrospective, observational study to monitor the 2-year outcomes following ranibizumab treatment for wet age-related macular degeneration in Portugal. Patients treated between January 2009 and December 2009 were retrospectively evaluated. All decisions were made by the treating physician in accordance with their usual routine clinical practice. The primary assessment was mean change in visual acuity score using Early Treatment Diabetic Retinopathy Study or Snellen equivalent.A total of 128 patients with wet age-related macular degeneration were analyzed (mean age 79.4 years; mean visual acuity score 54.2 letters). Mean change in visual acuity score from baseline was -1.6 letters (n = 82) at year one and -5.1 letters (n = 72) at year two. The mean number of ranibizumab injections was 3.8 (year one) and 1.6 (year two). On average, patients attended 8.6 and 5.0 visits and optical coherence tomography was used in 75.0% of patients in year one and in 56.3% of patients in year two, respectively.Despite a relatively high number of visits, including monitoring visits and use of optical coherence tomography - guided therapy, few injections were administered and visual acuity was not improved.These findings indicate that as-needed treatment resulted in under-dosing in a real-life setting in Portugal. Such limitations may also be related to increasing numbers of patients, resulting in clinic saturation.Introdução: A terapeutica com anti-factor de proliferação endotelial vascular revolucionou o tratamento da degenerescência macular da idade exsudativa; no entanto, é importante monitorizar o uso em contexto real do ranibizumab e os resultados associados ao tratamento na prática clínica corrente. Material e Métodos: Este foi um estudo observacional, retrospetivo, para monitorizar os resultados de dois anos, após o tratamento com ranibizumab para a da degenerescência macular da idade exsudativa em Portugal. Os doentes tratados entre janeiro de 2009 e dezembro de 2009 foram avaliados retrospetivamente. Todas as decisões foram tomadas pelo médico responsável pelo tratamento, em conformidade com a respetiva prática clínica corrente. A avaliação primária foi a alteração média na melhor acuidade visual corrigida utilizando a tabela ETDRS (Early Treatment of Diabetic Retinopathy Study) ou Snellen equivalente. Resultados: Foi analisado um total de 128 doentes com degenerescência macular da idade exsudativa (idade média de 79,4 anos; média de acuidade visual de 54,2 letras). A alteração média na melhor acuidade visual corrigida desde a situação basal foi de -1,6 letras (n = 82) no ano um e -5,1 letras (n = 72) no ano dois. O número médio de injeções de ranibizumab foi de 3,8 (ano um) e 1,6 (ano dois). Em média, os doentes tiveram entre 8,6 e 5,0 consultas e foi utilizada a tomografia de coerência ótica em 75,0% dos doentes no ano um e em 56,3% dos doentes no ano dois, respetivamente. Discussão: Apesar do número de consultas relativamente elevado, incluindo consultas de monitorização e de utilização de terapêutica guiada por tomografia de coerência ótica, foram administradas poucas injeções e não houve melhoria na acuidade visual. Conclusão: Em Portugal, num contexto real, estes achados indicam que o tratamento consoante as necessidades resultou numa dosagem insuficiente. Essas limitações também podem estar associadas ao número crescente de doentes, o que resulta numa saturação clínica.

O objetivo da presente pesquisa foi analisar a percepção que homens gays tem de si nas relações sociais e afetivas no município do Rio de Janeiro. Tendo a cidade como analisador do processo de perceber-se, significar-se e ver-se em relação a situações vivenciadas em seu ambiente social, analisamos a forma que se percebem no trânsito pela cidade, além de identificar as formas de violências vividas e percebidas por estes a partir de suas relações familiares, de amizades, sociais. A pesquisa de cunho qualitativo utilizou a técnica de entrevistas semiestruturadas, com 10 participantes de 18 a 25 anos. As principais categorias analisadas para discutir a percepção que homens gays têm de si nas relações sociais e afetivas no município do Rio de Janeiro foram: família, amigos, religião, a cidade do Rio de Janeiro e seus mapas (bairros, regiões, territórios LGBTT ou não), a figura do gay/ homossexual, preconceitos. A análise das entrevistas indicou caminhos possíveis no campo de pesquisa em questão que possam contribuir com a produção nacional. Foram elas: A forma como os jovens homossexuais se expressa em vários lugares da cidade do Rio de Janeiro, dando voz às suas opiniões, refletindo a maneira como a sociedade machista influência e interfere na construção da auto-imagem do homem homossexual.

Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2017 Submitted by Repositório FFUL (repositorio@ff.ul.pt) on 2018-12-17T12:22:25Z No. of bitstreams: 1 MICF_Ana_Bugalho.pdf: 726462 bytes, checksum: e417248e9b39bd581ee0427cf15b39b1 (MD5) Made available in DSpace on 2018-12-17T16:12:20Z (GMT). No. of bitstreams: 1 MICF_Ana_Bugalho.pdf: 726462 bytes, checksum: e417248e9b39bd581ee0427cf15b39b1 (MD5) Previous issue date: 2017-10-23

Resumo O objetivo do artigo é evidenciar as negociações e disputas entre saberes e poderes na história da Política Nacional de Atenção Integral à Saúde do Homem, a partir da criação da Área Técnica de Saúde do Homem, instituída em 2008 no Departamento de Ações Programáticas Estratégicas no Ministério da Saúde. Acompanhamos a posição da Sociedade Brasileira de Urologia no processo de constituição da política. Recuperamos a disputa colocada em discurso tendo como referência as entrevistas realizadas com gestores do Ministério da Saúde e com o representante auxiliar do Fundo de População das Nações Unidas no Brasil. Nas aparições do sujeito de direitos à saúde, analisamos a visibilidade do corpo masculino nos signos das resistências às intervenções do biopoder. Abstract The aim of this article is to demonstrate the negotiations and disputes between different kinds of knowledge and power in the history of the Brazilian National Policy for Comprehensive Men’s Healthcare based on the creation in 2008 of the Technical Area for Men’s Health within the Ministry of Health’s Department of Strategic Programs. We observed the Brazilian Society of Urology’s position as the policy was being drawn up, including the discourse adopted, based on interviews held with managers from the Ministry of Health and the assistant representative of the United Nations Population Fund in Brazil. We analyzed the visibility of the male body in signs of resistance to the interventions of biopower in the expression of the right to health.

A danca sempre esteve presente na historia da humanidade. Na sua forma mais antiga, as dancas sagradas foram vivenciadas em diversos rituais. O bale surge mais recentemente permeado de fantasia, romance e misticismo, influenciando a estetica do corpo do bailarino e a construcao do imaginario da figura da bailarina. O corpo torna-se entao um lugar central da danca, seja pelo estudo e analise do movimento, pela beleza da danca ou pelo ideal de leveza e beleza que ele representa. O objetivo do presente artigo e delinear a producao do corpo no ensino do baby class , corpo este atravessado pela gramatica binaria do genero na constituicao de territorios/praticas femininas e masculinas. Para isso, faz um breve historico do surgimento da danca e do bale, do classico ao contemporâneo, para falar deste lugar do corpo na contemporaneidade, no qual a constituicao/oposicao dos generos se faz presente. Apesar de o bale classico nos dias atuais ser rotulado como uma danca tipicamente/tradicionalmente feminina e os bailarinos serem em maioria mulheres, nem sempre foi assim. E mesmo hoje, em pleno seculo XXI, ainda ha muito preconceito contra meninos que se interessam pela danca e, em especial, pelo bale nas turmas de baby class , demostrando o conservadorismo existente e como os estereotipos de genero sao continuamente reforcados e naturalizados, ajudando entao na manutencao do pensamento conservador. DOI: 10.12957/demetra.2016.22504

Aim: Evaluate the real-life experience with ocriplasmin on vitreomacular traction (VMT) release and full-thickness macular hole (FTMH) closure in Portugal. Methods: Multicentric, retrospective study of 83 eyes of 78 patients who were treated with intravitreal ocriplasmin for VMT with and without FTMH. Primary outcomes were VMT release and FTMH closure. Secondary outcomes included visual acuity changes and structural features on spectral-domain ocular coherence tomography. Results: VMT resolved in 47 of the 83 eyes (56.6%) and 6 of the 12 FTMH were closed (50.0%). Mean best-corrected visual acuity (BCVA) improved from 65.1 at baseline to 70.8 ETDRS letters at the end of follow-up (p < 0.0001) with a mean follow-up of 138.8 days. Improvement in BCVA was significantly better in eyes with VMT release (p = 0.021). Approximately 73% of patients had normal ellipsoid zone integrity at the end of follow-up, 87% had no neurosensorial detachment and 40% had no intra- or subretinal fluid. Conclusion: VMT release and FTMH closure were achieved in more than half of the treated eyes and were correlated with significant BCVA improvements and favorable baseline characteristics. In fact, if a careful patient selection is carried out, VMT resolution with ocriplasmin can be optimized, tailoring the best approach to each patient.

Resumo O artigo analisa a Política Nacional de Atenção Integral à Saúde do Homem do governo brasileiro. Foram analisados os documentos “Princípios e diretrizes da Política Nacional de Atenção Integral à Saúde do Homem”, “Princípios e diretrizes da Política Nacional de Atenção Integral à Saúde da Mulher”; e entrevistas realizadas com gestores federais da Área Técnica de Saúde do Homem. A análise do discurso a partir de Michel Foucault permitiu lidar com o corpus em suas condições de produção mediante um gesto analítico-descritivo de manejo dos enunciados dispersos. O argumento central é o de que a Política de saúde tem um “gênero” como uma rede discursiva que produz os sujeitos referências de sua inteligibilidade. Destacam-se na análise a emergência do sujeito feminino do cuidado, representada pela mulher-mãe higiênica e mulher-sujeito; e do homem como sujeito de direitos à saúde sob o signo de acontecimento de seu nascimento. Abstract The article examines the National Policy of Comprehensive Men and Women’s Healthcare of the Brazilian government. Documents analyzed were: “Principles and guidelines of the National Policy of Comprehensive Men’s Healthcare”, “Principles and guidelines of the National Policy of Comprehensive Women’s Healthcare”, and interviews to federal managers of the Technical Field of Men’s Healthcare. Discourse analysis from Michel Foucault allowed to deal with the corpus in their production conditions through an analytical -descriptive gesture handling of scattered statements. The central argument is that the health policy analyzed has a “gender” as a discursive network that produces the subject references its intelligibility. Stand - in analyzes the emergence of the female subject of care, represented by the woman-mother hygienic and woman -subject, and the man as the subject of rights to health under the sign of newness of his birth. The dialogue with Judith Butler and Jacques Derrida is one of the enablers axes theoretical analysis of the issues that build the product , in addition to the title itself also seeks to highlight , namely the biopolitics gears that move the policy in question .

Este artigo tem o objetivo de apresentar parte dos resultados da pesquisa multicêntrica "Masculinidades e Práticas de Saúde", em que foram investigados, junto à população masculina de Florianópolis (SC), os significados sobre saúde/doença e práticas de cuidados com a saúde por ela desenvolvidas. Para tal, foram realizados sete grupos focais com homens usuários dos serviços de saúde, entrevistas com os profissionais que compõem a equipe técnica de saúde sexual e reprodutiva do Hospital Universitário (HU) da Universidade Federal de Santa Catarina (UFSC), bem como 260 entrevistas com homens. Investigou também, junto à equipe de profissionais do serviço (médicos, enfermeiros, psicólogos, assistentes sociais, gestores em saúde), as discursividades de gênero em relação aos cuidados com a saúde e promoção do acesso de homens aos serviços. A proposta filosófico-metodológica de Judith Butler sobre gênero inteligível, performatividade e suas implicações na constituição de sujeitos em saúde foi o vetor de análise do material empírico da pesquisa, sem perder de vista o projeto biopolítico em que estes enunciados são possíveis de serem formulados, principalmente no que se refere ao SUS e a seus princípios de universalidade, integralidade e equidade. A categoria gênero é elemento de grande importância no padrão dos riscos de saúde nos homens e na forma como estes percebem, usam e cuidam de seus corpos, tanto como possibilidade de transformação de valores como na reiteração dos vigentes. This paper aims to present partial results of the multicentered research "Masculinities and Health Practices". This research explored the meanings of health and illness among the male population in Florianopolis and the healthcare adopted by them. The research methodology was based on seven focal groups with male patients of the local health services, interviews with the professionals who take part of the sexual health and reproductive team of the Santa Catarina University Hospital, as well as 260 interviews with males. It also explored gender discursive practices of the medical team (doctors, nurses, psychologists, social assistants, and health professionals in general) regarding healthcare and the availability of the services for the male population. Judith Butler's philosophical and methodological proposals regarding intelligible gender, performances and its consequences for the constitution of the subjects was the theoretical vector of analyses of the empirical material. The paper also considers the biopolitical project that encapsulated these ideas, in particular the Unified Health System (SUS) and its principles of universality, integral care and equity. The concept of gender is a key element of the health risk pattern among the males and how they perceive, act and take care of their bodies, both as possibility of values transformations or reiteration of current values.

Acute lymphoblastic leukemia is a malignant hematopoietic neoplasia, which is rare in adults. Although ocular fundus alterations may be commonly observed in the course of the disease, such alterations are rarely the presenting signs of the disease. Here we describe the case of a patient with painless and progressive loss of visual acuity (right eye, 2/10; left eye, 3/10) developing over two weeks, accompanied by fever and cervical lymphadenopathy. Fundus examination showed bilateral macular serous detachment, which was confirmed by optical coherence tomography. Fluorescein angiography revealed hyperfluorescent pinpoints in the posterior poles. The limits of the macular detachment were revealed in the late phase of the angiogram. The results of blood count analysis triggered a thorough, systematic patient examination. The diagnosis of acute lymphoblastic leukemia B (CD10+) was established, and intensive systemic chemotherapy was immediately initiated. One year after the diagnosis, the patient remains in complete remission without any ophthalmologic alterations. info:eu-repo/semantics/publishedVersion

Purpose: Primary intraocular lymphoma is a primary central nervous system lymphoma in which lymphoma cells invade the retina, vitreous, or optic nerve head without concomitant central nervous system involvement. The aim of this presentation is to report a case of primary intraocular non-Hodgkin lymphoma. Methods: The authors present a case report of a 77 years-old female with painless decreased in visual acuity and floaters. Ophthalmic examination, Static computerized Perimetry, Spectral-Domain Optical Coherence Tomography, angiography, laboratory study, lumbar puncture, computed tomography scan and magnetic resonance imaging were performed. Results: On examination, best corrected visual acuity was 20/25 in the right eye and 30/60 in the left eye. Slip lamp examination revealed anterior chamber reaction and fundoscopy showed vitritis, optic disc edema, macular edema and vasculitis in left eye. After three months of follow-up, the patient’s best corrected visual acuity decreased to 20/60 in right eye and light perception in left eye. Fundoscopy revealed vitritis, optic disc edema, macular edema and vasculitis in both eyes. A granular pattern, leakage from retinal vessels and optic disc were observed in fluorescein angiography. Infectious and inflammatory etiologies were excluded. Pars plana vitrectomy and retinal biopsy were performed in left eye. Cytology evaluation revealed atypical lymphoid cells with large nuclei, prominent nucleoli and basophilic cytoplasm, and confirmed the diagnosis of intraocular lymphoma. Conclusion: Intraocular Lymphomas are rare malignancies that display a wide array of clinical manifestation, therefore diagnosis can be challenging. It requires a high degree of clinical suspicion and differential diagnosis includes infectious and non-infectious etiologies.

Introducao: o modulo de Trabalho em Saude da Universidade Federal de Sao Paulo – UNIFESP, nos mostra que equipes multidisciplinares trabalham de forma mais ampla na atencao ao paciente, nao tratando-o apenas como uma doenca e sim verificando suas reais necessidades, mostrando ao paciente que ele e importante e que realmente estamos ouvindo o que ele diz. e com isso o modulo nos mostra que o servico de saude pode ser diferenciado. Objetivos: Apresentar como se deu o processo de ensino-aprendizagem da interdisciplinaridade no caso de uma esposa cuidadora pertencente a uma Unidade Basica de Saude (UBS) na cidade de Santos. Metodo: Dona A. foi encaminhada para o atendimento de Trabalho em Saude, em 2012, pela equipe da UBS do Embare, pois comecou a apresentar problemas de diabetes. ao mesmo tempo, surgiu a demanda de seu marido, que desenvolveu Mal de Alzheimer muito rapidamente, desestruturando a rotina do casal que sempre foi muito ativa. com o passar do tempo ele ficou completamente dependente e os filhos acabaram se afastamento por nao conseguirem ver o pai no estado em que se encontrava, assim sobrou toda a demanda de cuidados e responsabilidade para a esposa. o projeto terapeutico singular deste ultimo grupo de alunos, que seguiu o caso no periodo de setembro de 2013 a janeiro de 2014 pensou em favorecer a aproximacao entre dona A. e seus filhos, de propor momentos de prazer, relaxamento e sensibilizar Dona A. para a necessidade de autovalorizacao. Neste processo Dona A. quis ensinar a equipe a tricotar, a jogar cartas e aprendeu algumas atividades como a construir um mural de fotos familiares, com este foi possivel retomar alguns aspectos e momentos marcantes de sua historia, foi possivel ela coordenar as fases da atividade, e com autonomia conseguia escolher o que queria e o que nao queria que fosse feito, principalmente quanto as cores e as fotos escolhidas por ela, a acao em equipe favoreceu para uma rememoracao da familia reunida. a todo o momento a cuidadora demonstrou prazer em poder ensinar o que gosta de fazer e vontade de aprender coisas novas. Resultados: Desde a primeira visita, dona A. recebeu muito bem a equipe e de forma carinhosa, entretanto, foi no decorrer das visitas que se sucederam que os lacos de confianca e o vinculo entre nos foi se formando. Era visivel sua alegria ao poder nos receber e fazer alguma atividade proposta, ou que pensavamos em conjunto e, essas ocasioes, se convertiam em historias de sua vida. Depois de algumas visitas, dona A. comecou a nos oferecer lanche da tarde, como forma de demonstrar o vinculo criado, nesses momentos, sentavamos na cozinha e passavamos a tarde inteira conversando. Conclusoes: Pode-se perceber a importância da interdisciplinaridade, pois essa forma humanizada de atuar nos abriu as possibilidades de intervencao junto ao paciente. Perceber a forma como o vinculo foi criado nos faz acreditar cada vez mais nessa proposta de atuacao.

The aim of this article is to demonstrate the negotiations and disputes between different kinds of knowledge and power in the history of the Brazilian National Policy for Comprehensive Men's Healthcare based on the creation in 2008 of the Technical Area for Men's Health within the Ministry of Health's Department of Strategic Programs. We observed the Brazilian Society of Urology's position as the policy was being drawn up, including the discourse adopted, based on interviews held with managers from the Ministry of Health and the assistant representative of the United Nations Population Fund in Brazil. We analyzed the visibility of the male body in signs of resistance to the interventions of biopower in the expression of the right to health.

Nonarteritic anterior ischemic optic neuropathy (NA-AION) is the most common nonglaucomatous optic neuropathy in adults over 50 years of age. It is usually related to cardiovascular risk factors. The primary objective of this study was to evaluate choroidal thickness in patients with chronic NA-AION, and the secondary objective was to evaluate macular thickness in these patients. This cross-sectional study compared two groups: group 1 included 20 eyes of 20 patients with chronic NA-AION, and group 2 included 31 eyes of 31 healthy controls. In both groups, the choroidal thickness was measured using the enhanced depth imaging program of Heidelberg Spectralis® optical coherence tomography (Heidelberg Engineering, Heidelberg, Germany). The macular thickness was also measured using the automatic software of the same device. The mean follow-up time after NA-AION in group 1 was 57.17 ± 26.92 months. The mean choroidal thickness of the posterior pole was 244.38 ± 61.03 µm in group 1 and 214.18 ± 65.97 µm in group 2 (p = 0.004). The mean macular thickness was higher in group 2. Macular thickness is reduced in eyes that had an episode of NA-AION, whereas choroidal thickness is generally higher in these eyes when compared with normal eyes. The increase in choroidal thickness may be due to a local dysfunction in vascular autoregulatory mechanisms, which may predispose to ischemic phenomena. info:eu-repo/semantics/publishedVersion

Wild rodents (n=248) were trapped in two ecologically distinct sites at El Cielo Biosphere Reserve in the state of Tamaulipas, Mexico, during the summer of 2003. Samples from 199 individuals were tested for Hantavirus antibodies by an indirect enzyme-linked immunosorbent assay (ELISA). Hantavirus antibodies to recombinant Sin Nombre virus nucleocapsid protein were found in seven rodents (3.5%) of a single species, Peromyscus levipes. Antibody-positive rodents were found only in the Cloud Forest site, which had lower rodent species diversity than the Tropical Subdecidous Forest site. Although the identity of the virus in P. levipes remains to be determined, our study provides further evidence that Hantavirus antibody-positive individuals are prevalent in the rodent fauna of Mexico. This is the first survey for Hantavirus antibodies in the rodent fauna of Tamaulipas and the first report of P. levipes as a potential host for a Hantavirus.

Se determinó la distribución geográfica de los roedores identificados como reservorios del virus Sin Nombre y otros posibles hantavirus en México, causante del síndrome pulmonar por hantavirus (SPH). Ante la ausencia de casos de SPH documentados en México, este estudio pretende identificar posibles regiones de riesgo, considerando la distribución geográfica de los roedores reservorios. Se modeló el nicho ecológico de las especies de roedores reservorios del virus, y se proyectó en mapas para estimar distribuciones potenciales, usando localidades de colecta, mapas ambientales digitales, el algoritmo genético de cómputo GARP (Genetic Algorithm for Rule-set Prediction, por sus siglas en inglés) y un sistema de información geográfico. Se incluyeron distribuciones potenciales de tres especies conocidas como reservorios importantes de hantavirus en Estados Unidos, cuatro especies de roedores que se consideran reservorios potenciales del virus en México y de todas las demás especies del género Peromyscus. Las localidades geográficas de los casos de SPH detectados en humanos en los Estados Unidos coincidieron de forma significativamente mayor que en un modelo al azar, con las distribuciones potenciales de los tres roedores reservorios. En México, los roedores reservorios y los roedores potencialmente reservorios, cubren extensas zonas geográficas, identificándose amplias regiones de posible riesgo de transmisión de hantavirus. La población potencialmente expuesta a la infección, considerando las características de vivienda rural y la distribución potencial de especies de roedores reservorios del virus, se estimó entre 650,000 y 1’750,000 personas. La coincidencia geográfica significativa entre la distribución de roedores reservorios con los casos de SPH reportados en los Estados Unidos, sugiere que la distribución de los roedores reservorios se correlaciona con áreas de riesgo de SPH. Ante la similitud entre México y las regiones de riesgo en los Estados Unidos respecto a sus condiciones biológicas, ecológicas y sociales propicias para la transmisión de SPH, predecimos que (1) en México se detectarán casos de SPH en amplias zonas geográficas, las cuales coinciden con las distribuciones de roedores reservorios y, (2) se va a registrar una mayor tasa de transmisión de SPH en México que en los Estados Unidos.