Síndrome de insuficiência androgênica: critérios diagnósticos e terapêuticos

A síndrome da insuficiência androgênica na mulher (SIA) desperta, mesmo nos dias atuais, muitas discussões e encerra muitas controvérsias. Sabe-se, no entanto, que os níveis plasmáticos de testosterona declinam progressivamente ao longo do período reprodutivo. Conceitua-se a SIA como o conjunto de sintomas clínicos, a presença de biodisponibilidade diminuída de testosterona e os níveis normais de estrogênios. Entre os principais sintomas, citam-se o comprometimento do bem-estar, o humor disfórico, a fadiga sem causa aparente, o comprometimento do desejo sexual, o emagrecimento e a instabilidade vasomotora em mulheres pós-menopáusicas sob terapêutica estrogênica. Esses sintomas, no entanto, são potencialmente atribuíveis a diferentes etiologias e dificultam o correto diagnóstico na maioria dos casos, ainda que ele seja lembrado com freqüência em pacientes que se submetem à ooforectomia bilateral. O diagnóstico da SIA parece ser essencialmente clínico, não havendo a necessidade das dosagens laboratoriais para a sua comprovação. Não se deve indicar a terapêutica androgênica (TA) em pacientes que não estejam adequadamente estrogenizadas. Considera-se a testosterona o hormônio ideal para a TA. As pacientes com sintomas sugestivos de SIA, excluídas outras causas identificáveis, especialmente se pós-menopáusicas, são candidatas à TA. Não existem dados de segurança sobre a TA em usuárias em longo prazo. A via transdérmica - através de adesivos, cremes e gel - parece ser preferível à oral.

Culturally-sensitive complaints of depressions and anxieties in women

Background: Current classifications of Mental Disorders are centered on Westernized concepts and constructs. Cross-cultural sensitivity emphasizes culturally-appropriate translations of symptoms and questions, assuming that concepts and constructs are applicable.Methods: Groups and individual psychiatrists from various cultures from Asia, Latin America, North Africa and Eastern Europe prepared descriptions of main symptoms and complaints of treatment-seeking women in their cultures, which are interpreted by clinicians as a manifestation of a clinically-relevant dysphoric disorder. They also transliterated the expressions of DSM IV criteria of main dysphoric disorders in their cultures.Results: In many non-western cultures the symptoms and constructs that are interpreted and treated as dysphoric disorders are mostly somatic and are different from the Western-centered DSM or ICD systems. In many cases the DSM and ICD criteria of depression and anxieties are not even acknowledged by patients.Limitations: the descriptive approach reported here is a preliminary step which involved local but Westernized clinicians-investigators following a biomedical thinking. It should be followed by a more systematic-comprehensive surveys in each culture.Conclusions: Westernized concepts and constructs of mental order and disorders are not necessarily universally applicable. Culturallysensitive phenomena, treatments and treatment responses may be diversified. Attempts at their cross-cultural harmonization should take into consideration complex interactional multi-dimensional processes. (c) 2006 Elsevier B.V. All rights reserved.

Imaginário e envelhecimento: imagens simbólicas de três nonagenários

Ensaio de hermenêutica sobre as imagens simbólicas de nonagenários com a finalidade de investigar as estruturas do imaginário prevalentes e suas organizações psíquicas. Por meio de entrevistas semanais abertas, foram coligidas estórias, grafismos, sonhos, devaneios e lembranças dos anciões. O material foi analisado analisado segundo a teoria do imaginário de Gilbert Durand, que propõe uma interpretação não pulsional do símbolo. Os critérios de amostragem foram: faixa etária acima de 90 anos, ausência de um quadro de demência senil arteriosclerótica (serem clinicamente saudáveis), atividade social e participação voluntária. Os resultados indicam ausência de uma estrutura do imaginário recorrente, presença de uma exuberante imaginação simbólica, permeabilidade entre conteúdos da memória e imaginação, além de criatividade e vívidos processos afetivos.

Transtorno bipolar do humor e gênero

Although the bipolar disorder (BD) occurs almost with the same frequency in both genders, the phenomenology and the outcome of the illness differ between them. Nevertheless, there is evidence that women with BD show, more than men, delayed beginning, especially in their fifth decade, more rapid cycling outcome, more depressive episodes, more dysphoric mania, more mixed states and more BD type II. Even so, the findings are not always consistent. Although the risk of comorbidities in BD includes, for both the sorts, excessive alcoholic consumption and drugs, bipolar men would have greater probability of being alcohol dependent, of not seeking treatment and of committing suicide. Suggested hypotheses to explain such differences vary from those centered in cultural or psychological aspects to those that focus on the steroids hormones, and other hormones such as cortisol, thyroid hormones and even on the cerebral anatomy. The reproductive cycle (menstrual cycle, pregnancy and menopause) influences on the BD phenomenology and its relevance to the therapeutical options in the treatment of the BD in women are presented in the last part of this review. Further investigations must to be done in order to clarify this controversy. However, up to now the data indicate that estrogen therapy is not to be primarily indicated to prevent depression, Alzheimer disease or cognition impairment.

Cursos de geologia: expansão, interiorização e consolidação do ensino de geologia no brasil

A short time after the creation of the first Geology courses in Brazil (in 1957 with the pioneers in the University of São Paulo and in the Federal Universities of Ouro Preto, Pernambuco and Rio Grande do Sul, and then in the following year in the Federal Universities of Bahia and Rio de Janeiro), there arose other initiatives that spread almost twenty Geology courses throughout Brazil. In addition to expanding the Geology teaching in the South, Southeast and Northeast regions, these initiatives succeeded in allowing access to geological education for the population in the North and Central-west of Brazil. In the 1960s, the courses in the Federal University of Para in Belém (1964), University of Brasilia (1965) and São Paulo State University in Rio Claro (1969) were implanted. In the following decade, the courses in the Federal Rural University of Rio de Janeiro in Seropédica (1970), the Federal University of Ceará in Fortaleza (1970), the University of Rio dos Sinos in São Leopoldo (1973), the Federal University of Paraná in Curitiba (1973), the Federal University of Minas Gerais in Belo Horizonte (1973), the Federal University of Amazonas in Manaus (1976), the Federal University of Mato Grosso in Cuiabá (1976), the Federal University of Rio Grande do Norte in Natal (1976), and the State University of Rio de Janeiro in Rio de Janeiro (1977) were all created. At the close of the twentieth century, the course was implanted in the State University of Campinas (1998). Now, at the beginning of the twenty-first century, new Geology courses are being implanted, accentuating the movement inland of Geology teaching in Brazil. The Federal University of Pará began a new course in its campus in Marabá in the south-east of Pará and the Federal University of Bahia implanted a new course in its campus in Barreiras in the west of Bahia. Finally, the Federal Universities of Sergipe, Espírito Santo and Roraima commenced Geology courses in Aracaju, Alegre and Boa Vista, respectively. This chapter will present the synthesis of the Geology courses which, over the last decades of the twentieth century, contributed to the expansion of Geology teaching in the country, taking it to every region and giving opportunities to a large number of Brazilian citizens to realize their dreams and tread the paths of their professional vocation.

Métodos de avaliação da eficácia dos tratamentos para a dor.

Pain is a subjective condition and, thus, difficult to measure. The best tools to assess pain are the pain evaluation questionnaires, which provide either diagnostic, pain evolution or pain intensity information. To provide information which could help differentiate between nociceptive pain and neuropathic pain is one of the most important functions of these questionnaires. The questionnaires can measure pain intensity, quality of life, or sleep quality. Quality of life and sleep are two really important characteristics to assess the pain impact on patients' life. Pain intensity assessing questionnaires combine physical evaluations with questions, providing information either from the patient sensations or clinical assessment of pain manifestations as well as the underlying biological mechanisms (such as hyperalgesia or allodynia). For example, the Pain Detect questionnaire has two parts: the patient form (intuitive, with pictures and easy understandable) and the physician form. Thus, in this questionnaire, subjective information is provided by the patient and the objective one is provided by the physician. Other pain intensity questionnaires are NPSI, DN4, LANSS or StEP. Quality of life questionnaires are versatile (can be used in different pathologies). These questionnaires include functional self-evaluation questions, and other ones associated to physical and mental health. Two of such quality of life questionnaires are SF-36 and NHP. Sleep evaluation questionnaires include quantitative features such as the number of sleep interruptions, sleep latency or sleep duration as well as qualitative characteristics such as rest sensation, mood and dreams. One of the most used sleep evaluation questionnaires is PSQI, which includes patient questions and bed-partner questions, providing information from two points of view. Copyright 2009 Prous Science, S.A.U. or its licensors. All rights reserved.

Students' foregrounds: Hope, despair, uncertainty

A foreground is formed through the possibilities, tendencies, propensities, obstructions, barriers, hindrances, et cetera, which his or her context provides for a person. Simultaneously, a foreground is formed through the person's interpretations of these possibilities, tendencies, propensities, obstructions, barriers, hindrances. A foreground is a fragmented, partial, and inconsistent constellation of bits and pieces of aspirations, hopes, and frustrations. It might be both promising and frightening; it is always being rebuilt and restructured. Foregrounds are multiple as one person might see very different possibilities; at the same time they are collective and established through processes of communication. In this article educational meaning is discussed in terms of relationships between the students' foregrounds and activities in the classroom. I illustrate how students' dreams might be kept in cages, and how this has implications for how they engage or do not engage in learning processes. I investigate how a foreground might be ruined, and in what sense a ruined foreground might turn into a learning obstacle. Finally, I discuss processes of inclusion and exclusion with reference to the notion of foreground. © 2012. The Authors.

Rowapari Danho're: sonhar e pegar cantos no xamanismo a'uwe

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Arte, vida e formação de professores

Pós-graduação em Artes - IA

O 'Grupo Tapir'e a pintura de casarios (1960-1980)

Pós-graduação em Artes - IA

A figura humana fragmentada na pintura: Tiradentes esquartejado em Pedro Américo e Adriana Varejão

Pós-graduação em Artes - IA

Experiências da precarização e precariedade do trabalho bancário: um enfoque sobre as narrativas de vida e trabalho do antigo e do novo bancário do Bradesco

Pós-graduação em Ciências Sociais - FFC

Videoclipe 2.0: interatividade e regimes de interação na era digital

Pós-graduação em Comunicação - FAAC

Deusa das noites: personagens (des)veladas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Máscara e representação no livro do Desassossego

Pós-graduação em Estudos Literários - FCLAR