CONHECIMENTOS E PREVENÇÃO DE DST/AIDS EM ADOLESCENTES

A Psicologia da Saúde vem se desdobrando para atender a demanda da saúde pública, principalmente sobre prevenção de doenças e promoção da saúde. No que se refere a epidemia da AIDS e outras doenças sexualmente transmissíveis, o adolescente tem sido o público mais vulnerável. A adolescência é considerada uma fase perturbada e perturbadora. Nesse período da vida o adolescente está mais sujeito à contaminação das DST/AIDS em razão da instabilidade emocional e sua postura frente a valores e padrões de conduta. Este estudo tem por objetivo descrever conhecimentos e comportamentos de proteção e risco de práticas sexuais de adolescentes; descrever dados sócio-econômicos e demográficos desses adolescentes, descrever o conhecimento dos adolescentes em relação as DST/AIDS e descrever os comportamentos de proteção e riscos a respeito das DST/AIDS. A população deste estudo foi constituída por 95 adolescentes de ambos os gêneros, com um predomínio do gênero masculino, faixa etária entre 14 e 21 anos e com renda familiar média de 4 (quatro) salários mínimos. Trata-se de pesquisa descritiva, para o qual utilizou-se um questionário de autopreenchimento composto por questões norteadas ao tema. A coleta de dados ocorreu em sala de aula no período noturno, de uma escola estadual do município de Guarulhos. Após o término do preenchimento do questionário, os adolescentes assistiram uma palestra de prevenção e orientação sobre DST/AIDS, onde elucidaram dúvidas. Os resultados demonstram 67,4% dos adolescentes, tanto o gênero feminino quanto o gênero masculino, tem dificuldades de definir o conceito de sexualidade e 84,2% sabem corretamente a definição de doenças sexualmente transmissíveis. A maioria dos adolescentes (67,4%) respondeu conhecer algum tipo de doença sexualmente transmissível, destacando-se aqui a AIDS e a gonorréia. O gênero masculino teve início da vida sexual aos 10 anos e o gênero feminino aos 13 anos, representando 53,7% com vida sexual ativa. Neste estudo 58,9% informam saber quais são os comportamentos de proteção, porém entre estes, apenas 55,8% utilizam o preservativo masculino (camisinha). Não há diferenças significativas quanto à modalidade de relacionamento e o uso constante do preservativo masculino. Verificou-se que 63,1% dos adolescentes obtém informações e conhecimentos sobre as DST/AIDS através dos profissionais da educação e da saúde. Portanto, a sala de aula passa a ser um fator de proteção. Esse estudo confirma que parte dos adolescentes tem conhecimento e informações sobre conceitos relativos as DST/AIDS, porém quanto às práticas para um comportamento de proteção frente às mesmas apresentam conhecimentos frágeis, gerando assim comportamentos de risco. Estas situações comprometem a tomada de comportamentos de proteção. Portanto, um programa contínuo da área da saúde e da educação dentro da escola que desenvolva atividades interativas a fim de transformar o comportamento do adolescente sobre informações e conhecimentos em consciência de comportamentos de proteção efetivas poderá melhorar essa relação entre ter o conhecimento e utilizá-lo na prática.(AU)

Reflecting on mirror mechanisms:motor resonance effects during action observation only present with low-intensity transcranial magnetic stimulation

Transcranial magnetic stimulation (TMS) studies indicate that the observation of other people's actions influences the excitability of the observer's motor system. Motor evoked potential (MEP) amplitudes typically increase in muscles which would be active during the execution of the observed action. This 'motor resonance' effect is thought to result from activity in mirror neuron regions, which enhance the excitability of the primary motor cortex (M1) via cortico-cortical pathways. The importance of TMS intensity has not yet been recognised in this area of research. Low-intensity TMS predominately activates corticospinal neurons indirectly, whereas high-intensity TMS can directly activate corticospinal axons. This indicates that motor resonance effects should be more prominent when using low-intensity TMS. A related issue is that TMS is typically applied over a single optimal scalp position (OSP) to simultaneously elicit MEPs from several muscles. Whether this confounds results, due to differences in the manner that TMS activates spatially separate cortical representations, has not yet been explored. In the current study, MEP amplitudes, resulting from single-pulse TMS applied over M1, were recorded from the first dorsal interosseous (FDI) and abductor digiti minimi (ADM) muscles during the observation of simple finger abductions. We tested if the TMS intensity (110% vs. 130% resting motor threshold) or stimulating position (FDI-OSP vs. ADM-OSP) influenced the magnitude of the motor resonance effects. Results showed that the MEP facilitation recorded in the FDI muscle during the observation of index-finger abductions was only detected using low-intensity TMS. In contrast, changes in the OSP had a negligible effect on the presence of motor resonance effects in either the FDI or ADM muscles. These findings support the hypothesis that MN activity enhances M1 excitability via cortico-cortical pathways and highlight a methodological framework by which the neural underpinnings of action observation can be further explored. © 2013 Loporto et al.

Highly sensitive refractive index sensor based on cascaded microfiber knots with Vernier effect

We propose and experimentally demonstrate a refractive index (RI) sensor based on cascaded microfiber knot resonators (CMKRs) with Vernier effect. Deriving from high proportional evanescent field of microfiber and spectrum magnification function of Vernier effect, the RI sensor shows high sensitivity as well as high detection resolution. By using the method named "Drawing-Knotting-Assembling (DKA)", a compact CMKRs is fabricated for experimental demonstration. With the assistance of Lorentz fitting algorithm on the transmission spectrum, sensitivity of 6523nm/RIU and detection resolution up to 1.533 x 10-7 RIU are obtained in the experiment which show good agreement with the numerical simulation. The proposed all-fiber RI sensor with high sensitivity, compact size and low cost can be widely used for chemical and biological detection, as well as the electronic/magnetic field measurement

Seafloor spreading magnetic anomaly isochron map compilation for the Weddell Sea and Scotia Sea

The deep sea sedimentary record is an archive of the pre-glacial to glacial development of Antarctica and changes in climate, tectonics and ocean circulation. Identification of the pre-glacial, transitional and full glacial components in the sedimentary record is necessary for ice sheet reconstruction and to build circum-Antarctic sediment thickness grids for past topography and bathymetry reconstructions, which constrain paleoclimate models. A ~3300 km long Weddell Sea to Scotia Sea transect consisting of multichannel seismic reflection data from various organisations, were used to interpret new horizons to define the initial basin-wide seismostratigraphy and to identify the pre-glacial to glacial components. We mapped seven main units of which three are in the inferred Cretaceous-Paleocene pre-glacial regime, one in the Eocene-Oligocene transitional regime and three units in the Miocene-Pleistocene full glacial climate regime. Sparse borehole data from ODP leg 113 and SHALDRIL constrain the ages of the upper three units. Compiled seafloor spreading magnetic anomalies constrain the basement ages and the hypothetical age model. In many cases, the new horizons and stratigraphy contradict the interpretations in local studies. Each seismic sedimentary unit and its associated base horizon are continuous and traceable for the entire transect length, but reflect a lateral change in age whilst representing the same deposition process. The up to 1240 m thick pre-glacial seismic units form a mound in the central Weddell Sea basin and, in conjunction with the eroded flank geometry, support the interpretation of a Cretaceous proto-Weddell Gyre. The base reflector of the transitional seismic unit, which marks the initial ice sheet advances to the outer shelf, has a lateral model age of 26.6-15.5 Ma from southeast to northwest. The Pliocene-Pleistocene glacial deposits reveals lower sedimentations rates, indicating a reduced sediment supply. Sedimentation rates for the pre-glacial, transitional and full glacial components are highest around the Antarctic Peninsula, indicating higher erosion and sediment supply of a younger basement. We interpret an Eocene East Antarctic Ice Sheet expansion, Oligocene grounding of the West Antarctic Ice Sheet and Early Miocene grounding of the Antarctic Peninsula Ice Sheet.

Fossil associations from the middle and upper Eocene strata of the Pamplona Basin and surrounding areas (Navarre, western Pyrenees)

Fossil associations from the middle and upper Eocene (Bartonian and Priabonian) sedimentary succession of the Pamplona Basin are described. This succession was accumulated in the western part of the South Pyrenean peripheral foreland basin and extends from deep-marine turbiditic (Ezkaba Sandstone Formation) to deltaic (Pamplona Marl, Ardanatz Sandstone and Ilundain Marl formations) and marginal marine deposits (Gendulain Formation). The micropalaeontological content is high. It is dominated by foraminifera, and common ostracods and other microfossils are also present. The fossil ichnoasssemblages include at least 23 ichnogenera and 28 ichnospecies indicative of Nereites, Cruziana, Glossifungites and ?Scoyenia-Mermia ichnofacies. Body macrofossils of 78 taxa corresponding to macroforaminifera, sponges, corals, bryozoans, brachiopods, annelids, molluscs, arthropods, echinoderms and vertebrates have been identified. Both the number of ichnotaxa and of species (e. g. bryozoans, molluscs and condrichthyans) may be considerably higher. Body fossil assemblages are comparable to those from the Eocene of the Nord Pyrenean area (Basque Coast), and also to those from the Eocene of the west-central and eastern part of South Pyrenean area (Aragon and Catalonia). At the European scale, the molluscs assemblages seem endemic from the Pyrenean area, although several Tethyan (Italy and Alps) and Northern elements (Paris basin and Normandy) have been recorded. Palaeontological data of studied sedimentary units fit well with the shallowing process that throughout the middle and late Eocene occurs in the area, according to the sedimentological and stratigraphical data.

The hypoxia that developed in a microtidal estuary following an extreme storm produced dramatic changes in the benthos

Runoff from an extreme storm on 22 March 2010 led, during the next 3 months, to the formation of a pronounced halocline and underlying hypoxia in the upper reaches of the microtidal Swan–Canning Estuary. Benthic macroinvertebrates were sampled between January 2010 and October 2011 at five sites along 10 km of this region. By mid-April, the number of species, total density, Simpson’s evenness index and taxonomic distinctness had declined markedly, crustaceans had disappeared and the densities of annelids and molluscs had declined slightly. These faunal attributes (except Simpson’s index) and species composition did not recover until after the end of the hypoxia. The survival of annelids and loss of crustaceans in this period reflects different sensitivities of these taxa to severe environmental stress. The results emphasise that microtidal estuaries with long residence times are highly vulnerable to the effects of environmental perturbations, particularly during warmer periods of the year.

The hypoxia that developed in a microtidal estuary following an extreme storm produced dramatic changes in the benthos

Runoff from an extreme storm on 22 March 2010 led, during the next 3 months, to the formation of a pronounced halocline and underlying hypoxia in the upper reaches of the microtidal Swan–Canning Estuary. Benthic macroinvertebrates were sampled between January 2010 and October 2011 at five sites along 10 km of this region. By mid-April, the number of species, total density, Simpson’s evenness index and taxonomic distinctness had declined markedly, crustaceans had disappeared and the densities of annelids and molluscs had declined slightly. These faunal attributes (except Simpson’s index) and species composition did not recover until after the end of the hypoxia. The survival of annelids and loss of crustaceans in this period reflects different sensitivities of these taxa to severe environmental stress. The results emphasise that microtidal estuaries with long residence times are highly vulnerable to the effects of environmental perturbations, particularly during warmer periods of the year.

Time-dependent Suppression of Oscillatory Power in Evolving Solar Magnetic Fields

Oscillation amplitudes are generally smaller within magnetically active regions like sunspots and plage when compared to their surroundings. Such magnetic features, when viewed in spatially resolved power maps, appear as regions of suppressed power due to reductions in the oscillation amplitudes. Employing high spatial- and temporal-resolution observations from the Dunn Solar Telescope (DST) in New Mexico, we study the power suppression in a region of evolving magnetic fields adjacent to a pore. By utilizing wavelet analysis, we study for the first time how the oscillatory properties in this region change as the magnetic field evolves with time. Image sequences taken in the blue continuum, G-band, Ca ii K, and Hα filters were used in this study. It is observed that the suppression found in the chromosphere occupies a relatively larger area, confirming previous findings. Also, the suppression is extended to structures directly connected to the magnetic region, and is found to get enhanced as the magnetic field strength increased with time. The dependence of the suppression on the magnetic field strength is greater at longer periods and higher formation heights. Furthermore, the dominant periodicity in the chromosphere was found to be anti-correlated with increases in the magnetic field strength.

Severe and Symptomatic Calcium Disorders Caused by Secondary Bone Disease in a Patient with a Thyroid Storm

A patient with Graves’ disease was admitted with a thyroid storm. She had severe hypercalcaemia caused by thyrotoxicosis. Treatment was complicated by vomiting and diarrhoea. With intravenous ondansetron, hydration and bisphosphonates, GI symptoms improved and oral thyreostatics could be started. This, combined with bisphosphonate administration, resulted in a mild hungry bone syndrome.

Immunologic Storm Simulating Systemic Lupus Erythematosus Following Parvovirus B19 Infection

Background: The appearance of symptoms compatible with systemic autoimmune diseases has been described in relation to several viral infections like HIV, cytomegalovirus and especially PVB19, depending on the evolution of the immunological condition of the host and their age. We present a young immunocompetent male patient, with clinical manifestations simulating systemic lupus erythematosus (SLE) with important activation of cytokines. Methods: For quantification of the different cytokines in plasma, a commercially available multiplex bead immunoassay, based on the Luminex platform (Cat # HSCYTO-60SK-08, Milliplex® MAP High Sensitivity, Millipore), was used according to the manufacturer’s instructions. All samples were run in duplicate and the data (mean fluorescence intensity) were analyzed using a Luminex reader. The mean concentration was calculated using a standard curve. Results: The clinical evolution was favourable without the need for any specific treatment, showing complete recovery after two months. Whilst the symptoms and viral charge were disappearing, the anti-DNA continued to increase and we demonstrate important activation of IL-10, IL-6 and TNFα cytokines as a result of a hyperstimulating response by an immunocompetent hyperfunctional system, which persists after clinical improvement. We should emphasize the behaviour of two cytokines: IL-12p70 and IL-2, which showed opposite tendencies. Conclusions: Viral infections, especially PVB19, can produce or simulate several autoimmune diseases as a hyperstimulation response from an immunocompetent hyperfunctional system. Consequently, a persistent increase of autoantobodies and important activation of cytokines, even after clinical improvement and seroconversion, can be demonstrated.

Cardiac magnetic resonance imaging in the diagnosis and determination of outcome of pulmonary hypertension

Pulmonary hypertension (PH) is a rare but serious condition that causes progressive right ventricular (RV) failure and death. PH may be idiopathic, associated with underlying connective-tissue disease or hypoxic lung disease, and is also increasingly being observed in the setting of heart failure with preserved ejection fraction (HFpEF). The management of PH has been revolutionised by the recent development of new disease-targeted therapies which are beneficial in pulmonary arterial hypertension (PAH), but can be potentially harmful in PH due to left heart disease, so accurate diagnosis and classification of patients is essential. These PAH therapies improve exercise capacity and pulmonary haemodynamics, but their overall effect on the right ventricle remains unclear. Current practice in the UK is to assess treatment response with 6-minute walk test and NYHA functional class, neither of which truly reflects RV function. Cardiac magnetic resonance (CMR) imaging has been established as the gold standard for the evaluation of right ventricular structure and function, but it also allows a non-invasive and accurate study of the left heart. The aims of this thesis were to investigate the use of CMR in the diagnosis of PH, in the assessment of treatment response, and in predicting survival in idiopathic and connective-tissue disease associated PAH. In Chapter 3, a left atrial volume (LAV) threshold of 43 ml/m2 measured with CMR was able to distinguish idiopathic PAH from PH due to HFpEF (sensitivity 97%, specificity 100%). In Chapter 4, disease-targeted PAH therapy resulted in significant improvements in RV and left ventricular ejection fraction (p<0.001 and p=0.0007, respectively), RV stroke volume index (p<0.0001), and left ventricular end-diastolic volume index (p=0.0015). These corresponded to observed improvements in functional class and exercise capacity, although correlation coefficients between Δ 6MWD and Δ RVEF or Δ LVEDV were low. Finally, in Chapter 5, one-year and three-year survival was worse in CTD-PAH (75% and 53%) than in IPAH (83% and 74%), despite similar baseline clinical characteristics, lung function, pulmonary haemodynamics and treatment. Baseline right ventricular stroke volume index was an independent predictor of survival in both conditions. The presence of LV systolic dysfunction was of prognostic significance in CTD-PAH but not IPAH, and a higher LAV was observed in CTD-PAH suggesting a potential contribution from LV diastolic dysfunction in this group.