Abstract Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.

Objective: To evaluate the association between childhood trauma (CT) and serum levels of brain-derived neurotrophic factor (BDNF) and thiobarbituric acid-reactive substances (TBARS) during crack-cocaine withdrawal. Method: Thirty-three male crack-cocaine users were recruited at admission to a public addiction treatment unit. Serum BDNF and TBARS levels were evaluated at intake and discharge. Information about drug use was assessed by the Addiction Severity Index-6th Version (ASI-6); CT was reported throughout the Childhood Trauma Questionnaire (CTQ). CTQ scores were calculated based on a latent analysis model that divided the sample into low-, medium-, and high-level trauma groups. Results: There was a significant increase in BDNF levels from admission to discharge, which did not differ across CT subgroups. For TBARS levels, we found a significant time vs. trauma interaction (F2,28 = 6.357, p = 0.005,ηp 2 = 0.312). In participants with low trauma level, TBARS decreased, while in those with a high trauma level, TBARS increased during early withdrawal. Conclusion: TBARS levels showed opposite patterns of change in crack-cocaine withdrawal according to baseline CT. These results suggest that CT could be associated with more severe neurological impairment during withdrawal.

Objectives: To compare levels of a marker of lipid peroxidation (thiobarbituric acid reactive substances, TBARS) and brain-derived neurotrophic factor (BDNF) in umbilical cord blood (UCB) between newborns exposed to crack/cocaine in utero (exposed newborns [EN], n=57) and non-exposed newborns (NEN, n=99), as well as in maternal peripheral blood at delivery. Methods: This was a cross-sectional study. Potential confounders, including perinatal parameters, psychopathology, and use of other substances, were assessed. Results: After adjusting for potential confounders, adjusted mean BDNF was significantly higher in EN (3.86 ng/mL, 95% confidence interval [95%CI] 2.29-5.43) than in NEN (0.85 ng/mL, 95%CI 0.47-1.23; p < 0.001; Cohen effect size: 1.12), and significantly lower in crack/cocaine mothers than in control mothers (4.03 ng/mL, 95%CI 2.87-5.18 vs. 6.67 ng/mL, 95%CI 5.60-7.74; p = 0.006). The adjusted mean TBARS level was significantly lower in EN (63.97 µM MDA, 95%CI 39.43-88.50) than NEN (177.04 µM MDA, 95%CI 140.93-213.14; p < 0.001; effect size = 0.84), with no difference between mother groups (p = 0.86). Conclusions: The changes in TBARS levels observed in EN suggest that fetuses exposed to cocaine mobilize endogenous antioxidant routes since very early stages of development. The increase in BDNF levels in EN might indicate changes in fetal development, whereas the changes in BDNF levels in mothers provide evidence of the complex metabolic processes involved in drug use during pregnancy.

Resumo Objetivo: Descrever a história clínica de paciente com diagnóstico pré-natal de shunt portossistêmico, condição rara na espécie humana. Descrição do caso: Recém-nascido do sexo feminino internada aos 17 dias para investigação de suspeita diagnóstica de shunt portossistêmico, aventada na ecografia obstétrica. A hipótese foi confirmada após angiotomografia do abdome e ecodoppler hepático. Outros exames, como ecocardiograma e eletroencefalograma, foram feitos para investigação de possíveis comorbidades ou complicações associadas e tiveram resultados normais. Optou-se por tratamento conservador do shunt, já que não havia quaisquer complicações relacionadas à doença e tratava-se de shunt intra-hepático, que pode fechar espontaneamente até os dois anos de idade. Comentários: O shunt portossistêmico pode levar a diversas complicações, como encefalopatia hepática, hipergalactosemia, tumores hepáticos e síndrome hepatopulmonar. A maioria dos diagnósticos é feita a partir de um mês de vida, após tais complicações ocorrerem. O diagnóstico pré-natal dessa paciente possibilitou maior segurança para o manejo do quadro, bem como um acompanhamento periódico que permite antecipar possíveis complicações e adotar conduta intervencionista, se necessário.

Abstract Objective: To report a patient with prenatal diagnosis of portosystemic shunt; a rare condition in humans. Case description: 17-Day-old female infant admitted for investigation of suspected diagnosis of portosystemic shunt, presumed in obstetric ultrasound. The hypothesis was confirmed after abdominal angiography and liver Doppler. Other tests such as echocardiography and electroencephalogram were performed to investigate possible co-morbidities or associated complications, and were normal. We chose conservative shunt treatment, as there were no disease-related complications and this was intrahepatic shunt, which could close spontaneously by the age of 2 years. Comments: Portosystemic shunt can lead to various complications such as hepatic encephalopathy, hypergalactosemia, liver tumors, and hepatopulmonary syndrome. Most diagnoses are done after one month of age, after such complications occur. The prenatal diagnosis of this patient provided greater security for the clinical picture management, as well as regular monitoring, which allows the anticipation of possible complications and perform interventional procedures when needed.

Introdução A exposição pré-natal à cocaína está associada a problemas neurocomportamentais durante a infância e adolescência. A ativação precoce da resposta inflamatória pode contribuir para tais alterações. Nosso objetivo foi comparar marcadores inflamatórios (IL-6 e IL-10) no sangue do cordão umbilical e no sangue periférico materno na hora do parto, entre recém-nascidos expostos ao crack intraútero e recém-nascidos não expostos. Métodos Neste estudo transversal, 57 recém-nascidos expostos ao crack intraútero (RNE) e 99 recém-nascidos não expostos (RNNE) foram comparados quanto aos níveis de IL-6 e IL-10. Dados sociodemográficos e perinatais, psicopatologia materna, consumo de nicotina e outras substâncias foram sistematicamente coletados em casos e controles. Resultados Após o ajuste para potenciais confundidores, a média de IL-6 foi significativamente maior nos RNE em comparação aos RNNE [10.208,54, intervalo de confiança (IC95%) 1.328,54-19.088,55 versus2.323,03, IC95% 1.484,64-3.161,21; p = 0,007; modelo linear generalizado (MLG)]. A média ajustada de IL-10 foi significativamente maior nos RNE do que nos RNNE (432,2189, IC95% 51,44-812,88 versus 75,52, IC95% 5,64-145,39, p = 0,014; MLG). Medidas pós-parto ajustadas de IL-6 foram significativamente maiores nas mães que usaram de crack/cocaína (25.160,05, IC95% 10.958,15-39.361,99 versus 8.902,14, IC95% 5.774,97-12.029,32; p = 0,007; MLG), sem diferenças significativas para IL-10. Não houve correlação entre níveis maternos e neonatais de citocinas (teste de Spearman, p ≥ 0,28 para todas as medidas). Conclusões IL-6 e IL-10 podem ser biomarcadores precoces da exposição pré-natal a cocaína em recém-nascidos. Esses resultados podem ajudar a elucidar as vias neurobiológicas subjacentes a alterações do desenvolvimento e aumentar a gama de possibilidades para intervenção precoce.

Introduction Prenatal cocaine exposure (PCE) is associated with neurobehavioral problems during childhood and adolescence. Early activation of the inflammatory response may contribute to such changes. Our aim was to compare inflammatory markers (IL-6 and IL-10) both in umbilical cord blood and in maternal peripheral blood at delivery between newborns with history of crack/cocaine exposure in utero and non-exposed newborns. Methods In this cross-sectional study, 57 newborns with a history of crack/cocaine exposure in utero (EN) and 99 non-exposed newborns (NEN) were compared for IL-6 and IL-10 levels. Sociodemographic and perinatal data, maternal psychopathology, consumption of nicotine and other substances were systematically collected in cases and controls. Results After adjusting for potential confounders, mean IL-6 was significantly higher in EN than in NEN (10,208.54, 95% confidence interval [95%CI] 1,328.54-19,088.55 vs. 2,323.03, 95%CI 1,484.64-3,161.21; p = 0.007; generalized linear model [GLM]). Mean IL-10 was also significantly higher in EN than in NEN (432.22, 95%CI 51.44-812.88 vs. 75.52, 95%CI 5.64-145.39, p = 0.014; GLM). Adjusted postpartum measures of IL-6 were significantly higher in mothers with a history of crack/cocaine use (25,160.05, 95%CI 10,958.15-39,361.99 vs. 8,902.14, 95%CI 5,774.97-12,029.32; p = 0.007; GLM), with no significant differences for IL-10. There was no correlation between maternal and neonatal cytokine levels (Spearman test, p ≥ 0.28 for all measures). Conclusions IL-6 and IL-10 might be early biomarkers of PCE in newborns. These findings could help to elucidate neurobiological pathways underlying neurodevelopmental changes and broaden the range of possibilities for early intervention.

Objective: In the present study, we aimed to examine the effects of repeated D-amphetamine (AMPH) exposure, a well-accepted animal model of acute mania in bipolar disorder (BD), and histone deacetylase (HDAC) inhibitors on locomotor behavior and HDAC activity in the prefrontal cortex (PFC) and peripheral blood mononuclear cells (PBMCs) of rats. Moreover, we aimed to assess brain-derived neurotrophic factor (BDNF) protein and mRNA levels in these samples. Methods: We treated adult male Wistar rats with 2 mg/kg AMPH or saline intraperitoneally for 14 days. Between the 8th and 14th days, rats also received 47.5 mg/kg lithium (Li), 200 mg/kg sodium valproate (VPT), 2 mg/kg sodium butyrate (SB), or saline. We evaluated locomotor activity in the open-field task and assessed HDAC activity in the PFC and PBMCs, and BDNF levels in the PFC and plasma. Results: AMPH significantly increased locomotor activity, which was reversed by all drugs. This hyperactivity was associated with increased HDAC activity in the PFC, which was partially reversed by Li, VPT, and SB. No differences were found in BDNF levels. Conclusion: Repeated AMPH administration increases HDAC activity in the PFC without altering BDNF levels. The partial reversal of HDAC increase by Li, VPT, and SB may account for their ability to reverse AMPH-induced hyperactivity.

OB JETIVO: Analisar as informações contidas nos pareceres dos Conselhos de Alimentação Escolar de todo o Brasil sobre a execução do Programa Nacional de Alimentação Escolar. MÉTODOS: Estudo quantiqualitativo que analisa 4.256 pareceres na fase quantitativa e 2.299 na qualitativa, referentes ao ano de 2009. Também foram analisados 4.135 Demonstrativos Sintéticos Anuais, que tratam da execução físico-financeira do Programa. Na fase qualitativa, investigou-se o conteúdo dos pareceres por meio da técnica de análise de conteúdo. RESULTADOS: A análise quantitativa mostrou que, em 24,4% (n=1.009) das localidades, não houve contrapartida da entidade executora na compra de gêneros alimentícios, e a maioria dos pareceres (78,7%, n=3.348) apresentou assinatura de apenas um conselheiro. A análise qualitativa dos pareceres apontou que 64,5% (n=1.483) das localidades brasileiras adotavam a gestão centralizada e que 23,9% (n=549) das entidades executoras investiam recursos próprios na compra de gêneros alimentícios. A modalidade de licitação mais frequente foi o pregão (32,7%, n=751), e apenas 4,9% (n=112) dos pareceres afirmaram realizar a compra de alimentos oriundos da agricultura familiar. Entre as atribuições dos conselhos, ressaltaram-se a análise da prestação de contas (59,1%, n=1.359) e o acompanhamento da elaboração dos cardápios (36,5%, n=838) como sendo as mais frequentes. CONCLUSÃO: A execução do Programa Nacional de Alimentação Escolar em suas diferentes vertentes foi evidenciada pela análise dos pareceres dos Conselhos de Alimentação Escolar e dos Demonstrativos Sintéticos Anuais, caracterizando-os como instrumentos de monitoramento do Programa. Os achados servem de subsídio para estratégias de melhoria da qualidade da alimentação escolar e fortalecimento do Conselho de Alimentação Escolar.

OBJECTIVE: This study analyzed the conclusive reports of the Brazilian School Food Council on the implementation of the National School Food Program. METHODS: This quantitative and qualitative study analyzed 4,256 reports in the quantitative phase and 2,299 reports in the qualitative phase. The reports were issued in 2009. A total of 4,135 annual synthetic statements on physical and financial implementation of the Program were also analyzed. The reports were analyzed in the qualitative phase by content analysis. RESULTS: Quantitative analysis showed that the implementing party provided no consideration for food purchase in 24.4% (n=1,009) of the locations, and 78.7% (n=3,348) of the reports were signed by a single council member. Qualitative analysis of the reports showed that 64.5% (n=1,483) of the locations were under a central management and that 23.9% (n=549) of the implementing parties purchased food with their own funds. Most auctions were open ascending price auctions (32.7%, n=751) and only 4.9% (n=112) of the reports disclosed buying foods from family farms. The main council responsibilities are analyzing the expense reports (59.1%, n=1,359) and following menu development (36.5%, n=838). CONCLUSION: Execution of the different parts of the National School Food Program was evidenced by analyzing the School Food Council reports and annual synthetic statements, which characterized them as program-monitoring tools. The findings may help to support the strategies used for improving the quality of school food and strengthening the School Food Council.

Na psicanálise francesa, principalmente com Lacan, o conceito de falta passou a ser de grande importância. Ao que, então, perguntamos: o que é a falta? E quando esta falta? O que acontece? O que acontece quando o não especularizável não está excluído, se fazendo, assim, especular? Quando Perseu vai ao encontro de Medusa, guiando-se por sua imagem refletida em um espelho de bronze polido, segurado por Atena, como pôde este herói defender-se de Medusa? Qual foi a forma encontrada por ele para se defender da presença do objeto que introduz a dimensão do real nu?

According to French psychoanalysis, specially with Lacan, the concept of lack turned to be an important formulation. But what is the concept of lack? What happens when the non-specularizable is not excluded and therefore turns into something specular? When Perseus runs into Medusa, guided by a bronze shield held by Atena, how did this hero defend himself from Medusa? What did he do in order to defend himself from the presence of the object that introduces the dimension of the real?

The advent of AIDS for over 25 years in epidemiological setting in the world brings the discussion about sexual behavior, beliefs and values. Among the models and theories that help in understanding the risk exposure to HIV, is in the Health Belief Model. The model emphasizes that the conduct in relation to a threat to their health, is dependent on four variables: perception of susceptibility, severity, perceived benefits and barriers. The study aims to identify the perception of vulnerability of adolescent males, of the IST/HIV. Qualitative study conducted in a public school in Fortaleza-CE. The informants were 16 adolescents aged between 14 and 18 years old. Data collection occurred in May and June of 2008, through semi-structured interview, based on the variables in the model proposed. The adolescents identified more benefits than barriers as regards the prevention of IST. For the perceived benefits are associated with the use of condoms and to improve the dialogue between sexual partners. Is important the nurse encouraging preventive measures and Health Education among the adolescents, to encourage reflection on the vulnerability to IST/HIV and its impact on quality of life.

La aparición del SIDA hace más de 25 años en el escenario epidemiológico mundial, lleva la discusión el comportamiento sexual, creencias y valores. Entre los modelos y teorías que ayudan a comprender el riesgo de exposición al HIV, se encuentra el Modelo de Creencias en Salud. El modelo hace hincapié en que la conducta en relación con una amenaza a su salud, depende de cuatro variables: percepción de la susceptibilidad, gravedad, percepción de los beneficios y barreras. El estudio tuvo como objetivo identificar la percepción de vulnerabilidad de los adolescentes varones, acerca de las DST/HIV. Estudio cualitativo que tuvo como escenario una escuela pública en Fortaleza-CE. Los informantes fueron 16 adolescentes de edades comprendidas entre 14 y 18 años. La recolección de datos ocurrió entre mayo y junio de 2008, a través de entrevista semi-estructurada, basada en las variables propuestas en el modelo. Los adolescentes han identificado más beneficios que barreras en lo que respecta a la prevención de DST. Con relación a los beneficios percibidos, son asociados con el uso de preservativo y aun las mejorías en el diálogo entre parejas sexuales. Es importante que la enfermera fomente medidas preventivas y de Educación en Salud entre los adolescentes que favorezcan la reflexión sobre la vulnerabilidad a las DST/HIV y su impacto sobre la calidad de vida.

O advento da AIDS há mais de 25 anos no cenário epidemiológico mundial, traz consigo a discussão acerca de comportamentos sexuais, crenças e valores. Dentre os modelos e teorias, que auxiliam na compreensão da exposição ao risco para o HIV, destaca-se o Modelo de Crenças em Saúde. O modelo enfatiza que o comportamento em relação a uma ameaça à sua saúde, é dependente de quatro variáveis: percepção de susceptibilidade; de severidade; benefícios e barreiras percebidas. Objetivou-se identificar a percepção de vulnerabilidade de adolescentes do sexo masculino, acerca das DST/HIV. Estudo qualitativo teve como cenário uma escola pública em Fortaleza-CE. Os informantes foram 16 adolescentes com idade entre 14 e 18 anos. A coleta de informações ocorreu em maio e junho de 2008, através de entrevista semi-estruturada, baseada nas variáveis propostas no modelo. Os adolescentes identificam mais benefícios do que barreiras no que concerne à prevenção das DST. Em relação aos benefícios percebidos, são associados ao uso de preservativo e ainda a melhorias no diálogo entre parceiros sexuais. É mister que o Enfermeiro fomente medidas preventivas e de Educação em Saúde junto aos adolescentes, que favoreçam a reflexão acerca da vulnerabilidade às DST/HIV e seu impacto na qualidade de vida.

This study addressed the use of educational technology as a strategy for health education among the teenagers in the school. Data collection occurred between April and May of 2007 in a public school in the city of Fortaleza-CE, through a cycle of four educational workshops held with 30 teenagers. The workshops had the intent to promote discussion / action from the participants on the themes: sexuality, gender, STD/AIDS and contraceptive methods. Study of research-action type of qualitative approach, backed by the pedagogical model of Paulo Freire. The results showed gaps in knowledge about the ways to infection by STDs and appropriate use of contraceptive methods. Another relates to issues of gender that seem to influence the quality of life of young people in the study. The use of educational technologies could arouse among adolescents, a rethink on the experience of sexual and reproductive health from the perceived vulnerabilities. According to the findings recommend that the activities of STD/AIDS prevention within the school, break with the vision heterossexist, normative and biological. In this context, the nurse should produce/readjust new technologies that support the educational process in health education, valuing the skills and aspirations of adolescents.

Este estudio se dirigió a la utilización de la tecnología educativa como una estrategia de educación para la salud entre los adolescentes en la escuela. El estudio se llevó a cabo entre los meses de abril y mayo de 2007 en una escuela pública en la ciudad de Fortaleza-CE, a través de un ciclo de cuatro talleres educativos con 30 adolescentes. Los talleres tuvieron la intención de promover el debate y acción de los participantes sobre los temas: sexualidad, género, ETS/sida y los métodos anticonceptivos. Estudio de investigación-acción tipo de enfoque cualitativo, respaldado por el modelo pedagógico de Paulo Freire. Los resultados mostraron lagunas en los conocimientos acerca de las maneras a la infección por enfermedades de transmisión sexual y el uso adecuado de métodos anticonceptivos. Otro se refiere a las cuestiones de género que parecen influir en la calidad de vida de los jóvenes en el estudio. El uso de tecnologías de la educación podría despertar entre los adolescentes, un replanteamiento de la experiencia de la salud sexual y reproductiva de la percepción de vulnerabilidad. Según las conclusiones recomiendan que las actividades de ETS/SIDA dentro de la escuela, romper con la visión heterossexista, normativo y biológicas. En este contexto, la enfermera debe producir/reajustar las nuevas tecnologías que apoyen el proceso educativo en la educación para la salud, la valoración de las aptitudes y las aspiraciones de los adolescentes.

O objetivo deste estudo é abordar o uso de tecnologias educativas como estratégia de educação em saúde junto a adolescentes no contexto escolar. A coleta de dados ocorreu entre abril e maio de 2007 em uma escola pública municipal na cidade de Fortaleza-CE, por meio de um ciclo de quatro oficinas educativas realizadas com 30 adolescentes. As oficinas tiveram o intuito promover a reflexão/ação junto aos participantes sobre as temáticas: sexualidade, gênero, DST/AIDS e métodos contraceptivos. Estudo do tipo pesquisa-ação, de abordagem qualitativa, apoiado no Modelo Pedagógico de Paulo Freire. Os resultados evidenciaram lacunas no conhecimento quanto às formas de infecção pelas DST e uso adequado de métodos contraceptivos. Outro dado refere-se às questões de gênero que parecem influenciar na qualidade de vida dos jovens do estudo. O uso de tecnologias educativas pôde despertar entre os adolescentes, um repensar sobre a vivência da saúde sexual e reprodutiva a partir das vulnerabilidades percebidas. Recomendamos a partir dos achados, que as atividades de prevenção às DST/AIDS no âmbito da escola, rompam com a visão heterossexista, normativa e biologicista. Nesse contexto, a Enfermeira deve produzir/readequar novas tecnologias educativas que favoreçam o processo educação em saúde, valorizando as habilidades e aspirações dos adolescentes.