RESUMEN En este artículo, los autores relatan el caso de un individuo que cometió el delito de homicidio y fue evaluado en peritaje psiquiátrico para el análisis de imputabilidad penal. Se le diagnosticó trastorno delirante con inimputabilidad penal, y se le aplicó una medida de seguridad, con internación en Hospital de Custodia y Tratamiento Psiquiátrico en Río de Janeiro, Brasil. Este caso ejemplifica la técnica para la aplicación del criterio biopsicológico según el Código de Proceso Penal brasileño.

ABSTRACT In this article, the authors report the case of a man who committed the crime of homicide and was evaluated for criminal liability in a psychiatric expert's report. He was diagnosed with delusional disorder and found not guilty. Security measures were applied and he was committed to a high-security psychiatric hospital in Rio de Janeiro, Brazil. This case presents the correct technique to apply the biopsychological criterion, according to the Brazilian Penal.

Abstract Neonatal herpes is a serious condition. Newborns can be contaminated in utero via transplacental hematogenic transmission, upon delivery (the most frequent route), or during the postnatal period (indirect transmission). Optimal management requires prompt and accurate recognition, particularly in newborns, in order to prevent complications. Acyclovir is the treatment of choice, but its implementation is often delayed while awaiting test results, such as PCR and serology. Cytology for diagnostic purposes is rarely used in dermatology, despite the quick and reliable results. We report a case of neonatal herpes caused by type 2 herpes simplex virus diagnosed by cytology.

Abstract: Syringocystadenoma papilliferum is a rare benign hamartomatous adnexal tumor of the apocrine or eccrine sweat glands. Most patients present a solitary lesion in the head and neck region. Presentation outside the head and neck region is even more uncommon. We present a case of Syringocystadenoma papilliferum with papulonodular lesion located on the vulva of an infant girl. This case illustrates the atypical location of this rare disease and adds to the differential diagnosis of lesions on the vulva.

Abstract Metastasis is defined as a neoplastic lesion originating from another primary tumor, with which it is no longer in contact. Cutaneous metastases result from lymphatic embolization, hematogenous or contiguous dissemination or also direct implantation during surgical procedures. In women, the tumor most likely to metastasize to skin is breast cancer, which may manifest as papulonodular neoplastic lesions. We report the case of a 66 years old female patient, presenting papulonodular lesions13 years after the initial treatment with surgery and chemotherapy for a cancer of the left breast.

OBJECTIVE: This study aimed to compare skeletal, dentoalveolar and soft tissue characteristics in white and black Brazilian subjects presenting normal occlusions. MATERIAL AND METHODS: The sample comprised the lateral cephalograms of 106 untreated Brazilian subjects with normal occlusion, divided into two groups: Group 1- 50 white subjects (25 of each gender), at a mean age of 13.17 years (standard deviation 1.07); and Group 2- 56 black subjects (28 of each gender), at a mean age of 13.24 years (standard deviation 0.56). Variables studied were obtained from several cephalometric analyses. Independent t tests were used for intergroup comparison and to determine sexual dimorphism. RESULTS: black subjects presented a more protruded maxilla and mandible, a smaller chin prominence and a greater maxillomandibular discrepancy than white subjects. Blacks presented a more horizontal craniofacial growth pattern than whites. Maxillary and mandibular incisors presented more protruded and proclined in black subjects. The nasolabial angle was larger in whites. Upper and lower lips were more protruded in blacks than in whites. CONCLUSIONS: The present study found a bimaxillary skeletal, dentoalveolar and soft tissue protrusion in black Brazilian subjects compared to white Brazilian subjects, both groups with normal occlusion. Upper and lower lips showed to be more protruded in blacks, but lip thickness was similar in both groups.

O objetivo deste trabalho foi delimitar indicadores clínicos e neuropsicológicos em crianças com suspeita de transtorno do déficit de atenção e hiperatividade (TDA/H). Foram avaliadas 150 crianças (idade de 7 a 14 anos) encaminhados ao NANI da UNIFESP. RESULTADOS: 75 crianças (55 M e 20 F) preenchiam os critérios para o TDA/H, dentre os quais 35 (46,6%) pacientes eram desatentos, 28 do tipo combinado e 12 do tipo hiperatividade/impulsivo. Observou-se correlação negativa com o escore de dígitos e no escore do teste de Corsi. Crianças com hiperatividade e impulsividade apresentaram baixo desempenho nas funções relacionadas à memória operacional. Crianças com transtorno opositor desafiante apresentaram alterações nos padrões de adaptação às mudanças do ritmo com menor adaptação às variações do tempo de exposição aos estímulos (Hit RT), além de maiores taxas de omissão no teste contínuo de performance. CONCLUSÃO: Este estudo sugere múltiplas interrelacões entre os escores em provas neuropsicológicas que são úteis para uma delimitação do perfil clínico de crianças com TDAH.

The aim of this study was to evaluate clinical and neuropsychological findings in children with suspicion of attention deficity hyperactivity disorder (ADHD). The assessment involved 150 children aged 7 to 14 referred to NANI at UNIFESP. RESULTS: 75 children (55 M and 20 F) fulfilled the criteria for ADHD, among which 35 were of the inattentive type, 28 of combined type and 12 were hyperactive/impulsive. There was negative correlation between the digit score and the Corsi test. Children with hyperactivity and impulsivity had a low performance for functional memory. Children with oppositional defiant disorder presented pattern changes in adaptability when there was a change in the rhythm the stimuli were presented and lower adaptation to time variability (Hit RT), in addition to higher rates of omission in the continuous performance test. CONCLUSION: This study suggests multiple interrelations between the scores of neuropsychological battery useful for detailed delimitation of the clinical profile of children with ADHD.

O estudo analisa dados referentes a 1.144 usuários de drogas injetáveis (UDIs) brasileiros, recrutados por dois estudos transversais multicêntricos: 287 do Projeto AjUDE-Brasil I e 857 do AjUDE-Brasil II. Procedeu-se análise comparativa de características relacionadas ao uso de drogas, comportamento sexual, situação jurídica e de saúde. Construíram-se modelos multivariados, por meio das árvores de decisão e regressão logística, para cada estudo, utilizando a infecção pelo HIV como variável-resposta. Cerca de 52% dos UDIs estavam infectados pelo HIV no AjUDE I e 36,5%, no AjUDE II. Em ambos os estudos a infecção pelo HIV se mostrou independentemente associada à soroprevalência média de fundo para o HIV (OR = 2,17; 10,66), soropositividade para o vírus da hepatite C (OR = 19,79; 15,48) e relato de sexo de homem-com-outro-homem (OR = 2,10; 2,09). No âmbito do AjUDE II, história de encarceramento (OR = 1,41) e oito ou mais anos de uso injetável (OR = 2,13) se mostraram também associados à infecção pelo HIV. Elevadas taxas de infecção pelo HIV entre UDIs relacionadas a comportamentos de risco injetável e sexual reforçam a necessidade de vigilância epidemiológica e prevenção.

This study assessed 1,144 Brazilian injecting drug users (IDUs) recruited on the street through outreach syringe exchange programs by two multi-center cross-sectional studies: 287 IDUs were recruited during the AjUDE-Brasil I Project and 857 during the AjUDE-Brasil II Project. IDU characteristics related to drug use and sexual behavior, and legal and health conditions for the two studies were compared, using decision tree and logistic regression for each individual study, with HIV infection as the outcome. Fifty-two percent of IDUs were HIV-infected in AjUDE I versus 36.5% in AjUDE II. In both studies, HIV infection was independently associated with: mean background HIV prevalence for each site (OR = 2.17; 10.66), HCV seropositive status (OR = 19.79; 15.48), and men who reported ever having sex with other men (OR = 2.10; 2.09). Incarceration (OR = 1.41) and 8 or more years of injecting drug (OR = 2.13) were also associated with HIV in AjUDE II. The high HIV infection rates and high prevalence of both parenteral and sexual risk behaviors in the context of syringe-exchange programs are of great concern and demand thorough surveillance and renewed prevention strategies.

O estudo analisa dados referentes a 1.144 usuários de drogas injetáveis (UDIs) brasileiros, recrutados por dois estudos transversais multicêntricos: 287 do Projeto AjUDE-Brasil I e 857 do AjUDE-Brasil II. Procedeu-se análise comparativa de características relacionadas ao uso de drogas, comportamento sexual, situação jurídica e de saúde. Construíram-se modelos multivariados, por meio das árvores de decisão e regressão logística, para cada estudo, utilizando a infecção pelo HIV como variável-resposta. Cerca de 52% dos UDIs estavam infectados pelo HIV no AjUDE I e 36,5%, no AjUDE II. Em ambos os estudos a infecção pelo HIV se mostrou independentemente associada à soroprevalência média de fundo para o HIV (OR = 2,17; 10,66), soropositividade para o vírus da hepatite C (OR = 19,79; 15,48) e relato de sexo de homem-com-outro-homem (OR = 2,10; 2,09). No âmbito do AjUDE II, história de encarceramento (OR = 1,41) e oito ou mais anos de uso injetável (OR = 2,13) se mostraram também associados à infecção pelo HIV. Elevadas taxas de infecção pelo HIV entre UDIs relacionadas a comportamentos de risco injetável e sexual reforçam a necessidade de vigilância epidemiológica e prevenção.

This study assessed 1,144 Brazilian injecting drug users (IDUs) recruited on the street through outreach syringe exchange programs by two multi-center cross-sectional studies: 287 IDUs were recruited during the AjUDE-Brasil I Project and 857 during the AjUDE-Brasil II Project. IDU characteristics related to drug use and sexual behavior, and legal and health conditions for the two studies were compared, using decision tree and logistic regression for each individual study, with HIV infection as the outcome. Fifty-two percent of IDUs were HIV-infected in AjUDE I versus 36.5% in AjUDE II. In both studies, HIV infection was independently associated with: mean background HIV prevalence for each site (OR = 2.17; 10.66), HCV seropositive status (OR = 19.79; 15.48), and men who reported ever having sex with other men (OR = 2.10; 2.09). Incarceration (OR = 1.41) and 8 or more years of injecting drug (OR = 2.13) were also associated with HIV in AjUDE II. The high HIV infection rates and high prevalence of both parenteral and sexual risk behaviors in the context of syringe-exchange programs are of great concern and demand thorough surveillance and renewed prevention strategies.