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Despite being subject to lower AIDS-related mortality rates and having a higher life expectancy, patients with HIV are more prone to develop non-AIDS events. A low CD4+/CD8+ ratio during antiretroviral therapy identifies people with heightened immune senescence and increased risk of mortality. In clinical practice, finding determinants of a low CD4+/CD8+ ratio may be useful for identifying patients who require close monitoring due to an increased risk of comorbidities and death. We performed a prospective study on the evolution of the CD4+/CD8+ ratio in 60 patients infected with HIV (80% males), who were subjected to two different antiretroviral regimens: early and deferred therapy. The initial CD4+/CD8+ ratio was ≤1 for 70% of the patients in both groups. Older age, CD4+ cell count at inclusion, Nadir CD8+T-cell count, and Initial CD4+/CD8+ ratio ≤ 1 were risk factors for lack of ratio recovery. In the multivariate analysis, a CD4+/CD8+ ratio > 1 at the start of the treatment was found to be a determinant factor in maintaining a CD4+/CD8+ ratio > 1. The nadir CD4+T-cell count was lower in the deferred therapy group (p=0.004), and the last CD4+/CD8+ ratio ≤1 was not associated with comorbidities. Ratio recovery was not associated with the duration of HIV infection, time without therapy, or absence of AIDS incidence. A greater improvement was observed in patients treated early (p=0.003). In contrast, the slope of increase was slower in patients who deferred treatment. In conclusion, the increase in the CD4+/CD8+ ratio occurred mostly for patients undergoing early strategy treatment and its extension did not seem to be related to previous HIV-related factors.

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ABSTRACT Despite being subject to lower AIDS-related mortality rates and having a higher life expectancy, patients with HIV are more prone to develop non-AIDS events. A low CD4+/CD8+ ratio during antiretroviral therapy identifies people with heightened immune senescence and increased risk of mortality. In clinical practice, finding determinants of a low CD4+/CD8+ ratio may be useful for identifying patients who require close monitoring due to an increased risk of comorbidities and death. We performed a prospective study on the evolution of the CD4+/CD8+ ratio in 60 patients infected with HIV (80% males), who were subjected to two different antiretroviral regimens: early and deferred therapy. The initial CD4+/CD8+ ratio was ≤1 for 70% of the patients in both groups. Older age, CD4+ cell count at inclusion, Nadir CD8+T-cell count, and Initial CD4+/CD8+ ratio ≤ 1 were risk factors for lack of ratio recovery. In the multivariate analysis, a CD4+/CD8+ ratio > 1 at the start of the treatment was found to be a determinant factor in maintaining a CD4+/CD8+ ratio > 1. The nadir CD4+T-cell count was lower in the deferred therapy group (p=0.004), and the last CD4+/CD8+ ratio ≤1 was not associated with comorbidities. Ratio recovery was not associated with the duration of HIV infection, time without therapy, or absence of AIDS incidence. A greater improvement was observed in patients treated early (p=0.003). In contrast, the slope of increase was slower in patients who deferred treatment. In conclusion, the increase in the CD4+/CD8+ ratio occurred mostly for patients undergoing early strategy treatment and its extension did not seem to be related to previous HIV-related factors.

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Resumo: O raciocínio e a emoção apresentam complexas e numerosas relações entre si, podendo prejudicar ou beneficiar o processamento lógico. Visando investigar a influência da tonalidade afetiva sobre o raciocínio, realizou-se uma revisão sistemática advinda da busca de estudos publicados nas bases de dados do Portal de Periódicos da Capes, Scielo, PubMed e Google Acadêmico. Os descritores utilizados foram: (affective content OR evaluative content OR emotion*) AND (reasoning). Após análise e submissão aos critérios de inclusão e exclusão, restaram 17 artigos, duas dissertações de mestrado e uma tese de doutorado. Apenas um dos estudos foi realizado no Brasil. Os participantes das pesquisas selecionadas tiveram pior desempenho nas tarefas de raciocínio formadas por conteúdos valorativos negativos. Entretanto, os conteúdos negativos influenciaram de forma positiva o raciocínio dedutivo quando se mostravam relevantes para a realização da tarefa. Assim, os estudos selecionados parecem apontar para a importância das emoções sobre o raciocínio humano.

Abstract: Reasoning and emotions have many complex relations which can hinder or benefit logical processing. Intending to investigate the influence of affective content on reasoning, we conducted a systematic review on scientific articles published on the Capes Journals Portal, Scielo, PubMed and Academic Google databases, retrieved using the descriptors (affective content OR evaluative content OR emotion*) AND (reasoning). After analysis and application of inclusion and exclusion criteria, 17 papers, two master's dissertations and one doctorate thesis remained. Only one study was conducted in Brazil. Research participants showed a worse performance in reasoning tasks composed by negative emotional content. However, negative emotional content influenced deductive reasoning positively when they proved to be relevant to the task. Hence, the reviewed studies suggest an importance of emotions for human reasoning.

Résumé : Le raisonnement et l'émotion entretiennent de nombreuses relations complexes qui peuvent entraver ou favoriser le procès logique. Dans le but d'étudier l'influence du contenu affectif sur le raisonnement, on a effectué une revue systématique des articles scientifiques publiés sur les base des données Portail des Périodiques du Capes, Scielo, PubMed et Google Académique, retrouvés en utilisant les descripteurs (affective content OR evaluative content OR emotion*) AND (reasoning). Après l'analyse et application des critères d'inclusion et d'exclusion, 17 articles, deux mémoires de maîtrise et une thèse de doctorat ont été retenus. Une seule étude a été menée au Brésil. Les participants aux recherches ont montré une pire perfomance dans les tâches de raisonnement composés d'un contenu affectif négatif. Cependant, ce contenu a influencé positivement le raisonnement déductif lorsqu'il s'est avéré pertinent pour la tâche. Les études examinées suggèrent donc que les émotions jouent un rôle important dans le raisonnement humain.

Resumen: El razonamiento y las emociones tienen relaciones complejas entre sí, que pueden perjudicar o ayudar el procesamiento lógico. Para investigar la influencia del tono afectivo sobre el razonamiento, se realizó una revisión sistemática a partir de la búsqueda de estudios publicados en las bases de datos del Portal de Periódicos Capes, SciELO, PubMed y Google Académico. Los descriptores utilizados fueron los siguientes: (affective content OR evaluative content OR emotion*) AND (reasoning). Después de la aplicación de los criterios de inclusión y exclusión, se seleccionaron 17 artículos, dos disertaciones de maestría y una tesis doctoral. Solo uno de los estudios se llevó a cabo en Brasil. Los participantes de las investigaciones seleccionadas tuvieron un peor desempeño en las tareas de razonamiento formadas por contenidos emocionales negativos. Estos influenciaron de forma positiva el razonamiento deductivo cuando eran relevantes para la realización de la tarea. Los estudios seleccionados parecen evidenciar la importancia de las emociones sobre el razonamiento humano.

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Cryptococcosis in HIV-negative patients can be an opportunistic or endemic disease. There are no published studies on the use of the finger-prick whole blood (point-of-care) cryptococcal antigen lateral flow assay (CrAg LFA) for diagnosing cryptococcosis in HIV-negative patients. We conducted a case series study of HIV-negative patients with cryptococcosis in two centers in São Paulo, Brazil. The objectives were to identify the sensitivity of a finger-prick whole blood CrAg LFA and to describe the main characteristics of this population. We identified 30 HIV-negative patients with cryptococcosis [19 (63%), male; median age, 47 years]. Ten (33%) patients were immunosuppressed, ten (33%) had other comorbidities, and ten (33%) were apparently immunocompetent and without comorbidities. The distribution of the sites of cryptococcosis was as follows: the central nervous system, 90% (n = 27); pulmonary, 43% (n = 13); and other extrapulmonary sites, 40% (n = 12). The sensitivity of the finger-prick whole blood CrAg LFA for the diagnosis of cryptococcosis was 97% (29/30). Among 26 participants with cryptococcal meningitis, the sensitivity of testing cerebrospinal fluid was as follows: CrAg latex agglutination, 77% (20/26); CrAg LFA, 96% (25/26); and culture, 81% (21/26). Culture speciation identified Cryptococcus gattii in 16 (62%) cases, and all had a positive finger-prick whole blood CrAg LFA. This test presented high sensitivity to the diagnosis of cryptococcosis in HIV-negative patients, including those caused by C. gattii.

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Culture seems to affect how empathy's development is influenced by parental behaviors. Considering that empathy is a social ability whose development is affected by many environmental and biological factors, differences can be expected in the way fathers and mothers care for and protect their sons and daughters, as social roles are influenced by culture. The objective of this research was to assess to what extent empathy, perceived parental care, and overprotection are affected by the offspring's sex. 477 adults participated in the study and three instruments were used: the Brazilian versions of the Parental Bonding Instrument, the Interpersonal Reactivity Index, and the Empathy Quotient. Pearson correlation, multiple linear regression, and moderation analyses were conducted. Maternal and paternal care were related to empathy variables for women in the Brazilian context, whereas the perceived parenting behaviors of care and overprotection did not show significant associations with empathy for male participants. Preliminary analysis also suggests that the offspring's sex influences paternal care expressed through variables such as perspective taking and combined cognitive empathy. This study's outcomes suggest that the way Brazilian parents behave is dependent on their offspring's sex. The main results were discussed in comparison to literature that used distinct cultural samples, especially to the outcomes found in British reports, to identify Brazilian parents' behaviors specificities and their association with the autonomous-relational parenting orientation.

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RESUMO Este texto objetiva analisar artigos científicos sobre Psicologia Escolar/Educacional, especificamente relacionados à formação de psicólogos. Realizamos uma revisão sistemática de artigos (2009-2019), pela plataforma Portal Periódicos CAPES, mediante os descritores "psicologia escolar AND formação do psicólogo" e "psicologia educacional AND formação do psicólogo". Após a aplicação dos critérios de inclusão e exclusão e identificação de artigos repetidos, procedemos à seleção pela leitura das publicações, resultando um total de 26 artigos, em sua maioria publicados na Revista de Psicologia Escolar e Educacional. Nas discussões, identificamos o uso de práticas tradicionais, de instrumentais clínicos e práticas clínicas como ponto de problematização relacionado às formas de estigmatização e a ausência de referenciais teóricos próprios da Psicologia Escolar. Quanto à formação na área, emergem questões sobre formação inicial e continuada, pouco espaço curricular para Psicologia Escolar e a Psicologia Histórico-Cultural como alternativa metodológica para atuação.

RESUMEN Este texto tiene por objetivo analizar artículos científicos sobre Psicología escolar/educacional, específicamente relacionados a la formación de psicólogos. Realizamos una revisión sistemática de artículos (2009-2019), por la plataforma Portal Periódicos CAPES, utilizando los descriptores "psicología escolar AND formación del psicólogo" y "psicología educacional AND formación del psicólogo". Tras aplicar los criterios de inclusión y exclusión e identificación de artículos repetidos, procedemos la selección por la lectura de las publicaciones, resultando en un total de 26 artículos, en su mayoría publicados en la Revista de Psicología Escolar/Educacional. En las discusiones, identificamos el uso de prácticas tradicionales, de instrumentales y prácticas clínicos como punto de problematización relacionado a las formas de estigmatización y a la ausencia de referenciales teóricos propios de la Psicología Escolar. En lo que se refiere a la formación en el área, emergen cuestiones sobre formación inicial y continuada, poco espacio curricular para Psicología escolar y la Psicología Histórico-Cultural como alternativa metodológica para actuación.

ABSTRACT This article aims to analyze scientific articles about School and Educational Psychology, specifically related to the training of psychologists. We carried out a systematic review of articles (2009-2019), using the Portal Periódicos CAPES platform, using the descriptors "school psychology AND psychologist training" and "educational psychology AND psychologist training". After applying the inclusion and exclusion criteria and identifying repeated articles, we proceeded with the selection by reading the publications, resulting in a total of 26 articles, mostly published in the Revista de Psicologia Escolar e Educational. In the discussions, we identified the use of traditional practices, clinical instruments and clinical practices as a questioning point related to forms of stigmatization and the absence of theoretical references specific to School Psychology. As for training in the area, questions emerge about initial and continuing training, little curricular space for School Psychology and Historical-Cultural Psychology as a methodological alternative for action.

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Abstract Introduction: Type 1 diabetes mellitus is associated with an increased risk of coronary artery disease, which is frequently asymptomatic. This risk increases significantly in those with nephropathy. In selected patients, simultaneous pancreas-kidney transplantation is the renal and pancreatic replacement therapy of choice, as it increases longevity and stabilizes diabetic complications. Despite essential, universal screening protocols are still controversial for coronary artery disease in this population. Methods: We retrospectively analysed 99 simultaneous pancreas-kidney recipients from our centre from 2011 to 2018 and selected 77 patients who underwent coronary angiography during the pre-transplant evaluation. Our aim was to identify potential risk factors associated with significant lesions on coronary angiography. Results: Almost half of our cohort of 77 candidates submitted to coronary angiography had coronary artery disease. Of these, nearly 30% underwent revascularization, although only one of them reported symptoms of myocardial ischemia. In a univariate analysis, the presence of smoking habits was the only risk factor for coronary artery disease. We also found that 20 or more years of type 1 diabetes mellitus was significantly associated with the presence of coronaropathy. Discussion: Selection of diabetic candidates with acceptable cardiac risk before simultaneous pancreas-kidney transplantation is imperative. Given the impact of a correct diagnosis and a low procedural risk, we defend the routine use of coronary angiography as the initial screening method for coronary artery disease in this population. Particularly care must be taken in evaluating asymptomatic patients with long-term type 1 diabetes mellitus and smokers.

Resumo Introdução: O diabetes mellitus tipo 1 está associado ao risco aumentado de doença arterial coronariana, que é frequentemente assintomática. Este risco aumenta significativamente em pessoas com nefropatia. Em pacientes selecionados, o transplante de pâncreas- rim simultâneo é a terapia substitutiva, renal e pancreática, de escolha, pois aumenta a longevidade e estabiliza complicações diabéticas. Apesar de essenciais, protocolos de triagem universais ainda são controversos para doença arterial coronariana nesta população. Métodos: Analisamos retrospectivamente 99 receptores de pâncreas-rim simultâneo de nosso centro, de 2011 a 2018, e selecionamos 77 pacientes que realizaram angiografia coronária durante avaliação pré-transplante. Nosso objetivo foi identificar fatores de risco potenciais associados a lesões significativas na angiografia coronária. Resultados: Quase metade de nossa coorte de 77 candidatos submetidos à angiografia coronária apresentou doença arterial coronariana. Destes, quase 30% foram submetidos à revascularização, embora apenas um tenha relatado sintomas de isquemia miocárdica. Em uma análise univariada, a presença do hábito de fumar foi o único fator de risco para doença arterial coronariana. Também descobrimos que 20 ou mais anos de diabetes mellitus tipo 1 estavam significativamente associados à presença de coronariopatia. Discussão: A seleção de candidatos diabéticos com risco cardíaco aceitável antes do transplante de pâncreas-rim simultâneo é imperativa. Dado o impacto de um diagnóstico correto e baixo risco de procedimento, defendemos o uso rotineiro da angiografia coronária como método de triagem inicial para doença arterial coronariana nesta população. Deve-se ter um cuidado especial na avaliação de pacientes assintomáticos com diabetes mellitus tipo 1 de longa duração e fumantes.

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INTRODUCTION: People living with Human Immunodeficiency Virus (HIV) are under risk for co-infection with SARS-CoV-2. This population may be more prone to complications from COVID-19 due to persistent inflammation caused by HIV and higher incidence of metabolic syndromes, cardiovascular diseases, and malignancies, as well as being considered elderly at 50 years of age. The objective of this study was to report SARS-CoV-2 infection frequency, clinical evolution, and mortality in HIV-positive patients on antiretroviral therapy. METHODS: The period of inquiry ranged from January to September 2020. Due to the social distance and the suspension of in-person medical care during the time of the investigation, we sent electronic questions about demographic, epidemiological, and clinical data to 403 HIV-infected patients. RESULTS: Among 260 patients who answered the questionnaire, thirty-nine patients (15%) had suggestive symptoms and were tested for SARS-CoV-2 infection. Of this, 11 had positive results (32.4%) and no patient died of COVID-19 complications. Nine were male (3.4%), and the mean age of the patients with positive results was 43.2 years (± 9.6). 107 patients (41.1%) were over 50 years of age and their mean T-CD4+ cell count was 768. Eleven patients (4.2%) had a detectable HIV RNA viral load and 127 (48.8%) had comorbidities. These variables were not associated with an increased risk for infection. CONCLUSION: The frequency of SARS-COV2 infection among HIV-infected is similar to the general population, and the clinical course is associated with the presence of comorbidities and not due to the HIV infection. However, new studies should be done to assess if this vulnerable population could answer the vaccine anti-SARS-Cov2.

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INTRODUCTION: Type 1 diabetes mellitus is associated with an increased risk of coronary artery disease, which is frequently asymptomatic. This risk increases significantly in those with nephropathy. In selected patients, simultaneous pancreas-kidney transplantation is the renal and pancreatic replacement therapy of choice, as it increases longevity and stabilizes diabetic complications. Despite essential, universal screening protocols are still controversial for coronary artery disease in this population. METHODS: We retrospectively analysed 99 simultaneous pancreas-kidney recipients from our centre from 2011 to 2018 and selected 77 patients who underwent coronary angiography during the pre-transplant evaluation. Our aim was to identify potential risk factors associated with significant lesions on coronary angiography. RESULTS: Almost half of our cohort of 77 candidates submitted to coronary angiography had coronary artery disease. Of these, nearly 30% underwent revascularization, although only one of them reported symptoms of myocardial ischemia. In a univariate analysis, the presence of smoking habits was the only risk factor for coronary artery disease. We also found that 20 or more years of type 1 diabetes mellitus was significantly associated with the presence of coronaropathy. DISCUSSION: Selection of diabetic candidates with acceptable cardiac risk before simultaneous pancreas-kidney transplantation is imperative. Given the impact of a correct diagnosis and a low procedural risk, we defend the routine use of coronary angiography as the initial screening method for coronary artery disease in this population. Particularly care must be taken in evaluating asymptomatic patients with long-term type 1 diabetes mellitus and smokers.

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