Background: The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population.

No abstract

Information about mental health systems is essential for mental health planning to reduce the burden of neuropsychiatric disorders. Unfortunately, many low- and middle-income countries lack systematic information on their mental health systems. The objectives, scope, structure, and contents of mental health assessment and monitoring instruments commonly used in high-income countries may not be appropriate for use in middle- and low-income countries. The World Health Organization (WHO) has recently developed the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS), a comprehensive assessment tool for mental health systems designed for middle- and low-income countries. WHO-AIMS was developed through an iterative process that included input from in-country and international experts on the clarity, content, validity, and feasibility of the instrument, as well as a pilot trial. The resulting instrument, WHO-AIMS 2.2, consists of six domains: policy and legislative framework, mental health services, mental health in primary care, human resources, public information and links with other sectors, and monitoring and research. These domains address the ten recommendations of the World Health Report 2001 through 28 facets and 155 items. All six domains need to be assessed to form a basic, yet broad, picture of a mental health system, with a focus on health sector activities. WHO-AIMS provides essential information for mental health policy and service delivery. Countries will be able to develop information-based mental health policy and plans with clear baseline information and targets. Moreover, they will be able to monitor progress in implementing reform policies, providing community services, and involving consumers, families, and other stakeholders in mental health promotion, prevention, care and rehabilitation. This article provides an overview of the rationale, development process, and potential uses and benefits of WHO-AIMS.

The number of cases of genital warts (condyloma accuminata, verruca accuminata) has been noted to increase tremendously on the establishment of a replace¬ ment center at Camp Atterbury, Indiana. After treating approximately 50 cases of these lesions and seeing the high incidence in the troops returning from overseas compared to civilians or soldiers from the United States, we have felt that a closer evaluation should be made.After a study of 70 men and 24 women, we are making a preliminary report because we feel the medical profes¬ sion should be alerted to this problem for the reasons to be discussed. TREATMENT IN MENComplete studies of 70 men have been carried out ( fig. 1). Of these patients, 65 had been stationed in Korea and Japan, 4 had never been out of the United States, and one was in Okinawa. All 65 patients who were in the Far East admitted contact with native women.Other venereal diseases found were syphilis in one case; gonorrhea in 12, and penile ulcérations, type unknown, in 12. Only one of these 70 men was circumcised at birth, and the type of wart was smaller and more keratotic in this patient. These patients were treated by four methods:(1) application of 20% podophyllin in tincture of ben¬ zoin; (2) application of 20% podophyllin in tincture of benzoin, followed by circumcision; (3) circumcision alone; and (4) fulguration followed by circumcision.A total of 57 patients were treated by application of 20% podophyllin in tincture of benzoin. We have used the following technique: 20% podophyllin in tincture of benzoin was applied directly to the lesions by sterile applicator. This was allowed to dry before the foreskin was pulled forward (three to four minutes); the patient was then instructed to wash the medication off completely in exactly two hours with soap and water. Reactions from this treatment were seen in only three cases; one was due to neglect in washing, and one patient was not able to retract his foreskin to cleanse the area. A total of 28 patients were seen here with recurrences following the use of podophyllin at other Army installations. Recur¬ rences were re-treated by this technique at this hospital one to three times, with subsequent complete disappear¬ ance of the warts. These patients are now undergoing a long term follow-up, which will be reported in the future. Thirteen patients were treated by use of 20% podo¬ phyllin in tincture of benzoin, followed by circumcision. There were no recurrences in this group. Four patients were treated by circumcision alone. Two of these had complete disappearance of the warts, and two required podophyllin treatment after circumcision for complete eradication of the disease. Five patients were treated by fulguration with electric cautery, with complete dis-appearance. One patient required two treatments by this method. It is of interest that in one patient with multiple warts they disappeared spontaneously. TREATMENT IN WOMENAt the time of writing 24 women were under treatment for genital warts (fig. 2 ). They were all wives of returnees from ...

Background: The presence of cell cycle markers in postmortem Alzheimer’s disease (AD) brains suggest a potential role of cell cycle activation in AD. It was shown that cell cycle activation in postmitotic neurons in mice produces Aβ and tau pathologies from endogenous mouse proteins in the absence of AβPP or tau mutations. Objective: In this study, we examined the microglial and astrocytic responses in these mice since neuroinflammation is another key pathological feature in AD. Methods: Our neuronal cell cycle re-entry (NCCR) mouse model are bitransgenic mice heterozygous for both Camk2a-tTA and TRE-SV40T. Using this tet-off system, we triggered NCCR in our animals via neuronal expression of SV40T starting at 1 month of age. TRE-SV40T Tg mice were used as SV40T transgene controls. The animals were examined at following time points: 2, 3, 4, 6, and 12 months of age. The microglia and astrocyte responses in our mice were determined by image analysis and stereology on brain sections immunofluorescently labeled using the following antibodies: Iba1, CD45, CD68, MHCII, and GFAP. Cellular senescent marker p16 was also used in this study. Results: Our NCCR mice demonstrate early and persistent activation of microglia and astrocytes. Additionally, proinflammatory and senescent microglia phenotype and brain leukocyte infiltration is present at 12 months of age. Conclusion: In the absence of FAD gene mutations, our NCCR mice simultaneously display many of the pathological changes associated with AD, such as ectopic neuronal cell cycle re-entry, Aβ and tau pathologies, neuroinflammation, and neurodegeneration. These animals represent a promising alternative AD mouse model.