Effects of autism spectrum disorders on outcome in teenage-onset anorexia nervosa evaluated by the Morgan-Russell outcome assessment schedule: a controlled community-based study

Background: The purpose of the study was to evaluate time trends and effects of co-existing autism spectrum disorders (ASD) on outcome in an ongoing long-term follow-up study of anorexia nervosa (AN). Methods: The Morgan-Russell Outcome Assessment Schedule (MROAS) was used at 6-, 10- and 18-year follow-up of a representative sample of 51 individuals with teenage-onset AN and a matched group of 51 healthy comparison cases. The full multinomial distribution of responses for the full scale and each of the subscales was evaluated using exact nonparametric statistical methods. The impact of diagnostic stability of ASD on outcome in AN was evaluated in a dose–response model. Results: There were no deaths in either group. Food intake and menstrual pattern were initially poor in the AN group but normalised over time. MROAS ‘mental state’ was much poorer in the AN group and did not improve over time. The psychosexual MROAS domains ‘attitudes’ and ‘aims’ showed persistent problems in the AN group. In the MROAS socioeconomic domain, the subscales ‘personal contacts’, ‘social activities’ and ‘employment record’ all showed highly significant between-group differences at all three follow-ups. A statistically significant negative dose–response relationship was found between a stable diagnosis of ASD over time and the results on the subscales ‘mental state’, ‘psychosexual state’ and ‘socio-economic state’. Conclusions: Outcome of teenage-onset AN is favourable with respect to mortality and persisting eating disorder, but serious problems remain in the domains ‘mental state’, ‘psychosexual function’ and ‘socioeconomic state’. Outcome is considerably worse if ASD is present. Treatment programmes for AN need to be modified so as to accommodate co-existing ASD

SEGURANÇA DO PACIENTE EM ANESTESIA E ESTRATÉGIA PARA PREVENÇÃO DE EVENTOS ADVERSOS

Patient safety during anesthetic procedures is a fundamental pillar in medical practice, aiming to mitigate risks and prevent adverse events. In this context, the implementation of effective strategies plays a crucial role in ensuring patient well-being. Objectives: Implement effective strategies in anesthesia to prevent adverse events, ensuring patient safety during surgical procedures. Methodology: The articles found were read, upon reading the articles were subjected to inclusion and exclusion criteria, within the inclusion criteria original articles were considered, which addressed the topic researched and allowed full access to the content of the study, published in the period of 2015 to 2023, in Portuguese and English, totaling 22 articles for the present study. The research was carried out through online access to the National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Literature in Health Sciences (LILACS) databases in March 2024. Results and Discussions:  Consistent application of safety protocols significantly reduced the incidence of adverse events in anesthesia. The effectiveness of these strategies such as the checklist before the procedure, during and after the procedure is highlighted, emphasizing the continuous importance of monitoring and improving practices carried out in the surgical environment during the anesthesia process, further improving patient safety. Conclusion: In summary, the implementation of preventive strategies proves to be crucial in reducing adverse events in anesthesia, strengthening patient safety. The constant evaluation and improvement of these approaches are essential to ensure increasingly safe and effective anesthetic practices.A segurança do paciente durante procedimentos anestésicos é um pilar fundamental na prática médica, visando mitigar riscos e prevenir eventos adversos. Nesse contexto, a implementação de estratégias eficazes desempenha um papel crucial na garantia do bem-estar do paciente. Objetivos: Implementar estratégias eficazes na anestesia para prevenir eventos adversos, garantindo a segurança do paciente durante procedimentos cirúrgicos. Metodologia: Foi realizada a leitura doas artigos encontrados, mediante a leitura os artigos foram submetidos a critérios de inclusão e de exclusão, dentro os de inclusão foram considerados artigos originais, que abordassem o tema pesquisado e permitissem acesso integral ao conteúdo do estudo, publicados no período de 2015 a 2023, em português e em inglês, totalizando 22 artigos para o presente estudo. A pesquisa foi realizada através do acesso online nas bases de dados National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) no mês de março de 2024. Resultados e Discussões: A aplicação consistente de protocolos de segurança reduziu significativamente a incidência de eventos adversos em anestesia. Destaca-se a eficácia dessas estratégias como o checklist antes do procedimento, durante e a pós, enfatizando a importância contínua da vigilância e aprimoramento das práticas realizadas no ambiente cirúrgico mediante ao processo de anestesia melhorando ainda mais a segurança do paciente. Conclusão: Em síntese, a implementação de estratégias preventivas demonstra ser crucial na redução de eventos adversos em anestesia, fortalecendo a segurança do paciente. A constante avaliação e aprimoramento dessas abordagens são essenciais para garantir práticas anestésicas cada vez mais seguras e eficazes

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin

Gingival overgrowth (GO) is a frequent finding in patients treated with cyclosporine (CsA). This study investigated the prevalence and severity of GO in patients who received kidney transplant and CsA therapy, as well as associations with pharmacological and clinical factors. This cross-sectional study included 63 kidney transplant recipients who were treated with CsA in a university hospital. Demographic, pharmacological, and periodontal data were collected. The primary variable was GO. Independent sample t- and chi-square tests were used to compare means in groups with versus without GO. The response rate was 86.3%. Overall, 40% of patients had some degree of GO. Eleven individuals presented GO scores > 10%, and 5 individuals reached 30%. The mean GO percentage was low (6.79 ± 15.83). Patients that were concurrently under nifedipine treatment showed a non-significant trend toward a greater prevalence of GO. Mean CsA dosage and serum levels were 3.20 ± 0.94 mg/kg/d and 156.12 ± 162.75 ng/mL, respectively. There were no statistically significant differences between patients with versus without GO nor between the groups receiving nifedipine, no drug, or verapamil. The GO prevalence and severity rates were lower than those reported in previous studies and seemed to be independent of drug interactions

Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin

Gingival overgrowth (GO) is a frequent finding in patients treated with cyclosporine (CsA). This study investigated the prevalence and severity of GO in patients who received kidney transplant and CsA therapy, as well as associations with pharmacological and clinical factors. This cross-sectional study included 63 kidney transplant recipients who were treated with CsA in a university hospital. Demographic, pharmacological, and periodontal data were collected. The primary variable was GO. Independent sample t- and chi-square tests were used to compare means in groups with versus without GO. The response rate was 86.3%. Overall, 40% of patients had some degree of GO. Eleven individuals presented GO scores > 10%, and 5 individuals reached 30%. The mean GO percentage was low (6.79 ± 15.83). Patients that were concurrently under nifedipine treatment showed a non-significant trend toward a greater prevalence of GO. Mean CsA dosage and serum levels were 3.20 ± 0.94 mg/kg/d and 156.12 ± 162.75 ng/mL, respectively. There were no statistically significant differences between patients with versus without GO nor between the groups receiving nifedipine, no drug, or verapamil. The GO prevalence and severity rates were lower than those reported in previous studies and seemed to be independent of drug interactions