Efetividade de uma intervenção não farmacológica para manejo do ganho de peso em pacientes com transtornos mentais graves: resultados de um estudo multicêntrico

OBJECTIVE: To evaluate the effectiveness of a non-pharmacological intervention for weight gain management in severe mental disorders. METHOD: An open, multicentre interventional study was conducted in 93 mental health services. Patients concerned with weight gain were included in this study and received a 12-week 1-hour group intervention focused on nutrition counseling, lifestyle, physical activity and self-esteem. Weight, waist circumference and blood pressure were measured before and after the intervention. RESULTS: 1,071 patients were enrolled in the study, and 73.9% completed the 12-week intervention. Significant weight loss (Mean difference: 0.41, CI 95%: 0.18 to 0.64, p = 0.001) and a significant BMI reduction (Mean difference: 0.13, CI 95%: 0.04 to 0.22, p = 0.006) were observed. During the intervention 37 (4.4%) patients lost > 7% of their initial weight, 780 (92.5%) maintained their weight, and 26 (3.1%) of the patients had a meaningful weight gain (> 7%). There was a significant increase in the proportion of patients undertaking physical activity after the intervention (70.8%, p < 0.001). CONCLUSION: In this 3-month open study we found a small weight and waist reduction, and increased physical activity practice, suggesting a trend towards anthropometric profile improvement. However, further randomized-controlled trials are necessary to evaluate the efficacy and clinical relevance of this psychosocial intervention for weight gain.OBJETIVO: Avaliar a efetividade de uma intervenção não farmacológica no manejo do ganho de peso para pacientes com transtornos mentais graves. MÉTODO: Foi realizado um estudo aberto multicêntrico longitudinal em 93 serviços de saúde. Pacientes preocupados com o peso foram incluídos e participaram de uma intervenção em grupo de uma hora de duração durante 12 semanas com foco em educação alimentar, atividade física e autoestima. Peso, circunferência da cintura e pressão arterial foram avaliados antes e após a intervenção. RESULTADOS: 1071 pacientes foram incluídos no estudo, 73,9% completaram a intervenção. Foram observados diminuição de peso e índice de massa corporal significativos (peso: diferença da média: 0,41, IC 95%: 0,18-0,64, p = 0,001; índice de massa corporal: diferença da média: 0,13, IC 95%: 0,04-0,22, p = 0,006). Após a intervenção, 37 (4,4%) pacientes perderam mais que 7% do peso inicial, 780 (92,5%) mantiveram o peso e 26 (3,1%) dos pacientes apresentaram ganho de peso acima de 7%. Houve aumento da proporção de pacientes que praticavam atividade física (70,8%, p < 0,001). CONCLUSÃO: Encontramos uma pequena redução de peso e cinturae aumento de atividade física, sugerindo uma tendência à melhora no perfil antropométrico. Ensaios clínicos controlados e randomizados são necessários para avaliar a eficácia e a relevância clínica dessa intervenção.Universidade Federal de São Paulo (UNIFESP) Department of PsychiatryUniversidade Federal de São Paulo (UNIFESP) Department of EndocrinologyUNIFESP, Department of PsychiatryUNIFESP, Department of EndocrinologySciEL

Selective eating: a nutritional approach

Selective eating is known by food refusal, lack of appetite and interest in food. It is atypical behavior of preschool, but when present in adverse family environments, can perpetuate and remain until adolescence. This paper is a case report of a patient with diagnosis of selective eating that seeks for specialized treatment center for eating disorders at 14 years old. The particularity of this case is the fast and good evolution, possibly due to the desire to treat himself and the support received by the family. The case points out the importance of identifying earlier and correctly cases of selectivity so they will be submitted as soon as possible to professionals specialized in treatment of eating disorders in different developmental stages of childhood and adolescence, resulting in a better prognosis framework.A seletividade alimentar é caracterizada por recusa alimentar, pouco apetite e desinteresse pelo alimento. É um comportamento típico da fase pré-escolar, mas, quando presente em ambientes familiares desfavoráveis, pode acentuar-se e permanecer até a adolescência. Este artigo trata de um relato de caso em que o paciente, com diagnóstico de seletividade alimentar, inicia tratamento em serviço especializado de transtornos alimentares aos 14 anos. A particularidade deste caso é a rápida e boa evolução do quadro, possivelmente decorrente do desejo próprio de se tratar e do apoio recebido pela família. A análise do caso em questão aponta para a importância de identificar os casos de seletividade de forma correta e precoce para que eles sejam encaminhados o quanto antes a profissionais habilitados no tratamento de distúrbios alimentares nos diferentes estágios de desenvolvimento da infância e adolescência, resultando em melhor prognóstico do quadro.Universidade Federal de São Paulo (UNIFESP) Departamento de Psiquiatria e Psicologia Médica Programa de Atenção aos Transtornos AlimentaresUNIFESP, Depto. de Psiquiatria e Psicologia Médica Programa de Atenção aos Transtornos AlimentaresSciEL

Protective role of chlorogenic acid on DNA damage caused by ochratoxin A exposure

Chlorogenic acid (ChlA) has shown short-term protective effects against the cytogenotoxiceffects of ochratoxin A (OTA). The present study evaluated the effect of oraladministration of ChlA in male Wistar rats exposed to OTA. OTA (0.4 mg/kg bw/day), ChlA (5 mg/kg bw/day), or the combination of both, were administered orally toanimals during 28 days. No deaths, decrease in feed consumption or change in the bodyweight of animals were observed in any group. In the OTA-treated group a decrease inlocomotion as well as increased DNA damage in blood, kidney and bone marrow cellswere observed. ChlA alone was not genotoxic for animals. The combination of OTA+ChlA decreased the DNA damage by 37% in blood cells, by 55% in kidney cells andby 80% in bone marrow cells compared to OTA-treated group. In conclusion, oraltreatment with ChlA showed a good protective effect on genotoxicity produced byOTA in rats during 28 days exposure.El ácido clorogé nico (ChlA) mostró efectos protectores a corto plazo contra los efectos citogenotóxicos de ocratoxina A (OTA). En el presente estudio se evaluó si este polifenol mantiene su efecto protector mediante la administración oral en ratas Wistar machos expuestas a OTA. OTA (0,4 mg/kg/día), ChlA (5 mg/kg/día), o la combinación de ambos, fueron administrados a los animales por vía oral durante 28 días. No se observaron muertes, ni disminución en el consumo de alimento, ni cambios en el peso corporal en ningún grupo de animales. En el grupo tratado con OTA se observó disminución en la locomoción, así como daño en el ADN en las cé lulas de sangre, riñó n y mé dula ósea. En los animales que solo recibieron ChlA no se observaron efectos genotóxicos. La combinación de OTA + ChlA disminuyó el daño del ADN en un 37%en las cé lulas sanguíneas, en un 55% en las cé lulas renales y en un 80% en las cé lulas de la mé dula ósea con respecto al grupo tratado con OTA. En conclusión, el tratamiento oral con ChlA mostró buen efecto protector sobre la genotoxicidad producida por OTA en ratas durante 28 días de exposición.Fil: Campra, Noelia Anahí. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Fisicoquímicas y Naturales. Instituto de Biotecnología Ambiental y Salud - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Biotecnología Ambiental y Salud; ArgentinaFil: Cariddi, Laura Noelia. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Fisicoquímicas y Naturales. Instituto de Biotecnología Ambiental y Salud - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Biotecnología Ambiental y Salud; ArgentinaFil: Escobar, Franco Matias. Universidad Nacional de Río Cuarto; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; ArgentinaFil: Sabini, Maria Carola. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Fisicoquímicas y Naturales. Instituto de Biotecnología Ambiental y Salud - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Biotecnología Ambiental y Salud; ArgentinaFil: Freire de lima, Celio Geraldo. Universidade Federal do Rio de Janeiro; BrasilFil: Decote Ricardo, Debora. Universidade Federal do Rio de Janeiro; BrasilFil: Roma, Dardo Andrés. Universidad Nacional de Río Cuarto; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; ArgentinaFil: Mañas, Fernando Javier. Universidad Nacional de Río Cuarto; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; ArgentinaFil: Dalcero, Ana Maria. Universidad Nacional de Río Cuarto; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; Argentin

Caracterização, aptidão agrícola e capacidade de uso de um Argissolo Vermelho-Amarelo Eutrófico abrúptico: Estudo de caso em Itapetinga-BA

The livestock agriculture from Itapetinga are in area of Argissolos. The management of livestock has caused compaction. Thus, the purpose of the study was: i) describe the morphological, Chemical, and physical of the Argissolo Vermelho-Amarelo; ii) classify your agricultural aptitude and use capacity. The morphological characterization was described: depth, color, structure, texture, consistency, and transition. The physical analysis was: texture and clay dispersed in water. The Chemical analysis determined the cations (Ca2+, Mg2+ Na+, K+, Al3+ e H+), pH, carbon, nitrogen and phosphorus. The oxides Al2O3 and Fe2O3were determined. The “Sistema de Avaliação de Aptidão Agrícola das Terras” and “Sistema de Capacidade de Uso” were used for classification. The soil was classified with Argissolo Vermelho-Amarelo Eutrófico abrúptico. Your aptitude has been graded as 1abC and IV E-3 to use capacity. Therefore, the use of soil is incorrect, because the perennial pasture with practices against erosion is the correct form of use. The abrupt character with compaction by the animals result in losses of the productive capacity of the soil. This is reality of the microregion of Itapetinga because most of the territory is in area of Argissolos Vermelho-Amarelos Eutróficos, totaling 41% of the total area.No município de Itapetinga, 90% das terras são ocupadas com pecuária e os Argissolos são os solos mais comuns. A pequena capacidade protetora das pastagens e também o adensamento dos rebanhos, tem causado severa compactação no solo, que se torna preocupante.  Diante disso, os objetivos da pesquisa foram: i) caracterizar morfológica, física e quimicamente um Argissolo Vermelho-Amarelo; ii) indicar a aptidão agrícola e capacidade de uso. Realizou-se a caracterização morfológica do solo e coletaram-se amostras dos horizontes para caracterização física e química. Fisicamente determinou-se a granulometria e argila dispersa em água (ADA). Quimicamente foram analisados os cátions trocáveis do complexo sortivo (Ca2+, Mg2+ Na+, K+, Al3+ e H+), pH, carbono, nitrogênio total e fósforo disponível, bem como, óxidos Al2O3 e Fe2O3 por ataque sulfúrico. Os sistemas de Avaliação de Aptidão Agrícola das Terras e de Capacidade de Uso foram as metodologias utilizadas para essas classificações. A descrição morfológica e dados analíticos permitiram classificar o solo como Argissolo Vermelho-Amarelo Eutrófico abrúptico. Quanto à aptidão agrícola e capacidade de uso, o solo foi classificado como 1abC e IV E-3, respectivamente. Conclui-se que o uso atual está inadequado, recomendando-se pastagens perenes associadas a práticas conservacionistas que evitem a erosão do solo. O caráter abrúptico, aliado à compactação provocada pela pecuária extensiva, agrava ainda mais a perda da capacidade produtiva desse solo, condição representativa para a microrregião de Itapetinga, onde a maior parte do seu território é coberto por Argissolos Vermelho-Amarelos Eutróficos, sendo cerca de 41%

Large-Area Paper Batteries with Ag and Zn/Ag Screen-Printed Electrodes

This work was partially funded by H2020-ICT-2014-1, RIA, ERC-CoG-2014, and FEDER funds through the COMPETE 2020 Program and National Funds through FCT -Portuguese Foundation for Science and Technology under the project UID/CTM/50025/2019.Large-area paper batteries have been explored in this paper, correlating electrode materials and screen printing with the electrochemical performances. The use of office paper embedded in salt solution with two electrodes performed by an easy and large-scale application technique opens doors to a new concept of energy storage. The proposed device is Li-free and uses zinc and silver powder-based screen printable pastes to deposit the electrodes. Cyclic voltammetry and charge-discharge curves reveal the performance of the produced devices using NaCl and KOH solutions in different concentrations. The simulation of electrochemical impedance spectroscopy measurements gave clue of a similar working mechanism to conventional Li-ion batteries. After charging, a single paper battery achieves 1.83 V with 60 mA/cm2 and 90.6% charge-discharge efficiency. As a proof of concept, a small paper battery and a set integrated in series and parallel were used to power a commercial red light-emitting diode.publishersversionpublishe

Age-dependent changes in rat lacrimal gland anti-oxidant and vesicular related protein expression profiles

Anti-oxidation and exocytosis are important for maintaining exocrine tissue homeostasis. During aging, functional and structural alterations occur in the lacrimal gland (LG), including oxidative damage to proteins, lipids, and DNA. The aims of the present study were to determine in the aging LG: a) the effects of aging on LG structure and secretory activity and b) changes in the expression of oxidative stress markers.Journal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe

The concentrations of heavy metals and the incidence of micronucleated erythrocytes and liver EROD activity in two edible fish from the Paraíba do Sul river basin in Brazil

The Paraíba do Sul river (PSR) basin crosses one of the most populated and industrialized regions of Brazil and receives effluent from the metallurgic, paper mill and agricultural industries. PSR water has multiple uses, including being a supply of potable water and riverine populations which consume some species of its fish. In the present study, we investigated the responses of two biomarkers of aquatic pollution, EROD activity in the liver and micronuclei frequency in peripheral blood, as well as the concentrations of seven heavy metals in the muscle tissue of two species of fish native to the PSR: Geophagus brasiliensis and Hypostomus sp. Sampling was performed in both the wet and dry seasons of 2003, with a total of 339 fish collected from 16 sites along the PSR basin. Fish collected at Levy Gasparian, Barra Mansa and Três Rios both had higher EROD activity and micronuclei frequency. The results also suggested a moderate induction of EROD activity in fish collected from S.L. Paraitinga and Sapucaia. Micronuclei frequency was elevated in fish from S.J. Campos, Além Paraíba, Campos and S.J. Barra. In all cases, heavy metal concentrations did not exceed the maximum considered safe for fish meat consumption.Título PT: Concentração de metais pesados e incidência de eritrócitos micronucleados e atividade de EROD hepática em duas espécies de peixes comestíveis na bacia do Rio Paraíba do Sul, BrasilA bacia do rio Paraíba do Sul (PSR) atravessa uma das regiões mais povoadas e industrializadas do Brasil, recebendo efluentes de indústrias metalúrgicas, de papel e celulose e agrícolas. Os usos das águas do PSR são múltiplos, incluem o fornecimento de água potável, e as populações ribeirinhas consomem algumas de suas espécies de peixes. No presente trabalho foram investigadas as respostas de dois biomarcadores à poluição, a atividade hepática de EROD e a freqüência de micronúcleo em sangue periférico, e medidos os níveis de sete metais pesados no músculo de duas espécies de peixes nativas do PSR, Geophagus brasiliensis and Hypostomus sp.. As amostragens foram realizadas nos períodos de seca e de cheias de 2003. Ao todo foram coletados 339 peixes em 16 regiões ao longo da bacia do PSR. Os peixes coletados em Levy Gasparian, Barra Mansa e Três Rios apresentaram alta atividade de EROD e frequência de micronúcleo. Também foi detectada uma moderada indução de EROD nos peixes coletados em S.L. Paraitinga e Sapucaia. A frequência de micronúcleo foi elevada nos peixes coletados em S.J. Campos, Além Paraíba, Campos e S.J. Barra. Em todos os casos, as concentrações de metais pesados não excederam os valores máximos permitidos para carne de peixes

Psycho-social factors associated with mental resilience in the Corona lockdown.

The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience (p < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics

Increasing and sustaining blood-borne virus screening in Spain and Portugal throughout the COVID-19 pandemic: a multi-center quality improvement intervention

BackgroundAround 57,000 people in Spain and Portugal currently living with HIV or chronic hepatitis C are unaware of their infection. The COVID-19 pandemic severely disrupted screening efforts for these infections. We designed an intervention to increase and sustain opportunistic blood-borne virus (BBV) screening and linkage to care (SLTC) by implementing the TEST model.MethodsThe Plan Do Study Act (PDSA) method of quality improvement (QI) was implemented in 8 healthcare organizations (HCOs), including four hospitals, two clusters of community health centers, and two community-based organizations (CBOs). Baseline assessment included a review of BBV SLTC practices, testing volume, and results 12 months before the intervention. Changes in BBV testing rates over time were measured before, during, and after the COVID-19 lockdowns in 2020. A mixed ANOVA model was used to analyze the possible effect on testing volumes among HCOs over the three study periods.InterventionBBV testing was integrated into normal clinical flow in all HCOs using existing clinical infrastructure and staff. Electronic health record (EHR) systems were modified whenever possible to streamline screening processes, implement systemic institutional policy changes, and promote QI.ResultsTwo years after the launch of the intervention in screening practices, testing volumes increased by 116%, with formal healthcare settings recording larger increases than CBOs. The start of the COVID-19 lockdowns was accompanied by a global 60% decrease in testing in all HCOs. Screening emergency department patients or using EHR systems to automate screening showed the highest resilience and lowest reduction in testing. HCOs recovered 77% of their testing volume once the lockdowns were lifted, with CBOs making the fullest recovery. Globally, enhanced screening techniques enabled HCOs to diagnose a total of 1,860 individuals over the research period.ConclusionsImplementation of the TEST model enabled HCOs to increase and sustain BBV screening, even during COVID-19 lockdowns. Although improvement in screening was noted in all HCOs, additional work is needed to develop strong patient linkage to care models in challenging times, such as global pandemics