Motor cortical inhibitory deficits in patients with obsessive-compulsive disorder–A systematic review and meta-analysis of transcranial magnetic stimulation literature

Funding Information: DR was supported by H2020-SC1-DTH-2019-875358-FAITH. AM and GC are supported by Fundação para a Ciência e Tecnologia (FCT) through Ph.D. Scholarships (respectively, SFRH/BD/144508/2019 and SFRH/BD/130210/2017). GC and AO-M are supported by grant FCT-PTDC/MED-NEU/31331/2017, funded by FCT/MCTES. AO-M was funded by a Starting Grant from the European Research Council under the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement no. 950357). JB-C and AO-M were supported by grant FCT-PTDC/MEC-PSQ/30302/2017-IC&DT-LISBOA-01-0145-FEDER, funded by national funds from FCT/MCTES and co-funded by FEDER, under the Partnership Agreement Lisboa 2020–Programa Operacional Regional de Lisboa. JO was supported by BBRF-27595-2018 NARSAD. None of the agencies had a role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, in the preparation, review, or approval of the manuscript, nor in the decision to submit the manuscript for publication. Publisher Copyright: Copyright © 2022 Rodrigues da Silva, Maia, Cotovio, Oliveira, Oliveira-Maia and Barahona-Corrêa.Introduction: Obsessive-compulsive disorder (OCD) is a highly prevalent chronic disorder, often refractory to treatment. While remaining elusive, a full understanding of the pathophysiology of OCD is crucial to optimize treatment. Transcranial magnetic stimulation (TMS) is a non-invasive technique that, paired with other neurophysiological techniques, such as electromyography, allows for in vivo assessment of human corticospinal neurophysiology. It has been used in clinical populations, including comparisons of patients with OCD and control volunteers. Results are often contradictory, and it is unclear if such measures change after treatment. Here we summarize research comparing corticospinal excitability between patients with OCD and control volunteers, and explore the effects of treatment with repetitive TMS (rTMS) on these excitability measures. Methods: We conducted a systematic review and meta-analysis of case-control studies comparing various motor cortical excitability measures in patients with OCD and control volunteers. Whenever possible, we meta-analyzed motor cortical excitability changes after rTMS treatment. Results: From 1,282 articles, 17 reporting motor cortex excitability measures were included in quantitative analyses. Meta-analysis regarding cortical silent period shows inhibitory deficits in patients with OCD, when compared to control volunteers. We found no statistically significant differences in the remaining meta-analyses, and no evidence, in patients with OCD, of pre- to post-rTMS changes in resting motor threshold, the only excitability measure for which longitudinal data were reported. Discussion: Our work suggests an inhibitory deficit of motor cortex excitability in patients with OCD when compared to control volunteers. Cortical silent period is believed to reflect activity of GABAB receptors, which is in line with neuroimaging research, showing GABAergic deficits in patients with OCD. Regardless of its effect on OCD symptoms, rTMS apparently does not modify Resting Motor Threshold, possibly because this measure reflects glutamatergic synaptic transmission, while rTMS is believed to mainly influence GABAergic function. Our meta-analyses are limited by the small number of studies included, and their methodological heterogeneity. Nonetheless, cortical silent period is a reliable and easily implementable measurement to assess neurophysiology in humans, in vivo. The present review illustrates the importance of pursuing the study of OCD pathophysiology using cortical silent period and other easily accessible, non-invasive measures of cortical excitability. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020201764], identifier [CRD42020201764].publishersversionpublishe

O trabalho remoto no Secretariado: panorama da realidade brasileira a partir do cenário do Covid-19

O cenário da pandemia do COVID-19 obrigou, em função do isolamento social recomendado pela Organização Mundial da Saúde (OMS), organizações públicas e privadas a adotarem a modalidade de trabalho remoto para vários cargos e ocupações. Na área secretarial não foi diferente. O trabalho remoto, prática profissional recorrente nas áreas secretarial e de assessoria, ganha destaque nesse período por ser uma alternativa de atuação para os trabalhadores. Entretanto, apresenta pontos positivos e negativos no que se refere às suas condições objetivas de trabalho. Para compreender as dinâmicas que envolvem este contexto, foi realizada uma pesquisa nos meses de abril e maio de 2020 com profissionais dessa categoria, totalizando 149 (cento e quarenta e nove) participantes que estão atuando remotamente, com uso de plataformas digitais. O objetivo principal deste estudo foi analisar as formas de atuação, as percepções e as condições objetivas de trabalho do profissional do secretariado na modalidade remota. A pesquisa é de natureza aplicada, de cunho exploratório e com abordagem quantitativa e qualitativa para coleta e análise dos dados. Como resultados principais, percebem-se impactos positivos e negativos do trabalho remoto, como a flexibilização de contratos, jornadas estendidas de trabalho, demanda por autonomia e novas competências profissionais, além de ser possível observar um cenário de fronteiras borradas entre tempos e espaços de trabalho e de não-trabalho. ABSTRACT The pandemic scenario of COVID-19 forced, due to the social isolation recommended by the World Health Organization (WHO), public and private organizations to adopt the remote work modality for various positions and occupations. In the secretarial area it was no different. Remote work, a recurring professional practice in the secretarial and advisory areas, is highlighted in this period for being an alternative for workers. However, it presents positive and negative aspects regarding its objective labor conditions. To understand the dynamics surrounding this context, a survey was conducted in April and May 2020 with professionals in this category, approaching 149 (one hundred and forty-nine) participants who are working remotely, using digital platforms. The research has an applied nature, exploratory objective and quantitative and qualitative approach to data analysis. The main objective of this study was to analyze the ways of acting, the perceptions and the objective working conditions of the secretariat professionals in the remote work modality. As main results, were found positive and negative impacts of remote work, such as flexible contracts, extended working hours, demand for autonomy and new professional skills, in addition to being able to observe a scenario of blurred borders between labor and non-labor times and spaces, besides the possibility of damage to workers' health

The contribution of somatic items

Funding Information: JO is supported by the NARSAD 2018 Young Investigator Award from the Brain & Behavior Research Foundation , (Grant ID: 27595 ). RL is supported by the 2018 Scientific Employment Stimulus from Fundação para a Ciência e Tecnologia, Portugal (CEECIND/04157/2018). DF, BS and AJO-M are supported by the BOUNCE project (grant agreement number 777167 ), and RL and AJO-M are supported by the FAITH project (grant agreement number 875358 ), both funded by the European Union's Horizon 2020 research and innovation programme. JBB-C and AJO-M are supported by grant FCT-PTDC/MEC-PSQ/30302/2017-IC&DT-LISBOA-01-0145-FEDER, funded by national funds from FCT/MCTES and co-funded by FEDER, under the Partnership Agreement Lisboa 2020 - Programa Operacional Regional de Lisboa. AJO-M is supported by grant FCT-PTDC/MED-NEU/31331/2017, funded by FCT/MCTES. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. Publisher Copyright: © 2022 The AuthorsBackground/Objective: Screening for depression in patients with cancer can be difficult due to overlap between symptoms of depression and cancer. We assessed validity of the Beck Depression Inventory (BDI-II) in this population. Method: Data was obtained in an outpatient neuropsychiatry unit treating patients with and without cancer. Psychometric properties of the BDI-II Portuguese version were assessed separately in 202 patients with cancer, and 376 outpatients with mental health complaints but without cancer. Results: Confirmatory factor analysis suggested a three-factor structure model (cognitive, affective and somatic) provided best fit to data in both samples. Criterion validity was good for detecting depression in oncological patients, with an area under the ROC curve (AUC) of 0.85 (95% confidence interval [CI], 0.76–0.91). A cut-off score of 14 had sensitivity of 87% and specificity of 73%. Excluding somatic items did not significantly change the ROC curve for BDI-II (difference AUCs = 0.002, p=0.9). A good criterion validity for BDI-II was also obtained in the non-oncological population (AUC = 0.87; 95% CI 0.81–0.91), with a cut-off of 18 (sensitivity=84%; specificity=73%). Conclusions: The BDI-II demonstrated good psychometric properties in patients with cancer, comparable to a population without cancer. Exclusion of somatic items did not affect screening accuracy.publishersversionpublishe

Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic

Introduction: Hypomania symptoms are best described as a continuum, ranging beyond Bipolar Spectrum Disorders (BSD). Other nosological entities, such as major depressive disorder, schizoaffective disorder, or borderline personality disorder, may also share symptoms with BSD, raising challenges for differential diagnosis. While the Hypomania Checklist-32 is one of the most widely used tools for screening hypomania, there is limited evidence describing its use in a real-world outpatient psychiatric clinical setting.Methods: Here we tested the psychometric properties of a European Portuguese adaptation of the HCL-32, establishing its factor structure, reliability and construct validity. Furthermore, we analyzed differences in hypomanic symptoms among several clinical groups and in a non-clinical sample. Data was obtained retrospectively in an ecological setting from a clinical sample of an outpatient psychiatry and psychology clinic, comprising 463 Portuguese individuals, 326 of whom had a psychiatric diagnosis, namely BSD (n = 66), major depressive disorder (n = 116), or other psychiatric disorders (n = 144). A separate non-clinical sample was also collected among healthy volunteers (n = 62). A battery of self-report measures of affective symptoms was applied, and in a subset of patients, diagnosis was established using a structured diagnostic interview.Results: Psychometric properties of the HCL-32 were adequate, with good internal consistency (Cronbach's α = 0.86) and test-retest stability (ICC = 0.86), and two subscores (“active/elated” and “risk-taking/irritable”) defined by Principal Component Analysis. Receiver Operating Characteristic curve analysis demonstrated that the test score discriminated moderately between patients with BSD and other clinical samples as well as healthy volunteers, with a cut-off score of 17 for the total score of the HCL-32 rendering the best combination of sensitivity and specificity. When compared to the HCL-32 total score, the risk-taking/irritable subscore seems to provide additional benefit in discriminating between different clinical groups, namely regarding specificity in the discrimination from patients with a diagnosis of major depressive disorder that was low for the full scale and the alternate subscale.Conclusions: HCL-32 can be used as a screening tool for BSD among adult patients presenting in an outpatient psychiatric clinical setting

USO DA ACTIGRAFIA NA AVALIAÇÃO DO RITMO ATIVIDADE-REPOUSO EM PACIENTES COM DOENÇA DE PARKINSON

Distúrbios do sono são os mais comuns sintomas não-motores encontrados na doença de Parkinson (DP). OBJETIVOS: Avaliar a relação entre actigrafia e distúrbios do sono mais incidentes na DP. MÉTODOS: Pacientes com e sem DP foram avaliados quanto aos sintomas motores, qualidade do sono, cronotipo e objetivamente através do uso do actímetro. RESULTADOS: Encontrou-se uma significante redução da qualidade do sono entre os pacientes com DP (p = 0.0023), uma pior qualidade subjetiva do sono, maior uso de medicamentos para insônia, mais distúrbios do sono e uma maior fragmentação do ritmo atividade-repouso (IV) (p=0.0271). CONCLUSÃO: Pacientes com DP possuem uma pior qualidade de sono e um ritmo atividade-repouso mais fragmentado. A Actigrafia pode ser útil na avaliação da qualidade do sono e do ciclo atividade- repouso em pacientes com DP, contribuindo para o rastreio e acompanhamento de eventuais distúrbios do ritmo circadiano a esta doença associado

Abordagem Multidisciplinar no Tratamento de Emergências Cardiovasculares em Pacientes Pediátricos. Revisão Integrativa

To evaluate the challenges in the diagnosis and treatment of pediatric primary arterial hypertension, considering the effectiveness of the diagnosis, adherence to treatment, quality of life, blood pressure control and long-term impact. Methods: This is an integrative review developed through research in the PubMed database, using the following search strategy (((Hypertension) AND ((Child) OR (Adolescent)) AND (((Treatment) AND (Diagnosis )) OR (Management))) NOT ((Adult) OR (Newborn) OR (Pregnancy)). 3075 articles were found, of which 60 articles were pre-selected after applying the inclusion and exclusion criteria. 41 were removed after the selection. reading and initial analysis, totaling 19 for complete analysis. Results: The studies indicate the relationship between obesity and a sedentary lifestyle with cases of pediatric hypertension. increase in cardiovascular events. Dietary measures are emphasized as the main therapeutic approach, with few studies targeting medications used that are confirmed to be safe. Final considerations: The importance of lifestyle changes is highlighted, in addition to rigorous screening measures. in order to prevent future complications. Keywords: Cardiology, Pediatrics, Care.Analisando os obstáculos no diagnóstico e tratamento da hipertensão arterial primária em crianças, levando em conta a eficácia do diagnóstico, adesão ao tratamento, qualidade de vida, controle da pressão arterial e impacto a longo prazo. A metodologia consistiu em uma revisão integrativa realizada através de pesquisa na plataforma PubMed, com a seguinte estratégia de busca (((Hipertensão) E ((Criança) OU (Adolescente)) E (((Tratamento) E (Diagnóstico)) OU (Controle))) NÃO ((Adulto) OU (Recém-nascido) OU (Gravidez)). Foram identificados 3075 artigos, dos quais 60 foram pré-selecionados após aplicação dos critérios de inclusão e exclusão. Após análise inicial, 41 foram excluídos, totalizando 19 para análise detalhada. Resultados indicam a correlação entre a obesidade e o sedentarismo com casos de hipertensão em crianças. Devido à natureza silenciosa da doença e aos sintomas inespecíficos, intervenções tardias podem aumentar os eventos cardiovasculares. Enfatiza-se a dieta como principal intervenção terapêutica, com poucos estudos sobre a segurança dos medicamentos usados. Conclui-se ressaltando a importância da mudança de estilo de vida e de um rigoroso rastreamento para evitar complicações no futuro

Nascidos vivos com comunicação interventricular: estudo epidemiológico

Introduction: Ventricular septal defect (VSD) is a medical condition characterized by the presence of an opening or gap between the two ventricles of the heart, the lower chambers responsible for pumping blood to the body. This opening allows oxygenated blood, which should be pumped to the body, to mix with deoxygenated blood, causing an overload on the lungs and consequently on the heart. Methodology: The exploratory epidemiological study on live births with ventricular septal defect adopted an approach that combined data from the Information System on Live Births (SINASC) of DATASUS and research from academic sources, such as Google Scholar. Results: Analyzing the variable Color/Race, the data reveals a distribution among different ethnic groups. Most cases of congenital heart disease occurred in individuals of white ethnicity, totaling 1,449 cases, representing 58.57% of the total. Next, the brown ethnicity contributed 796 cases, equivalent to 32.17%. Conclusion: Understanding the incidence in different ethnic groups, gestation duration, and types of delivery provides a comprehensive overview, emphasizing the need for public health strategies that consider not only the cardiac condition itself but also associated socioeconomic and clinical factors.Introdução: A comunicação interventricular (CIV) é uma condição médica que se caracteriza pela presença de uma abertura ou abertura entre os dois ventrículos do coração, como câmaras inferiores responsáveis pelo bombeamento do sangue para o corpo. Essa abertura permite que o sangue oxigenado, que deveria ser bombeado para o corpo, se misture com o sangue não oxigenado, causando uma sobrecarga nos pulmões e, por consequência, no coração. Metodologia: O estudo epidemiológico exploratório sobre nascidos vivos com comunicação interventricular adotou uma abordagem que combinou dados do Sistema de Informações sobre Nascidos Vivos (SINASC) do DATASUS e pesquisa em fontes acadêmicas, como o Google Acadêmico. Resultado: Ao analisar a variável Cor/Raça, os dados revelam uma distribuição entre diferentes grupos étnicos. A maioria dos casos de cardiopatia congênita ocorreu em indivíduos de cor/raça branca, totalizando 1.449 casos, o que representa 58,57% do total. Em seguida, a cor/raça parda contribuiu com 796 casos, equivalente a 32,17%. Conclusão: A compreensão da incidência em diferentes grupos étnicos, duração da gestação e tipos de parto oferece um panorama abrangente, ressaltando a necessidade de estratégias de saúde pública que levem em consideração não apenas a condição cardíaca em si, mas também os fatores socioeconômicos e clínicos associado

CAMINHO CONTRA A DENGUE: RELATO DE EXPERIÊNCIA DE UM PROJETO DE EXTENSÃO UNIVERSITÁRIO

A dengue é uma doença febril aguda com etiologia viral típica e de evolução benigna que é grave quando se apresenta na forma hemorrágica. Sua transmissão ocorre pela picada do Aedes aegypti, em um ciclo humano-Aedes aegypti-humano. Sendo assim, o cuidado e a prevenção contra a dengue é uma prática que deve ser sempre incentivada, especialmente em áreas de risco, além de buscar incluir a população como partícipes nas ações de prevenção contra essa arbovirose. O artigo trata-se de um relato de experiência cujo objetivo é descrever a experiência desenvolvida e vivenciada pelos acadêmicos do curso de graduação em Medicina da UniFipMoc-Afya durante o projeto de extensão "Caminho Contra a Dengue" que ocorreu em maio de 2022 no Parque Municipal Cândido Canelas, localizado no bairro Canelas, Montes Claros – MG. As ações realizadas tinham caráter socioeducativo, tendo como objetivo reconhecer e demarcar os determinantes da dengue dos bairros Canelas e Antônio Canelas, para se realizar uma sensibilização da comunidade local sobre as medidas preventivas contra a proliferação da doença e, dessa forma, contribuir para a integralização da saúde dos moradores. As estratégias empregadas trouxeram a reflexão, a problematização da pauta e a valorização de uma mudança de comportamento visando à diminuição da transmissão da dengue no bairro Antônio Canelas e no Canelas. Logo, esse conjunto de experiências proporcionou a possibilidade de promover um avanço no cuidado e na prevenção da dengue, colocando a própria comunidade como precursora e responsável pelos atos que irão fornecer uma promoção da saúde e melhorias em suas vidas

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio