Intervenções mente-corpo para o tratamento de insônia: uma revisão

OBJECTIVE: As insomnia is highly prevalent, and side effects of medication are well-known, mind-body interventions are increasingly being sought. The objective of this study is to present a narrative review regarding the effects of mind-body interventions for the treatment of insomnia. METHOD: A PubMed search was conducted including only randomized, controlled trials in which the main objective was to treat insomnia. DISCUSSION: Twelve studies were selected. In three of the studies, objective parameters (polysomnography) were analyzed. Mind-body interventions were able to improve sleep efficiency and total sleep time. Most can ameliorate sleep quality; some can reduce the use of hypnotic drugs in those who are dependent on these drugs. CONCLUSION: According to the studies we selected, self-reported sleep was improved by all mind-body treatments, among them yoga, relaxation, Tai Chi Chih and music. Cognitive behavioral therapy seems to be the most effective mind-body intervention. Cognitive behavioral therapy was the only intervention that showed better results than medication. However, considering that only five of the twelve studies chosen reached a score of 3 in the Jadad scale, new studies with a higher methodological quality have to be conducted especially in mind-body interventions that belong to the complementary or alternative medicine field.OBJETIVO: Considerando-se que a insônia é altamente prevalente, e os efeitos colaterais das medicações para seu tratamento são bem conhecidos, pesquisas no campo das intervenções mente-corpo têm sido desenvolvidas. O objetivo deste estudo é apresentar uma revisão narrativa sobre os efeitos das intervenções mente-corpo para o tratamento de insônia. MÉTODO: Uma busca pelo site Pubmed foi conduzida incluindo-se apenas estudos controlados e randomizados nos quais o principal objetivo era o tratamento da insônia. DISCUSSÃO: Doze estudos foram selecionados. Em três deles, parâmetros objetivos (polissonografia) foram analisados. Vários destes estudos mostraram melhora na qualidade do sono; em grupos de usuários de drogas hipnóticas ocorreu redução no uso das mesmas. CONCLUSÃO: De acordo com os estudos selecionados, todas as intervenções mente-corpo melhoraram ao menos a qualidade subjetiva do sono, dentre elas yoga, Tai Chi Chih e música. A terapia comportamental cognitiva parece ser a mais efetiva destas intervenções e foi a única que mostrou melhores resultados que a medicação. Porém, considerando que apenas cinco dos 12 estudos selecionados alcançaram o escore 3 na escala de Jadad, novos estudos com melhor qualidade metodológica precisam ser conduzidos especialmente dentre as intervenções mente-corpo que estão no campo das práticas complementares ou alternativas.Universidade Federal de São Paulo (UNIFESP) Department of PsychobiologyUniversidade Nove de Julho Núcleo de Estudos em Saúde Coletiva e da FamíliaInstituto Israelita de Ensino e Pesquisa Albert Einstein Instituto do CérebroUniversidade Federal de São Paulo (UNIFESP) Instituto do SonoUniversidade Federal de São Paulo (UNIFESP) Department of GynecologyUniversidade Federal de São Paulo (UNIFESP) Centro Cochrane do BrasilUniversidade Federal de São Paulo (UNIFESP) Department of PhysiologyUNIFESP, Department of PsychobiologyUNIFESP, Instituto do SonoUNIFESP, Department of GynecologyUNIFESP, Centro Cochrane do BrasilUNIFESP, Department of PhysiologySciEL

Posición Ghlischro-cárica: conocerla puede ampliar sus recursos médicos y psicoanalíticos.

Melanie Klein enunció las posiciones Depresiva (1935) y Esquizoparanoide (1946). Esther Bick y Donald Meltzer desarrollaron, a partir de los estudios de Klein, el concepto de identificación adesiva. José Bleger, presenta (post mortem), en 1977, utilizando este conocimiento y conjeturando sobre la simbiosis, la posición Ghlischro-cárica, que él consideraba, con maestría, una posición anterior a la posición Esquizoparanoide. La posición Ghlischro-cárica incluye un conglomerado yoico con el objeto de que no está diferenciado, que fue nombrado por Bleger como un núcleo aglutinado. Tiene en su constitución, ansiedad por defusión que puede manifestarse como ansiedad de tipo pánico, somatizaciones y enfermedades psicosomáticas, como esclerosis múltiple, artritis reumatoide, vitiligo, entre otras. Es interesante decir que 72% de los pacientes que buscan atención médica neuropsiquiátrica y psicológica utilizan la posición Ghlischro-cárica dentro de su universo relacional, con sus idiosincrasias que afectan sus vidas y el entorno terapéutico. El conocimiento de sus particularidades puede ampliar el volumen de recursos del profesional de la salud mental, en el uso de técnicas psicoterapéuticas e incluso en la elección de los medicamentos psicotrópicos más adecuados para los clientes en este puesto, lo que hace que el desarrollo de este tema sea esencial. Utilizamos un modelo de estudio clínico-cualitativo y transdisciplinario basado en una revisión conceptual sobre el tema

SPIRITS 15c and SPIRITS 14buu: Two Obscured Supernovae in the Nearby Star-Forming Galaxy IC 2163

SPIRITS---SPitzer InfraRed Intensive Transients Survey---is an ongoing survey of nearby galaxies searching for infrared (IR) transients with Spitzer/IRAC. We present the discovery and follow-up observations of one of our most luminous ($M_{[4.5]} = -17.1\pm0.4$ mag, Vega) and red ($[3.6] - [4.5] = 3.0 \pm 0.2$ mag) transients, SPIRITS 15c. The transient was detected in a dusty spiral arm of IC 2163 ($D\approx35.5$ Mpc). Pre-discovery ground-based imaging revealed an associated, shorter-duration transient in the optical and near-IR (NIR). NIR spectroscopy showed a broad ($\approx 8400$ km s$^{-1}$), double-peaked emission line of He I at $1.083 \mu$m, indicating an explosive origin. The NIR spectrum of SPIRITS 15c is similar to that of the Type IIb SN 2011dh at a phase of $\approx 200$ days. Assuming $A_V = 2.2$ mag of extinction in SPIRITS 15c provides a good match between their optical light curves. The IR light curves and the extreme $[3.6]-[4.5]$ color cannot be explained using only a standard extinction law. Another luminous ($M_{4.5} = -16.1\pm0.4$ mag) event, SPIRITS 14buu, was serendipitously discovered in the same galaxy. The source displays an optical plateau lasting $\gtrsim 80$ days, and we suggest a scenario similar to the low-luminosity Type IIP SN 2005cs obscured by $A_V \approx 1.5$ mag. Other classes of IR-luminous transients can likely be ruled out in both cases. If both events are indeed SNe, this may suggest $\gtrsim 18\%$ of nearby core-collapse SNe are missed by currently operating optical surveys.Comment: 19 pages, 7 Figures, 4 Table

Staphylococcus aureus na boca e no nariz de indivíduos sãos: verificação de identidade entre as cepas isoladas

The material collected from nose and mouth (saliva and tongue smear, separately) in 130 clinically healthy individuals, enabled the characterization of 47 (36.15%) of them as carriers for S. aureus. Of these 21 were buccal carriers exclusively and 11 nasal carriers exclusively. Once it had been observed that nose and mouth shelter different phagotypes, it was discovered that the simultaneous collecting of material from two different niches (saliva and tongue, nose and tongue and nose and saliva) affords the identification of a larger number of carriers. It is recomended that, on the detection of S. aureus carriers, the isolation should be made starting with materials simultaneously collected from nasal and buccal areas (saliva or tongue).Material colhido do nariz e da boca (saliva e raspado lingual, isoladamente) de 130 indivíduos clinicamente sadios, permitiu caracterizar 47 (36,15%) deles como portadores de S. aureus, sendo 21 portadores exclusivamente bucais e 31 exclusivamente nasais. Tendo sido constatado que o nariz e a boca albergam cepas de diferentes fagotipos, foi verificado que a colheita simultânea de material de dois nichos distintos (saliva e língua, nariz e língua e nariz e saliva) proporcionava a determinação de maior número de portadores. Foi recomendado que, na detecção de portadores de S. aureus, os isolamentos devem ser feitos a partir de materiais colhidos simultaneamente das áreas nasal e bucal (saliva ou língua)

Risk Factors for Ocular Infection with Chlamydia trachomatis in Children 6 Months following Mass Treatment in Tanzania

Trachoma control programs aim for high coverage of endemic communities with oral azithromycin to reduce the pool of infection with Chlamydia trachomatis. However, even with high coverage, infection is seen following treatment. In four communities in Tanzania, we followed every child aged under ten years from baseline through treatment to six months post-treatment. We determined who had infection at baseline and who still had or developed infection six months later. Coverage was over 95% in children in these communities, and infection in these children decreased by over 50% at six months. The study found that, at baseline, uninfected children who were treated had prevalence of infection at 6 months of 6%, but infected children who were treated had prevalence of infection of 22% at 6 months. Other risk factors for infection at 6 months included living in a household with other infected children, and living in a household with untreated children. Our data suggest that households with untreated children might be targeted for more intensive follow up to increase coverage and reduce subsequent infection in the community

Rising from the Ashes: Mid-infrared Re-brightening of the Impostor SN 2010da in NGC 300

We present multi-epoch mid-infrared (IR) photometry and the optical discovery observations of the "impostor" supernova (SN) 2010da in NGC 300 using new and archival Spitzer Space Telescope images and ground-based observatories. The mid-infrared counterpart of SN 2010da was detected as Spitzer Infrared Intensive Transient Survey (SPIRITS) 14bme in the SPIRITS, an ongoing systematic search for IR transients. Before erupting on 2010 May 24, the SN 2010da progenitor exhibited a constant mid-IR flux at 3.6 and only a slight ~10% decrease at 4.5 μm between 2003 November and 2007 December. A sharp increase in the 3.6 μm flux followed by a rapid decrease measured ~150 days before and ~80 days after the initial outburst, respectively, reveal a mid-IR counterpart to the coincident optical and high luminosity X-ray outbursts. At late times, after the outburst (~2000 days), the 3.6 and 4.5 μm emission increased to over a factor of two times the progenitor flux and is currently observed (as of 2016 Feb) to be fading, but still above the progenitor flux. We attribute the re-brightening mid-IR emission to continued dust production and increasing luminosity of the surviving system associated with SN 2010da. We analyze the evolution of the dust temperature (T_d ~ 700–1000 K), mass (M_d ~ 0.5–3.8 × 10^(−7) M⊙), luminosity (L_(IR) ~ 1.3–3.5 × 10^4 L⊙), and the equilibrium temperature radius (R_(eq) ~ 6.4–12.2 au) in order to resolve the nature of SN 2010da. We address the leading interpretation of SN 2010da as an eruption from a luminous blue variable high-mass X-ray binary (HMXB) system. We propose that SN 2010da is instead a supergiant (sg)B[e]-HMXB based on similar luminosities and dust masses exhibited by two other known sgB[e]-HMXB systems. Additionally, the SN 2010da progenitor occupies a similar region on a mid-IR color–magnitude diagram (CMD) with known sgB[e] stars in the Large Magellanic Cloud. The lower limit estimated for the orbital eccentricity of the sgB[e]-HMXB (e > 0.82) from X-ray luminosity measurements is high compared to known sgHMXBs and supports the claim that SN 2010da may be associated with a newly formed HMXB system

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (<50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, <50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

The FLUXNET2015 dataset and the ONEFlux processing pipeline for eddy covariance data

The FLUXNET2015 dataset provides ecosystem-scale data on CO2, water, and energy exchange between the biosphere and the atmosphere, and other meteorological and biological measurements, from 212 sites around the globe (over 1500 site-years, up to and including year 2014). These sites, independently managed and operated, voluntarily contributed their data to create global datasets. Data were quality controlled and processed using uniform methods, to improve consistency and intercomparability across sites. The dataset is already being used in a number of applications, including ecophysiology studies, remote sensing studies, and development of ecosystem and Earth system models. FLUXNET2015 includes derived-data products, such as gap-filled time series, ecosystem respiration and photosynthetic uptake estimates, estimation of uncertainties, and metadata about the measurements, presented for the first time in this paper. In addition, 206 of these sites are for the first time distributed under a Creative Commons (CC-BY 4.0) license. This paper details this enhanced dataset and the processing methods, now made available as open-source codes, making the dataset more accessible, transparent, and reproducible.Peer reviewe