VALIDAÇÃO DE INSTRUMENTO PARA MENSURAR A ADESÃO AO TRATAMENTO FARMACOLÓGICO EM PACIENTES PSIQUIÁTRICOS

Objective: To validate the Scale of Assessment of Adherence to Pharmacological Treatment in Patients with Psychiatric Disorders (VERUM), developed to specifically assess the elements that influence adherence to pharmacological treatment in patients with Mental Disorders, as to its reproducibility, reliability and validity. Methods: Statistical techniques were used to test the reproducibility of the scale (H coefficient), internal consistency through Cronbach's Alpha and Mcdonald's Omega Coefficient, and validity of the instrument through comparison with the MARS Scale and Exploratory Factor Analysis. Results: Cronbach's alpha (0.81) and Mcdonald's Omega (0.826) indicated that VERUM has good internal consistency and Spearman's Correlation (-0.69) showed that there is correlation between MARS and VERUM items. Exploratory Factor Analysis grouped the VERUM Scale items into three dimensions that influence study group adherence: secondary gain, inner world, and relationships with the outer world. Conclusion: Results of the statistical analyses showed that the VERUM Scale is a valid and reliable tool to assess adherence to pharmacological treatment in psychiatric patients. The dimensions of adherence are organized into factors that go beyond those recognized in the literature.    Objetivo: Validar la Escala de Evaluación de la Adherencia al Tratamiento Farmacológico en Pacientes con Trastornos Psiquiátricos (VERUM), desarrollada para evaluar específicamente los elementos que influyen en la adherencia al tratamiento farmacológico en pacientes con trastornos mentales, en términos de su reproducibilidad, fiabilidad y validez. Métodos: Se utilizaron técnicas estadísticas para comprobar la reproducibilidad de la escala (coeficiente H), la consistencia interna mediante el Alfa de Cronbach y el Coeficiente Omega de Mcdonald, y la validez del instrumento mediante la comparación con la Escala MARS y el Análisis Factorial Exploratorio. Resultados: El Alfa de Cronbach (0,81) y el Omega de Mcdonald (0,826) indicaron que VERUM tiene una buena consistencia interna y la Correlación de Spearman (-0,69) mostró que existe una correlación entre los ítems de MARS y VERUM. El Análisis Factorial Exploratorio agrupó los ítems de la Escala VERUM en tres dimensiones que influyen en la adherencia del grupo de estudio: ganancia secundaria, mundo interior y relaciones con el mundo exterior. Conclusiones: Los resultados de los análisis estadísticos mostraron que la Escala VERUM es una herramienta válida y fiable para evaluar la adherencia al tratamiento farmacológico en pacientes psiquiátricos. Las dimensiones de la adherencia se organizan en factores que van más allá de los reconocidos en la literatura.  Objetivo: Validar a Escala de Avaliação da Adesão ao Tratamento Farmacológico em Pacientes Portadores de Transtornos Psiquiátricos (VERUM), desenvolvida para avaliar especificamente os elementos que influenciam a adesão ao tratamento farmacológico em pacientes com Transtornos Mentais, quanto à sua reprodutibilidade, confiabilidade e validade. Métodos: Foram utilizadas técnicas estatísticas para testar a reprodutibilidade da escala (coeficiente H), consistência interna por meio do Alfa de Cronbach e Coeficiente Ômega de Mcdonald, e validade do instrumento através de comparação com a Escala MARS e Análise Fatorial Exploratória. Resultados: Alfa de Cronbach (0,81) e Ômega de Mcdonald (0,826) indicaram que VERUM possui boa consistência interna e a Correlação de Spearman (-0,69) mostrou que há correlação entre os itens de MARS e VERUM. A Análise Fatorial Exploratória agrupou os itens da Escala VERUM em três dimensões que influenciam a adesão do grupo de estudo: ganho secundário, mundo interior e relações com o mundo exterior. Conclusões: Resultados das análises estatísticas mostraram que a Escala VERUM é uma ferramenta válida e confiável para avaliar a adesão ao tratamento farmacológico em pacientes psiquiátricos. As dimensões de adesão organizam-se em fatores que vão além dos reconhecidos na literatura.  Objetivo: Validar a Escala de Avaliação da Adesão ao Tratamento Farmacológico em Pacientes Portadores de Transtornos Psiquiátricos (VERUM), desenvolvida para avaliar especificamente os elementos que influenciam a adesão ao tratamento farmacológico em pacientes com Transtornos Mentais, quanto à sua reprodutibilidade, confiabilidade e validade. Métodos: Foram utilizadas técnicas estatísticas para testar a reprodutibilidade da escala (coeficiente H), consistência interna por meio do Alfa de Cronbach e Coeficiente Ômega de Mcdonald, e validade do instrumento através de comparação com a Escala MARS e Análise Fatorial Exploratória. Resultados: Alfa de Cronbach (0,81) e Ômega de Mcdonald (0,826) indicaram que VERUM possui boa consistência interna e a Correlação de Spearman (-0,69) mostrou que há correlação entre os itens de MARS e VERUM. A Análise Fatorial Exploratória agrupou os itens da Escala VERUM em três dimensões que influenciam a adesão do grupo de estudo: ganho secundário, mundo interior e relações com o mundo exterior. Conclusões: Resultados das análises estatísticas mostraram que a Escala VERUM é uma ferramenta válida e confiável para avaliar a adesão ao tratamento farmacológico em pacientes psiquiátricos. As dimensões de adesão organizam-se em fatores que vão além dos reconhecidos na literatura.

Artisanal cheese of Minas Gerais, not all are AMC: a brief review

The artisanal Minas cheese (AMC) is a product widely produced and consumed throughout the state of Minas Gerais, with the regions of Araxá, Campo das Vertentes, Canastra, Cerrado, Ibitipoca, Serra do Salitre, Serro, Triângulo considered as the eight traditional regions of artisanal Minas cheese. With the publication of the Law 23,157, of December 18, 2018, related to the production and sale of artisanal cheeses in Minas Gerais, other artisanal cheese varieties could also be recognized and regularized, in addition to the AMC. Among the varieties of artisanal cheeses of Minas Gerais (ACM), which are not AMC, are: artisanal cheese from Alagoa, artisanal Mantiqueira de Minas cheese, Cabacinha cheese, artisanal cheese from Vale do Suaçuí, artisanal cheese from Serra Geral, and also the artisanal processed cheese, known as requeijão Moreno. While the AMC must follow a standard manufacturing technology in all regions where it is produced, other artisanal cheeses made in Minas Gerais have some particularities, such as heating and cooking the curd, melting, or stretching, among other steps that are not allowed in the AMC. In short, artisanal cheeses of Minas Gerais include artisanal Minas cheeses (AMC) and artisanal cheeses that have specific manufacturing technology only for their variety. The artisanal cheeses of Minas Gerais are part of history and culture of the state, however they have not yet been extensively studied, so there are not many scientific publications about their characteristics and how these cheeses are made. In this context, this review aimed to study the literature to elucidate the main characteristics of artisanal cheeses of Minas Gerais that do not fit the AMC classification, as well as their production regions and manufacturing technologies

Deregulation of desmosomal proteins and extracellular matrix proteases in odontogenic keratocyst

OBJECTIVE : Odontogenic keratocyst (OKC) is a benign lesion that tends to recur after surgical treatment. In an attempt to clarify the molecular basis underlining the OKC pathobiology, we aimed to analyze its proteomic profile. MATERIALS AND METHODS : We compared the proteomic profiles of five OKC and matched normal oral mucosa by using liquid chromatography–tandem mass spectrometry (LC-MS/MS). Then, we performed enrichment analysis and a literature search for the immunoexpression of the proteomics targets. RESULTS : We identified 1,150 proteins and 72 differently expressed proteins (log2 fold change ≥ 1.5; p < .05). Twenty-seven peptides were exclusively detected in the OKC samples. We found 35 enriched pathways related to cell differentiation and tissue architecture, including keratinocyte differentiation, keratinization, desmosome, and extracellular matrix (ECM) organization and degradation. The immunoexpression information of 11 out of 50 proteins identified in the enriched pathways was obtained. We found the downregulation of four desmosomal proteins (JUP, PKP1, PKP3, and PPL) and upregulation of ECM proteases (MMP-2, MMP-9, and cathepsins). CONCLUSIONS : Proteomic analysis strengthened the notion that OKC cells have a similar proteomic profile to oral keratinocytes. Contextual investigation of the differentially expressed proteins revealed the deregulation of desmosome proteins and ECM degradation as important alterations in OKC pathobiology.Conselho Nacional de Desenvolvimento Científico e Tecnológico and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.http://www.wileyonlinelibrary.com/journal/odihj2022Oral Pathology and Oral Biolog

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Avanços da cirurgia robótica no tratamento de doenças cardiovasculares

Várias cirurgias médicas já utilizaram a tecnologia robótica, tais como: cirurgias no estômago, bexiga, rins, próstata, cérebro e inclusive no coração, o qual proporciona-se a reparação de válvulas cardíacas e até mesmo cirurgias nas artérias. O principal objetivo do presente estudo é discutir por meio da literatura científica acerca dos avanços da cirurgia robótica no tratamento de doenças cardiovasculares. Trata-se de uma revisão sistemática da literatura, dos quais, utilizou-se as bases e biblioteca eletrônica Scielo e Periódico Capes, totalizando 5 artigos elegíveis. A cirurgia robótica tem sido um dos principais métodos utilizados em tratamentos cardiovasculares quando comparados com técnicas convencionais, sobretudo, no que diz respeito, a cirurgia de revascularização do miocárdio

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

KRAS mutations in implant‐associated peripheral giant cell granuloma

Objectives: To investigate the molecular pathogenesis of implant‐associated peripheral giant cell granuloma (IA‐PGCG). Methods: A convenience sample of 15 IA‐PGCG cases was selected. Hotspot mutations of KRAS, FGFR1, and TRPV4 genes, previously reported in conventional giant cell lesions of the jaws, were investigated by Sanger sequencing. As these mutations could activate MAPK/ERK pathway, the expression of phospho‐ERK1/2 was also evaluated by immunohistochemistry. Results: KRAS mutations were detected in 8/15 (53.4%) samples. Similar to conventional peripheral giant cell granuloma, the KRAS mutations most frequently occurred in codon 146 (p.A146V, n = 3), followed by codon 12 (p.G12A and p.G12D, n = 1 each) and codon 14 (p.V14L, n = 1). Variants of unknown significance (VUS) were also detected in two cases, affecting codons 37 (p.E37K) and 127 (p.T127I). All samples showed wild‐type (WT) sequences for FGFR1 and TRPV4 genes. Consistent with MAPK/ERK pathway activation, all mononuclear cells of the lesion showed strong staining for phospho‐ERK1/2 protein in the immunohistochemical analysis. Conclusions: KRAS mutations and activation of the MAPK‐ERK signaling pathway occur in IA‐PGCG. This is the first study to demonstrate cancer‐associated gene mutations in a non‐neoplastic reactive condition associated with dental implants

Deregulation of desmosomal proteins and extracellular matrix proteases in odontogenic keratocyst

OBJECTIVE : Odontogenic keratocyst (OKC) is a benign lesion that tends to recur after surgical treatment. In an attempt to clarify the molecular basis underlining the OKC pathobiology, we aimed to analyze its proteomic profile. MATERIALS AND METHODS : We compared the proteomic profiles of five OKC and matched normal oral mucosa by using liquid chromatography–tandem mass spectrometry (LC-MS/MS). Then, we performed enrichment analysis and a literature search for the immunoexpression of the proteomics targets. RESULTS : We identified 1,150 proteins and 72 differently expressed proteins (log2 fold change ≥ 1.5; p < .05). Twenty-seven peptides were exclusively detected in the OKC samples. We found 35 enriched pathways related to cell differentiation and tissue architecture, including keratinocyte differentiation, keratinization, desmosome, and extracellular matrix (ECM) organization and degradation. The immunoexpression information of 11 out of 50 proteins identified in the enriched pathways was obtained. We found the downregulation of four desmosomal proteins (JUP, PKP1, PKP3, and PPL) and upregulation of ECM proteases (MMP-2, MMP-9, and cathepsins). CONCLUSIONS : Proteomic analysis strengthened the notion that OKC cells have a similar proteomic profile to oral keratinocytes. Contextual investigation of the differentially expressed proteins revealed the deregulation of desmosome proteins and ECM degradation as important alterations in OKC pathobiology.Conselho Nacional de Desenvolvimento Científico e Tecnológico and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.http://www.wileyonlinelibrary.com/journal/odihj2022Oral Pathology and Oral Biolog