Is heart rate variability a valuable method to investigate cardiac autonomic dysfunction in subjects with leukemia? A systematic review to evaluate its importance in clinical practice

Impaired cardiovascular and autonomic function during treatment and during recovery from leukemia has been indicated. In this context, heart rate variability (HRV) is a non-invasive measure that describes the oscillations of the intervals between consecutive heart beats (RR intervals), influenced by the autonomic nervous system. We intend to review literature showing HRV changes in leukemia subjects. The articles selected in the current review were attained up to March 2018, and the search was limited to articles in English language, published in peer-reviewed journals, with both adult and child age samples. The articles were investigated in the five electronic databases: PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Clinical Trials, Scientific Electronic Library Online (SciELO), and Excerpta Medica dataBASE (EMBASE). Towards the end of the research, 9 studies were included. Subjects undergoing treatment for leukemia have reduced HRV, signifying decreased vagal control of heart rate. The subjects that undertook leukemia treatment and their survivors experienced a reduction in HRV with subsequent recovery, but the recovery time is ill defined. HRV is reduced in leukemia subjects who progress to neuropathy secondary to chemotherapy, accompanied by cardiac dysfunction. We advocate the use of HRV to evaluate autonomic function and decide the treatment to prevent autonomic impairment in leukemia subjects

VALIDITY OF SOFTWARE FOR MEASUREMENT OF TOTAL REACTION TIME WITH SIMPLE STIMULUS -TRT_S 2012

Objective: Determine the validity of the TRT_S2012 software in to assess the total reaction time (TRT) with a simple visual stimulus (TRTSimple) and mental fatigue from TRT (TRTFatigue). Methods: Three types of validation were applied: a) concurrent, for determining the correlation between the TRT_S2012 Software and Vienna Test System (VTS), b) content of a sample of adults, and c)mechanical, using a robot that performs a mechanic motion to respond to a light stimulus.The study included 216 young adults, college students aged 17 – 45 years (x = 24.0 ± 6.0) and a robot. Descriptive and inferential statistics were used for performance on TRT obtained by young adults and robot in two software. Results: The intra-class correlation in the adults TRT showed strong correlation between VTS and TRTSimple (R = .72). Identification of the proposed initial stimulus in TRTFatigue presented intermediate correlation with VTS (R = .56) and the final stimulus presented low correlation with VTS (R=.35).The robot TRT showed standard deviation ranging .5 ms (on average) between the highest and lowest.The standard error of the mean ranged from .23 to .28 and the distributions were homogeneous between 8.2 to 9.7%. Conclusion: The results confirmed the validity of the software TRT_S2012 2012. It is a reliable cognitive test that can be applied to young adults for measuring the TRT with simple visual stimuli and for evaluating the influence of mental fatigue from the TRT. however, the delays caused by the computer resources used should be considered and measured with a resource like the robot. We conclude that the TRT_S2012 software is valid for assessing the TRT and cognitive fatigue in healthy adults

Mental health problems among medical students in Brazil: a systematic review and meta-analysis

Objective: To provide a comprehensive picture of mental health problems (MHPs) in Brazilian medical students by documenting their prevalence and association with co-factors. Methods: We systematically searched the MEDLINE/PubMed, SciELO, LILACS, and PsycINFO databases for cross-sectional studies on the prevalence of MHPs among medical students in Brazil published before September 29, 2016. We pooled prevalences using a random-effects meta-analysis, and summarized factors associated with MHP. Results: We included 59 studies in the analysis. For meta-analyses, we identified the summary prevalence of different MHPs, including depression (25 studies, prevalence 30.6%), common mental disorders (13 studies, prevalence 31.5%), burnout (three studies, prevalence 13.1%), problematic alcohol use (three studies, prevalence 32.9%), stress (six studies, prevalence 49.9%), low sleep quality (four studies, prevalence 51.5%), excessive daytime sleepiness (four studies, prevalence 46.1%), and anxiety (six studies, prevalence 32.9%). Signs of lack of motivation, emotional support, and academic overload correlated with MHPs. Conclusion: Several MHPs are highly prevalent among future physicians in Brazil. Evidence-based interventions and psychosocial support are needed to promote mental health among Brazilian medical students.Escola Super Ciencias Santa Casa Misericordia Vit, Fac Med, Vitoria, ES, BrazilNatl Univ Singapore, Yong Loo Lin Sch Med, Alice Lee Ctr Nursing Studies, Singapore, SingaporeUniv Fed Sao Paulo UNIFESP, Escola Paulista Med, Dept Cardiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Escola Paulista Med, Dept Cardiol, Sao Paulo, SP, BrazilWeb of Scienc

REVIEW OF “OXFORD TEXTBOOK OF PUBLIC HEALTH”

The fifth edition of the “ Oxford textbook of public health” , edited by Roger Detels, Robert Beaglehole, Mary Ann Lansang and Martin Gulliford, consists of 12 sections grouped into three volumes: scope, methods, and practices of public health. This edition deals with the development and application of science of disease prevention, increased longevity and health promotion by community action, to promote the physical, psychological and mental well-being of subjects, involving technology, social sciences, and politics. Each chapter describes public health problems, how to avoid them by early identification, suggestions, presentation of strategies for solving these problems, and evaluations of actions’ effectiveness. The entire book addresses public health in developed, emerging, and developing countries. Volume I presents the history of public health, determinants of health and disease, policies, laws and their ethics. In the first section, public health actions are described in different countries

Fatores associados a casos de Dengue na área industrial brasileira: um estudo ecológico

Introduction: Dengue is an acute systemic viral infectious disease, established worldwide in epidemic and endemic transmission cycles. High levels of precipitation, adequate temperatures, proximity between urban and peri-urban centers, human movement between population centers and urban solid waste (USW) production may facilitate dengue transmission and spread. Objective: To identify the relationship between diagnosed dengue cases and socioeconomic factors, USW mass generation and rainfall index. Methods: Ecological study, with secondary data collection from 2010 to 2016 for each municipality of the Greater ABC Region in São Paulo, Brazil. Total population, gross domestic product (GDP) per capita, USW, number of dengue cases and rainfall index were investigated. Data were collected on the websites of the Brazilian Institute of Geography and Statistics (IBGE), the municipalities of the Greater ABC Region, the Greater ABC Intermunicipal Consortium, the Greater ABC Economic Development Agency, the National Sanitation Information System, Surveillance Epidemiological Survey of the State of São Paulo and the Department of Water and Electric Energy of the State of São Paulo. Relationships between variables were tested by Spearman correlation. Results: Data analysis of all municipalities showed a positive correlation between dengue cases with total population (r=0.675, p<0.01), gross domestic product per capita (r=0.539, p<0.01) and MSW by inhabitant per year (r=0.492, p<0.01). Positive correlations were also observed between total population and gross domestic product per capita (r=0.583, p<0.01), MSW / Day (r=0.302, p<0.05) and MSW/year (r=0.961, p<0.01); gross domestic product per capita and MSW/day (r=0.849, p<0.01), MSW/year (r=0.410, p<0.05) and rainfall index (RI) (r=0.416, p<0.05); MSW / day and MSW / year (r=0.389, p<0.01) and RI (r=0.388, p<0.05). Conclusion: The larger the total population, purchasing power or socioeconomic status (GDP per capita) and the generation of MSW, the greater the number of dengue cases. Proper packaging of MSW seems to be a way to help in dengue cases control.Introdução: A dengue é uma doença infecciosa viral sistêmica aguda, estabelecida mundialmente em ciclos de transmissão epidêmica e endêmica. Altos níveis de precipitação, temperaturas adequadas, proximidade entre centros urbanos e peri-urbanos, movimento humano entre centros populacionais e produção de resíduos sólidos urbanos (RSU) podem facilitar a transmissão e a disseminação da dengue. Objetivo: Identificar a relação entre casos diagnosticados de dengue e fatores socioeconômicos, geração de massa de RSU e índice pluviométrico.   Método: Estudo ecológico, com coleta secundária de dados de 2010 a 2016 para cada município da Região do Grande do ABC, em São Paulo, Brasil. Foram investigados a população total, o produto interno bruto (PIB) per capita, RSU, número de casos de dengue e índice pluviométrico. Os dados foram coletados nos sites do Instituto Brasileiro de Geografia e Estatística (IBGE), os municípios da Região do Grande ABC, o Consórcio Intermunicipal do Grande ABC, a Agência de Desenvolvimento Econômico do Grande ABC, o Sistema Nacional de Informação sobre Saneamento, Centro de Vigilância Epidemiológica do Estado de São Paulo e o Departamento de Água e Energia Elétrica do Estado de São Paulo. As relações entre variáveis foram testadas pela correlação de Spearman.   Resultados: A análise dos dados de todos os municípios mostrou correlação positiva entre casos de dengue com população total (r = 0,675, p <0,01), produto interno bruto per capita (r = 0,539, p <0,01) e RSU por habitante por ano (r = 0,492, p <0,01). Também foram observadas correlações positivas entre população total e produto interno bruto per capita (r = 0,583, p <0,01), RSU / dia (r = 0,302, p <0,05) e RSU / ano (r = 0,961, p <0,01); produto interno bruto per capita e RSU / dia (r = 0,849, p <0,01), RSU / ano (r = 0,410, p <0,05) e índice de precipitação (IR) (r = 0,416, p <0,05); RSU / dia e RSU /ano (r = 0,389, p <0,01) e IR (r = 0,388, p <0,05). Conclusão: Quanto maior a população total, poder de compra ou condição socioeconômica (PIB per capita) e a geração de RSU, maior o número de casos de dengue. O descarte adequada dos RSU parece ser uma maneira de ajudar no controle dos casos de dengue

ENIGMA-Sleep:Challenges, opportunities, and the road map

Neuroimaging and genetics studies have advanced our understanding of the neurobiology of sleep and its disorders. However, individual studies usually have limitations to identifying consistent and reproducible effects, including modest sample sizes, heterogeneous clinical characteristics and varied methodologies. These issues call for a large-scale multi-centre effort in sleep research, in order to increase the number of samples, and harmonize the methods of data collection, preprocessing and analysis using pre-registered well-established protocols. The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium provides a powerful collaborative framework for combining datasets across individual sites. Recently, we have launched the ENIGMA-Sleep working group with the collaboration of several institutes from 15 countries to perform large-scale worldwide neuroimaging and genetics studies for better understanding the neurobiology of impaired sleep quality in population-based healthy individuals, the neural consequences of sleep deprivation, pathophysiology of sleep disorders, as well as neural correlates of sleep disturbances across various neuropsychiatric disorders. In this introductory review, we describe the details of our currently available datasets and our ongoing projects in the ENIGMA-Sleep group, and discuss both the potential challenges and opportunities of a collaborative initiative in sleep medicine