O lago não é tão raso quanto parece

Nos últimos dois anos o mundo vivenciou uma crise sanitária com a pandemia do coronavírus 19 (COVID-19). O crescimento exponencial de casos novos da doença no globo e o aumento da morbidade e mortalidade levou a busca incessante por novas terapias que pudessem aumentar as curvas de cura da infecção. As vacinas e terapias de suporte ainda fazem parte do escopo de inúmeras Farmacêuticas que investem em pesquisa clínica para obtenção de melhores resultados. O SARS-CoV-2, vírus causador da doença COVID-19, pode resultar em sintomas respiratórios rápidos e intensos, insuficiência pulmonar e até o óbito. Dos sintomas que podem ser apresentados é reportadona literatura febre, tosse, mialgia ou fadiga, seguidos por pneumonia e dispneia. Sintomas relatados menos comuns incluem: dor de cabeça, diarreia e hemoptise.

Conceptions on Interdisciplinarity between Teachers of the College Education

With the implementation of Interdisciplinary Bachelor s degrees in Brazilian universities new dynamics of teaching and research proved necessary but few analyzes were made to better clarify the concepts about interdisciplinarity present among teachers This study aims to present a possibility of understanding on this topic from the perspectives of some teachers who teach in interdisciplinary degrees For that the Free Word Association Test TALP was applied and semi-structured interviews were conducted with them The corpus was organized in Word Wordle and Iramuteq and evaluated according to Bardin s Content Analysis The results of this study corroborate and at the same time ratify the idea of interdisciplinarity as pluriconceptual and polysemic covering from the simple to the most complex way of understanding the hyperdynamic structure of knowledge in which we are faced with several possibilities of interpretation understanding and practices they point above all to the subjects attitudes as evidenced by the basic literature about this them

Melatonin supplementation in the management of obesity and obesity-associated disorders: a review of physiological mechanisms and clinical applications

Despite the evolving advances in clinical approaches to obesity and its inherent comorbidities, the therapeutic challenge persists. Among several pharmacological tools already investigated, recent studies suggest that melatonin supplementation could be an efficient therapeutic approach in the context of obesity. In the present review, we have amalgamated the evidence so far available on physiological effects of melatonin supplementation in obesity therapies, addressing its effects upon neuroendocrine systems, cardiometabolic biomarkers and body composition. Most studies herein appraised employed melatonin supplementation at dosages ranging from 1 to 20 mg/day, and most studies followed up participants for periods from 3 weeks to 12 months. Overall, it was observed that melatonin plays an important role in glycaemic homeostasis, in addition to modulation of white adipose tissue activity and lipid metabolism, and mitochondrial activity. Additionally, melatonin increases brown adipose tissue volume and activity, and its antioxidant and anti-inflammatory properties have also been demonstrated. There appears to be a role for melatonin in adiposity reduction; however, several questions remain unanswered, for example melatonin baseline levels in obesity, and whether any seeming hypomelatonaemia or melatonin irresponsiveness could be clarifying factors. Supplementation dosage studies and more thorough clinical trials are needed to ascertain not only the relevance of such findings but also the efficacy of melatonin supplementation

The Usefulness of Melatonin in the Field of Obstetrics and Gynecology

Disorders of the female reproductive system, including those associated with hormone regulation, fertility rate and fetal health, are issues of great concern worldwide. More recently, melatonin supplementation has been suggested as a therapeutic approach in gynecological practice. In both animal models and in women, melatonin supplementation suggests a therapeutic and preventative potential, effects attributed mainly to its antioxidant properties and action as hormone modulator. The aim of this literature review is to further investigate the evidence available on the effects of melatonin supplementation in animal and human studies, focusing on its potential application to gynecology. Melatonin-containing supplements are easily found in online and high street retailers, and despite its supplementation deemed to be relatively safe, no consensus has been reached on effective dosage and supplementation period. Short term supplementation studies, of up to six months, suggest that a daily posology of 2 to 18 mg of melatonin may have the potential to improve fertility rate, oocyte quality, maturation and number of embryos. However, the evidence available so far on the effects of melatonin supplementation covering gestational age and gestational outcomes is very scarce. Clinical trials and longer-term supplementation studies are required to assess any clinical outcome associated with melatonin supplementation in the field of gynecology

Profile of herbal and dietary supplements induced liver injury in Latin America: A systematic review of published reports

Hepatotoxicity related to HDS is a growing global health issue. We have undertaken a systematic review of published case reports and case series from LA from 1976 to 2020 to describe the clinical features of HDS related hepatotoxicity in this region. We search in PubMed, Web of Science, Scopus and specific LA databases according to PRISMA guidelines. Only HILI cases published in LA that met criteria for DILI definition were included. Duplicate records or reports that lacked relevant data that precluded establishing causality were excluded. Finally, 17 records (23 cases) were included in this review. Centella asiatica, Carthamus tinctorius, and Herbalife® were the most reported HDS culprit products, the main reason for HDS consumption was weight loss. The clinical characteristics of HDS hepatotoxicity in our study were compared to those of other studies in the USA, Europe and China showing a similar signature with predominance of young females, hepatocellular damage, a high rate of ALF and mortality, more frequent inadvertent re-challenge and chronic damage. This study underscores the challenge in causality assessment when multi-ingredients HDS are taken and the need for consistent publication practice when reporting hepatotoxicity cases due to HDS, to foster HDS liver safety particularly in LA

Uso de suplementos alimentares por universitários da área de saúde em Salvador-BA

Introduction: The use of dietary supplementation is a constant reality in contemporary society, however, there are few studies on the subject. What used to be a practice of a specific population of athletes, today, is a reality in all groups. In the university population of health is no different. Objective: To evaluate the frequency and profile of the use of dietary supplements by students in the health area in Salvador. Methods: Descriptive study, with the university population of the health area. The data were obtained from the application of an online questionnaire, without identification. Categorical variables were analyzed in the form of frequencies and percentages, while continuous variables were evaluated as means ± standard deviation. Results: Of the 401 students evaluated, the predominant age group was 20 to 24 years old and the majority were female (69,3%). In relation to the university course, the highest percentage was of the medical course (27,4%). From the sample of the participating students, 51,1% answered using some type of supplement and 61,6% said they practiced some physical activity. Most users, 83,4%, reported having achieved the expected results, however, 11,2% reported adverse event appearance. Conclusion: In the sample studied, a high frequency of dietary supplements and a predominant use of protein supplements were observed. Adverse events have been reported that may possibly be associated with the consumption of supplements.Introdução: O uso de suplementação alimentar é uma realidade constante na sociedade contemporânea, no entanto, existem poucos estudos em relação ao assunto. O que antes era prática de uma população específica de atletas, hoje, é uma realidade em todos os grupos. Na população universitária da área de saúde não é diferente. Objetivo: Avaliar a frequência e o perfil do uso de suplementos alimentares por estudantes da área de saúde em uma universidade privada em Salvador. Materiais e métodos: Estudo descritivo, com a população universitária da área de saúde. Os dados foram obtidos a partir da aplicação de um questionário online, sem identificação. Foi realizada análise das variáveis categóricas sob a forma de frequências e porcentagens, enquanto as variáveis contínuas foram avaliadas na forma de médias ± desvio-padrão. Resultados: Dos 401 estudantes avaliados, a faixa etária predominante foi 20 a 24 anos e a maioria foi do gênero feminino (69,3%). Em relação ao curso universitário, a maior porcentagem era do curso de medicina (27,4%). Da amostra dos estudantes participantes, 51,1%, responderam fazer uso de algum tipo de suplemento e 61,6% afirmou praticar alguma atividade física. A maioria dos usuários, 83,4%, afirmou ter obtido os resultados esperados, no entanto, 11,2% relataram presença de eventos adversos. Conclusão: Na amostra estudada foi observada uma elevada frequência do uso de suplementos alimentares e um uso predominante de suplementos proteicos. Eventos adversos foram relatados que podem possivelmente associados ao consumo dos suplementos

RESISTÊNCIA ANTIMICROBIANA NA INFECÇÃO URINÁRIA EM UNIDADE DE TERAPIA INTENSIVA

A infecção do trato urinário (ITU) nada mais é do que o acometimento das vias urinárias por microrganismo. Entre as infecções hospitalares de maior incidência está a infecção do trato urinário, acometendo mais mulheres do que homens. Uma das possíveis causas dessa infecção, em pacientes na unidade de terapia intensiva (UTI), é o uso de cateter vesical. Seu tratamento inadequado pode ocasionar uma pielonefrite, podendo adentrar à circulação sanguínea, gerando uma infecção sistêmica e levar o paciente a óbito. A resistência antimicrobiana é uma das principais dificuldades encontrada em UTI sendo considerado um problema de saúde pública. O objetivo deste trabalho foi realizar  um breve relato, baseado na literatura, sobre a resistência antimicrobiana na infecção urinária em unidade de terapia intensiva adulta. Em ambientes hospitalares o principal microrganismo causador de ITU é Escherichia coli, sendo 55,5% das culturas positivas estão associadas a procedimentos invasivos, como as sondas vesicais de demora, como consequência este é o microrganismo que mais apresenta resistência aos antimicrobianos utilizados como a ampicilina, trimetoprima e ciprofloxacino.  O uso indiscriminado de antibióticos deixa em evidência a necessidade de análise criteriosa da real necessidade de qual antimicrobianos usar, tempo de uso e forma correta de administração. Portanto é necessária a ação dos profissionais de saúde frente a atenção ao paciente, desde a higiene das mãos, uso do cateter, quando necessário observar a real necessidade do uso do antimicrobianos e que esse seja feito após cultura e antibiograma.

Zebrafish as a Model of Neurodevelopmental Disorders

Neurodevelopmental disorders (NDDs) caused by aberrant brain growth and development are life-long, debilitating illnesses that markedly impair the quality of life. Animal models are a valuable tool for studying NDD pathobiology and therapies. Mounting evidence suggests the zebrafish (Danio rerio) as a useful model organism to study NDDs, possessing both high physiological homology to humans and sensitivity to pharmacological and genetic manipulations. Here, we summarize experimental models of NDDs in zebrafish and highlight the growing translational significance of zebrafish NDD-related phenotypes. We also emphasize the need in further development of zebrafish models of NDDs to improve our understanding of their pathogenesis and therapeutic treatments. © 2019 IBROThis research is supported by the Russian Science Foundation grant 19-05-00053. KAD is supported by the Russian Foundation for Basic Research grant 18‐34‐00996, the President of Russia PhD Fellowship and the SPSU Rector's Productivity Fellowship for PhD students. ACVVG is supported by the Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS) research fellowships 17/2551-0001-269-0. AVK is the President of the International Stress and Behavior Society (ISBS, www.stress-and-behavior .com) and the Chair of the International Zebrafish Neuroscience Research Consortium (ZNRC) that coordinated this multi-laboratory collaborative project

Herbal and dietary supplements-induced liver injury in Latin America: Experience from the LATINDILI Network

Background: Herbal and dietary supplements (HDS) consumption, a growing cause of hepatotoxicity, is a common practice among Latin-American populations. Objectives: To evaluate clinical, laboratory features and outcome in HDS-hepatotoxicity included in the Latin America-Drug Induced Liver Injury (LATINDILI) Network. Material and methods: A total of 29 adjudicated cases of HDS hepatotoxicity reported to the LATINDILI Network from October 2011 through December 2019 were compared with 322 DILI cases due to conventional drugs and 16 due to anabolic steroids as well as with other series of HDS-hepatotoxicity. Results: From 367 DILI cases, 8% were attributed to HDS. An increasing trend in HDS-hepatotoxicity was noted over time (p=0.04). Camellia sinensis, Herbalife® products, and Garcinia cambogia, mostly used for weight loss, were the most frequently adjudicated causative agents. Mean age was 45 years (66% female). Median time to onset was 31 days. Patients presented typically with hepatocellular injury (83%) and jaundice (66%). Five cases (17%) developed acute liver failure. Compared to conventional medications and anabolic steroids, HDS hepatotoxicity cases had the highest levels of aspartate and alanine transaminase (p=0.008 and p=0.021, respectively), had more re-exposure events to the culprit HDS (14% vs 3% vs 0%; p=0.026), and had more severe and fatal/liver transplantation outcome (21% vs 12% vs 13%; p=0.005). Compared to other DILI cohorts, less HDS hepatotoxicity cases in Latin America were hospitalized (41%). Conclusions: HDS-hepatotoxicity in Latin-America affects mainly young women, manifests mostly with hepatocellular injury and is associated with higher frequency of accidental re-exposure. HDS hepatotoxicity is more serious with a higher chance of death/liver-transplant than DILI related to conventional drugs.The present study has been supported by grants of the Andalusian Health Service (SAS) (contract number: PI-0285-2016). Instituto de Salud Carlos III co-funded by Fondo Europeo de Desarrollo Regional – FEDER (contract numbers: (PI-0274-2016, PI-0285-2016, PI-0310-2018, PI18-00901, PI18/01804). IAA holds a Sara Borrell research contract from the National Health System, ISCiii (CD 20/00083), and by the Agencia Española del Medicamento. CIBERehd is funded by Instituto de Salud Carlos III