O adoecimento psicossomático: um novo olhar a partir da terapia cognitivo-comportamental / Psychosomatic illness: a new look based on cognitive-behavioral therapy

A psicossomática integra uma perspectiva colocando a doença em uma dimensão psicológica. Considerando que as emoções se expressam por meio do corpo e dos sintomas e que as alterações emocionais estão presentes antes e durante o curso da patologia, este estudo busca respostas para a seguinte questão: De que modo a Terapia Cognitivo-Comportamental (TCC) pode contribuir efetivamente em caso de doenças psicossomáticas? O objetivo do artigo é, assim, analisar a aplicabilidade das intervenções e técnicas da TCC no tratamento de doenças psicossomáticas, discorrer sobre o adoecimento psicossomático, a partir dos múltiplos fatores que o caracterizam; abordar a relação entre os eventos estressantes e o aparecimento de doenças; apontar as contribuições da TCC para o tratamento das doenças psicossomáticas. O presente trabalho caracteriza-se como um estudo qualitativo, realizado por meio de uma pesquisa bibliográfica baseada na obra de autores como França e Rodrigues (2007), Mello Filho e Burd (2010), Rangé (2011), entre outros. Conclui-se que as manifestações fisiológicas resultantes dos processos psicológicos, são uma forma de o corpo se expressar e, quanto menos eficientes são os mecanismos mentais, mais o sistema somático será utilizado   para expressar certos desequilíbrios, desencadeando o adoecimento psicossomático. Nesse sentido a TCC, em suas múltiplas formas de intervenção, vem colaborar expressivamente

Antifungal and anti-biofilm activity of designed derivatives from kyotorphin

© 2019 British Mycological Society. Published by Elsevier Ltd. All rights reserved.Kyotorphin (KTP, l-tyrosyl-l-arginine) is an endogenous analgesic neuropeptide first isolated from bovine brain in 1979. Previous studies have shown that kyotorphins possess anti-inflammatory and antimicrobial activity. Six kyotorphins—KTP-NH2, KTP–NH2–DL, ibuprofen-conjugated KTP (IbKTP), IbKTP-NH2, N-methyl-D-Tyr-L-Arg, and N-methyl-L-Tyr-D-Arg—were designed and synthesized to improve lipophilicity and resistance to enzymatic degradation. This study assessed the antimicrobial and antibiofilm activity of these peptides. The antifungal activity of kyotorphins was determined in representative strains of Candida species, including Candida albicans ATCC 10231, Candida krusei ATCC 6258, and six clinical isolates—Candida dubliniensis 19-S, Candida glabrata 217-S, Candida lusitaniae 14-S, Candida novergensis 51-S, Candida parapsilosis 63, and Candida tropicalis 140-S—obtained from the oral cavity of HIV-positive patients. The peptides were synthesized by standard solution or solid-phase synthesis, purified by RP-HPLC (purity >95 %), and characterized by nuclear magnetic resonance. The results of the broth microdilution assay and scanning electron microscopy showed that IbKTP-NH2 presented significant antifungal activity against Candida strains and antibiofilm activity against the clinical isolates. The absence of toxic activity and survival after infection was assessed after injecting the peptide in larvae of Galleria mellonella as experimental infection model. Furthermore, IbKTP-NH2 had strong antimicrobial activity against multidrug-resistant bacteria and fungi and was not toxic to G. mellonella larvae up to a concentration of 500 mM. These results suggest that IbKTP-NH2, in addition to its known effect on cell membranes, can elicit a cellular immune response and, therefore, is promising for biomedical application.This research was supported by FAPESP (Grant No. 2017/00032-0). This article is also part of the Fungal Adaptation to Hostile Challenges special issue for the third International Symposium on Fungal Stress (ISFUS), which is supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (Grant No. 2018/20571-6) and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) (Grant No. 88881.289327/2018-01).info:eu-repo/semantics/publishedVersio

The Psychedelic State Induced by Ayahuasca Modulates the Activity and Connectivity of the Default Mode Network

The experiences induced by psychedelics share a wide variety of subjective features, related to the complex changes in perception and cognition induced by this class of drugs. A remarkable increase in introspection is at the core of these altered states of consciousness. Self-oriented mental activity has been consistently linked to the Default Mode Network (DMN), a set of brain regions more active during rest than during the execution of a goal-directed task. Here we used fMRI technique to inspect the DMN during the psychedelic state induced by Ayahuasca in ten experienced subjects. Ayahuasca is a potion traditionally used by Amazonian Amerindians composed by a mixture of compounds that increase monoaminergic transmission. In particular, we examined whether Ayahuasca changes the activity and connectivity of the DMN and the connection between the DMN and the task-positive network (TPN). Ayahuasca caused a significant decrease in activity through most parts of the DMN, including its most consistent hubs: the Posterior Cingulate Cortex (PCC)/Precuneus and the medial Prefrontal Cortex (mPFC). Functional connectivity within the PCC/Precuneus decreased after Ayahuasca intake. No significant change was observed in the DMN-TPN orthogonality. Altogether, our results support the notion that the altered state of consciousness induced by Ayahuasca, like those induced by psilocybin (another serotonergic psychedelic), meditation and sleep, is linked to the modulation of the activity and the connectivity of the DMN.The Brazilian Federal Agencies: CNPq, CAPES; FINEP; The Sao Paulo State financial agency (FAPESP)

Prevalence of dementia subtypes in a developing country: a clinicopathological study

OBJECTIVES: To assess the distribution of dementia subtypes in Brazil using a population-based clinicopathological study. METHOD: Brains from deceased individuals aged ≥50 years old were collected after the next of kin signed an informed consent form and provided information through standardized questionnaires. Post-mortem clinical diagnoses were established in consensus meetings, and only cases with moderate or severe dementia or without cognitive impairment were included in the analysis. Immunohistochemical neuropathological examinations were performed following the universally accepted guidelines. A diagnosis of Alzheimer's disease was made when there were at least both a moderate density of neuritic plaques (Consortium to Establish a Register for Alzheimer's disease B or C) and Braak stage III for neurofibrillary tangle distribution. For the diagnosis of vascular dementia, at least three zones or strategic areas had to be affected by infarcts, lacunae, or microinfarcts. RESULTS: From 1,291 subjects, 113 cases were classified as having moderate or severe dementia, and 972 cases were free of cognitive impairment. The neuropathological diagnoses of the dementia sub-group were Alzheimer's disease (35.4%), vascular dementia (21.2%), Alzheimer's disease plus vascular dementia (13.3%), and other causes of dementia (30.1%). Small-vessel disease, which alone was not considered sufficient for a vascular dementia diagnosis, was present in 38.9% of all of the dementia cases and in 16.8% of the group without cognitive impairment (odds ratio = 2.91; 95% confidence interval, 1.53-5.51), adjusted for age, sex, and education. CONCLUSIONS: The relatively high frequencies of vascular dementia and small-vessel disease in the dementia sub-group constitute relevant findings for public health initiatives because control of vascular risk factors could decrease the prevalence of dementia in developing countries

E-Book Planejamento do Ensino: Apoio para a Formação de Estudantes do Curso de Bacharelado e Licenciatura em Enfermagem

Buscou-se aqui relatar o processo de construção de um livro digital sobre planejamento do ensino no contexto da Educação Básica e Profissional em Enfermagem para ser utilizado como recurso auxiliar por alunos de graduação em Enfermagem da Escola de Enfermagem de Ribeirão Preto-USP. Tal iniciativa deu-se a partir do trabalho de um grupo interdisciplinar de docentes que adotou o referencial teórico da problematização, e, para a construção da metodologia empregada, utilizou quatro fases sequenciais: definição do escopo, planejamento, produção e implementação. Para a avaliação do e-book foram convidados oito experts em conteúdo. Na primeira etapa, o grupo de docentes realizou vários encontros, e optou-se pela estruturação seguindo as etapas de um plano de aula. Assim, foi produzido um e-book de onze páginas no qual foram reunidos texto e mídias como links para vídeos armazenados na internet. Na avaliação de layout e conteúdo, os peritos emitiram opiniões as quais foram incorporadas na versão final do e-book. Concluiu-se que desenvolver o livro digital possibilitou a atuação interdisciplinar docente. Além disso, a obra em questão contribui para suprir a lacuna existente de materiais educativos e inovação no processo de ensino-aprendizagem da Licenciatura em Enfermagem, de modo a atender ao novo perfil de alunos que se apresenta.This work reports the construction of an e-book about teaching planning in the context of Basic and Professional Education in Nursing to be used as an auxiliary resource by nursing undergraduate students at Universidade de São Paulo at Ribeirão Preto College of Nursing. This initiative was based on the work of an interdisciplinary group of teachers that adopted the theoretical reference of the problematization and four sequential phases were used: definition of the scope, planning, production and implementation. For evaluation of the e-book eight experts in content were invited. On the first step, the group of teachers held several meetings and chose the structure following the steps of a lesson plan. Thus, an eleven-page e-book was produced in which text and media were gathered as links to videos stored on the internet. In the evaluation of the layout and content, the experts issued opinions that were incorporated into the final version of the e-book. In conclusion, developing the digital material enabled the interdisciplinary work of the teacher and could contribute to supply the existing gap of educational materials and innovation in the teaching process of the undergraduate nursing education in addition to attending to the new profile of students

Extreme Delta Brush em traçado de eletroencefalograma – primeiro relato de caso em crise tireotóxica

Relato de cas

EFEITO DAS SOLUÇÕES IRRIGADORAS USADAS EM ENDODONTIA REGENERATIVA SOBRE AS CÉLULAS-TRONCO DE ORIGEM DENTAL

Stem cells derived from teeth act in the maintenance of pulp homeostasis, in addition to having high plasticity and pluripotency. It is worth mentioning that the apical papilla region is full of mesenchymal stem cells (SCAPs), which can survive endodontic infection, and jointly with Hertwig's epithelial root sheath, they direct root development. Therefore, regenerative endodontic therapies are necessary for immature teeth to maintain the viability of these structures and ensure the complete root maturation process. Regenerative endodontic therapy is still evolving, lacking evidence from translational and clinical research to support informed physician choice regarding the best therapeutic irrigation protocol to promote the release of dentin growth factors and tissue repair. Furthermore, clinical studies inherent heterogeneity and complexity have hampered the evaluation of data on the release of growth factors during regenerative endodontic therapies.As células-tronco derivadas dos dentes atuam na manutenção da homeostase pulpar, além de possuir alta plasticidade e pluripotência,  vale ressaltar que a região da papila apical está repleta de células-tronco mesenquimais (SCAPs), que podem sobreviver à infecção endodôntica, e conjuntamente com a bainha epitelial da raiz de Hertwig, eles direcionam o desenvolvimento da raiz. Portanto, regenerativo terapias endodônticas são necessárias para dentes imaturos manterem a viabilidade dessas estruturas e garantir o processo completo de maturação radicular. A endodontia regenerativa a terapia ainda está evoluindo, faltando evidências da pesquisa translacional e clínica apoiar a escolha informada do médico sobre o melhor protocolo de irrigação terapêutica para promover a liberação de fatores de crescimento dentinário e reparo tecidual. Além disso, estudos clínicos heterogeneidade e complexidade inerentes prejudicaram a avaliação dos dados sobre a liberação de fatores de crescimento durante terapias endodônticas regenerativas

Abordagens Integrativas na Saúde Pública Fisioterapia e Fitoterapia no tratamento de Doenças Crônicas Não Transmissíveis

This article aims to describe the importance of integrative approaches in public health, in the context of phytotherapy and physiotherapy in the treatment of chronic non-communicable diseases (NCDs). This study is an integrative literature review, with searches carried out in the LILACS, SCIELO and Google Scholar. The searches were carried out between June and July 2023. The following health descriptors were used: Chronic Noncommunicable Diseases; Public health; Integrative and Complementary Practices; Phytotherapy and Physiotherapy. As an inclusion criterion, only complete studies were used, in Portuguese and within the time frame of 2016 and 2023. As an exclusion criterion, course completion papers, repeated studies, studies outside the scope and with private access. After the screening process, only 10 studies were selected to compose the final sample. The articles demonstrated that in phytotherapy, medicinal plants are used, such as extracts, essential oils and teas, which have proven therapeutic properties for the treatment of NCDs. In physiotherapy, the main interventions include therapeutic exercises, joint mobilization, massage, stretching and other physical techniques aimed at improving physical capacity, reducing pain and preventing complications related to CNCDs. It is concluded that the integration between the use of medicinal plants with physical therapeutic techniques complement the treatment of CNCD, helping in physical rehabilitation, pain control and prevention of complications.Este artigo tem por objetivo descrever qual a importância das abordagens integrativas na saúde pública, no contexto de fitoterapia e fisioterapia no tratamento de doenças crônicas não transmissíveis (DCNT). Esse estudo é uma revisão integrativa de literatura, com buscas feitas nas bases de dados LILACS, SCIELO e Google Acadêmico. As buscas foram feitas entre junho e julho de 2023. Foram utilizados os descritores em saúde: Doenças Crônicas não Transmissíveis; Saúde Pública; Práticas Integrativas e Complementares; Fitoterapia e Fisioterapia. Como critério de inclusão, utilizou-se apenas estudos completos, em português e dentro do recorte temporal de 2016 e 2023. Já como critério de exclusão, trabalhos de conclusão de curso, repetidos, estudos fora do escopo e de acesso privado. Após o processo de triagem, foram selecionados apenas 10 estudos para compor a amostra final. Os artigos demonstraram que na fitoterapia, são utilizadas plantas medicinais, como extratos, óleos essenciais e chás, que possuem propriedades terapêuticas comprovadas para o tratamento das DCNT. Já na fisioterapia, as principais intervenções incluem exercícios terapêuticos, mobilização de articulações, massagens, alongamentos e outras técnicas físicas que visam melhorar a capacidade física, reduzir a dor e prevenir complicações relacionadas às DCNT. Conclui-se que, a integração entre utilização de plantas medicinais com técnicas terapêuticas físicas complementam o tratamento das DCNT, auxiliando na reabilitação física, controle da dor e prevenção de complicações