Evaluation of the oxidative and inflammatory profile of patients with migraine

Among one of the most commonly seen and primary headaches is migraine. Oxidative stress and inflammation is discussed to be implicated in the pathogenesis of migraine. However, further knowledge about this issue is necessary because data are in part controversial and the possible underlying mechanisms remain inconclusive to date. To evaluate and compare the oxidative and inflammatory profile of patients with migraine 47 volunteers were divided into 3 groups: 15 women with chronic migraine (WCM); 17 women with episodic migraine (WEM) and 15 men with migraine (MM) and enrolled in this study.Total antioxidant status; the enzymatic activity of the antioxidant agents Catalase (CAT), Glutathione S-transferase (GST) and Superoxide Dismutase (SOD); oxidative stress markers malondialdehyde (MDA) and carbonylated proteins; blood count and neutrophil/lymphocyte ratio; uric acid, c-reactive protein and cholesterol total and fractions were determined in pacients with migraine in the interictal phase. The group male participants (MM) displayed a reduction in total antioxidant status, as well as a lower value for antioxidant enzymes, but had no significant alterations in markers related to damage by oxidative stress compared to women. These findings suggest that there is a difference in the oxidative profile between the sexes among migraine patients. This may allow a better understanding of patients profile with different migraine phenotypes and identify new markers that might help understanding the pathophysiology and migraine patient management

Determinantes de saúde em crianças dos 3 aos 10 anos

RESUMO 1: Introdução: Os estilos de vida atuais sugerem comportamentos de risco que estão na base do perfil de saúde do país. Objetivo: Avaliar os estilos de vida e sua associação com dados sociodemográficos numa amostra de crianças portuguesas dos 3 aos 10 anos de idade. Participantes e métodos: Estudo transversal de natureza quantitativa num universo de 1617 crianças dos jardins de infância e escolas do 1.º ciclo dos dois agrupamentos de escolas de Tondela e do agrupamento de escolas de Vouzela. A amostra do estudo foi constituída por um total de 1385 crianças. A análise estatística dos dados foi efetuada com recurso ao software estatístico IBM SPSS versão 21.0. A comparação de proporções foi realizada através do teste Qui-quadrado, onde as prevalências foram expressas em proporções, com base no nível de significância de p=0,05, com intervalos de confiança de 95%. Resultados: Constatou-se que as crianças com mais idade apresentavam uma menor adesão a comportamentos alimentares saudáveis, uma maior prevalência de atividade física (49,2%), no entanto, foram, também aquelas que apresentaram um maior índice de atividades sedentárias (27,1%). Os rapazes apresentaram maiores níveis de atividade física (51,6%) e índices mais elevados de comportamentos sedentários (28,6%). Relativamente à zona de residência, existiu uma maior prevalência de consumo de legumes (73,2%) e fastfood (24,0%) e de comportamentos sedentários (26,1%) em zonas urbanas. As crianças que pertenciam a agregados familares de rendimentos mais favoráveis e com maior nível de habilitações literárias consumiam mais leite e derivados, legumes e praticavam mais atividade física. No entanto, apresentaram maior prevalência de consumo de fastfood e comportamentos sedentários. Conclusões:Torna-se perceptível a necessidade de se intervir nos grupos mais vulneráveis no sentido de uma mais eficaz equidade em saúde. Palavras-chave: Crianças; estilos de vida; dados sociodemográficos; escolas.ABSTRACT 1: Introduction: The current lifestyles suggests risk behaviors that are the basis of a country's health profile. Objective: Assess the lifestyles and its association with sociodemographic variables among a sample of Portuguese children from 3 to 10 years old. Participants and methods: A Cross-sectional study was desgined with a total of 1617 children from public schools, from the two main school groups of Tondela and Vouzela. The final study sample was built with a total of 1385 children. Statistical analysis was performed using the IBM SPSS software version 21.0 for Windows. Comparison of proportions was performed using the “Chi-square” test, where prevalences were expressed as proportions, based on the significance level of p = 0.05, with a 95% confidence intervals. Results: It was found that the older children had a lower adherence to healthy eating habits and a higher prevalence of physical activity (49.2%). However, there were also those with higher rate of sedentary activities (27.1%). The boys had higher levels of physical activity (51.6%) and higher rates of sedentary behaviors (28.6%). With regard to residence area, there was a higher prevalence of consumption of vegetables (73.2%), fastfood (24.0%) and sedentary behaviors (26.1%) in urban areas. Children belonging to households of more favorable monthly earnings and a higher level of educational qualifications consumed more dairy product, vegetables and practiced more physical activity. However, they had a higher prevalence of fastfood consumption and sedentary behaviors. Conclusions: It becomes noticeable the need to make an intervention on the most vulnerable groups to obtain more effective health equity. Keywords: Children; lifestyles; sociodemographic data; schools.RESUMO 2: Introdução: As iniquidades de género na distribuição de recursos estão ainda profundamente associadas à saúde precária e à diminuição do bem-estar das mulheres e das crianças. Objetivo: Analisar a influência dos fatores materno-fetais nos estilos de vida numa amostra de crianças portuguesas dos 3 aos 10 anos de idade Participantes e métodos: Estudo transversal de natureza quantitativa num universo de 1617 crianças dos jardins de infância e escolas do 1.º ciclo dos dois agrupamentos de escolas de Tondela e do agrupamento de escolas de Vouzela. A amostra do estudo foi constituída por um total de 1385 crianças. A análise estatística dos dados foi efetuada com recurso ao software estatístico IBM SPSS versão 21.0. A comparação de proporções foi realizada através do teste Qui-quadrado, onde as prevalências foram expressas em proporções, com base no nível de significância de p=0,05, com intervalos de confiança de 95%. Resultados: As crianças que habitam em meio rural apresentavam um peso à nascença superior comparativamente às do meio urbano (93,7%). As grávidas com mais idade obtiveram uma prevalência de antecipação da primeira consulta de gravidez mais elevada (96,5%) assim como uma prevalência mais elevada de consultas de vigilância durante a gravidez (97,2%) quando comparadas com as grávidas mais novas. As mães com habilitações literárias superiores ao 9.º ano de escolaridade apresentavam uma prevalência de amamentação superior (58,0%) e os seus filhos uma prevalência de consumo de fastfood superior (64,9%) quando comparadas com as mães com habilitações literárias inferiores. Conclusões: Denota-se a importância da maturidade, formação e capacitação das mães para os cuidados maternos e neonatais. Palavras-chave: crianças; estilos de vida; fatores materno-fetais.ABSTRACT 2: Introduction: Gender inequalities in the distribution of resources is still deeply associated with poor health and reduced welfare of women and children. Objective: To analyze the influence of maternal and fetal factors in lifestyles of children, in a sample of children from 3 to 10 years old. Participants and methods: A Cross-sectional study was desgined with a total of 1617 children from public schools, from the two main school groups of Tondela and Vouzela. The final study sample was built with a total of 1385 children. Statistical analysis was performed using the IBM SPSS software version 21.0 for Windows. Comparison of proportions was performed using the “Chi-square” test, where prevalences were expressed as proportions, based on the significance level of p = 0.05, with a 95% confidence intervals. Results: Children who live in rural areas presented a higher birth weight compared to those who live in urban areas (93.7%). Older pregnant women obtained a higher prevalence of the first medical appointment antecipation (96.5%) as well as a higher prevalence of medical appointments during pregnancy (97.2%) when compared with younger pregnant women. Mothers with qualifications higher than the 9th grade showed a higher prevalence of breastfeeding (58.0%) and their children presented a higher prevalence of fastfood consumption (64.9%) when compared with mothers with lower educational qualifications. Conclusion: To denote the importance of maturity and training of mothers in maternal and neonatal care. Keywords: children; lifestyles; maternal fetal factors

Influence of HLA-DRB1 and HLA-DQB1 Alleles on IgG Antibody Response to the P. vivax MSP-1, MSP-3α and MSP-9 in Individuals from Brazilian Endemic Area

Background: the antibody response generated during malaria infections is of particular interest, since the production of specific IgG antibodies is required for acquisition of clinical immunity. However, variations in antibody responses could result from genetic polymorphism of the HLA class II genes. Given the increasing focus on the development of subunit vaccines, studies of the influence of class II alleles on the immune response in ethnically diverse populations is important, prior to the implementation of vaccine trials.Methods and Findings: in this study, we evaluated the influence of HLA-DRB1* and -DQB1* allelic groups on the naturally acquired humoral response from Brazilian Amazon individuals (n = 276) against P. vivax Merozoite Surface Protein-1 (MSP-1), MSP-3 alpha and MSP-9 recombinant proteins. Our results provide information concerning these three P. vivax antigens, relevant for their role as immunogenic surface proteins and vaccine candidates. Firstly, the studied population was heterogeneous presenting 13 HLA-DRB1* and 5 DQB1* allelic groups with a higher frequency of HLA-DRB1*04 and HLA-DQB1*03. the proteins studied were broadly immunogenic in a naturally exposed population with high frequency of IgG antibodies against PvMSP1-19 (86.7%), PvMSP-3 (77%) and PvMSP-9 (76%). Moreover, HLA-DRB1*04 and HLA-DQB1*03 alleles were associated with a higher frequency of IgG immune responses against five out of nine antigens tested, while HLA-DRB1* 01 was associated with a high frequency of non-responders to repetitive regions of PvMSP-9, and the DRB1*16 allelic group with the low frequency of responders to PvMSP3 full length recombinant protein.Conclusions: HLA-DRB1*04 alleles were associated with high frequency of antibody responses to five out of nine recombinant proteins tested in Rondonia State, Brazil. These features could increase the success rate of future clinical trials based on these vaccine candidates.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Yerkes National Primate Research Center BaseNational Center for Research Resources of the National Institutes of HealthNIHCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Inst Oswaldo Cruz, Lab Immunoparasitol, BR-20001 Rio de Janeiro, BrazilOswaldo Cruz Fdn Fiocruz, Ctr Technol Dev Hlth CDTS, Rio de Janeiro, BrazilInst Oswaldo Cruz, Lab Simulideos & Oncocercose, BR-20001 Rio de Janeiro, BrazilEmory Univ, Emory Vaccine Ctr, Atlanta, GA 30322 USAUniv Estado Rio de Janeiro, Histocompatibil & Cryopreservat Lab, Rio de Janeiro, BrazilUniversidade Federal de São Paulo, Ctr Terapia Celular & Mol CTCMol, Escola Paulista Med, São Paulo, BrazilEmory Univ, Sch Med, Div Infect Dis, Atlanta, GA USACDC Natl Ctr Infect Dis, Div Parasit Dis, Atlanta, GA USAUniversidade Federal de São Paulo, Ctr Terapia Celular & Mol CTCMol, Escola Paulista Med, São Paulo, BrazilFAPESP: 2009/15132-4Yerkes National Primate Research Center Base: RR00165NIH: RO1 AI0555994Web of Scienc

A estratificação e o manejo adequado da dor: Stratification and proper pain management

A dor é um potencial de risco para a saúde pública, esta se caracteriza pela experiência multidimensional associada a aspectos físicos e emocionais. A dor alerta o perigo e evita danos orgânicos, mas quando está impossibilita atividades diárias e impacta a qualidade de vida do paciente é classificada como patológica e urge por interferência médica. O seguinte artigo objetivou descrever através da revisão narrativa de literatura os aspectos referentes da dor e o seu manejo adequado. A dor é um amplo complexo que possui a classificação conforme a localização, tipo, intensidade, periodicidade. As categorias referentes a dor são nociceptivas, neuropática, psicogênica. Ademais, as síndromes dolorosas são diversas e podem acometer qualquer sistema do corpo. Ressaltando ser essencial a categorização do máximo possível de informações para conduzir adequadamente ao tratamento destas enfermidades.&nbsp

A farmacopsiquiatria dos antidepressivos: The pharmacopsychiatry of antidepressants

Os fármacos antidepressivos compõem o manejo terapêutico da depressão e inúmeros outros transtornos de origem neuropsiquiátrica. Logo, a ocorrências destes distúrbios tornam viável a aplicação destes, ressaltando ser essencial individualizar o tratamento e compreender a respeito das diversas classes, mecanismo de ação, interação medicamentosa, indicação clinica, grupo de risco e a intoxicação por superdosagem. O seguinte artigo objetivou descrever a respeito das particularidades dos antidepressivos, de modo a compreender sobre seu efeito farmacopsiquiatríco. Trata-se de uma revisão narrativa de literatura fundamentada nas renomadas plataformas de artigos indexados a respeito do tema. Foram selecionados os estudos que apresentavam relevância clinica para a compreensão do artigo, descartando-se os demais que não respondiam ao objetivo proposto. Na literatura científica estão disponíveis muitas informações pertinentes ao tema, ressaltando a importância deste. Atualmente, se encontram em aplicabilidade diversas classes que são os Inibidores Seletivos da Recaptação de Serotonina (ISRSs), Antidepressivos Tricíclicos (ADTs), Tetracíclicos e os Inibidores da Monoamina Oxidase (IMAO). Cada um destes possui um mecanismo de ação diferente, mas basicamente estes interferem no impulso nervoso de neurotransmissores beneficiando o portador de distúrbios neurocognitivos. Destacando que mesmo com o efeito terapêutico retrógrado, estes já manifestam os efeitos adversos. Logo, é imprescindível analisar qual o tipo e a dose do fármaco para se conduzir o melhor prognóstico do paciente.&nbsp

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Role of peroxisome proliferator activated nuclear receptor (PPAR) in induced periodontitis in rats.

Este estudo investigou o efeito da Roziglitazona (RTZ) sobre a perda óssea alveolar induzida pela periodontite (POAIP). Durante 3 semanas, ratos receberam sal puro de RTZ (i.p.) ou a formulaço comercial AvandiaÒ (v.o.); os grupos controles receberam os repectiovos veículos (DMSO ou CMC). Duas semanas após o inicio do tratamento, a periodontite (P) foi induzida. Após 7 dias da indução da P, as mandíbulas foram removidas para mediço da perda óssea alveolar. Amostras de osso alveolar foram analisadas por qPCR para RUNX2, Osterix, TRAF6, TRAF2, RANKL, óxido nítrico sintases (e, n e iNOS) e PPARs (a, b e g). A farmacocinética da RTZ para cada formulaço foi estudada por HPLC-MS/MS. Tanto o sal puro como a formulaço comercial de RTZ resultou no agravamento da POAIP. Apesar dos resultados similares nas concentrações plasmáticas de RTZ os mecanismos de sinalizaço parecem depender da formulaço administrada a qual pode ser devido a interferência do veículo.This study investigate the effects of rosiglitazone (RTZ) on periodontitis-induced alveolar bone loss (PIABL). Rats received RTZ during 3 weeks, either as the pure maleate salt (i.p.) or the commercial formulation Avandiaâ (p.o.); control animals received the respective vehicles (DMSO or CMC). Two weeks after the treatments begins, periodontitis (P) were induced. After 7 days after P induction, jaws were removed for ABL measurement. Alveolar bone samples were analyzed by qPCR for RUNX2, Osterix, TRAF6, TRAF2, RANKL, nitric oxide sintase (e, n and iNOS) and PPARs (a, b e g). RTZ pharmacokinetics from each formulation was also studied (HPLC-MS/MS). RTZ, either from the pure maleate salt or the commercial Avandia, resulted in aggravated PIABL. Despite resulting in similar plasma RTZ concentrations, signaling mechanisms seem to depend on the administered formulation which could be due to vehicle related effects interfence

iNOS-Derived Nitric Oxide Stimulates Osteoclast Activity and Alveolar Bone Loss in Ligature-Induced Periodontitis in Rats

Background: Inflammatory stimuli activate inducible nitric oxide synthase (iNOS) in a variety of cell types, including osteoclasts (OC) and osteoblasts, resulting in sustained NO production. In this study, we evaluate the alveolar bone loss in rats with periodontitis under long-term iNOS inhibition, and the differentiation and activity of OC from iNOS-knockout (KO) mice in vitro.Methods: Oral aminoguanidine (an iNOS inhibitor) or water treatment was started 2 weeks before induction of periodontitis. Rats were sacrificed 3, 7, or 14 days after ligature placement, and alveolar bone loss was evaluated. In vitro OC culture experiments were also performed to study the differentiation of freshly isolated bone marrow cells from both iNOS KO and wild-type C57BL/6 mice. OC were counted 6 days later after tartrate-resistant acid phosphatase staining (a marker of osteoclast identity), and bone resorption activity was assessed by counting the number of resorption pits on dentin disks.Results: Rats with ligature showed progressive and significant alveolar bone loss compared to sham animals, and aminoguanidine treatment significantly inhibited ligature-induced bone loss at 7 and 14 days after the induction. In comparison to bone marrow cells from wild-type mice, cells from iNOS KO mice showed decreased OC growth and the resulting OC covered a smaller culture dish area and generated fewer resorption pit counts.Conclusion: Our results demonstrate that iNOS inhibition prevents alveolar bone loss in a rat model of ligature-induced periodontitis, thus confirming that iNOS-derived NO plays a crucial role in the pathogenesis of periodontitis, probably by stimulating OC differentiation and activity. J Periodontol 2011;82:1608-1615.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq