Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part II: cognitive-behavioral therapy

Objectives: To summarize evidence-based cognitive-behavioral therapy (CBT) treatment and propose clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The literature on CBT interventions for adult OCD, including BT and exposure and response prevention, was systematically reviewed to develop updated clinical guidelines for clinicians, providing comprehensive details about the necessary procedures for the CBT protocol. We searched the literature from 2013-2020 in five databases (PubMed, Cochrane, Embase, PsycINFO, and Lilacs) regarding study design, primary outcome measures, publication type, and language. Selected articles were assessed for quality with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association. Results: We examined 44 new studies used to update the 2013 American Psychiatric Association guidelines. High-quality evidence supports CBT with exposure and response prevention techniques as a first-line treatment for OCD. Protocols for Internet-delivered CBT have also proven efficacious for adults with OCD. Conclusion: High-quality scientific evidence supports the use of CBT with exposure and response prevention to treat adults with OCD

Tuberculose pulmonar: perfil epidemiológico do sertão Pernambucano, Brasil / Pulmonary tuberculosis: epidemiological profile of sertão Pernambucano, Brazil

Atualmente, observa-se que a tuberculose pulmonar constitui um importante problema de Saúde Pública no mundo, uma vez que esse agravo apresentou, em 2015, 10,4 milhões de casos, dos quais, mais de um milhão de pessoas vieram a óbito. Sob essa perspectiva, o presente artigo tem como objetivo traçar um perfil epidemiológico dos casos de Tuberculose Pulmonar notificados no município de Serra Talhada, entre os anos de 2007 a 2017. Foi realizado um estudo de série histórica observacional do tipo transversal, no intervalo de tempo de 2007 a 2017.  No período investigado o número de casos de tuberculose pulmonar foi de 246 casos, o local que teve a maior prevalência foi Serra Talhada, 287 por 100 mil habitantes. Diante dos dados apresentados, é imprescindível concluir, portanto, que esse estudo corrobora o perfil epidemiológico brasileiro para a Tuberculose Pulmonar, o qual indica variabilidade nos índices de acometimento durante o período analisado

Qualidade de vida de indivíduos com HIV: revisão integrativa / Quality of living of individuals with HIV integration review

 A qualidade de  vida de pacientes vivendo com HIV/AIDS é essencial, tendo em vista o caso específico dos adolescentes é ainda mais importante porque o jovem além de lidar com a resistência e a aceitação da doença, deve também enfrentar os conflitos da puberdade.O presente trabalho tem como objetivo realizar uma revisão integrativa em relação a qualidade de vida dos pacientes com HIV. Trata-se de um estudo de revisão integrativa realizado no período de 2016 a 2017, utilizando-se o banco de dados Medline e Lilacs. Apesar do impacto da infecção pelo HIV/AIDS na saúde psicológica e nas relações sociais dos indivíduos infectados, assim como no domínio físico, o uso da TARV provocou consequências positivas na saúde psicológica, proporcionando a desconstrução da ideia de morte advinda ao diagnóstico de portador do HIV/AIDS e a construção de melhores perspectivas de vida. A adesão ao tratamento em HIV/AIDS está relacionada a um aumento da sobrevida e de sua qualidade. Porém deve-se respeitar a posição pessoal do portador para fazer ou não o tratamento

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Triagem virtual de metabólitos secundários com potencial atividade antimicrobiana do gênero solanum e estudo fitoquimico de solanum Capsicoides all

The human body has a large bacterial flora, but when these bacteria, the principle of commensal character, become part of site other than it's natural, they can cause some severe diseases. Researches that are based either on the search of new drugs from plants or on the improvement of phytotherapics are in prominence and continue to play an important role nowadays. In this perspective, the aim was to carry out a phytochemical study of Solanum capsicoides All. fruits to isolate and characterize the chemical substances of this species and to use in silico studies to carry out investigations of new molecules potentially active for methicillin resistant Staphylococcus aureus (MRSA) and Escherichia coli using a database created with secondary metabolites isolated from Solanum genus. The phytochemical study of Solanum capsicoides All. fruits resulted in the isolation of three substances: carpesterol, acetylated glucose and 4-hydroxybenzaldehyde. A review of the literature led to the creation of a database with 421 different secondary metabolites isolated from the Solanum genus. Two databases from CHEMBL were selected. The first one with activity against MRSA and another against E. coli. The compounds were classified according to the pIC50 values to generate and validate the model using "Random Forest"(RF). The structure of six new target proteins against S. aureus obtained from the PDB (Protein database) were used for virtual screening of the based on the receptor structure using docking studies by the Molegro Virtual Docker, reaching to select Solanum database molecules capable of interacting in the binding sites of proteins. The RF prediction model for MRSA obtained a percent accuracy of 81%, area under the Receiver Operating Characteristic (ROC) curve of 0.885, selecting 8 molecules with an active potential above 60%. The prediction model for Escherichia coli obtained an accuracy rate of 88%, area under ROC curve of 0.932, selecting 4 molecules with potential probability above 84%. The study of the coupling of six target enzymes to S. aureus selected an average of 50 molecules from the bank of 421 isolated molecules of the genus Solanum with an ability to interact with on active site of each enzyme. In addition, it was possible to obtain 1 molecule with active potential and interaction capacity with 5 enzymes studied, 7 molecules interacting with 3 enzymes and 6 with 2 enzymes of S. aureus. The rutin, a molecule potentially active in the in silico study for S. aureus and E. coli, together with carpesterol, were tested in vitro against these bacteria. Microbiological tests have shown that carpesterol has no antimicrobial activity for the studied strains, and that the rutin has activity only for E. coli. An interaction study with strains of S. aureus ATCC 25923, a standard strain sensitive to all antibiotics, and SAM-01, a multidrug resistant strain, was designed. There was interaction only between rutin and oxacillin, one of the three antibiotics studied in the interaction, for a strain SAM- 01, reducing the resistance of this strain.Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqO ser humano possui uma vasta flora bacteriana que é comensal, mas quando essas bactérias, a princípio de caráter comensal, passam a fazer parte de outro sítio que não o seu natural, podem causar graves patogenias. Pesquisas que se fundamentam na busca por novos medicamentos a partir de plantas ou no melhoramento de fitoterápicos já existentes vem se destacando e continuam a desempenhar um papel importante nos dias de hoje. Nessa perspectiva objetivou-se realizar um estudo fitoquímico dos frutos de Solanum capsicoides All. para isolar e caracterizar substâncias químicas desta espécie e, utilizando estudos in silico, realizar investigações de novas moléculas potencialmente ativas para Staphylococcus aureus resistente a meticilina (MRSA) e Escherichia coli, utilizando um banco de dados criado com metabólitos secundários isolados do gênero Solanum. O estudo fitoquímico dos frutos de Solanum capsicoides All. resultou no isolamento de três substancias: carpesterol, glicose acetilada e 4-hidroxi-benzaldeído. A revisão de literatura levou à criação de um banco de dados com 421 diferentes metabólitos secundários isolados do gênero Solanum. Foram selecionados dois bancos de dados obtidos a partir do CHEMBL. O primeiro com atividade contra S. aureus multirresistente (MRSA) e o outro contra E. coli. Os compostos foram classificados de acordo com valores de pIC50 para gerar e validar o modelo utilizando “Random Forest”(RF). A estrutura de seis novas proteínas alvo contra S. aureus obtidas do Protein Data Bank (PDB) foram utilizadas para triagem virtual baseada na estrutura do receptor utilizando estudos de “docking” com o software Molegro Virtual Docker, a fim de selecionar moléculas do banco de dados de Solanum com potencial capacidade de interagir nos sítios de ligação dessas proteínas. O modelo RF de predição para S. aureus multirresistente obteve uma porcentagem de acerto de 81%, área sob a curva Receiver Operating Characteristic (ROC) de 0,885, selecionando 8 moléculas com potencial ativo superior a 60%. O modelo de predição para Escherichia coli obteve taxa de acerto de 88%, área sob curva ROC de 0,932, selecionando 4 moléculas com probabilidade de potencial ativo superior a 84%. O estudo do docking das seis enzimas alvo para S. aureus selecionou uma média de 50 moléculas do banco de 421 moléculas isoladas do gênero Solanum com a capacidade de interagir no sitio ativo de cada enzima. Analisando moléculas multitarget, foi possível obter 1 molécula com potencial ativo e capacidade de interação com 5 das 6 enzimas estudadas, 7 moléculas interagindo com 3 enzimas e 6 com 2 enzimas de S. aureus. A rutina, uma molécula potencialmente ativa no estudo in silico para S. aureus e E. coli, juntamente com o carpesterol, foram testadas in vitro contra essas bactérias. Os testes microbiológicos mostraram que o carpesterol não possui atividade antimicrobiana para as cepas estudadas, e que a rutina possui atividade apenas para a cepa de E. coli. Foi realizado ainda estudo de interação com as cepas de S. aureus ATCC 25923, uma cepa padrão sensível a todos os antibióticos, e SAM-01, uma cepa multirresistente. Houve interação apenas entre a rutina e a oxacilina, um dos três antibióticos estudados na interação, para a cepa SAM-01, diminuindo a resistência dessa cepa