Mental health in the era of COVID-19 : prevalence of psychiatric disorders in a cohort of patients with type 1 and type 2 diabetes during the social distancing

Background: In patients with diabetes, the prevalence of depression and anxiety symptoms is about two to four times greater than in the general population. The association between diabetes and mental health disorders could be exacerbated in a stressful environment, and psychological distress could increase depressive symptoms and cause adverse diabetes outcomes. Objectives: To assess the prevalence of mental health disorders in patients with diabetes during the social distancing period due to COVID-19 pandemic. Methods: This is a cross-sectional study developed to assess the impact of social distancing on a cohort of adults with type 1 (n = 52) and type 2 diabetes (n = 68) in Brazil. Inclusion criteria involved having an HbA1c test collected in the past 3 months and having a valid telephone number in electronic medical records. The primary outcome was the prevalence of minor psychiatric disorders, assessed by survey (SRQ-20). Secondary outcomes included the prevalence of diabetes related emotional distress, eating and sleeping disorders, all assessed by validated surveys at the moment of the study. Statistical analyses included unpaired t-test for continuous variables and χ2 test for categorical variables. Results: Overall (n = 120), participants had a mean age of 54.8 ± 14.4 years-old, and HbA1c of 9.0 ± 1.6% (75 ± 17.5 mmol/mol); 93% of patients showed signs of current mental suffering based on the surveys measured. Almost 43% of patients showed evidence of significant psychological distress, with a significant greater tendency in patients with type 2 diabetes. The presence of diabetes related emotional distress was found in 29.2% of patients; eating disorders in 75.8%; and moderate/severe sleeping disorders in 77.5%. Conclusions: We found a high prevalence of evidence of psychological distress among patients with diabetes during the COVID-19 pandemic and this highlights the need for mental health access and support for patients with type 1 and type 2 diabetes

Type 1 diabetes and the challenges of emotional support in crisis situations : results from a feasibility study of a multidisciplinary teleintervention

The association between type 1 diabetes and mental health disorders could be exacerbated in a stressful environment. This study aimed to evaluate the feasibility of a teleguided intervention on emotional disorders in patients with type 1 diabetes during the COVID-19 outbreak. This study was performed during the social distancing period in the COVID-19 outbreak in Brazil. Individuals with type 1 diabetes aged≥ 18 years were selected to receive a teleguided multidisciplinary intervention or the usual care plus an educational website access. The proposed intervention aimed addressing aspects of mental health, diabetes care and lifestyle habits during the pandemic. The feasibility outcome included the assessment of recruitment capability and adherence to the proposed intervention. Moreover, we evaluated the presence of positive screening for emotional disorders (Self Report Questionnaire 20) after a 16-week intervention, patients’ perceptions of pandemicrelated changes, diabetes-related emotional distress, eating disorders, and sleep disorders. Data were analyzed with the intent-to-treat principle. Fifty-eight individuals (mean age, 43.8± 13.6 years) were included (intervention group, n= 29; control group, n= 29). At the end of the study, a total of 5 participants withdrew from the study in the intervention group compared to only 1 in the control group. Participants who dropout from the study had similar mean age, sex and income to those who remained in the study. The analysis of mental health disorders was not diferent between the groups at the follow up: a positive screening result was found in 48.3% and 34.5% of participants in the intervention and control groups, respectively (P= 0.29). The intervention group felt more supported in their diabetes care during the social distancing period (82.8% vs. 48.3% in the control group, P< 0.01). Our study identifed a disproportionate higher number of withdrawals in the intervention group when compared to the control group. This diference may have compromised the power of the study for the proposed assessments and should be reevaluated in future studies

CÂNCER ”“ UMA DOENÇA PSICOSSOCIAL:: CÂNCER NO HOMEM E A HERANÇA DA CULTURA MACHISTA

O presente trabalho objetivou compreender o câncer do homem abrangendo seu lado psicossocial,trazendo à tona a cultura machista impregnada na sociedade e seus efeitos sobreo diagnóstico e recuperação desses pacientes. O estudo foi baseado principalmenteem coleta de dados de 7 artigos publicados entre os anos de 2006 a 2012, sobreos quais foi relatado o câncer no pênis, o câncer de próstata e o câncer detestículo. No contexto estudado, o câncer em homens mostrou-se especialmentenegligenciado por afetar o símbolo da virilidade, dentro da cultura machista.Por este motivo, foi-se identificado a dificuldade do homem em procurarassistência de saúde, acompanhada de diagnósticos tardios e prejudiciais aoprognóstico. Vergonha de se submeter a práticas invasivas e medo dasconsequências da doença demonstraram ser as maiores causas para omissãomasculina mediante ajuda médica. Dessa forma, viu-se necessária investimento emcapacitação da equipe de saúde para orientação, atendimento e recuperação dessepaciente

Perfil Epidemiológico de mães de pacientes com transtorno do Espectro Autista da Associação de Pais de Autistas do Município de São João Del Rei / Epidemiological profile of mothers of patients with autistic spectrum disorder of the Association of Parents of Autism of the Municipality of São João Del Rei

O autismo hoje é definido como TEA (Transtorno do Espectro Autista) e é conhecido como um estado ou uma condição em que o indivíduo parece estar recluso a si próprio. Pouco se conhece sobre a patogenia do autismo e, com isso, os sintomas ainda são pouco claros. Alguns fatores de riscos podem estar envolvidos como: aspiração de mecônio, lesão ou traumatismo no nascimento, malformação congênita, anemia no lactente e incompatibilidade ABO ou Rh também estão entre os fatores relacionados. Além disso, sabe-se que há um componente genético envolvido para que o transtorno se manifeste. O aumento da prevalência do autismo está possivelmente relacionado às mudanças na conscientização, critérios diagnósticos mais apurados, maior acesso a instrumentos de diagnóstico ou triagem. Este trabalho teve por objetivo analisar a frequência das etiologias para a predição do TEA na ASPAS (Associação de Pais de Autistas de São João del Rei-MG), indicando os fatores de riscos que podem estar associados ao TEA. Foi realizado um estudo envolvendo 16 pacientes de ambos os sexos assistidos pela ASPAS. Os dados coletados foram:sexo, idade materna no parto, idade gestacional no parto, uso de medicação no decorrer da gestação, traumas obstétricos ou complicações periparto, incompatibilidade do sistema ABO(Rh), diabetes mellitus gestacional, doença autoimune na história familiar, infecções no período gestacional, exposição a poluentes atmosféricos, carência de vitamina D no período gestacional, tabagismo no período gestacional, . A análise foi realizada através das distribuições de frequências e porcentagem. Foi possível delinear o perfil epidemiológico dos pacientes, observando os fatores de risco e as características demográficas.Estes resultados poderão auxiliar nas condutas de assistência aos pacientes com TEA de São João del Rei - MG

Caderno de pós-graduação em direito: novas tendências do direito ambiental

Pioneirismo sempre foi uma característica do UniCEUB; outra característica é a evolução permanente. A Instituição sempre acompanhou a evolução tecnológica e pedagógica do ensino. Isso se coaduna com a filosofia institucional que é a de preparar o homem integral por meio da busca do conhecimento e da verdade, assegurando-lhe a compreensão adequada de si mesmo e de sua responsabilidade social e profissional. Destarte, a missão institucional é a de gerar, sistematizar e disseminar o conhecimento visando à formação de cidadãos reflexivos e empreendedores, comprometidos com o desenvolvimento socioeconômico sustentável. E não poderia ser diferente. Com a expansão do conteúdo acadêmico que se transpassa do físico para o virtual, do local para o universal, do restrito para o difundido, isso porque o papel não é mais apenas uma substância constituída por elementos fibrosos de origem vegetal, os quais formam uma pasta que se faz secar sob a forma de folhas delgadas donde se cria, modifica, transforma letras em palavras; palavras em textos; textos em conhecimento, não! O papel se virtualiza, se desenvolve, agora, no infinito, rebuscado de informações. Assim, o UniCEUB acompanha essa evolução. É dessa forma que se desafia o leitor a compreender a atualidade, com a fonte que ora se entrega à leitura virtual, chamada de e-book. Isso é resultado do esforço permanente, da incorporação da ciência desenvolvida no ambiente acadêmico, cujo resultado desperta emoção, um sentimento de beleza de que o conteúdo científico representa o diferencial profissional. Portanto, convido-os a leitura desta obra, que reúne uma sucessão de artigos que são apresentados com grande presteza e maestria; com conteúdo forte e impactante; com sentimento e método, frutos da excelência acadêmicaOrganizadores: Gabriel R. Rozendo Pinto, Leandro Soares Nunes, Naiara Ferreira Martins, Paulo Victor Lima, Pedro Almeida Costa, Pietro Pimenta, Rodrigo Gonçalves Ramos de Oliveir

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension