O Papel Preditivo da Incapacidade Física e da Desregulação Emocional nos Sintomas Depressivos na Idade Avançada: estudo numa amostra de idosos institucionalizados

Contextos e Objetivos: Uma vez que existe uma maior prevalência de idosos com sintomatologia depressiva nas instituições, o objetivo principal da presente investigação foi estudar os níveis de sintomatologia depressiva numa amostra da população idosa institucionalizada e verificar em que medida a incapacidade física e a desregulação emocional predizem esses sintomas. Métodos: A amostra foi constituída por 326 pessoas idosas, divididas num grupo da comunidade (n = 209) e num grupo de pessoas idosas institucionalizadas (n = 117), com idades entre os 60 e os 91 anos (M ± DP =81.80 ± 7.80), sendo 81% mulheres. A avaliação incluiu a Geriatric Depression Scale (GDS), o World Health Organization Disability Assessment Schedule (WHODAS-2) e a Difficulties in Emotion Regulation Scale - 16 itens (DERS-16). Resultados: As mulheres apresentaram maior pontuação no GDS que os homens (p < 0,05). Nos idosos institucionalizados, o GDS correlacionou-se de forma positiva com o WHODAS-2 (r = 0,29; p < 0,01) e com a DERS-16 (r = 0,32; p < 0,001). Os sintomas depressivos nos idosos institucionalizados tiveram como preditores o sexo (b = 0,18; p < 0,05), o conjunto do consumo de fármacos agonistas adrenérgicos-beta (b = - 0,21; p < 0,05) a disfuncionalidade (b = 0,26; p < 0,01) e a desregulação emocional (b = 0,35; p < 0,001). Conclusões: Este estudo permitiu verificar que a disfuncionalidade e a desregulação emocional predizem a sintomatologia depressiva e destacar a importância de trabalhar na sua prevenção e reconhecimento. / Background and Objective: Since there is a higher prevalence of older people with depressive symptoms in institutions, this research's main objective was to study the levels of depressive symptoms in a sample of the institutionalized elderly population and verify to what extent physical disability and emotional deregulation predict these symptoms. Methods: The sample consisted of 326 older adults, divided into a community group (n = 209) and an institutionalized group of older people (n = 117), aged between 60 and 91 years (M ± SD = 81.80 ± 7.80), 81% of whom were women. The evaluation included the Geriatric Depression Scale (GDS), World Health Organization Disability Assessment Schedule (WHODAS-2), and Difficulties in Emotion Regulation Scale - 16 items (DERS-16). Results: Women scored higher at GDS than men (p < 0.05). In institutionalized elderly, the GDS correlated positively with WHODAS-2 (r = 0.29; p < 0.01) and with DERS-16 (r = 0.32; p < 0.001). The depressive symptoms in institutionalized elderly had as predictors sex (b = 0.18; p < 0.05), the set of adrenergic-beta agonistic drugs consumption (b = - 0.21; p < 0.05), dysfunctionality (b = 0.26; p < 0.01) and emotional deregulation (b = 0.35; p < 0.001). Conclusions: This study allowed to verify that dysfunctionality and emotional deregulation predict depressive symptoms and highlight the importance of working on their prevention and recognition

Categorização CIF de instrumentos de medida e intervenções utilizados na Fisioterapia em sujeitos com AVC

Appropriate relation of dimensions and categories among interventions, outcomes and outcomes measures are needed on physiotherapy context, in order to improve rehabilitation programs and research conclusions. International Classification of Functioning (ICF) core sets can facilitate this organization, by the use of ICF linking rules developed to link ICF categories to the common intervention and outcomes used in practice and research. The goal of this study is to propose a categorization of PT interventions and outcome measures on stroke patients under the ICF model. A list of 43 interventions and a list of 65 outcome measures on stroke was selected and initially categorized according to the ICF 10 linking rules, within 43 previous selected 2nd level categories related with movement. This categorization proposal was then validated on a 2-round electronic-mail survey of 7 Portuguese physical therapists using the Delphi technique. The 65 outcome measures are categorized in a total of 243 ICF codes: “body functions” – 86; “body structures” – 11 “activity” – 125 and “participation” – 20.The 43 interventions are categorized in a total of 223 ICF codes: “body functions” – 97; “body structures” – 18; “activity” – 106 and “participation” – 2. For this panel of experts, its consensual that the categories “body functions” and “activity” are the ones that better characterize physiotherapy assessement and intervention, in the context of neurology specifically on stroke patients. This categorization should be validated at international level. &nbsp;De forma a melhor programar e obter resultados em investigação e planos de intervenção clínicos, no contexto da Fisioterapia, é necessária uma relação clara entre tipologias de intervenção, problemas a resolver, resultados esperados e instrumentos de avaliação aplicados. A Classificação Internacional de Funcionalidade (CIF) e os Core Sets já desenvolvidos são uma estrutura que facilita esta relação e organização. A aplicação das regras de correspondência entre as categorias da CIF, as intervenções e os instrumentos de medida poderão ser a forma facilitadora para este processo. O objetivo deste estudo é propor a categorização dos instrumentos de medida e intervenções da Fisioterapia, no contexto da reabilitação de sujeitos com Acidente Vascular Cerebral (AVC). Quarenta e três intervenções e 65 instrumentos de medida foram categorizados em 43 categorias e códigos relacionados com o movimento, pertencentes ao Core Set para AVC, de acordo com as regras de correspondência. Foi feita uma proposta inicial de categorização e a sua validação foi feita por sete Fisioterapeutas peritos no uso da CIF e em neurologia, através do método de Delphi modificado. Os resultados demonstram que os instrumentos de medida foram categorizados num total de 243 categorias de 2.º nível da CIF: “funções” – 86; “estruturas” – 11; “atividade” – 125, e “participação” – 20. As intervenções foram categorizadas num total de 223 categorias de 2.º nível da CIF: “funções” – 97; “estruturas” – 18; “atividade” – 106, e “participação” – 2. Conclui-se que é consensual, para este painel de peritos, que são os construtos das “funções do corpo” e “atividades” que melhor expressam a caracterização dos instrumentos de medida e as intervenções realizadas no contexto da Fisioterapia a sujeitos que sofreram AVC. Esta categorização deve ser validada ao nível internacional.&nbsp

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Probiotic prato cheese consumption attenuates development of renal calculi in animal model of urolithiasis

The effect of probiotic Prato cheese containing Lactobacillus casei 01 (7–8 log CFU/g) on urolithiasis was evaluated. Twenty-four male Rattus novergicus, Wistar line (8 weeks old), with surgical implant of calcium oxalate tablets (CaOx) were used. The animals were organized into four groups (n = 6) randomly divided into: Naive Control (NC); Control of calcium oxalate (CaOx-C); Calcium oxalate with conventional cheese (CC), Calcium oxalate with probiotic cheese (PC). Urinalysis was performed to evaluate volume, density, pH, urea, creatinine, together with serum urea, creatinine, sodium, potassium and magnesium, and latero-lateral radiographs of the abdominal cavity. Only the PC group presented a significant reduction in the size of the pellets (CaOx-C Δ = 1.24 mg, CC Δ = 5.78 mg and e PC Δ = −0.933 mg). Changes in urinary mineral excretion were observed, with a reduction in potassium (NC = 183.7, Caox-C = 313.8, CC = 108, and e PC = 76.4 mmol/L), calcium (NC = 11.0, Caox-C = 3.8, CC = 4.7 and e PC = 3.4 mg/dL. p = 0.002) and magnesium (NC = 11.4, Caox-C = 12.9, CC = 5.7 e PC = 2.4 mg/dL, p = 0.01) excretion. Radiological examination confirmed the role of PC in preventing kidney stone development, which support the PC a superior to the current therapeutics, together with a functional ingredient in nutraceutical applications49378383CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQSem informaçã

Syndecan-4 is a maestro of gastric cancer cell invasion and communication that underscores poor survival

Gastric cancer is a dominating cause of cancer-associated mortality with limited therapeutic options. Here, we show that syndecan-4 (SDC4), a transmembrane pro-teoglycan, is highly expressed in intestinal subtype gastric tumors and that this sig -nature associates with patient poor survival. Further, we mechanistically demonstrate that SDC4 is a master regulator of gastric cancer cell motility and invasion. We also find that SDC4 decorated with heparan sulfate is efficiently sorted in extracellular vesicles (EVs). Interestingly, SDC4 in EVs regulates gastric cancer cell-derived EV organ distribution, uptake, and functional effects in recipient cells. Specifically, we show that SDC4 knockout disrupts the tropism of EVs for the common gastric cancer metastatic sites. Our findings set the basis for the molecular implications of SDC4 expression in gastric cancer cells and provide broader perspectives on the development of therapeutic strategies targeting the glycan-EV axis to limit tumor progression