Perspectiva dos acadêmicos de medicina no uso de animais em ensino e pesquisa : Medical students' perspective on the use of animals in teaching and research

O uso de animais é um recurso utilizado no ensino médico no processo de aprendizado e pesquisa, o que gera debate acerca da utilização eticamente adequada desses seres. O objetivo do estudo foi analisar indicadores éticos do uso de animais nas atividades científicas e de ensino no curso de medicina da Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), por meio de um questionário. O estudo foi aprovado pelo Comitê de Ética da EMESCAM. Os indicadores éticos analisados reforçam a ideia de que o uso de animais para fins didáticos e científicos ainda gera conflitos, especialmente quando a percepção do sofrimento animal é identificada pelos estudantes. Os alunos entrevistados entendem a importância do uso de animais para as atividades de ensino e pesquisa, desde que realizada de forma ética e fazendo uso de métodos alternativos quando for possível a substituição

A lactate shuttle system between tumour and stromal cells is associated with poor prognosis in prostate cancer

Background In a malignant tumour, cancer cells are embedded in stromal cells, namely cancer-associated fibroblasts (CAFs). These CAFs are now accepted as important players in cancer dynamics, being involved in tumour growth and progression. Although there are various reports on the interaction between tumour and stromal cells, the clinico-pathological significance of this cross-talk is still largely unknown. In this study, we aimed to characterise the expression of key metabolic proteins involved in glucose transport, pyruvate/lactate shuttle system, glycolytic metabolism and fatty acid oxidation in CAFs and tumour cells in different stages of malignant transformation. We further aimed to contextualise the clinico-pathological significance of these protein expression profiles with reference to known prognostic indicators, including biochemical recurrence in pT stage. Methods Prostate tissues were obtained from 480 patients with a median age of 64 years following radical prostatectomy with no previous hormonal therapy. Tissues were analysed for the expression of several key metabolism-related proteins in glands and surrounding fibroblasts by immunohistochemistry. Reliable markers of prognosis such as pT stage and biochemical recurrence were assessed for each case. Results We observed that prostate cancer cells did not rely mainly on glycolytic metabolism, while there was a high expression of MCT4 and CAIX - in CAFs. This corroborates the hypothesis of the "Reverse Warburg effect" in prostate cancer, in which fibroblasts are under oxidative stress and express CAIX, an established hypoxia marker. We found that alterations in the expression of metabolism-related proteins were already evident in the early stages of malignant transformation, suggesting the continuing alteration of CAFs from an early stage. Additionally, and for the first time, we show that cases showing high MCT4 expression in CAFs with concomitant strong MCT1 expression in prostate cancer (PCa) cells are associated with poor clinical outcome, namely pT3 stage of the tumour. Conclusions In summary, this work demonstrates for the first time the clinico-pathological significance of the lactate shuttle in prostate cancer. It also suggests that other alterations in CAFs may be useful prognostic factors, and further supports the use of MCT1/MCT4 as targets for PCa therapy.NPG received a fellowship from the Portuguese Foundation for Science and Technology (FCT), refs. SFRH/BD/61027/2009. This work was supported by the FCT grant ref. PTDC/SAUMET/113415/2009, under the scope of "Programa Operacional Tematico Factores de Competitividade" (COMPETE) of "Quadro Comunitario de Apoio III" and co-financed by Fundo Comunitario Europeu FEDER. JA was supported by a Boehringer Ingelheim Fonds fellowship

Evaluation of Protein Sources in Different Base Formulations Based on Total and Digestible Amino Acids for Japanese Quails

The Japanese quail (Coturnix coturnix japonica) rearing activity has grown considerably over the past few years. The purpose of this study was to compare diet formulations based on total (TAA) and digestible amino acids (DAA) and the use of different protein sources such as meat cum bone meal and feather meal in Japanese quails. The first three treatments were based on TAA, formulated based on corn and soybean meal (CST); meat and bone meal (CSMT); feather meal (CSMFT). The three other treatments received the same sequence of ingredients as the previous treatments; however, the diets were formulated based on digestible amino acids (DAA) (CSD, CSMD, and CSMFD). The results show that the base of diet formulation improves the performance of quails from 1-21d and the quails show that is possible to replacement of soybean meal with animal-origin by-products such as meat bone meal and feather meal, buts is needed to evaluate more aspects. In conclusion, diets formulated base on DAA for Japanese quails can be utilized with the same efficiency as diets based on TAA

Digestible tryptophan:lysine ratio for laying hens

The objective of this study was to evaluate the requirement of digestible tryptophan for white laying hens in the production stage fed diets of different digestible tryptophan: digestible lysine ratios, as well as animal performance and histological alterations in their reproductive and digestive systems. A total of 280 white laying hens at 29 weeks of age were distributed in a completely randomized design with five treatments and seven replications with eight birds in each. The treatments consisted of a base feed, formulated with corn, soybean meal and corn gluten meal, and supplemented with the synthetic amino acids L-lysine, DL-methionine, L-threonine, L-isoleucine, L-arginine, and L-valine, so as to meet the nutritional requirements for laying hens, except for digestible tryptophan. The basal diet was supplemented with 0.00; 0.017; 0.035; 0.052; and 0.069 g/kg of L-tryptophan in substitution for corn starch with the objective of reaching the levels of 0.151; 0.167; 0.183; 0.199; and 0.215 g/kg of digestible tryptophan in the feed. For the ratio between digestible amino acids and lysine, the recommendation of Brazilian Tables for Poultry and Swine was followed, except for the digestible tryptophan: digestible lysine ratios, which were 19, 21, 23, 25 and 27 for each treatment. The variation in the digestible tryptophan: digestible lysine ratio promoted changes in performance and in the histological characteristics, improving the results. The digestible tryptophan: digestible lysine ratio of 24.5% in the feed of white laying hens in production stage promotes better animal performance and histological results.CNPq [141196/2009-2]CNP

Impactos pós Covid-19 na saúde mental dos profissionais de enfermagem de uma Unidade Básica de Sáude : Post Covid-19 impacts on the mental health of nursing professionals in a Basic Health Unit

Introdução: A pandemia do Covid-19 carregou consigo as consequências conduzidas pelo contexto de crise e emergência sanitária enfrentada principalmente pelos trabalhadores da assistência a saúde gerando resultados significantes na saúde mental do profissional da saúde. Objetivo: Conhecer os impactos que o contexto pandêmico influenciou na Saúde Mental dos profissionais de enfermagem de uma Unidade Básica de Saúde. Metodologia: Trata-se de uma pesquisa com abordagem quanti-qualitativo, de métodos mistos em que os dados foram coletados por meio de um questionário online adaptado, para identificação da incidência e a prevalência de estressores mentais, a mudança na rotina da equipe, as atitudes e os comportamentos diante dos estressores dos profissionais. Os participantes envolvidos foram todos os profissionais da equipe de enfermagem de uma unidade básica de saúde localizada em Iranduba, município do Amazonas. Resultados: As categorias definidas para análise foram: Perfil Sociodemográfico; Dados Comportamentais; Incidência e Prevalência de Estressores Mentais nos profissionais de Enfermagem da Atenção Básica; e Dificuldades percebidas e estratégias de enfrentamento como Profissional de Enfermagem na Atenção Básica. Considerações Finais: Ressalta-se, a importância no cuidado da saúde mental para a equipe de enfermagem, principalmente pós pandemia, devido ao seu impacto gerado ao longo prazo, há a necessidade de melhoria nas condições de trabalho, através políticas públicas direcionada ao amparo do profissional em momento de exaustão psicológica, que consequentemente gera melhor qualidade de vida

Burden of disease attributable to risk factors in European countries: a scoping literature review

Objectives: Within the framework of the burden of disease (BoD) approach, disease, and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe, and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. Methods: We searched multiple literature databases, including grey literature websites, and targeted public health agencies' websites. Results: A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year, or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors since they might significantly influence the quantification of the attributable burden. From our analysis, we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. Conclusions: Our review also highlighted misreporting, the lack of uncertainty analysis, and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, and avoid misinterpretations thus improving comparability among estimates.info:eu-repo/semantics/publishedVersio

A evolução clínica do paciente portador de abscesso pulmonar: Clinical evolution of patients with lung abscess

Atualmente, com a era da antibioticoterapia e demais meios terapêuticos, o abscesso pulmonar decaiu em termos de morbimortalidade, mas ainda permanece como um desafio em termos diagnósticos e manejo clínico. O abscesso pulmonar corresponde a uma cavidade com pus no pulmão, envolvido por tecido inflamado e geralmente oriunda de uma infecção. O artigo objetivou descrever de modo narrativo a evolução clínica do portador de abscesso pulmonar, ressaltando os principais dados para a compreensão deste fenômeno. Um abscesso pulmonar é causado principalmente por bactérias existentes na boca ou garganta, a qual são aspiradas até os pulmões. A sintomatologia é inespecífica, abordando fadiga, inapetência, sudorese noturna, febre, perda ponderal e tosse com expectoração. O quadro clínico geralmente necessita do complemento de exames de imagem, principalmente a radiografia torácica para diagnóstic

The burden of injury in Central, Eastern, and Western European sub-region : a systematic analysis from the Global Burden of Disease 2019 Study

Background Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. Methods We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. Results In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. Conclusions Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.Peer reviewe

Estimulação cerebral profunda na Doença de Parkinson: evidências de estudos de longa duração

A Doença de Parkinson (DP) é uma condição neurodegenerativa crônica que afeta principalmente idosos, mas pode ocorrer em adultos jovens. É a segunda doença neurodegenerativa mais comum, após o Alzheimer. A DP afeta 1% dos indivíduos acima de 60 anos em países industrializados. Sua causa envolve fatores genéticos e ambientais, como exposição a pesticidas e envelhecimento. A Estimulação Cerebral Profunda (DBS) é um tratamento que simula lesões cerebrais, melhorando sintomas motores e não motores. O presente estudo tem como objetivo analisar evidências de estudos sobre a eficácia da DBS no tratamento da DP. Trata-se de uma revisão sistemática de estudos quantitativos que utiliza as bases de dados PubMed (Medline), Cochrane Library e Scientific Electronic Library Online (SciELO) para selecionar artigos científicos. Os estudos incluídos abrangem o período de 2013 a 2023 e estão em inglês, abordando a DBS no tratamento da DP. A DBS melhora diversos sintomas motores e não motores, resultando em uma melhor qualidade de vida para os pacientes. Tais benefícios são sustentados mesmo em estágios avançados da Doença de Parkinson, a qual consiste em fornecer pulsos de corrente elétrica a áreas cerebrais profundas através de eletrodos implantados cirurgicamente, geralmente quando a terapia medicamentosa já não é eficaz. Em um estudo com 82 pacientes, a terapia com DBS resultou em uma redução de ± 52% nos sintomas motores do UPDRS sob medicação antes da cirurgia. A melhora nos sintomas motores com a estimulação, em comparação com a ausência de estimulação e medicação, foi de ± 61% no primeiro ano e ± 39% de 8 a 15 anos após a cirurgia (antes da reprogramação). A medicação foi reduzida em ± 55% após 1 ano e ± 44% após 8 a 15 anos, com a maioria dos pacientes mostrando melhorias após a reprogramação. De acordo com as literaturas analisadas, a DBS é uma terapia eficaz para a DP. Enfatiza-se a importância da inovação contínua e dos novos estudos para explorar as facetas não investigadas desse campo. Com a abordagem dos aspectos clínicos, cirúrgicos, tecnológicos e científicos, destacam-se os benefícios, limitações e desafios a serem superados. Ademais, inovações tecnológicas na DBS, como a estimulação direcional, adaptativa e a telemedicina estão sendo exploradas. Em suma, este artigo fornece evidências sobre os benefícios da DBS na DP, ressaltando a necessidade de pesquisas adicionais para otimizar tal intervenção terapêutica e melhorar a qualidade de vida dos pacientes