Chronic Use Of Diazepam In Primary Healthcare Centers: User Profile And Usage Pattern.

Chronic use of benzodiazepines is frequent in general practice. The aim of this study was to describe the usage pattern and profile of chronic users of diazepam who had been consuming this drug for a minimum of thirty-six months continuously. This was a descriptive study (survey and clinical assessment) at five primary healthcare centers in Campinas, Brazil. Psychotropic drug control books revealed 48 eligible patients. Among these, 41 were assessed by means of the Schedule for Clinical Assessment in Neuropsychiatry (SCAN), the Hospital Anxiety and Depression scale (HAD) and a questionnaire on usage pattern. Most patients were women (85.4%). The patients' mean age was 57.6 years, and they were from the social strata C (39%), D (54%) and E (7%). The mean length of diazepam consumption was 10 years. The patients presented a lack of prescription compliance and had made frustrated attempts to stop using the drug. 55.5% said their doctor had never given any guidance on the effects of the drug. According to SCAN, 25 patients (61%) suffered from depressive disorders; only 12 cases of benzodiazepine dependence were detected by this instrument. There is a need to improve the detection and treatment of mental disorders, as well as to prevent inappropriate prescription and use of benzodiazepines. Diazepam dependence has distinctive characteristics that make it undetected by SCAN.125270-

Efeito dos níveis de paratormônio sobre a capacidade funcional física de pacientes dialíticos / Effect of paratormonium levels on the physical functional capacity of dialytic patients

Introdução: A Doença Renal Crônica (DRC) é caracterizada pela anormalidade do funcionamento e da estrutura do rim. Nos pacientes dialíticos é observado um declínio da capacidade funcional física, que tem entre os fatores de risco não tradicionais, o paratormônio (PTH). A elevação dos níveis de PTH está associada ao aumento da mortalidade de dialíticos e a um efeito negativo sobre a função musculoesquelética o que sugere prejuízo à capacidade funcional.Objetivo: Avaliar os efeitos dos níveis de paratormônio sobre a capacidade funcional física de pacientes dialíticos.Métodos: Foi realizado um estudo transversal com dialíticos de ambos os sexos, com idade entre 20 a 59 anos. Foram avaliados os níveis de PTH e de acordo os mesmos, os voluntários foram distribuídos em 2 grupos: PTH (A) com níveis séricos acima da faixa de normalidade e PTH (C) com níveis normais de paratormônio. Foi realizada a avaliação da capacidade funcional física (CFF) pelo teste de caminhada de seis minutos (TC6’).Resultados: Foi observado que os níveis de PTH causaram um efeito negativo sobre a função musculoesquelética. Em relação a capacidade funcional física a distância média percorrida e a % do previsto obtida pelo grupo PTH (C) foram de 343,85 ± 98,14 metros e 42,35% enquanto as obtidas pelo grupo PTH (A) foram de 385,60 ± 94,14 metros e 47,04 %, respectivamente.Conclusão: Os níveis aumentados de PTH estão associados a efeitos negativos sobre a capacidade funcional pulmonar de pacientes dialíticos

Prevalence of suicidal ideation, suicide plans, and attempted suicide: a population-based survey in Campinas, São Paulo State, Brazil

This study aimed to estimate the lifetime prevalence rates for suicidal ideation, suicide plans, and attempted suicide, based on a cluster sample of 515 residents of Campinas, São Paulo State, Brazil. The Multisite Intervention Study on Suicidal Behavior interview was performed, and lifetime prevalence rates and 95% confidence intervals (95%CI) were calculated. Lifetime prevalence rates were 17.1% (95%CI: 12.9-21.2) for suicidal ideation, 4.8% (95%CI: 2.8-6.8) for suicide plans, and 2.8% (95%CI: 0.09-4.6) for attempted suicide. Suicidal behavior was more frequent among women and young adults. The suicide plan/attempt ratio was approximately 5:3. Only one-third of those who attempted suicide contacted a health service following the attempt. Prevalence rates for suicidal behavior were similar to most studies from other countries. Suicide prevention strategies should take data from community-based studies into account.O objetivo foi estimar as prevalências ao longo da vida de ideação, planos e tentativas de suicídio na população. Quinhentos e quinze indivíduos residentes em Campinas, São Paulo, Brasil, foram selecionados utilizando-se amostragem estratificada por conglomerados e avaliados por entrevista do Estudo Multicêntrico de Intervenção no Comportamento Suicida. Calculamos prevalências ponderadas, com os respectivos intervalos de 95% de confiança (IC95%). As prevalências foram de 17,1% (IC95%: 12,9;21,2) para ideação, 4,8% (IC95%: 2,8;6,8) para planos e 2,8% (IC95%: 0,09;4,6) para tentativas de suicídio. O comportamento suicida foi mais freqüente em mulheres e em adultos jovens. A existência de um plano de como tirar a própria vida, em termos de freqüência, situa-se próximo da tentativa (relação de 5:3). De cada três tentativas de suicídio, apenas uma chegou a ser atendida em um serviço médico. As prevalências se assemelham à maioria dos estudos de outros países. É essencial coletar diretamente na comunidade informações sobre o comportamento suicida, abarcando-o em sua abrangência.26322638Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Avaliação da funcionalidade de idosos com osteoartrite utilizando o Lower Extremity Functional Scale (LEFS)

Introdução: A osteoartrite é uma doença crônico-degenerativa muito prevalente em idosos, a qual desencadeia limitações funcionais e pior qualidade de vida. Embora existam questionários para avaliação da funcionalidade destes pacientes, a busca por instrumentos específi cos para avaliação de membros inferiores apresenta relevância na prática fi sioterapêutica. Objetivos: Avaliar a correlação do Lower Extremity Functional Scale (LEFS) com a funcionalidade e componentes físicos e mentais da qualidade de vida em idosos com osteoartrite. Método: Estudo transversal, no qual a funcionalidade foi avaliada pelos questionários WOMAC, Lequesne e LEFS e a qualidade de vida foi avaliada pelo questionário SF-36. Resultados: Participaram do estudo 105 idosos (Idade: 68,80± 6,3 anos) com osteoartrite de joelho ou quadril, sendo 31homens e 74 mulheres. Não foi observada associação entre a idade (p>0,05) e o comprometimento funcional avaliado tanto pelo índice WOMAC quanto Lequesne (p>0,05) na população estudada. Foi observada correlação negativa entre o indice WOMAC e o LEFS (rS=-0,81) e o Lequesne e o LEFS (rS=-0,86). Além disso, foi verifi cada associação entre os escores do LEFS e a capacidade funcional (rS=0,80), limitação por aspectos físicos (rS=0,44), dor (rS=0,55) e estado geral de saúde (rS=0,44). Ainda, foi verifi cada correlação entre o escore do LEFS e a vitalidade (rS=0,60), aspectos sociais (rS=0,38), limitação por aspectos emocionais (rS=0,38) e saúde mental (rS=0,41). Conclusão: Concluise que o LEFS apresenta boa correlação com os índices WOMAC e Lequesne e com os componentes físicos e mentais da qualidade de vida, podendo constituir um instrumento clínico para avaliação do impacto funcional da osteoartrite em idosos. Introduction: Osteoarthritis is a chronic degenerative disease very prevalent in the elderly, which triggers functional limitations and poorer quality of life. Although there are already established instruments to evaluate the functional status of these patients, the search for specific instruments for assessment of lower limbs has relevance in physical therapy practice. Objective: This study aimed to evaluate the correlation between LEFS with functional status and physical and mental components of quality of life of older adults with osteoarthritis. Methods: At this cross-sectional study, the functional status was assessed by WOMAC, Lequesne and LEFS indexes and the quality of life was assessed by SF-36. Results: This study included 105 elderly (age: 68.80 ± 6.3 years) with osteoarthritis of the knee or hip, being 31 men and 74 women. It was not observed a correlation between age and functional status (p>0.05) analyzed by WOMAC and Lequesne indexes. However, negative correlations between WOMAC and LEFS(rS=- 0.81) as well as Lequesne and LEFS(rS= -0.86) were observed according to Spearman’s correlation. Moreover, there was a correlation between the LEFS’ score and functional capacity (rS = 0.80), limitation by physical aspects (rS= 0.44), pain (rS= 0.55) and general health (rS = 0.44). Moreover, it was also observed a positive correlation between the LEFS’ score and vitality (rS=0.60), social status (rS= 0.38), limitation for emotional aspects (rS=0.38) and mental health (rS= 0.41). Conclusion: LEFS correlates well with the WOMAC and Lequesne indexes as well as the physical and mental components of quality of life and it may be an alternative clinical tool for assessing the functional impact of osteoarthritis in the elderly

Identification and characterization of expressed retrotransposons in the genome of the Paracoccidioides species complex

Background: Species from the Paracoccidioides complex are thermally dimorphic fungi and the causative agents of paracoccidioidomycosis, a deep fungal infection that is the most prevalent systemic mycosis in Latin America and represents the most important cause of death in immunocompetent individuals with systemic mycosis in Brazil. We previously described the identification of eight new families of DNA transposons in Paracoccidioides genomes. in this work, we aimed to identify potentially active retrotransposons in Paracoccidioides genomes.Results: We identified five different retrotransposon families (four LTR-like and one LINE-like element) in the genomes of three Paracoccidioides isolates. Retrotransposons were present in all of the genomes analyzed. P. brasiliensis and P. lutzii species harbored the same retrotransposon lineages but differed in their copy numbers. in the Pb01, Pb03 and Pb18 genomes, the number of LTR retrotransposons was higher than the number of LINE-like elements, and the LINE-like element RtPc5 was transcribed in Paracoccidioides lutzii (Pb01) but could not be detected in P. brasiliensis (Pb03 and Pb18) by semi-quantitative RT-PCR.Conclusion: Five new potentially active retrotransposons have been identified in the genomic assemblies of the Paracoccidioides species complex using a combined computational and experimental approach. the distribution across the two known species, P. brasiliensis and P. lutzii, and phylogenetics analysis indicate that these elements could have been acquired before speciation occurred. the presence of active retrotransposons in the genome may have implications regarding the evolution and genetic diversification of the Paracoccidioides genus.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Univ Fed Minas Gerais, Inst Ciencias Biol, Dept Microbiol, BR-31270901 Belo Horizonte, MG, BrazilUniv Fed Minas Gerais, Inst Ciencias Biol, Programa Posgrad Bioinformat, BR-31270901 Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, BR-04023062 São Paulo, SP, BrazilUniv Brasilia, Inst Ciencias Biol, Lab Biol Mol, BR-70910900 Brasilia, DF, BrazilUniv Fed Goias, Inst Ciencias Biol, Lab Biol Mol, BR-74001970 Goiania, Go, BrazilFIOCRUZ Minas, Ctr Pesquisas Rene Rachou, Grp Informat Biossistemas, BR-30190002 Belo Horizonte, MG, BrazilUniv Fed Minas Gerais, Dept Biol Geral, BR-31270901 Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, BR-04023062 São Paulo, SP, BrazilFAPEMIG: APQ-01661-13CNPq: 301652/2012-0CNPq: 486618/2013-7Web of Scienc

The Schistosoma mansoni cyclophilin A epitope 107-121 induces a protective immune response against schistosomiasis

Great efforts have been made to identify promising antigens and vaccine formulations against schistosomiasis. Among the previously described Schistosoma vaccine candidates, cyclophilins comprise an interesting antigen that could be used for vaccine formulations. Cyclophilin A is the target for the cyclosporine A, a drug with schistosomicide activity, and its orthologue from Schistosoma japonicum induces a protective immune response in mice. Although Schistosoma mansoni cyclophilin A also represents a promising target for anti-schistosome vaccines, its potential to induce protection has not been evaluated. In this study, we characterized the cyclophilin A (SmCyp), initially described as Smp17.7, analyzed its allergenic potential using in vitro functional assays, and evaluated its ability to induce protection in mice when administered as an antigen using different vaccine formulations and strategies. Results indicated that SmCyp could be successfully expressed by mammalian cells and bacteria. The recombinant protein did not promote IgE-reporter system activation in vitro, demonstrating its probable safety for use in vaccine formulations. T and B-cell epitopes were predicted in the SmCyp sequence, with two of them located within the active isomerase site. The most immunogenic antigen, SmCyp (107–121), was then used for immunization protocols. Immunization with the SmCyp gene or protein failed to reduce parasite burden but induced an immune response that modulated the granuloma area. In contrast, immunization with the synthetic peptide SmCyp (107–121) significantly reduced worm burden (48–50%) in comparison to control group, but did not regulate liver pathology. Moreover, the protection observed in mice immunized with the synthetic peptide was associated with the significant production of antibodies against the SmCyp (107–121) epitope. Therefore, in this study, we identified an epitope within the SmCyp sequence that induces a protective immune response against the parasite, thus representing a promising antigen that could be used for vaccine formulation against schistosomiasis

Fatores associados à depressão em profissionais de enfermagem no Brasil: uma revisão integrativa da literatura / Factors associated with depression in nursing professionals in Brazil: An integrative literature review

Esse artigo buscou identificar os fatores associados na depressão do profissional da enfermagem no Brasil. Para isto, foi realizada uma busca eletrônica de 15 artigos nas bases de dados online da Scielo e Lilacs, utilizando como critério de inclusão textos completos, escritos nas línguas portuguesa, inglesa e publicados entre os anos de 2007 a 2020, e os critérios de exclusão foram artigos em formato de resumo ou incompletos e incompatíveis com a temática aqui proposta. Dentre os fatores que desencadeiam a depressão nos profissionais de enfermagem foram: Exigência de habilidades como autonomia, liderança, relacionamento interpessoal e comunicação, estresse e dupla jornada de trabalho e exaustão emocional. Com isto, O estudo constatou que a depressão está presente nos profissionais e é desencadeada por diversos fatores sociais e pessoais, que agem em efeito dominó, onde um fator está ligado ao outro, levando o indivíduo a apresentar comportamento diferenciado e distante

School Psychology and Childhood – a public school experience

This work reports an activity performed as part of coursework in Psychology class during a school semester which aimed to provide students an effective experience of what public school psychologists do, based on the critical presumptions about Psychology and also aimed to present reflections on the performance of this professional together with children. The proposal involved encounters with teachers and children and the undergraduates were responsible for the preparation and execution of activities under the supervision of professors. The Psychology students highlighted the importance of this practice for their professional training, which provided discussions on key questions such as childhood, education and the impact of School Psychology in the Brazilian educational scope

Breastfeeding and chemokines : differences in schizophrenia and controls

Introdução: Avaliar a associação entre níveis plasmáticos da quimiocina CCL11, coeficiente de inteligência e prática da amamentação em homens com esquizofrenia em condições psiquiátricas estáveis sob acompanhamento ambulatorial em um serviço de saúde pública. Métodos: Foi realizado estudo caso-controle com 60 indivíduos: 30 pacientes com esquizofrenia e 30 controles saudáveis, dos quais 15 de cada grupo foram expostos ao aleitamento materno e 15 não foram. Foi aplicado questionário abordando questões socioeconômicas, história ao nascer, dados clínicos e alimentação ao nascer. Foi dosada a quimiocina CCL11 e aplicados testes psicológicos para avaliar quociente de inteligência, funcionalidade, sintomas psiquiátricos, curso da doença e diagnóstico. Para os controles, foi utilizada uma escala para descartar doença psiquiátrica. Resultados: A quimiocina CCL11 apresentou valores significativamente mais altos (> 0,5) em pacientes com esquizofrenia quando comparados aos controles. No grupo de amamentados, os esquizofrênicos apresentaram valores significativamente mais altos a nível intermediário (entre 0.106 e 0.5). Não houve correlação da CCL11 com o número de hospitalizações, idade, tempo de diagnóstico e escolaridade. Não foi evidenciada correlação entre tempo de aleitamento materno em relação aos fatores do Brief Psychiatric Rating Scale. Houve uma tendência de correlação entre a idade de início da doença e o aleitamento materno. Foi encontrada correlação positiva do CCL11 com o tempo de aleitamento materno. Ao comparar os pacientes esquizofrênicos que foram aleitados com os que não foram, foi encontrada diferença estatisticamente significativa apenas para o quociente de inteligência. Conclusão: O aleitamento materno está associado a níveis mais baixos de CCL11, escores mais altos de quociente de inteligência e a esquizofrenia. A quimiocina CCL11 é mais alta em quem não amamentou, especialmente nos esquizofrênicos.Introduction: To evaluate the association between plasma levels of chemokine CCL11, intelligence quotient, and exposure to breastfeeding in men with schizophrenia under stable psychiatric condition and monitored as outpatients in a public health care unit. Methods: A case-control study of 60 individuals, 30 patients with schizophrenia and 30 healthy controls; in each group, 15 were exposed to breastfeeding and 15 were not. A questionnaire addressing socioeconomic issues, history at birth, clinical data, and feeding at birth was administered. Chemokine CCL11 levels were measured, and psychological tests were applied to assess intelligence quotient, functional status, psychiatric symptoms, disease course, and diagnosis. A scale to rule psychiatric illness was used for the controls. Results: Chemokine CCL11 levels were significantly higher (> 0.5) in patients with schizophrenia than in controls. In the breastfed group, patients with schizophrenia also had significantly higher CCL11 levels, but at an intermediate level (between 0.106 and 0.5). There was no correlation between CCL11 and number of hospitalizations, age, time since diagnosis, or level of education, nor between duration of breastfeeding and the Brief Psychiatric Rating Scale factors. A trend toward a correlation was observed between age at disease onset and breastfeeding. There was a positive correlation between CCL11 and duration of breastfeeding. The comparison of patients with schizophrenia who were breastfed vs those who were not breastfed showed a statistically significant difference only in intelligence quotient. Conclusion: Breastfeeding is associated with lower CCL11 levels, higher intelligence quotient scores, and schizophrenia. Chemokine CCL11 levels are higher in those not exposed to breastfeeding, especially in patients with schizophrenia

Genome of the Avirulent Human-Infective Trypanosome—Trypanosoma rangeli

Background: Trypanosoma rangeli is a hemoflagellate protozoan parasite infecting humans and other wild and domestic mammals across Central and South America. It does not cause human disease, but it can be mistaken for the etiologic agent of Chagas disease, Trypanosoma cruzi. We have sequenced the T. rangeli genome to provide new tools for elucidating the distinct and intriguing biology of this species and the key pathways related to interaction with its arthropod and mammalian hosts.  Methodology/Principal Findings: The T. rangeli haploid genome is ,24 Mb in length, and is the smallest and least repetitive trypanosomatid genome sequenced thus far. This parasite genome has shorter subtelomeric sequences compared to those of T. cruzi and T. brucei; displays intraspecific karyotype variability and lacks minichromosomes. Of the predicted 7,613 protein coding sequences, functional annotations could be determined for 2,415, while 5,043 are hypothetical proteins, some with evidence of protein expression. 7,101 genes (93%) are shared with other trypanosomatids that infect humans. An ortholog of the dcl2 gene involved in the T. brucei RNAi pathway was found in T. rangeli, but the RNAi machinery is non-functional since the other genes in this pathway are pseudogenized. T. rangeli is highly susceptible to oxidative stress, a phenotype that may be explained by a smaller number of anti-oxidant defense enzymes and heatshock proteins.  Conclusions/Significance: Phylogenetic comparison of nuclear and mitochondrial genes indicates that T. rangeli and T. cruzi are equidistant from T. brucei. In addition to revealing new aspects of trypanosome co-evolution within the vertebrate and invertebrate hosts, comparative genomic analysis with pathogenic trypanosomatids provides valuable new information that can be further explored with the aim of developing better diagnostic tools and/or therapeutic targets