NEUROTRAUMA PROJECT: Educate to prevent – the best treatment

Introdução: As lesões neurológicas são as principais causas de deficiência. Os neurotraumas: trauma raquimedular (TRM) e traumatismo cranioencefálico (TCE) além de frequentes, causam, muitas vezes, danos neurológicos permanentes e acometem comumente os jovens que têm a sua vida inteiramente modificada. Os neurotraumas impactam a vida não só do indivíduo que sofre o trauma, mas de toda a sua família, além do sistema de saúde e previdenciário, tornando-se um problema de saúde pública. Objetivos: Promover ações educativas relacionadas aos neurotraumas a alunos do ensino médio das escolas públicas de Diamantina – Minas Gerais e conscientizar sobre a seriedade do TRM e TCE estimulando a prevenção. Métodos: Alunos do ensino médio das escolas públicas da cidade de Diamantina – Minas Gerais formaram o público alvo da intervenção deste projeto de extensão. A atividade extensionista iniciou após autorização da equipe escolar. Um questionário sobre o conhecimento e fatores de risco do TRM e TCE foi entregue para os alunos antes da aula expositiva e ilustrativa sobre os neurotraumas. A aula continha assuntos relacionados à anatomia neurológica, etiologia, incidência, fatores de risco, prognóstico, complicações e prevenção dos neurotraumas. Houve um período para debate e dúvidas, e um folder explicativo sobre o assunto foi entregue aos alunos no final da abordagem. Os dados relacionados ao questionário aplicado foram analisados e relatos dos alunos extensionistas e da equipe escolar foram registrados. Resultados: O número total de estudantes abordados nesta intervenção foi de 451, distribuídos entre os três anos do ensino médio, 32% do primeiro ano, 40% e 28% do segundo e terceiro, respectivamente. A média de idade dos estudantes foi de 16 anos e a maioria do gênero feminino (55%). Um número expressivo de alunos não tinha conhecimento sobre o TRM (41%) e TCE (52%) e vários deles apresentavam atitudes de risco para um possível neurotrauma. Conclusão: A melhor conduta para evitar o número crescente e as consequências dos neurotraumas é a prevenção, pois além da autoproteção, evita acidentes a terceiros e trazem benefícios econômicos para toda a sociedade e menos sofrimento para os indivíduos. Houve interação entre a universidade e as escolas o que proporcionou o aumento do aprendizado.Introducción: Las lesiones neurológicas son las principales causas de discapacidad. Los neurotraumas, trauma raquimedular (TRM) y traumatismo craneoencefálico (TCE), además de frecuentes, muchas veces causan daños neurológicos permanentes y se presentan con frecuencia en los jóvenes que tienen sus vidas completamente modificadas. Los neurotraumas no solo afectan la vida del individuo que lo sufre, sino también su vida familiar, el sistema de salud pública y de seguridad que se convierte en uno problema de salud pública. Objetivos: Promover acciones educativas relacionadas con neurotraumas a los alumnos de bachillerato de las escuelas públicas de Diamantina, Minas Gerais, y concientizar acerca de la seriedad del TRM y TCE estimulando la prevención. Métodos: Alumnos del bachillerato de las escuelas públicas de la ciudad de Diamantina, Minas Gerais, han formado el público objetivo de la intervención de este proyecto de extensión. La actividad extensionista empezó después de la autorización del equipo escolar. Un cuestionario acerca del conocimiento y los factores de riesgo del TRM y TCE fue entregado para los alumnos antes de la clase expositiva y ilustrativa sobre los neurotraumas. La clase contenía temas relacionados con la anatomía neurológica, etiología, incidencia, factores de riesgo, pronóstico, complicaciones y prevención de los neurotraumas. Hubo un período de debate para aclarar las dudas y se entregó un folleto explicativo sobre los contenidos, a los alumnos al final de la actividad. Los datos relacionados al cuestionario aplicado fueron analizados y se registraron informes de los alumnos extensionistas y del equipo escolar. Resultados: El número total de los estudiantes abordados en esta intervención fue de 451 distribuidos entre los tres años del bachillerato, 32% del primer año, 40% y 28% del segundo y tercero, respectivamente. El promedio de las edades de los estudiantes fueron de 16 años y la mayoría fue del género femenino (55%). Un número significativo de alumnos no tenían conocimiento sobre el TRM (41%) y TCE (52%) y varios de ellos presentaban actitudes de riesgo para un posible neurotrauma. Conclusiones: La prevalencia del desconocimiento sobre el TCE y el TRM y sus consecuencias fue alta entre los estudiantes de secundaria y los hábitos de riesgo para un neurotrauma fueron identificados y ampliamente discutidos. La mejor conducta para evitar el número creciente y las consecuencias de los neurotraumas es la prevención, además de la autoprotección, evita accidentes a terceros y traen beneficios económicos para toda la sociedad y menos sufrimiento para las personas. Hubo interacción entre la universidad y las escuelas proporcionando intercambio de saberes, agregando, posiblemente, nuevos conocimientos para todos los involucrados.Introduction: Neurological injuries are the main causes of disability. Neurotraumas, spinal cord injuries (SCI) and traumatic brain injury (TBI), besides being frequent, often cause permanent neurological damage and commonly affect young people whose lives are completely modified. Neurotraumas impact not only the life of the individual who suffers the trauma, but of the whole family, as well as the health and social security system, becoming a public health problem. Objectives: To promote educational actions related to neurotraumas for high school students in the public schools of Diamantina, Minas Gerais, and to raise awareness about the seriousness of SCI and TBI by stimulating prevention. Methods: High school students from the public schools of the city of Diamantina, Minas Gerais, formed the target audience for the intervention of this extension project. The extension activity started after authorization of the school team. A questionnaire about the knowledge and risk factors of SCI and TBI was delivered to students prior to the expository and illustrative class on neurotraumas. The class contained subjects related to the neurological anatomy; etiology, incidence, risk factors, prognosis, complications and prevention of neurotraumas. There was a period for debate and doubts and an explanatory folder on the subject was delivered to the students at the end of the approach. The data related to the applied questionnaire were analyzed and reports of extension students and school staff were recorded. Results: The total number of students broached in this intervention was 451 distributed between the three years of high school, 32% of the first year, 40% and 28% of the second and third respectively. The average age of the students was 16 years and the majority was female (55%). An expressive number of students were not aware of SCI (41%) and TBI (52%) and several of them presented attitudes of risk for a possible neurotrauma. Conclusion: The prevalence of unfamiliarity about SCI and TBI and its consequences was high among high school students and risk habits for neurotrauma were identified and widely discussed. The best conduct to avoid the increasing number and consequences of neurotraumas is prevention, beyond self-protection prevents accidents to third parties and brings economic benefits to the whole society and less suffering for individuals. There was interaction between a university and schools providing knowledge exchange, possibly adding new knowledge to all involved

NEUROTRAUMA PROJECT: Educate to prevent – the best treatment

Introdução: As lesões neurológicas são as principais causas de deficiência. Os neurotraumas: trauma raquimedular (TRM) e traumatismo cranioencefálico (TCE) além de frequentes, causam, muitas vezes, danos neurológicos permanentes e acometem comumente os jovens que têm a sua vida inteiramente modificada. Os neurotraumas impactam a vida não só do indivíduo que sofre o trauma, mas de toda a sua família, além do sistema de saúde e previdenciário, tornando-se um problema de saúde pública. Objetivos: Promover ações educativas relacionadas aos neurotraumas a alunos do ensino médio das escolas públicas de Diamantina – Minas Gerais e conscientizar sobre a seriedade do TRM e TCE estimulando a prevenção. Métodos: Alunos do ensino médio das escolas públicas da cidade de Diamantina – Minas Gerais formaram o público alvo da intervenção deste projeto de extensão. A atividade extensionista iniciou após autorização da equipe escolar. Um questionário sobre o conhecimento e fatores de risco do TRM e TCE foi entregue para os alunos antes da aula expositiva e ilustrativa sobre os neurotraumas. A aula continha assuntos relacionados à anatomia neurológica, etiologia, incidência, fatores de risco, prognóstico, complicações e prevenção dos neurotraumas. Houve um período para debate e dúvidas, e um folder explicativo sobre o assunto foi entregue aos alunos no final da abordagem. Os dados relacionados ao questionário aplicado foram analisados e relatos dos alunos extensionistas e da equipe escolar foram registrados. Resultados: O número total de estudantes abordados nesta intervenção foi de 451, distribuídos entre os três anos do ensino médio, 32% do primeiro ano, 40% e 28% do segundo e terceiro, respectivamente. A média de idade dos estudantes foi de 16 anos e a maioria do gênero feminino (55%). Um número expressivo de alunos não tinha conhecimento sobre o TRM (41%) e TCE (52%) e vários deles apresentavam atitudes de risco para um possível neurotrauma. Conclusão: A melhor conduta para evitar o número crescente e as consequências dos neurotraumas é a prevenção, pois além da autoproteção, evita acidentes a terceiros e trazem benefícios econômicos para toda a sociedade e menos sofrimento para os indivíduos. Houve interação entre a universidade e as escolas o que proporcionou o aumento do aprendizado.Introducción: Las lesiones neurológicas son las principales causas de discapacidad. Los neurotraumas, trauma raquimedular (TRM) y traumatismo craneoencefálico (TCE), además de frecuentes, muchas veces causan daños neurológicos permanentes y se presentan con frecuencia en los jóvenes que tienen sus vidas completamente modificadas. Los neurotraumas no solo afectan la vida del individuo que lo sufre, sino también su vida familiar, el sistema de salud pública y de seguridad que se convierte en uno problema de salud pública. Objetivos: Promover acciones educativas relacionadas con neurotraumas a los alumnos de bachillerato de las escuelas públicas de Diamantina, Minas Gerais, y concientizar acerca de la seriedad del TRM y TCE estimulando la prevención. Métodos: Alumnos del bachillerato de las escuelas públicas de la ciudad de Diamantina, Minas Gerais, han formado el público objetivo de la intervención de este proyecto de extensión. La actividad extensionista empezó después de la autorización del equipo escolar. Un cuestionario acerca del conocimiento y los factores de riesgo del TRM y TCE fue entregado para los alumnos antes de la clase expositiva y ilustrativa sobre los neurotraumas. La clase contenía temas relacionados con la anatomía neurológica, etiología, incidencia, factores de riesgo, pronóstico, complicaciones y prevención de los neurotraumas. Hubo un período de debate para aclarar las dudas y se entregó un folleto explicativo sobre los contenidos, a los alumnos al final de la actividad. Los datos relacionados al cuestionario aplicado fueron analizados y se registraron informes de los alumnos extensionistas y del equipo escolar. Resultados: El número total de los estudiantes abordados en esta intervención fue de 451 distribuidos entre los tres años del bachillerato, 32% del primer año, 40% y 28% del segundo y tercero, respectivamente. El promedio de las edades de los estudiantes fueron de 16 años y la mayoría fue del género femenino (55%). Un número significativo de alumnos no tenían conocimiento sobre el TRM (41%) y TCE (52%) y varios de ellos presentaban actitudes de riesgo para un posible neurotrauma. Conclusiones: La prevalencia del desconocimiento sobre el TCE y el TRM y sus consecuencias fue alta entre los estudiantes de secundaria y los hábitos de riesgo para un neurotrauma fueron identificados y ampliamente discutidos. La mejor conducta para evitar el número creciente y las consecuencias de los neurotraumas es la prevención, además de la autoprotección, evita accidentes a terceros y traen beneficios económicos para toda la sociedad y menos sufrimiento para las personas. Hubo interacción entre la universidad y las escuelas proporcionando intercambio de saberes, agregando, posiblemente, nuevos conocimientos para todos los involucrados.Introduction: Neurological injuries are the main causes of disability. Neurotraumas, spinal cord injuries (SCI) and traumatic brain injury (TBI), besides being frequent, often cause permanent neurological damage and commonly affect young people whose lives are completely modified. Neurotraumas impact not only the life of the individual who suffers the trauma, but of the whole family, as well as the health and social security system, becoming a public health problem. Objectives: To promote educational actions related to neurotraumas for high school students in the public schools of Diamantina, Minas Gerais, and to raise awareness about the seriousness of SCI and TBI by stimulating prevention. Methods: High school students from the public schools of the city of Diamantina, Minas Gerais, formed the target audience for the intervention of this extension project. The extension activity started after authorization of the school team. A questionnaire about the knowledge and risk factors of SCI and TBI was delivered to students prior to the expository and illustrative class on neurotraumas. The class contained subjects related to the neurological anatomy; etiology, incidence, risk factors, prognosis, complications and prevention of neurotraumas. There was a period for debate and doubts and an explanatory folder on the subject was delivered to the students at the end of the approach. The data related to the applied questionnaire were analyzed and reports of extension students and school staff were recorded. Results: The total number of students broached in this intervention was 451 distributed between the three years of high school, 32% of the first year, 40% and 28% of the second and third respectively. The average age of the students was 16 years and the majority was female (55%). An expressive number of students were not aware of SCI (41%) and TBI (52%) and several of them presented attitudes of risk for a possible neurotrauma. Conclusion: The prevalence of unfamiliarity about SCI and TBI and its consequences was high among high school students and risk habits for neurotrauma were identified and widely discussed. The best conduct to avoid the increasing number and consequences of neurotraumas is prevention, beyond self-protection prevents accidents to third parties and brings economic benefits to the whole society and less suffering for individuals. There was interaction between a university and schools providing knowledge exchange, possibly adding new knowledge to all involved

A farmacopsiquiatria dos antidepressivos: The pharmacopsychiatry of antidepressants

Os fármacos antidepressivos compõem o manejo terapêutico da depressão e inúmeros outros transtornos de origem neuropsiquiátrica. Logo, a ocorrências destes distúrbios tornam viável a aplicação destes, ressaltando ser essencial individualizar o tratamento e compreender a respeito das diversas classes, mecanismo de ação, interação medicamentosa, indicação clinica, grupo de risco e a intoxicação por superdosagem. O seguinte artigo objetivou descrever a respeito das particularidades dos antidepressivos, de modo a compreender sobre seu efeito farmacopsiquiatríco. Trata-se de uma revisão narrativa de literatura fundamentada nas renomadas plataformas de artigos indexados a respeito do tema. Foram selecionados os estudos que apresentavam relevância clinica para a compreensão do artigo, descartando-se os demais que não respondiam ao objetivo proposto. Na literatura científica estão disponíveis muitas informações pertinentes ao tema, ressaltando a importância deste. Atualmente, se encontram em aplicabilidade diversas classes que são os Inibidores Seletivos da Recaptação de Serotonina (ISRSs), Antidepressivos Tricíclicos (ADTs), Tetracíclicos e os Inibidores da Monoamina Oxidase (IMAO). Cada um destes possui um mecanismo de ação diferente, mas basicamente estes interferem no impulso nervoso de neurotransmissores beneficiando o portador de distúrbios neurocognitivos. Destacando que mesmo com o efeito terapêutico retrógrado, estes já manifestam os efeitos adversos. Logo, é imprescindível analisar qual o tipo e a dose do fármaco para se conduzir o melhor prognóstico do paciente.&nbsp

Genome-wide Analyses Identify KIF5A as a Novel ALS Gene

To identify novel genes associated with ALS, we undertook two lines of investigation. We carried out a genome-wide association study comparing 20,806 ALS cases and 59,804 controls. Independently, we performed a rare variant burden analysis comparing 1,138 index familial ALS cases and 19,494 controls. Through both approaches, we identified kinesin family member 5A (KIF5A) as a novel gene associated with ALS. Interestingly, mutations predominantly in the N-terminal motor domain of KIF5A are causative for two neurodegenerative diseases: hereditary spastic paraplegia (SPG10) and Charcot-Marie-Tooth type 2 (CMT2). In contrast, ALS-associated mutations are primarily located at the C-terminal cargo-binding tail domain and patients harboring loss-of-function mutations displayed an extended survival relative to typical ALS cases. Taken together, these results broaden the phenotype spectrum resulting from mutations in KIF5A and strengthen the role of cytoskeletal defects in the pathogenesis of ALS.Peer reviewe

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Measurement of inclusive J/ψ pair production cross section in pp collisions at √s = 13 Te

The production cross section of inclusive J/ψ pairs in pp collisions at a centre-of-mass energy s√=13 TeV is measured with ALICE. The measurement is performed for J/ψ in the rapidity interval 2.50. The production cross section of inclusive J/ψ pairs is reported to be 10.3±2.3(stat.)±1.3(syst.) nb in this kinematic interval. The contribution from non-prompt J/ψ (i.e. originated from beauty-hadron decays) to the inclusive sample is evaluated. The effective double-parton scattering cross section is computed, neglecting the single-parton scattering contribution

Energy dependence of coherent photonuclear production of J/ψ mesons in ultra-peripheral Pb-Pb collisions at sNN \sqrt{{\textrm{s}}_{\textrm{NN}}} = 5.02 TeV

International audienceThe cross section for coherent photonuclear production of J/ψ is presented as a function of the electromagnetic dissociation (EMD) of Pb. The measurement is performed with the ALICE detector in ultra-peripheral Pb-Pb collisions at a centre-of-mass energy per nucleon pair of $\sqrt{{\textrm{s}}_{\textrm{NN}}}$ = 5.02 TeV. Cross sections are presented in five different J/ψ rapidity ranges within |y| < 4, with the J/ψ reconstructed via its dilepton decay channels. In some events the J/ψ is not accompanied by EMD, while other events do produce neutrons from EMD at beam rapidities either in one or the other beam direction, or in both. The cross sections in a given rapidity range and for different configurations of neutrons from EMD allow for the extraction of the energy dependence of this process in the range 17 < W$_{γ Pb,n}$ < 920 GeV, where W$_{γ Pb,n}$ is the centre-of-mass energy per nucleon of the γPb system. This range corresponds to a Bjorken-x interval spanning about three orders of magnitude: 1.1 × 10$^{−5}$ < x < 3.3 × 10$^{−2}$. In addition to the ultra-peripheral and photonuclear cross sections, the nuclear suppression factor is obtained. These measurements point to a strong depletion of the gluon distribution in Pb nuclei over a broad, previously unexplored, energy range. These results, together with previous ALICE measurements, provide unprecedented information to probe quantum chromodynamics at high energies.[graphic not available: see fulltext

Charged-particle production as a function of the relative transverse activity classifier in pp, p–Pb, and Pb–Pb collisions at the LHC

Measurements of charged-particle production in pp, p−Pb, and Pb−Pb collisions in the toward, away, and transverse regions with the ALICE detector are discussed. These regions are defined event-by-event relative to the azimuthal direction of the charged trigger particle, which is the reconstructed particle with the largest transverse momentum (ptrigT) in the range 8<ptrigT<15 GeV/c. The toward and away regions contain the primary and recoil jets, respectively; both regions are accompanied by the underlying event (UE). In contrast, the transverse region perpendicular to the direction of the trigger particle is dominated by the so-called UE dynamics, and includes also contributions from initial- and final-state radiation. The relative transverse activity classifier, RT=NTch/⟨NTch⟩, is used to group events according to their UE activity, where NTch is the charged-particle multiplicity per event in the transverse region and ⟨NTch⟩ is the mean value over the whole analysed sample. The energy dependence of the RT distributions in pp collisions at s√=2.76, 5.02, 7, and 13 TeV is reported, exploring the Koba-Nielsen-Olesen (KNO) scaling properties of the multiplicity distributions. The first measurements of charged-particle pT spectra as a function of RT in the three azimuthal regions in pp, p−Pb, and Pb−Pb collisions at sNN−−−√=5.02 TeV are also reported. Data are compared with predictions obtained from the event generators PYTHIA 8 and EPOS LHC. This set of measurements is expected to contribute to the understanding of the origin of collective-like effects in small collision systems (pp and p−Pb)

Measurement of the production cross section of prompt Ξ0c baryons in p–Pb collisions at √sNN = 5.02 TeV

The transverse momentum (pT) differential production cross section of the promptly-produced charm-strange baryon Ξ0c (and its charge conjugate Ξ0c¯¯¯¯¯¯) is measured at midrapidity via its hadronic decay into π+Ξ− in p−Pb collisions at a centre-of-mass energy per nucleon−nucleon collision sNN−−−√ = 5.02 TeV with the ALICE detector at the LHC. The Ξ0c nuclear modification factor (RpPb), calculated from the cross sections in pp and p−Pb collisions, is presented and compared with the RpPb of Λ+c baryons. The ratios between the pT-differential production cross section of Ξ0c baryons and those of D0 mesons and Λ+c baryons are also reported and compared with results at forward and backward rapidity from the LHCb Collaboration. The measurements of the production cross section of prompt Ξ0c baryons are compared with a model based on perturbative QCD calculations of charm-quark production cross sections, which includes only cold nuclear matter effects in p−Pb collisions, and underestimates the measurement by a factor of about 50. This discrepancy is reduced when the data is compared with a model in which hadronisation is implemented via quark coalescence. The pT-integrated cross section of prompt Ξ0c-baryon production at midrapidity extrapolated down to pT = 0 is also reported. These measurements offer insights and constraints for theoretical calculations of the hadronisation process. Additionally, they provide inputs for the calculation of the charm production cross section in p−Pb collisions at midrapidity