Resumo Objetivo: Avaliar se o PET/CT interim com fluoreto-18F após a terceira dose da terapia com dicloreto de rádio-223 (223Ra) é capaz de identificar pacientes que não responderão ao tratamento. Materiais e Métodos: Revisamos, retrospectivamente, 34 pacientes com diagnóstico histológico de câncer de próstata refratários a hormonioterapia e com metástases ósseas que foram submetidos a 223Ra. Todos os pacientes foram submetidos a PET/CT com fluoreto-18F antes de iniciar o tratamento (basal) e imediatamente antes da quarta dose de 223Ra (interim). A carga tumoral esquelética (TLF10) foi calculada em ambos os exames da PET/CT com fluoreto-18F de cada paciente e foi determinada a alteração percentual na TLF10 entre eles (%TFL10 = TLF10 interim - TLF10 basal / TLF10 basal). Foram avaliados a sobrevida global, a sobrevida livre de progressão e o tempo para um evento ósseo. Resultados: A idade média dos pacientes foi 72,4 ± 10,2 anos (variação: 43,3-88,8 anos). A %TLF10 não foi capaz de predizer a sobrevida global (p = 0,6320; HR = 0,753; intervalo de confiança [IC] 95%: 0,236-2,101), a sobrevida livre de progressão (p = 0,5908; HR = 1,248; IC 95%: 0,557-2,797) nem o tempo para um evento ósseo (p = 0,5114; HR = 1,588; IC 95%: 0,399-6,312). Conclusão: A carga tumoral esquelética da PET/CT com fluoreto-18F realizada após três doses de 223Ra não é capaz de predizer sobrevida global, sobrevida livre de progressão ou tempo até um evento ósseo, e não deve ser realizada para monitorar a resposta ao tratamento desses pacientes, nesse momento.

Abstract Objective: To determine whether an interim 18F-fluoride positron-emission tomography/computed tomography (PET/CT) study performed after the third cycle of radium-223 dichloride (223RaCl2) therapy is able to identify patients that will not respond to treatment. Materials and Methods: We retrospectively reviewed 34 histologically confirmed cases of hormone-refractory prostate cancer with bone metastasis in patients submitted to 223RaCl2 therapy. All of the patients underwent baseline and interim 18F-fluoride PET/CT studies. The interim study was performed immediately prior to the fourth cycle of 223RaCl2. The skeletal tumor burden-expressed as the total lesion fluoride uptake above a maximum standardized uptake value of 10 (TLF10)-was calculated for the baseline and the interim studies. The percent change in TLF10 between the baseline and interim studies (%TFL10) was calculated as follows: %TFL10 = interim TLF10 - baseline TLF10 / baseline TLF10. End points were overall survival, progression-free survival, and skeletal-related events. Results: The mean age of the patients was 72.4 ± 10.2 years (range, 43.3-88.8 years). The %TLF10 was not able to predict overall survival (p = 0.6320; hazard ratio [HR] = 0.753; 95% confidence interval [CI]: 0.236-2.401), progression-free survival (p = 0.5908; HR = 1.248; 95% CI: 0.557-2.797) nor time to a bone event (p = 0.5114; HR = 1.588; 95% CI: 0.399-6.312). Conclusion: The skeletal tumor burden on an interim 18F-fluoride PET/CT, performed after three cycles of 223RaCl2, is not able to predict overall survival, progression-free survival, or time to bone event, and should not be performed to monitor response at this time.

There is evidence supporting the importance of the dorsolateral prefrontal cortex (DLPFC) in the perception of time. The tDCS (transcranial direct current stimulation) modulates cortical excitability and can be applied to influence the performance of different brain functions, such as timing. Our objective was to evaluate the effect of stimulation of right and left DLPFC on a task of production of time. 26 patients underwent transcranial stimulation of 2mA over the DLPFC for 20 min (anodic, cathodic or sham). Then they participated in a reproduction task of 4 and 8 seconds. Through ANOVA for repeated measures for stimulating factors (anode, cathode, sham), intervals (4S and / or 8s) and location (left and right), we observed that the anodic stimulation of the right DLPFC resulted in greater underestimation in 4-seconds interval, while the use of cathodic current on the left DLPFC caused an overestimation of 4-seconds interval. Our results confirm the importance of the right DLPFC in the perception of time. Furthermore, the observed asymmetric effect is interesting, confirming that the left DLPFC is associated with the executive, important roles in perception of time.

Existem evidências que apontam para a importância do córtex préfrontal dorsolateral (CPFDL) na percepção de intervalos de tempo. A ETCC (eletroestimulação transcraniana por corrente contínua) modula a excitabilidade cortical, podendo ser utilizada para influenciar o desempenho de diferentes funções cerebrais, como a estimativa de tempo. Nosso objetivo foi avaliar o efeito da estimulação do CPFDL direito e esquerdo sobre a reprodução de intervalos de tempo. 26 indivíduos foram submetidos a estimulação transcraniana de 2mA no CPFDL por 20 min (anódica, catódica ou sham). Em seguida, participaram de uma tarefa de reprodução de intervalos de tempo de 4 e 8 segundos. Através de ANOVA para medidas repetidas para os fatores estimulação (anódica, catódica, sham), Intervalos (4s e/ou 8s) e local (esquerdo e direito), pudemos observar que a estimulação anódica do CPFDL do hemisfério direito resultou em subestimativa maior no intervalo de 4 segundos, enquanto o uso de corrente catódica sobre o CPFDL esquerdo provocou uma superestimativa do tempo para o intervalo de 4 segundos. Nossos resultados corroboram a importância do CPFDL direito na percepção de tempo. Ainda, o efeito assimétrico observado é interessante, confirmando que o CPFDL esquerdo está associado às funções executivas, importantes na percepção de tempo.

When food is available recurrently at a particular time of day, several species increase their locomotion in the hours that precede food delivery, a phenomenon called food anticipatory activity (FAA). In mammals, many studies have shown that FAA is driven by a food-entrained circadian oscillator (FEO) that is distinct from the light-entrained pacemaker in the suprachiasmatic nucleus of the hypothalamus. Few studies have investigated the effect of sugar ingestion on food anticipatory rhythms and the FEO. We aimed to extend the understanding of the role of glucose on the emergence of food anticipatory rhythms by investigating whether glucose ingestion is sufficient to produce daily food anticipation, reflected by motor activity and core body temperature rhythms. Under a 12 h/12 h light/dark cycle, chow-deprived rats had glucose solution available between Zeitgeber Time (ZT) 6 and ZT 9 for 10 days (glucose restriction group), whereas control animals had chow available within the same time window (chow restriction group). Animals in both groups exhibited anticipatory motor activity and body temperature around the fourth day of the scheduled food restriction. Glucose-fed rats ingested ~15 kcal on the days immediately before FAA emergence and reached an intake of ~20 kcal/day, whereas chow-fed rats ingested ~40 kcal/day. The glucose restriction group exhibited a pattern of food anticipation (activity and temperature) that was extremely similar to that observed in the chow restriction group. We conclude that glucose ingestion is a sufficient temporal cue to produce recurrent food anticipation, reflected by activity and temperature rhythms, in rats.

Circadian rhythms are entrained to cyclic environmental cues such as the light-dark cycle and food availability. The suprachiasmatic nucleus of the hypothalamus is the main circadian oscillator in mammals and is entrained primarily by the light-dark cycle, although in some experimental situations food availability can affect its oscillation. Here we tested whether scheduled restricted feeding is capable of influencing the reentrainment of the motor activity rhythm (i.e., a behavioral rhythm controlled by the suprachiasmatic nucleus) to a 6-h phase advance of the light-dark cycle. Rats were housed in a standard 12 h:12 h light-dark cycle for 18 days, and then the time of lights-off was advanced. Rats subjected to scheduled restricted feeding starting on the first day of the light-dark shift showed faster reentrainment of the motor activity rhythm compared with control rats maintained with ad libitum food. The results showed that scheduled feeding effectively accelerates reentrainment of a behavioral circadian rhythm and suggest that the procedure may affect activity in the suprachiasmatic nucleus during the stage of reentrainment to light-dark shifts.

O objetivo deste estudo foi avaliar a qualidade subjetiva do sono em pacientes com transtorno depressivo. Setenta pacientes (44 mulheres e 26 homens) ambulatoriais com diagnóstico de transtorno depressivo foram entrevistados e responderam ao Índice de Qualidade de Sono de Pittsburgh (IQSP), ao Questionário de Hábitos do Sono e ao Inventário de Depressão de Beck (BDI). As médias das pontuações globais do IQSP e BDI foram respectivamente 12,80 ± 3,77 e 35,83 ± 8,85, e a correlação foi positiva e significativa entre essas escalas (r = 0,70; p < 0,05). As pontuações globais do IQSP em pacientes com insônia (16,61 ± 4,21) e hipersonia (8,82 ± 2,71) apresentaram diferenças marcantes (p < 0,05). Os resultados da análise multivariada indicaram que apenas a insônia foi significativamente associada à qualidade subjetiva do sono (RC = 4,1; 95% IC = 2,0-4,2). Os resultados sugerem que os pacientes da amostra apresentaram percepção inferior da qualidade subjetiva do sono, principalmente na insônia.

The aim of this study was to evaluate subjective sleep quality in patients with depressive disorder. Seventy outpatients (44 women and 26 men) with diagnosis of depressive disorder were interviewed and answered the Pittsburgh Sleep Quality Index (PSQI), the Sleep Habits questionnaire and the Beck Depression Inventory (BDI). Mean PSQI and BDI global scores were 12.80 ± 3.77 and 35.83 ± 8.85, respectively and correlation was positive and significant between these scales (r = 0.70; p < 0.05). The global PSQI scores of patients with insomnia (16.61 ± 4.21) and excessive sleepiness (8.82 ± 2.71) had marked differences (p < 0.05). The results of multivariate analysis indicated that only insomnia had a significant association with subjective sleep quality (OR = 4.1; 95% CI = 2.0-4.2). These results suggest that patients with depressive disorder of the study sample experienced poor subjective sleep quality, particularly in insomnia.