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PHYSICOCHEMICAL ASPECTS OF INDUSTRIAL PLANT-BASED BEVERAGES
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Francisquini, Júlia d’A.

; Altivo, Ramon

; Diaz, Cristian C. M.

; Costa, Juliana de C. da

; Kharfan, Daniela

; Stephani, Rodrigo

; Perrone, Ítalo T.

Química Nova

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2024, Volume 47 Nº 1 elocation e-20230089

Resumo: En | Texto: En | PDF: En

The variety of vegetables available for plant-based beverage production is associated with a lack of specific regulatory aspects and difficult standardization. The aim of this study was to characterize the physicochemical properties of plant-based beverages (five different sources, three different market brands for each vegetable). The parameters studied were pH, moisture content, acidity, soluble ionic calcium at initial pH and pH 4.3, soluble solids, heat coagulation time (HCT), density, conductivity, surface zeta potential, morphology, polydispersity index, particle size. When comparing the mean values of the results found in the present work with model emulsions and/or plant based beverages produced on a laboratory scale, it can be found that the mean values for pH, moisture, soluble solids, calcium, surface zeta potential, particle size, and polydispersity index were similar to the reported values in the literature, however, acidity, HCT, density, and conductivity were lower than those reported in the literature. The coconut plant-based beverage exhibited the most significant statistical difference as compared to other plant-based beverages, especially in terms of pH, conductivity, particle size, and polydispersity index. This study is a promising aid to regulatory agencies and industries for standardization of nutritional value, production, stability, storage and chemical attributes of these beverages.

https://doi.org/10.21577/0100-4042.20230089

Public health surveillance and the data, information, knowledge, intelligence and wisdom paradigm
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Choi, Bernard C.K.

; Barengo, Noël C.

; Diaz, Paula A.

Revista Panamericana de Salud Pública

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2024, Volume 48 elocation e9

Resumo: Es En Pt | Texto: Es En Pt | PDF: Es | PDF: En | PDF: Pt

RESUMEN En este artículo se señalan las deficiencias de las definiciones actuales de la vigilancia de salud pública, que incluyen la recopilación, el análisis, la interpretación y la difusión de los datos, pero no las medidas de salud pública. El control de un problema de salud pública de interés exige una respuesta de salud pública que vaya más allá de la difusión de información. No es deseable que la salud pública esté dividida por un lado en procesos de generación de datos (vigilancia de salud pública) y por otro en procesos de uso de datos (respuesta de salud pública), gestionados por dos grupos diferentes (expertos en vigilancia y responsables de la formulación de políticas). Ha llegado el momento de replantear la necesidad de modernizar la definición de la vigilancia de salud pública tomando como referencia el modelo mejorado de Datos, Información, Conocimiento, Inteligencia y Sabiduría de los autores. Entre las recomendaciones que se proponen se encuentran las de ampliar el alcance de la vigilancia de salud pública más allá de la difusión de información para que incluya también el conocimiento aplicable (inteligencia); instar a los expertos en vigilancia a que presten ayuda a los responsables de la formulación de políticas en la toma de decisiones basadas en la evidencia; alentar a los expertos en vigilancia a que se conviertan en responsables de la formulación de políticas; e incorporar la formación en conocimientos básicos de salud pública (desde los datos hasta los conocimientos y la sabiduría) en los planes de estudio de todos los profesionales de la salud pública. Un buen punto de partida será trabajar en la modernización del alcance y la definición de la vigilancia de salud pública.

ABSTRACT This article points out deficiencies in present-day definitions of public health surveillance, which include data collection, analysis, interpretation and dissemination, but not public health action. Controlling a public health problem of concern requires a public health response that goes beyond information dissemination. It is undesirable to have public health divided into data generation processes (public health surveillance) and data use processes (public health response), managed by two separate groups (surveillance experts and policy-makers). It is time to rethink the need to modernize the definition of public health surveillance, inspired by the authors’ enhanced Data, Information, Knowledge, Intelligence and Wisdom model. Our recommendations include expanding the scope of public health surveillance beyond information dissemination to comprise actionable knowledge (intelligence); mandating surveillance experts to assist policy-makers in making evidence-informed decisions; encouraging surveillance experts to become policy-makers; and incorporating public health literacy training – from data to knowledge to wisdom – into the curricula for all public health professionals. Work on modernizing the scope and definition of public health surveillance will be a good starting point.

RESUMO Este artigo aponta deficiências nas definições atuais de vigilância em saúde pública, que incluem coleta, análise, interpretação e disseminação de dados, mas não ações de saúde pública. O controle de um problema preocupante de saúde pública exige uma resposta de saúde pública que vá além da disseminação de informações. A saúde pública não deve ser dividida em processos de geração de dados (vigilância em saúde pública) e processos de uso de dados (resposta de saúde pública) gerenciados por dois grupos distintos (especialistas em vigilância e formuladores de políticas). É hora de repensar a necessidade de modernizar a definição de vigilância em saúde pública, inspirada no modelo aprimorado de Dados, Informações, Conhecimento, Inteligência e Sabedoria dos autores. Nossas recomendações incluem: expansão do escopo da vigilância em saúde pública para além da disseminação de informações, de modo a abranger conhecimentos acionáveis (inteligência); obrigatoriedade de que os especialistas em vigilância auxiliem os formuladores de políticas na tomada de decisões baseadas em evidências; incentivo para que os especialistas em vigilância se tornem formuladores de políticas; e incorporação de capacitação em letramento em saúde pública (partindo dos dados para o conhecimento e em seguida para a sabedoria) nos currículos de todos os profissionais de saúde pública. O trabalho de modernizar o escopo e a definição de vigilância em saúde pública será um bom ponto de partida.

https://doi.org/10.26633/rpsp.2024.9

Abscesos renales bilaterales multifocales por Candida albicans
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Rodríguez Arias, Edwin A.

; Santoya Espinosa, Liset C.

; Romano, Juan Pablo

; Mota, Maria Fernanda

; Chabay, Patricia

; Aguiar, Pablo Diaz

Medicina (Buenos Aires)

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Dez 2023, Volume 83 Nº 5 Páginas 832 - 835

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Renal abscesses are a rare complication of urinary tract infections and may be associated with increased morbidity and mortality. Most cases occur in patients with predisposing factors such as immunosuppression. Diagnosis requires high clinical suspicion and its treat ment consists in the use of parenteral antibiotics and antifungals associated or not with surgical interventions such as nephrostomy and nephrectomy. Few cases have been published in the medical literature of multifocal bilateral renal abscesses and even fewer due to Candida albicans. We present the case of a 20-year-old woman with type 1 diabetes mellitus, diagnosed at age 8, multiple hospitalizations for diabetic ketoacidosis, and recent hospitalization for candidemia (Candida albicans) treated with fluconazole for 23 days. Eighteen days after her discharge, she consulted for dull flank pain and gen eral symptoms. Contrast enhanced abdominal tomography showed bilateral multifocal abscesses and Candida albicans was isolated in one of the samples obtained from lesions. She received fluconazole 400 mg, 6 weeks i.v. and 2 weeks via enteral route, evolving favorably with clinical and imag ing improvement, continuing outpatient clinical monitoring. This report highlights the importance of diagnosis and treatment of this rare complication in complex diseases such as diabetes mellitus.

Resumen Los abscesos renales son una complicación poco frecuente de las infecciones del tracto urinario y suelen asociarse con un aumento de la morbi-mortalidad. La mayoría de los casos ocurre en pacientes con factores predisponentes como la inmunosupresión. El diagnóstico requiere de una elevada sospecha clínica y el trata miento consiste en el uso de antibióticos y antifúngicos parenterales asociados o no a intervenciones quirúrgicas como nefrostomía y nefrectomía. Son pocos los casos publicados en la literatura médi ca de abscesos renales bilaterales multifocales y menos aún por Candida albicans. Se presenta el caso de una mujer de 20 años de edad con diabetes mellitus tipo 1 diagnosticada a los 8 años, múltiples internaciones por cetoacidosis diabética y reciente internación por can didemia (Candida albicans) completando tratamiento con fluconazol por 23 días. A los 18 días de su externación, consulta por dolor en flancos de tipo sordo y síntomas ge nerales; se realizó tomografía de abdomen con contraste que mostró abscesos multifocales bilaterales. Aislándose Candida albicans en una de las muestras obtenidas de las lesiones; recibió tratamiento con fluconazol 400 mg por 6 semanas endovenoso y 2 semanas vía enteral, evolu cionando favorablemente con mejoría clínica e image nológica continuando seguimiento clínico ambulatorio. Este reporte resalta la importancia del diagnóstico y tratamiento de esta complicación infrecuente en enfer medades complejas como la diabetes.

Effect of school reopening on pediatric morbidity and mortality during the third epidemiological wave of COVID-19 in a Mexican state
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Reyna-Figueroa, Jesús

; Mirón-Calderón, Xochitl

; Durán-Mendieta, Victor

; Ramirez-Gijón, Guillermo

; Torres-Meza, Victor

; Anaya-López, Luis

; Frías-Badillo, Juan C.

; Mejía-Martínez, Valeria

; Salyano-Peñuelas, Yolanda A.

; Diaz-Martínez, Alfredo I.

; Fernández-Clamont, Francisco J.

Boletín médico del Hospital Infantil de México

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Dez 2023, Volume 80 Nº 6 Páginas 367 - 373

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Introducción: La determinación del efecto de reabrir las escuelas sobre las tasas de infección pediátrica por SARS-CoV-2 (síndrome respiratorio agudo grave coronavirus 2) incrementó la necesidad de trasmitir la experiencia de los gobiernos de muchas regiones geográficas para mejores decisiones futuras en emergencias sanitarias similares. Métodos: Mediante un estudio prospectivo basado en una cohorte poblacional se dio seguimiento a los alumnos de 18,988 escuelas del Estado de México que iniciaron con el regreso a clases. Se implementaron filtros sanitarios diarios en cada escuela y cotidianamente se informaban a los enlaces jurisdiccionales a través de una red negativa. Los casos identificados eran confirmados a través de RT-PCR (reacción en cadena de la polimerasa con transcriptasa inversa). Se estimaron frecuencias simples de casos, porcentajes e incidencias de COVID-19. Las incidencias del estado se compararon con la incidencia nacional. Resultados: Un total de 3,586 casos fueron confirmados; 2,048 (57.1%) correspondieron a niños. Veinticuatro (0.6%) fueron hospitalizados por COVID-19 moderado a grave; nueve (37.5%) fallecieron, y solamente una correspondió a un escolar. A partir de la semana 36 se observó una tasa promedio de infecciones de 0.36. En la semana epidemiológica 40 se observó la mayor tasa de infección en escolares (1.01); a partir de esta semana se observa un declive de los casos hasta la semana 50. Conclusiones: La implementación de intervenciones no farmacéuticas tiene más ventajas que limitaciones, siempre y cuando las estrategias sean homogéneas y correctamente ejecutadas, lo que asegurará un adecuado control en los contagios.

Abstract Background: Determining the effect of reopening schools on pediatric SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection rates increased the need to share the experience of governments in many geographic regions for better future decision-making in similar health emergencies. Methods: Through a prospective study based on a population-based cohort, students from 18,988 schools in the State of Mexico who began returning to school were followed. Daily sanitation filters were implemented in each school and district liaisons were informed on a daily basis through a negative network. Identified cases were confirmed by reverse transcriptase-polymerase chain reaction. Simple case frequencies, percentages, and incidences of COVID-19 were estimated. State incidences were compared with the national incidence. Results: A total of 3,586 cases were confirmed; 2,048 (57.1%) were children. Twenty-four (0.6%) were hospitalized for moderate to severe COVID-19; nine (37.5%) died, and only one was a schoolchild. From week 36, an average infection rate of 0.36 was observed. The highest infection rate in schoolchildren was observed in epidemiologic week 40 (1.01); from this week on, a decrease in the number of cases was observed until week 50. Conclusions: The use of non-pharmaceutical interventions has more advantages than limitations, as long as the strategies are homogeneous and properly implemented to ensure adequate control of infections.

https://doi.org/10.24875/bmhim.23000075

Brown tumors of the jaw: an atypical manifestation of primary hyperparathyroidism
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Genovesi, Elbio

; Lerena, Vanina S.

; Torres, Ilsen C.

; Paes De Lima, Andrea

; Lucas, Sabrina P.

; Diaz, Adriana G.

Medicina (Buenos Aires)

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Ago 2023, Volume 83 Nº 3 Páginas 462 - 466

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Los tumores pardos son raros y, por lo general, afectan huesos largos, pelvis y costillas. Pueden no estar incluidos en el diagnóstico diferencial inicial como manifestación de enfermedad esquelética, es pecialmente cuando se presentan en localizaciones atípicas. Comunicamos dos casos de tumores pardos orales como presentación inicial de hiperparatiroidismo primario. En el primer caso, una mujer de 44 años presentó una lesión dolorosa y sésil de 4 × 3 cm sobre el cuerpo central de la mandíbula que aumentó de tamaño progresivamente en 4 meses. El segundo caso corresponde a una mujer de 23 años que acudió por presentar una masa dolorosa y ul cerada de 2 cm en maxilar izquierdo de 3 meses de evolución, episodios de hemorragia gingival y difi cultad para respirar. Todos fueron tumores solitarios sin evidencia de linfadenopatía cervical palpable. La biopsia incisional de los tumores orales resultó en células gigantes, y las pruebas de laboratorio confirmaron el hiperparatiroidismo primario. Tras la paratiroidectomía, la histología confirmó adenoma en ambos casos. Los tumores pardos representan la etapa terminal de los procesos de remodelación ósea en el hiperparatiroidismo primario. Aunque este tipo de presentación clínica casi ha desaparecido en las últimas décadas, los tumores pardos deben ser considerados en el diagnóstico diferencial de las masas óseas orales.

Abstract Brown tumors represent the terminal stage of bone remodeling processes in primary hyperparathyroidism. Currently they are rare, and typically affect long bones, pelvis and ribs. Brown tumors may be not included in the initial differential diagnosis of bone disease, espe cially when they are present in atypical localizations. We reported two cases of oral brown tumors as the initial presentation of primary hyperparathyroidism. In the first case, a 44-year-old woman presented a painful and sessile lesion of 4x3 cm over the central body of the mandible which progressively increased in 4-month. The second case involved a 23-year-old woman who was referred with a 3-month history of a painful and ulcerated mass of 2 cm arising from left maxilla, episodes of gingival hemorrhage and difficulty of breathing. Both cases were solitary tumors with no evidence of palpable cervical lymphadenopathy. Incisional biopsy of oral tumors resul ted in giant cell and primary hyperparathyroidism was confirmed by laboratory tests. After parathyroidectomy, histology confirmed adenoma in both cases. Although this type of clinical presentation has almost disappeared in the recent decades, brown tumors should be consi dered in the differential diagnosis of bone oral masses.

Microplastic occurrence in fish species from the Iquitos region in Peru, western Amazonia
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ROJAS, Rommel R.

; ARANGO-MORA, Carlos

; NOLORBE-PAYAHUA, Christian

; MEDINA, Mishelly

; VASQUEZ, Melly

; FLORES, Josias

; MURAYARI, Fiorela

; VÁSQUEZ, Claudia

; ALMEIDA, Valeri de

; RAMOS, Wilfredo

; RIOS ISERN, Enrique

; MARAPARA DEL AGUILA, Jorge

; CASTRO, Juan C.

; DEL ÁGUILA, Javier

; DIAZ JARAMA, Felicia

; VASCONCELOS-SOUZA, Maria

Acta Amazonica

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Mar 2023, Volume 53 Nº 1 Páginas 65 - 72

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT The contamination of aquatic environments by microplastic has become a major threat to biodiversity. The presence of microplastic is documented in the aquatic fauna of the oceans, but, in the Amazon basin, reports on microplastic occurrence are few. The present study surveyed microplastic occurrence in fishes in an area of the Peruvian Amazon. We sampled 61 specimens of 15 commercial species from local markets in the city of Iquitos, Loreto Department. We detected a total of 2337 microplastic particles, 1096 in the gills and 1241 in the internal organs (esophagus, stomach, intestine, liver, gonads, pancreas, swim bladder and heart). The prevalence of microplastic particles was 100% and the overall average abundance was of 38.3 particles per individual (17.9 particles per individual in gills and 20.3 particles per individual in internal organs). Most particles were found in carnivorous fish. There was no correlation of particle abundance with fish standard length and weight. These results provided evidence of the degree of microplastic contamination of the fish fauna in the region of Iquitos.

RESUMEN La contaminación de ambientes acuáticos por microplásticos se ha convertido en una gran amenaza para la biodiversidad. La presencia de microplásticos está bien documentada en la fauna acuática de los océanos, pero en la cuenca del Amazonas hay pocos reportes de ocurrencia. En este trabajo se investigó la ocurrencia de partículas de microplásticos en peces de un área de la Amazonía peruana. Se obtuvieron 61 especímenes de 15 especies comerciales provenientes de los mercados locales de la ciudad de Iquitos. Se detectó un total de 2337 partículas de microplástico, 1096 en las branquias y 1241 en los órganos internos (esófago, estomago, intestinos, hígado, gónadas, páncreas, vejiga natatoria y corazón). La prevalencia de partículas de microplástico fue del 100% y la abundancia general de partículas de microplástico fue de 38.3 partículas por individuo (17.9 partículas por individuo en las branquias y 20.3 partículas por individuo en los órganos internos). La mayor cantidad de particulas fué encontrada en peces carnivoros. No hubo correlación entre la abundancia de las particulas y el tamaño estandar y peso de los peces. Estos resultados proporcionan evidencia de los niveles de contaminación por microplásticos en la fauna de peces amazónica en la región de Iquitos.

https://doi.org/10.1590/1809-4392202201212

Erosion of four Brazilian coastal deltas: how dam construction is changing the natural pattern of coastal sedimentary systems
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OLIVEIRA, EMILIANO C.

; BARBOZA, RAUL D.

; SILVA, BEATRIZ G.G.

; DIAZ FILHO, MAURICIO C.

Anais da Academia Brasileira de Ciências

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2023, Volume 95 Supl. 1 elocation e20220576

Resumo: En | Texto: En | PDF: En

Abstract Reservoir-building on rivers is still “the Brazilian energy culture”, such that many other dams are being constructed and planned, with many other rivers potentially suffering the same impact in their sediment flux. In this study, we evaluated the impacts of reservoir-building on the erosion of the São Francisco, Jequitinhonha, Doce, and Paraíba do Sul river deltas. A time series of Landsat images from 1973 to 2020 was analyzed, with three key highlighted moments (1973, 1997 and 2020) that summarize the erosion processes on these deltas. In addition to the images, continuous river water discharge, sediment discharge and basin rainfall data were analyzed between 1940 and 2020, providing river parameters over a period exceeding that of the satellite data. The findings suggest that coastal erosion has progressed in the four deltas, with higher estimated losses in the São Francisco and Paraíba do Sul over the 47 years of available satellite images. However, despite minimal overall estimated gains, the Jequitinhonha and Doce experienced high erosion at their river mouths, as in the other two rivers, compensated by accretion in distal coastal areas. These results can be explained by reductions in river flux and consequent sediment transport capacity due to reservoirs.

https://doi.org/10.1590/0001-3765202320220576

Análisis morfométrico de las semillas del género Capsicum (Solanaceae) en el Perú prehispánico
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Garcia, Luisa Hinostroza

; Melchor-Castro, Rosa

; Arriola, Luisa Diaz

; Castillo, Joaquina Albán

Boletim do Museu Paraense Emílio Goeldi. Ciências Humanas

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2023, Volume 18 Nº 3 elocation e20220034

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract The importance with which ají peppers (Capsicum spp.) were handled by the inhabitants of pre-Hispanic Peru is evidenced by the good preservation of the fruits and seeds of this plant in the archaeological record, and this abundance requires a methodology to determine taxonomy. This study presents the morphometric characteristics of domesticated Capsicum seeds, which can serve as a reference for comparisons with seeds of archaeological origin. A predictive model was developed from descriptive and morphometric data of seeds from five modern Capsicum species using the gradient boosting regression model (GBM) algorithm. The variables with the greatest contributions to prediction in modern and archaeological seeds were seed length, beak height, and hilum length. We found that 22.13% of archaeological seeds from the Huaca Pucllana site (Lima, Peru), associated with the Early Intermediate period (555-650 AD), are similar to modern seeds of C. baccatum L. (yellow ají pepper). This information suggests that the genetic variability of this species was managed at Pucllana, the result of intensified cultivation and cultural consumption preferences. One example is its recurrence in contexts of a ceremonial nature, in which association with other sites could refer to a ‘tradition’ of coastal consumption.

Resumen La importancia del manejo del ‘ají’ (Capsicum spp.) por los habitantes del Perú prehispánico ha quedado evidenciado por la buena preservación de sus frutos y semillas en el registro arqueológico. Su abundancia requiere contar con una metodología para su determinación taxonómica. En este trabajo se realiza la caracterización morfométrica de semillas actuales domesticadas de Capsicum que sirven de referencia para comparaciones con semillas arqueológicas. A partir de datos descriptivos y morfométricos de estas semillas actuales se elaboró un modelo predictivo mediante el algoritmo Gradient Boosting Regression Model (GBM). Las variables de mayor contribución para la predicción en semillas actuales y arqueológicas fueron: largo de semilla, altura del pico y largo del hilum. El porcentaje de predicción correspondió a 22.13 %, se deduce que las semillas arqueológicas procedentes de Huaca Pucllana (Lima-Perú), asociado al Intermedio Temprano (555-650 d.C.) sugieren semejanza con semillas de C. baccatum L. ‘ají amarillo’. Sobre esta información, se propone que en Pucllana hubo un manejo de la variabilidad genética de esta especie, resultado de la intensificación de su cultivo e influenciado por preferencias de consumo. Un ejemplo es su recurrencia en contextos de índole ceremonial, cuya asociación con otros sitios podría referirse a una ‘tradición’ costeña.

https://doi.org/10.1590/2178-2547-bgoeldi-2022-0034

Predominant polarity and associated post-traumatic stress disorder in patients with comorbid bipolar disorder and borderline personality disorder: a cross-sectional study
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Wolfenberger, Taylor

; Diaz, Alexandre Paim

; Bockmann, Taya

; Selvaraj, Sudhakar

; Sanches, Marsal

; Soares, Jair C.

Brazilian Journal of Psychiatry

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Out 2022, Volume 44 Nº 5 Páginas 557 - 558

Resumo: En | Texto: En | PDF: En

https://doi.org/10.47626/1516-4446-2021-2418

10.

Simple and fast process using hydrochloric acid for producing synthetic zinc-rich stevensite
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Carvalho, T. C.

; Michel, B. B,

; Silva-Valenzuela, M. G.

; Hildebrando, E.

; Neves, R. F.

; Valenzuela-Diaz, F. R.

Cerâmica

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Set 2022, Volume 68 Nº 387 Páginas 285 - 293

Resumo: En | Texto: En | PDF: En

Abstract In the last decades, clays have been used in sectors such as health and cosmetics. This requires products that are increasingly pure and present homogeneous properties, hardly found in natural clays. The use of synthetic clays can be a solution. For this, it is necessary to explore techniques for their production. The main focus of this study was to synthesize a smectite clay in a simple, fast and economic way at low temperature and pressure, called static and dynamic methods. To regulate the pH of the reaction and bring it closer to the ideal synthesis conditions, two different acids were used: nitric acid (the most widely used in the literature) and hydrochloric acid (more accessible and cheaper). The results showed characteristics of uniform crystalline material with a porous structure similar to that of the smectite group. Small particle sizes of approximately 100 nm were observed by scanning electron microscopy. Stevensite clay was obtained by both synthesis methods using two different acids; the static method with hydrochloric acid stood out. The greater practicality in its development provides a more viable option for large-scale industrial production.

https://doi.org/10.1590/0366-69132022683873262

11.

A narrative review on invasive brain stimulation for treatment-resistant depression
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Dandekar, Manoj P.

; Diaz, Alexandre P.

; Rahman, Ziaur

; Silva, Ritele H.

; Nahas, Ziad

; Aaronson, Scott

; Selvaraj, Sudhakar

; Fenoy, Albert J.

; Sanches, Marsal

; Soares, Jair C.

; Riva-Posse, Patricio

; Quevedo, Joao

Brazilian Journal of Psychiatry

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Jun 2022, Volume 44 Nº 3 Páginas 317 - 330

Resumo: En | Texto: En | PDF: En

While most patients with depression respond to pharmacotherapy and psychotherapy, about one-third will present treatment resistance to these interventions. For patients with treatment-resistant depression (TRD), invasive neurostimulation therapies such as vagus nerve stimulation, deep brain stimulation, and epidural cortical stimulation may be considered. We performed a narrative review of the published literature to identify papers discussing clinical studies with invasive neurostimulation therapies for TRD. After a database search and title and abstract screening, relevant English-language articles were analyzed. Vagus nerve stimulation, approved by the U.S. Food and Drug Administration as a TRD treatment, may take several months to show therapeutic benefits, and the average response rate varies from 15.2-83%. Deep brain stimulation studies have shown encouraging results, including rapid response rates (> 30%), despite conflicting findings from randomized controlled trials. Several brain regions, such as the subcallosal-cingulate gyrus, nucleus accumbens, ventral capsule/ventral striatum, anterior limb of the internal capsule, medial-forebrain bundle, lateral habenula, inferior-thalamic peduncle, and the bed-nucleus of the stria terminalis have been identified as key targets for TRD management. Epidural cortical stimulation, an invasive intervention with few reported cases, showed positive results (40-60% response), although more extensive trials are needed to confirm its potential in patients with TRD.

https://doi.org/10.1590/1516-4446-2021-1874

12.

Vascular retinal findings after COVID-19 vaccination in 11 cases: a coincidence or consequence?
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Silva, Letícia S. C. da

; Finamor, Luciana P. S.

; Andrade, Gabriel C.

; Lima, Luiz H.

; Zett, Claudio

; Muccioli, Cristina

; Sarraf, Eduardo P.

; Marinho, Paula M.

; Peruchi, Julia

; Oliveira, Raiza D. de L.

; Giralt, Lena

; Charcan, Ivonne

; Fonollosa, Alex

; Diaz, Jose D.

; Davis, Janet L.

; Nascimento, Heloisa

; Belfort Jr, Rubens

Arquivos Brasileiros de Oftalmologia

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Abr 2022, Volume 85 Nº 2 Páginas 158 - 165

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Objetivos: o principal objetivo deste estudo foi descrever pacientes com achados vasculares retinianos temporalmente relacionados à vacinação contra COVID-19. Com maior notificação de possíveis eventos adversos similares, esperamos compreender a real dimensão e relevância do que foi apresentado. Métodos: Onze pacientes com queixas visuais após vacinação contra COVID-19 foram estudados. Os dados analisados foram: idade, gênero, tipo de vacinação, tempo de aparecimento de sintomas, achados sistêmicos, antecedentes pessoais, acuidade visual com melhor correção, biomicroscopia e imagem retiniana multimodal (retinografia colorida, red-free, SD-OCT, OCTA e angiofluoresceinografia). Os critérios de inclusão foram a presença de alterações oftalmológicas ocorridas dentro de 30 dias após a primeira ou segunda dose de qualquer vacina contra COVID-19. Resultados: Onze pacientes foram incluídos: 5 com oclusão arterial (45,4%), 4 com oclusão venosa (36,4%) e 2 (18,2%) com alterações não específicas vasculares sugestivas de isquemia retiniana como exsudatos algodonosos. A idade média dos pacientes foi de 57 anos (DP=16; com intervalo de 27 a 84 anos). A média de tempo de aparecimento de sintomas após a vacinação foi de 10 dias (DP=5,4; com intervalo de 3 a 16 dias). Nove dos onze pacientes eram do sexo feminino (81,8%). Fatores de risco sistêmicos foram observados em 36,4% dos pacientes. Dois pacientes tiveram sintomas neurológicos e visuais, com oclusão arterial. 36,4% dos pacientes tiveram infecção prévia por COVID-19 no último ano. Sete pacientes (63,6%) receberam a vacina ChAdOx1 nCoV-19 (AZD1222). Conclusões: nossos dados sugerem que eventos retinianos temporalmente relacionados à vacinação contra COVID-19 são possíveis, porém raros. A relação entre estes eventos pós-vacinais exigem futura atenção antes de maiores conclusões.

ABSTRACT Purpose: The primary purpose of this study was to assess vascular retinal findings temporally related to COVID-19 vaccination. With greater information regarding all possible future adverse events, we hope to understand the real dimension and relevance of what was presented. Methods: Eleven patients with visual complaints after COVID-19 vaccination were enrolled. Data on the following were included: age, sex, vaccine, time of symptom onset, systemic findings, medical history, best-corrected visual acuity, and ocular findings by slit-lamp biomicroscopy as well as multimodal retinal imaging (color fundus, red-free photography, spectral-domain optical coherence tomography, optical coherence tomography angiography, and fluorescein-angiography). Inclusion criteria were the presence of ophthalmologic signs within 30 days after the first or second dose of any COVID-19 vaccine. Results: Of 11 patients, five had arterial occlusion (45.4%), four had venous occlusion (36.4%), and two (18.2%) had nonspecific vascular alterations suggestive of retinal ischemia such as cotton-wool spots. The mean age was 57 (SD = 16; range: 27-84) years. The mean time of symptoms onset was 10 (SD = 5.4; range: 3-16) days. Nine patients were female (81.8%). Systemic risk factors were observed in 36.4% of patients. Two patients had both neurological and visual symptoms, with arterial occlusion. Overall, 36.4% patients had COVID-19 in the previous year. Seven patients (63.6%) received ChAdOx1 nCoV-19 (AZD1222) vaccine. Conclusions: Our data suggest that retinal events temporally related to COVID-19 vaccination are possible but are very rare. The relationship of these events with post-COVID-19 vaccination warrants further attention to derive a meaningful conclusion.

https://doi.org/10.5935/0004-2749.20220071

13.

Treatment-resistant bipolar depression: concepts and challenges for novel interventions
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Diaz, Alexandre P.

; Fernandes, Brisa S.

; Quevedo, Joao

; Sanches, Marsal

; Soares, Jair C.

Brazilian Journal of Psychiatry

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Abr 2022, Volume 44 Nº 2 Páginas 178 - 186

Resumo: En | Texto: En | PDF: En

Treatment-resistant bipolar depression (TRBD) has been reported in about one-quarter of patients with bipolar disorders, and few interventions have shown clear and established effectiveness. We conducted a narrative review of the published medical literature to identify papers discussing treatment-resistant depression concepts and novel interventions for bipolar depression that focus on TRBD. We searched for potentially relevant English-language articles published in the last decade. Selected articles (based on the title and abstract) were retrieved for a more detailed evaluation. A number of promising new interventions, both pharmacological and non-pharmacological, are being investigated for TRBD treatment, including ketamine, lurasidone, D-cycloserine, pioglitazone, N-acetylcysteine, angiotensin-converting enzyme inhibitors, angiotensin II type 1 receptor blockers, cyclooxygenase 2 inhibitors, magnetic seizure therapy, intermittent theta-burst stimulation, deep transcranial magnetic stimulation, vagus nerve stimulation therapy, and deep brain stimulation. Although there is no consensus about the concept of TRBD, better clarification of the neurobiology associated with treatment non-response could help identify novel strategies. More research is warranted, mainly focusing on personalizing current treatments to optimize response and remission rates.

https://doi.org/10.1590/1516-4446-2020-1627

14.

O Impacto da COVID-19 no Diagnóstico de Doenças Cardíacas na América Latina Uma Subanálise do INCAPS COVID
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Cerci, Rodrigo Julio

; Vitola, João Vicente

; Paez, Diana

; Zuluaga, Alejandro

; Bittencourt, Marcio Sommer

; Sierra-Galan, Lilia M.

; Carrascosa, Patricia

; Campisi, Roxana

; Gutierrez-Villamil, Claudia

; Peix, Amalia

; Chambers, Duane

; Velez, Mayra Sánches

; Alvarado, Carla M. G.

; Ventura, Ana C. F.

; Maldonado, Alejandro

; Castanos, Alfredo P.

; Diaz, Teresa C.

; Herrera, Yariela

; Vasquez, Manuel C.

; Arrieta, Ana A.

; Mut, Fernando

; Hirschfeld, Cole

; Malkovskiy, Eli

; Goebel, Benjamin

; Cohen, Yosef

; Randazzo, Michael

; Shaw, Leslee J.

; Williams, Michelle C.

; Villines, Todd C.

; Better, Nathan

; Dorbala, Sharmila

; Raggi, Paolo

; Pascual, Thomas N. B.

; Pynda, Yaroslav

; Dondi, Maurizio

; Einstein, Andrew J.

Arquivos Brasileiros de Cardiologia

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Abr 2022, Volume 118 Nº 4 Páginas 745 - 753

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento A pandemia de COVID-19 interferiu na prestação de atendimento a doenças cardiovasculares na América Latina. No entanto, o efeito da pandemia nos volumes de procedimentos cardíacos diagnósticos ainda não foi quantificado. Objetivo Avaliar (1) o impacto de COVID-19 nos volumes de diagnóstico cardíaco na América Latina e (2) determinar sua relação com a incidência de casos de COVID-19 e as medidas de distanciamento social. Métodos A International Atomic Energy Agency realizou uma pesquisa mundial avaliando mudanças nos volumes diagnósticos cardíacos decorrentes da COVID-19. Foram obtidos os volumes diagnósticos cardíacos dos locais participantes para março e abril de 2020 e comparados com março de 2019. Foram coletados dados de distanciamento social a partir dos Relatórios de mobilidade da comunidade de Google e a incidência de COVID-19 por país a partir de Our World in Data. Resultados Foram realizadas pesquisas em 194 centros que realizam procedimentos diagnósticos cardíacos, em 19 países da América Latina. Em comparação com o mês de março de 2019, os volumes dos procedimentos diagnósticos cardíacos diminuíram 36% em março de 2020 e 82% em abril de 2020.As maiores reduções ocorreram em relação aos testes de estresse ecocardiográfico (91%), testes ergométricos de esteira (88%) e escore de cálcio por tomografia computadorizada (87%), com pequenas variações entre as sub-regiões da América Latina. As mudanças em padrões de distanciamento social (p < 0,001) estavam mais fortemente associadas com a redução do volume do que a incidência de COVID-19 (p = 0,003). Conclusões A COVID-19 foi associada a uma redução significativa de procedimentos diagnósticos cardíacos na América Latina, a qual foi mais relacionada ao distanciamento social do que ao aumento da incidência da COVID-19. São necessários melhor equilíbrio e timing de medidas de distanciamento social e planejamento para manter o acesso ao atendimento médico durante um surto pandêmico, especialmente em regiões com alta mortalidade cardiovascular.

Abstract Background The COVID-19 pandemic has disrupted the delivery of care for cardiovascular diseases in Latin America. However, the effect of the pandemic on the cardiac diagnostic procedure volumes has not been quantified. Objective To assess (1) the impact of COVID-19 on cardiac diagnostic volumes in Latin America and (2) determine its relationship with COVID-19 case incidence and social distancing measures. Methods The International Atomic Energy Agency conducted a worldwide survey assessing changes in cardiac diagnostic volumes resulting from COVID-19. Cardiac diagnostic volumes were obtained from participating sites for March and April 2020 and compared to March 2019. Social distancing data were collected from Google COVID-19 community mobility reports and COVID-19 incidence per country from the Our World in Data. Results Surveys were conducted in 194 centers performing cardiac diagnostic procedures, in 19 countries in Latin America. Procedure volumes decreased 36% from March 2019 to March 2020, and 82% from March 2019 to April 2020. The greatest decreases occurred in echocardiogram stress tests (91%), exercise treadmill tests (88%), and computed tomography calcium scores (87%), with slight variations between sub-regions of Latin America. Changes in social distancing patterns (p < 0.001) were more strongly associated with volume reduction than COVID-19 incidence (p = 0.003). Conclusions COVID-19 was associated with a significant reduction in cardiac diagnostic procedures in Latin America, which was more related to social distancing than to the COVID-19 incidence. Better balance and timing of social distancing measures and planning to maintain access to medical care is warranted during a pandemic surge, especially in regions with high cardiovascular mortality.

https://doi.org/10.36660/abc.20210388

15.

Anaerobic RSH-dependent tellurite reduction contributes to Escherichia coli tolerance against tellurite
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Muñoz Diaz, P.

; Jiménez, K.

; Luraschi, R.

; Cornejo, F.

; Figueroa, M.

; Vera, C.

; Rivas-Pardo, A.

; Sandoval, J. M.

; Vásquez, C.

; Arenas, F.

Biological Research

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2022, Volume 55 elocation 13

Resumo: En | Texto: En | PDF: En

Abstract Background: Tellurium is a rare metalloid that exerts high toxicity on cells, especially on bacteria, partly due to reactive oxygen species (ROS) generation. Moreover, it has also been observed that tellurite can target free cell thiols groups (RSH) (i.e. reduced glutathione (GSH)), enhancing the cellular redox imbalance. Additionally, in vitro experiments have suggested that several enzymes can reduce tellurite (IV) to its elemental form (0); where RSH present on their active sites may be responsible for the process. Nevertheless, the mechanisms implemented by bacteria for tellurite reduction and its role in resistance have not been evaluated in vivo. Results: This work shows that tellurite reduction to elemental tellurium is increased under anaerobic conditions in E. coli cells. The in vivo tellurite reduction is related to the intracellular concentration of total RSH, in the presence and absence of oxygen. This metabolization of tellurite directly contributes to the resistance of the bacteria to the oxyanion. Conclusions: We demonstrated that in vivo tellurite reduction is related to the intracellular thiol concentration, i.e. large availability of cellular RSH groups, results in a more significant reduction of tellurite. Furthermore, we observed that, when the bacterium exhibits less resistance to the oxyanion, a decreased tellurite reduction was seen, affecting the growth fitness. Together, these results let us propose that tellurite reduction and the intracellular RSH content are related to the oxyanion bacterial resistance, this tripartite mechanism in an oxygen independent anaerobic process.

https://doi.org/10.1186/s40659-022-00383-5 46 downloads

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