Fundamental neurochemistry review: Glutamatergic dysfunction as a central mechanism underlying flavivirus-induced neurological damage.

The Flaviviridae family comprises positive-sense single-strand RNA viruses mainly transmitted by arthropods. Many of these pathogens are especially deleterious to the nervous system, and a myriad of neurological symptoms have been associated with infections by Zika virus (ZIKV), West Nile virus (WNV), and Japanese encephalitis virus (JEV) in humans. Studies suggest that viral replication in neural cells and the massive release of pro-inflammatory mediators lead to morphological alterations of synaptic spine structure and changes in the balance of excitatory/inhibitory neurotransmitters and receptors. Glutamate is the predominant excitatory neurotransmitter in the brain, and studies propose that either enhanced release or impaired uptake of this amino acid contributes to brain damage in several conditions. Here, we review existing evidence suggesting that glutamatergic dysfunction-induced by flaviviruses is a central mechanism for neurological damage and clinical outcomes of infection. We also discuss current data suggesting that pharmacological approaches that counteract glutamatergic dysfunction show benefits in animal models of such viral diseases.

Systemic Inflammatory Response Syndrome in Patients Hospitalized for Acute Decompensation of Cirrhosis.

Background: Although recently challenged, systemic inflammatory response syndrome (SIRS) criteria are still commonly used in daily practice to define sepsis. However, several factors in liver cirrhosis may negatively impact its prognostic ability. Goals. To investigate the factors associated with the presence of SIRS, the characteristics of SIRS related to infection, and its prognostic value among patients hospitalized for acute decompensation of cirrhosis. Study. In this cohort study from two tertiary hospitals, 543 patients were followed up, up to 90 days. Data collection, including the prognostic models, was within 48 hours of admission. Results: SIRS was present in 42.7% of the sample and was independently associated with upper gastrointestinal bleeding (UGB), ACLF, infection, and negatively related to beta-blockers. SIRS was associated with mortality in univariate analysis, but not in multiple Cox regression analysis. The Kaplan-Meier survival probability of patients without SIRS was 73.0% and for those with SIRS was 64.7%. The presence of SIRS was not significantly associated with mortality when considering patients with or without infection, separately. Infection in SIRS patients was independently associated with Child-Pugh C and inversely related to UGB. Among subjects with SIRS, mortality was independently related to the presence of infection, ACLF, and Child-Pugh C. Conclusions: SIRS was common in hospitalized patients with cirrhosis and was of no prognostic value, even in the presence of infection.

Short or moderate-time exposure to the inhalational anesthetics isoflurane and sevoflurane does not alter the marble-burying behavior in mice.

Several studies suggest the involvement of glutamatergic neurotransmission in obsessive-compulsive disorder (OCD). Some NMDA glutamatergic receptor antagonists, such as the general anesthetic ketamine, have shown anti-OCD effects in preclinical and clinical studies. Therefore, we investigated whether the inhalational anesthetics isoflurane and sevoflurane, which are general anesthetics acting as NMDA receptor antagonists, would induce the same effects. To test our hypothesis, adult male Swiss mice were exposed to different concentrations of isoflurane (0.5, 1.5 or 3 %) or sevoflurane (0.8, 2.5 or 4 %) for 20 min (short-time exposure) or 1 h (moderate-time exposure) and submitted to the open field test (OFT) and the marble-burying test (MBT) in the same day (acute effect) or 7 days (long-lasting effect) after anesthetics administration. We found that single short or moderate-time exposure to isoflurane or sevoflurane, at sub-anesthetic or anesthetic concentrations, did not affect marble-burying behavior acutely or even 7 days after their administration. The same treatment schedules with isoflurane or sevoflurane did not impair total distance travelled in the OFT. A single moderate-time exposure to isoflurane (3 %) reduced, acutely, the central exploration of the open field, suggesting an anxiogenic-like effect of isoflurane in mice. Our results suggest that isoflurane and sevoflurane may not be promising anti-compulsive drugs.

Analysis of the accuracy of different laboratory methods for the diagnosis of intestinal parasites from stray and domiciled cats (Felis catus domesticus) in Goiânia, Goiás, Brazil.

Cats are carriers of zoonotic agents to humans, including intestinal parasites. The purpose of this study was to analyze the accuracy of different laboratory methods for the diagnosis of intestinal parasites. Fecal samples were processed by the Willis, Sheather, Faust and Hoffman-Janer-Pons-Lutz (HJPL) methods. Accuracy analysis was performed determining the sensitivity, specificity, positive and negative predictive value and Kappa. A total of 149 fecal samples were collected, 65 from stray cats and 84 from domiciled cats. The prevalence of intestinal parasites in stray cats was 60% while in domiciled cats it was 17%. In the analysis of accuracy, the techniques that showed the greatest accuracy for Ancylostomids were Willis and Faust, for Cystoisospora spp. Sheather with Faust or HPJL, and Toxoplasma gondii/Hammondia hammondi the association between Willis and Faust. Therefore, for a reliable evaluation of the prevalence of intestinal parasites, at least two different techniques should be used in parasitological exams of feces.

Percepção de racismo vivenciado por estudantes negros em cursos de Medicina no Brasil: uma revisão integrativa da literatura / Perceptions of racism experienced by black students on medical courses in Brazil: an integrative literature review / Percepción del racismo vivido por estudiantes negros y negras en cursos de Medicina en Brasil: una revisión integradora de la literatura

A Medicina permanece majoritariamente branca e elitizada, apesar das cotas universitárias. Esta revisão apresenta e discute a produção científica sobre o racismo vivenciado por estudantes de Medicina negros no Brasil. Foram consultadas as bases de dados Biblioteca Virtual em Saúde, US National Library of Medicine, Scientific Electronic Library Online, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Centre, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e Google Acadêmico. Os 11 estudos incluídos são qualitativos e das Ciências Sociais e Humanas. A negação de racismo explícito - apesar dos relatos de discriminação, piadas sobre o cabelo, sensação de não pertencimento, exclusão e baixa representatividade no corpo docente e discente - evidencia a especificidade da construção do racismo no Brasil, que é pouco identificado, mesmo por parte daqueles que o vivenciam cotidianamente nos cursos de Medicina.(AU)

Despite college quotas, medicine remains a predominantly white and elitist profession. This review discusses the literature on racism experienced by black medical students in Brazil. We searched the following databases: Virtual Health Library, US National Library of Medicine, Scientific Electronic Library Online, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Centre, periodical portal of the Coordination for the Improvement of the Higher Education Personnel, and Google Scholar. The 11 studies included in the review are qualitative and from the field of social and human sciences. The evident denial of racism, despite reports of discrimination, jokes about hair, feelings of estrangement, exclusion, and low levels of representation among academic staff and students highlight the specificities of the construction of racism in Brazil. The latter tends to go unnoticed, even by those who experience it on a daily basis on medical courses.(AU)

La Medicina permanece mayoritariamente blanca y de élite, a pesar de las cuotas universitarias. Esta revisión presenta y discute la producción científica sobre el racismo vivido por estudiantes de medicina negros y negras en Brasil. Se consultaron las bases de datos: Biblioteca Virtual em Saúde, US National Library of Medicine, Scientific Electronic Library Online, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Centre, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior y Google Acadêmico. Los 11 estudios incluidos son cualitativos y de las ciencias sociales y humanas. La negación de racismo explícito, a pesar de los relatos de discriminación, chistes sobre el pelo, sensación de no pertenencia, exclusión y baja representativad en el cuerpo docente y discente ponen en evidencia la especificidad de la construcción del racismo en Brasil que es poco identificado, incluso por parte de quienes lo viven cotidianamente en los cursos de Medicina.(AU)

Ambivalências do ser mãe: um estudo de caso em psicologia hospitalar / The ambivalences of being mother: a report of health psychology / Ambivalencias de ser madre: un estudio de caso en la psicologia hospitalaria

A gestação, ainda que vivenciada por muitas mulheres, não se trata de uma experiência igual para todas. Diversos aspectos sociais e subjetivos influenciam esse período. Assim, as intervenções do profissional da psicologia se demonstram relevantes, pois atuam possibilitando o encontro da mulher com o exercício da maternidade à sua maneira. Este relato trata de um estudo de caso de uma mãe atendida na maternidade de um hospital público de Brasília. Particularmente, buscou-se refletir a respeito das ambivalências presentes na experiência da maternidade. No caso investigado, o sentimento de culpa materno resultou em associar a rejeição atual do bebê com a recusa inicial da gestação. Assim, o lugar simbólico cedido ao bebê, bem como a história materna, foram elementos cruciais desenvolvidos nos atendimentos. A partir do caso investigado percebeu-se a importância de pôr em questão algumas ambivalências, conflitos e questionamentos que permeiam a maternidade, opondo-se a uma tendência social em idealizá-la

Gestation, although experienced by many women, is not an equal experience for all. Several social and subjective aspects influence this period. Thus, the interventions of the psychologist are relevant, since they act allowing the encounter of the woman with the exercise of motherhood in her own way. This study is a report of a mother attended at the maternity of a public hospital in Brasilia. We sought to reflect on the ambivalences present in the experience of motherhood. In the case investigated, the feeling of maternal guilt resulted to be associated the baby's current rejection with the initial refusal of gestation. Thus, the symbolic place given to the baby, as well as the maternal history, were crucial elements developed in the care. It was possible to see the importance of calling into question some ambivalences and issues that permeate motherhood, opposing a social tendency to idealize it.

La gestación, aunque vivida por muchas mujeres, no se trata de una experiencia igual para todas. Diversos aspectos sociales e subjetivos influencian este periodo. Así, las intervenciones del profesional de psicología se muestran relevantes, porque actúan posibilitando el encuentro de la mujer con el ejercicio de la maternidad a su manera. En este artículo presentamos un estudio de caso de una madre atendida en un hospital público de Brasilia. Particularmente, buscamos reflexionar sobre las ambivalencias presentes en la experiencia de la maternidad. En este caso, el sentimiento de culpa de la madre llevó a asociar el actual rechazo del bebé con la negativa inicial del embarazo. Así, el lugar simbólico cedido al bebé, como la historia materna fueron elementos cruciales desarrollados en los atendimientos. Desde el caso investigado, se percibió la importancia de discutir algunas ambivalencias, conflictos y cuestionamientos que impregnan la maternidad, oponiéndose a una tendencia social a idealizarla.

Analysis of the accuracy of different laboratory methods for the diagnosis of intestinal parasites from stray and domiciled cats (Felis catus domesticus) in Goiânia, Goiás, Brazil / Análise da acurácia de diferentes técnicas parasitológicas no diagnóstico de parasitos entéricos de gatos (Felis catus domesticus) errantes e domiciliados em Goiânia, Goiás, Brasil

Abstract Cats are carriers of zoonotic agents to humans, including intestinal parasites. The purpose of this study was to analyze the accuracy of different laboratory methods for the diagnosis of intestinal parasites. Fecal samples were processed by the Willis, Sheather, Faust and Hoffman-Janer-Pons-Lutz (HJPL) methods. Accuracy analysis was performed determining the sensitivity, specificity, positive and negative predictive value and Kappa. A total of 149 fecal samples were collected, 65 from stray cats and 84 from domiciled cats. The prevalence of intestinal parasites in stray cats was 60% while in domiciled cats it was 17%. In the analysis of accuracy, the techniques that showed the greatest accuracy for Ancylostomids were Willis and Faust, for Cystoisospora spp. Sheather with Faust or HPJL, and Toxoplasma gondii/Hammondia hammondi the association between Willis and Faust. Therefore, for a reliable evaluation of the prevalence of intestinal parasites, at least two different techniques should be used in parasitological exams of feces.

Resumo Gatos são veiculadores de agentes zoonóticos para o homem, entre eles os parasitos intestinais. O objetivo foi analisar a acurácia de diferentes métodos laboratoriais para o diagnóstico de parasitos entéricos. As amostras de fezes foram processadas pelos métodos de Willis, Sheather, Faust e Hoffman-Janer-Pons-Lutz (HJPL). A análise de acurácia foi realizada determinando a sensibilidade, especificidade, valor preditivo positivo e negativo e índice Kappa. Foram coletadas 65 amostras de fezes de gatos errantes e 84 amostras de gatos domiciliados, total de 149 amostras. A prevalência de parasitos entéricos nos errantes foi 60% e nos domiciliados 17%. Na análise de acurácia as técnicas que associadas apresentaram maior acurácia para Ancilostomídeos foram Willis e Faust, para Cystoisospora spp. Sheather com Faust ou HPJL, e para Toxoplasma gondii/Hammondia hammondi a associação entre Willis e Faust. Portanto, para uma avaliação fidedigna da prevalência de parasitos entéricos, deve-se usar no mínimo duas técnicas diferentes ao realizar os exames parasitológicos de fezes.

Avaliação do perfil lipídico de pacientes acima de 60 anos de idade atendidos em um laboratório-escola / Evaluation of the lipid profile between patients over 60 years old attended in a laboratory school

Objetivo: O objetivo deste trabalho é avaliar o perfil lipídico dos pacientes com idade entre 60 a 79 anos atendidos no Laboratório Clínico da Pontifícia Universidade Católica de Goiás em Goiânia, GO, no ano de 2013. Métodos: A amostragem utilizada foi de pacientes na faixa etária de 60 a 79 anos que tinham todos os exames de perfil lipídico, com um total de 158 indivíduos. Para os cálculos, os softwares utilizados foram: Microsoft Office Excel e o Bioestat 5.3. As análises das dislipidemias tiveram como valor de referência a V Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose. Resultados: Dos 158 pacientes analisados, 64,6% eram do sexo feminino e 35,4% do sexo masculino. Foram encontrados neste estudo 54% dos pacientes com HDL-C baixo, 32% de hipertrigliceridemia isolada, 9% de hipercolesterolemia isolada e 5% de hiperlipemia mista. As dislipidemias foram mais frequentes no sexo feminino. Conclusão: Por meio deste estudo foi possível identificar que houve alterações de HDL-C em mulheres, sendo maior que nos homens, devido a fatores como o sexo, e alguns secundários, como menopausa e reposição hormonal

Objective: The objective of this study is to evaluate the lipid profile in patients aged between 60 to 79 years treated at the Clinical Laboratory of the Pontifícia Universidade Católica de Goiás, located in Goiânia - GO, in 2013. Methods: The samples used were patients aged between 60-79 years that had complete lipid profile analysis, with a total of 158 individuals. The data were collected to the software Microsoft Office Excel and the BioStat 5.3. Analyses of dyslipidemias had as a benchmark the V Brazilian Guidelines on Dyslipidemia and Prevention of Atherosclerosis. Results: Among the 158 patients analyzed, 64.6% were female and 35.4% male. We found in this study that 54% of patients had low HDL-C, 32% isolated hypertriglyceridemia, 9% isolated hypercholesterolemia and 5% mixed hyperlipidemia. Lipid disorders were more frequent in females. Conclusion: Through this study, we observed that there was HDL-C changes in women, higher than in men due to many factors such as sex and some secondary factors as menopause and hormone replacement.