Impact of long-term feeding a high level of Spirulina combined with enzymes on growth performance, carcass traits and meat quality in broiler chickens.

This study evaluates the effect of prolonged feeding with a high inclusion level of Spirulina, combined with peptidases, on broiler chicken's growth performance, digesta viscosity, carcass attributes and meat quality. The experiment involved 120 male broilers divided into 40 battery brooders, each housing 3 birds. Post 7-day acclimatisation with a corn and soybean-based diet, the birds were provided with one of four diets: a corn and soybean meal-based diet (CON), a mix incorporating 15% Spirulina (SP), a Spirulina-rich mix supplemented with 0.025% of commercial VemoZyme® P (SPV), or a Spirulina-rich mix supplemented with 0.10% of porcine pancreatin (SPP). The CON group had higher body weight and weight gain (p < 0.001) and a lower feed conversion ratio (p < 0.001) from day 7-21, compared to the Spirulina-fed groups. Spirulina-fed chickens significantly increased ileum viscosity (p < 0.05). Spirulina also elevated the weight (p < 0.05) of the duodenum and the length (p < 0.001) of the entire gastrointestinal tract compared to CON. Breast and thigh muscles from Spirulina-fed broilers displayed higher values of yellowness (b*) (p < 0.001), pigments (p < 0.05), and n-3 PUFA (p < 0.01), while n-6/n-3 ratio (p < 0.001) and α-tocopherol (p < 0.001) decreased relative to the CON. In conclusion, the introduction of a high level of Spirulina into broiler diets for an extended duration, has the potential to diminish birds' growth performance, possibly due to increased digesta viscosity. However, it does enhance the nutritional quality of the meat.

Livestock in Riparian Areas: A Neglected Environmental Issue.

The presence of livestock in riparian areas raises several questions about the conservation and sustainable use of water resources and biodiversity in Brazil. Although the Native Vegetation Protection Law (No. 12,651) focuses on riparian vegetation, protected as Permanent Preservation Areas (APPs), it does not exclude the presence of livestock in these fragile areas. Here, we provide an overview of APPs in Brazil and analyze the legal instruments that enable livestock in these areas, gathering the scientific evidence on associated environmental impacts. Currently, cattle in riparian areas represent a direct threat to biodiversity and ecosystem functioning and services, especially because these animals promote trampling, loss of vegetation, soil erosion, siltation, and pollution through urine and feces. To avoid cattle in APPs, legislation should be revised to implement more stringent restrictions; in parallel, alternatives for watering the animals must be sought, such as, for example, the installation of artificial ponds and drinking fountains. It would be appropriate to propose legislation or create incentives to fence livestock in pasture areas to preventing it from accessing APPs. Increasing cattle confinement is an alternative measure to traditional ranching in open pasture. Riparian zones represent a critical environment for biodiversity and society, so the presence of cattle and its associated negative impacts should be seriously considered by authorities.

Effects of high dietary inclusion of Arthrospira platensis, either extruded or supplemented with a super-dosing multi-enzyme mixture, on broiler growth performance and major meat quality parameters.

BACKGROUND: This investigation assessed the effects of high dietary inclusion of Spirulina (Arthrospira platensis) on broiler chicken growth performance, meat quality and nutritional attributes. For this, 120 male broiler chicks were housed in 40 battery brooders (three birds per brooder). Initially, for 14 days, a standard corn and soybean meal diet was administered. Subsequently, from days 14 to 35, chicks were assigned to one of the four dietary treatments (n = 10 per treatment): (1) control diet (CTR); (2) diet with 15% Spirulina (SP); (3) diet with 15% extruded Spirulina (SPE); and (4) diet with 15% Spirulina plus a super-dosing enzymes supplement (0.20% pancreatin extract and 0.01% lysozyme) (SPM). RESULTS: Throughout the experimental period, both SP and SPM diets resulted in decreased final body weight and body weight gain compared to control (p < 0.001), with the SPE diet showing comparable results to CTR. The SPE diet prompted an increase in average daily feed intake (p = 0.026). However, all microalga treatments increased the feed conversion ratio compared to CTR. Dietary inclusion of Spirulina notably increased intestinal content viscosity (p < 0.010), which was mitigated by the SPM diet. Spirulina supplementation led to lower pH levels in breast meat 24 h post-mortem and heightened the b* colour value in both breast and thigh meats (p < 0.010). Furthermore, Spirulina contributed to an increased accumulation of total carotenoids, n-3 polyunsaturated fatty acids (PUFA), and saturated fatty acids (SFA), while diminishing n-6 PUFA, thus altering the n-6/n-3 and PUFA/SFA ratios favourably (p < 0.001). However, it also reduced zinc concentration in breast meat (p < 0.001). CONCLUSIONS: The findings indicate that high Spirulina levels in broiler diets impair growth due to increased intestinal viscosity, and that extrusion pre-treatment mitigates this effect. Despite reducing digesta viscosity, a super-dosing enzyme mix did not improve growth. Data also indicates that Spirulina enriches meat with antioxidants and n-3 PUFA but reduces α-tocopherol and increases saturated fats. Reduced zinc content in meat suggests the need for Spirulina biofortification to maintain its nutritional value.

Impact of high Spirulina diet, extruded or supplemented with enzymes, on blood cells, systemic metabolites, and hepatic lipid and mineral profiles of broiler chickens.

The impact of 15% dietary inclusion of Spirulina (Arthrospira platensis) in broiler chickens was explored, focusing on blood cellular components, systemic metabolites and hepatic lipid and mineral composition. From days 14 to 35 of age, 120 broiler chickens were divided and allocated into four dietary treatments: a standard corn and soybean meal-based diet (control), a 15% Spirulina diet, a 15% extruded Spirulina diet, and a 15% Spirulina diet super-dosed with an enzyme blend (0.20% porcine pancreatin plus 0.01% lysozyme). The haematological analysis revealed no significant deviations (p > 0.05) in blood cell counts across treatments, suggesting that high Spirulina inclusion maintains haematological balance. The systemic metabolic assessment indicated an enhanced antioxidant capacity in birds on Spirulina diets (p < 0.001), pointing toward a potential reduction in oxidative stress. However, the study noted a detrimental impact on growth performance metrics, such as final body weight and feed conversion ratio (both p < 0.001), in the Spirulina-fed treatments, with the super-dosed enzyme blend supplementation failing to alleviate these effects but with extrusion mitigating them. Regarding hepatic composition, birds on extruded Spirulina and enzyme-supplemented diets showed a notable increase in n-3 fatty acids (EPA, DPA, DHA) (p < 0.001), leading to an improved n-6/n-3 PUFA ratio (p < 0.001). Despite this positive shift, a reduction in total hepatic lipids (p = 0.003) was observed without a significant change in cholesterol levels. Our findings underscore the need for further exploration into the optimal inclusion levels, processing methods and potential enzymatic enhancements of Spirulina in broiler diets. Ultimately, this research aims to strike a balance between promoting health benefits and maintaining optimal growth performance in poultry nutrition.

Mpox: Aspectos epidemiológicos, imunopatogênicos e manejo pré e pós-infecção / Mpox: Epidemiological, immunopathogenic aspects and pre- and post-infection management

Mpoxou Varíola M é uma zoonose causada por vírus do gênero Orthopoxvirus, causadores também da varíola comum. É uma doença considerada rara e autolimitada, sendo endêmica em países africanos. Entretanto, no ano de 2022 ganhou destaque devido ao surto global que se iniciou, quando o mundo ainda se recuperava da pandemia da COVID-19. Dessa forma, por se tratar de uma doença emergente, a presente revisão visa pontuar aspectos gerais do que se sabe até o momento sobre a Mpox, desde sua imunopatogenia até as formas atuais de prevenção e cuidados pós-infecção

Mpox or Variola M is a zoonosis caused by viruses of the genus Orthopoxvirus, which also cause smallpox. It is a disease considered rare and self-limiting, being endemic in African countries. However, in 2022, it gained prominence due to the global outbreak that began when the world was still recovering from the COVID-19 pandemic. Thus, as it is an emerging disease, this review aims to point out general aspects of what is known so far about Mpox, from its immunopathogenesis to current forms of prevention and post-infection care

Behavior changes in children/adolescents with attention deficit hyperactivity disorder during the COVID-19 pandemic: a systematic review / Mudanças comportamentais em crianças/adolescentes com transtorno de déficit de atenção e hiperatividade durante a pandemia de COVID-19: uma revisão sistemática

Abstract Objectives: to describe behavioral changes related to mental health in children and adolescents with Attention Deficit Hyperactivity Disorder during social isolation due to the COVID-19 pandemic. Methods: this is a systematic review conducted under the PRISMA protocol (2020) in the PubMed, SciELO and VHL databases, with a period of 2019-2022. Results: 3,735 studies were screened and ten were selected, according to the eligibility criteria. The sample had 4,688 participants. There was evidence of a worsening of signs and symptoms regarding the mental health of this population, expressed mainly through changes in mood, with increased anxiety, sadness or depressed symptoms, in addition to increased hyperactivity. Behavioral changes also included reduced sleep quality and physical activity, and increased use of digital technologies and screen time. Conclusions: it was described that children and youth groups, especially those with attention deficit hyperactivity disorder, had increased emotional symptoms and conduct problems when compared to before the pandemic, making it possible to recognize the negative repercussions of the changes imposed by it. These factors are important for planning more effective care strategies.

Resumo Objetivos: descrever mudanças comportamentais, relacionadas à saúde mental, em crianças e adolescentes com Transtorno de Déficit de Atenção e Hiperatividade durante o isolamento social devido à pandemia da COVID-19. Métodos: trata-se de uma revisão sistemática conduzida sob protocolo PRISMA (2020) nas bases de dados PubMed, SciELO e BVS, com período de 2019-2022. Resultados: foram triados 3.735 estudos e selecionados dez, de acordo com os critérios de elegibilidade. A amostra contou com 4.688 participantes. Evidenciou-se um agravamento de sinais e sintomas quanto à saúde mental dessa população expresso principalmente através de mudanças no estado de humor, com aumento da ansiedade, tristeza ou sintoma deprimido, além do aumento da hiperatividade. As mudanças comportamentais incluíram ainda redução da qualidade do sono e da prática de atividades físicas e aumento do uso de tecnologias digitais e tempo de tela. Conclusões: foi descrito que os grupos infanto-juvenis, sobretudo com Transtorno de Déficit de Atenção e Hiperatividade, tinham sintomas emocionais e problemas de conduta aumentados quando comparados a antes da pandemia, sendo possível reconhecer as repercussões negativas das mudanças impostas por ela. Esses fatores são importantes para o planejamento de estratégias de cuidado mais efetivas.

Mastocytosis: the safety of different COVID-19 vaccines / Mastocitose: segurança de diferentes vacinas contra a COVID-19

The COVID-19 pandemic has forced the development of vaccines to fight SARS-CoV-2. After vaccination began, reports of adverse reactions, including anaphylaxis, emerged. This raised concerns about the safety of COVID-19 vaccines in patients diagnosed with mastocytosis. The authors share their experience in administering different COVID-19 vaccines to patients diagnosed with mastocytosis.

A pandemia por COVID-19 obrigou ao rápido desenvolvimento de vacinas para combate ao SARS-CoV-2. Após o início da vacinação começaram a surgir relatos de reações adversas às vacinas, incluindo reações anafiláticas, surgindo dúvidas sobre a segurança das vacinas em doentes com mastocitose. Os autores apresentam a sua experiência em relação à administração de diferentes vacinas contra a COVID-19 em doentes com diagnóstico de mastocitose.

Predictors of anaphylaxis to peanut and tree nuts in a Mediterranean population.

Background: Peanuts (PN) and tree nuts (TN) are major causes of anaphylaxis worldwide. We aimed to determine the clinical and demographic characteristics associated with anaphylaxis in patients sensitized to PN and/or TN in a Mediterranean population. Methods: We conducted a retrospective study, which included 198 patients allergic to PN and/or TN (allergy symptoms plus specific immunoglobulin E [sIgE] sensitization), evaluated in consultations from January 2015 to December 2020. Univariate analysis and multivariate logistic regression models were developed, including demographic, clinical, and laboratory data as independent variables, and anaphylaxis to each PN and/or TN as a dependent variables. Results: Anaphylaxis was associated with an earlier age of onset of allergy to PN, cashew and/or pistachio, and pine nut allergy but not to other TN allergies. Gender, atopic comorbidities, and cofactors were not associated with PN and/or TN anaphylaxis. Anaphylaxis to PN, cashew and/or pistachio, and pine nut were associated with reactivity to a fewer number of PN and/or TN foods. Although sIgE sensitization to lipid transfer proteins (LTP) was highly prevalent in our population, only seed storage protein (SSP) positivity was associated with anaphylaxis in PN allergy. The absence of pathogenesis-related protein family 10 sensitization correlated with PN and hazelnut anaphylaxis. A higher level of sIgE to almond extract predicted anaphylaxis but the level of sIgE to other PN and/or TN extracts did not predict it. Conclusion: The high prevalence of sensitization to the pan-allergen LTP did not seem to have a significant impact in PN and/or TN allergy severity in our study. Instead, other factors, such as early age of onset and positivity for SSPs, seem to strongly associate with anaphylaxis to specific PN and/or TN. These findings may contribute to individual risk assessment in these populations.

Can photobiomodulation therapy (PBMT) control blood glucose levels and alter muscle glycogen synthesis?

Photobiomodulation therapy (PBMT) has many effects on the energy metabolism of musculoskeletal tissue, such as increased glycogen and adenosine triphosphate synthesis. In addition, these effects may be due to a systemic blood glucose control. Twenty-four Wistar rats were randomly and equally allocated into four groups: sham, PBMT 10 J/cm2, PBMT 30 J/cm2 and PBMT 60 J/cm2. The animals were fasting for 6 h for blood glucose evaluations during pre-irradiation period, 1 h, 3 h and 6 h after PBMT. Muscle glycogen synthesis was measured 24 h after PBMT. This PBMT used a cluster of 69 LEDs (light-emitting diodes) with 35 red (630 ± 10 nm) and 34 infrared (850 ± 20 nm); 114 mW/cm2 for 90s (10 J/cm2), 270 s (30 J/cm2), 540 s (60 J/cm2) applied on large muscle areas (back and hind legs) of the animals. The 10 J/cm2 group showed lower blood glucose levels and glucose variability over 6 h (5.92 mg/dL) compared to the sham (13.03 mg/dL), 30 J/cm2 (7.77 mg/dL) and 60 J/cm2 (9.07 mg/dL) groups. The PBMT groups had the greatest increase in muscle glycogen (10 J/cm2 > 60 J/cm2 > 30 J/cm2 > sham), characterizing a triphasic dose-response of PBMT. There was a strong negative correlation between blood glucose variability over 6 h and muscle glycogen concentration for 10 J/cm2 group (r = -0.94; p < .001) followed by 30 J/cm2 group (r = -0.84; p < .001) and 60 J/cm2 group(r = -0.73; p < .006). These results suggest that PBMT can play a very important role in the control of blood glucose levels, and its possible mechanism of action is the induction of greater muscle glycogen synthesis independently of physical exercise.

Correction to: Photobiomodulation by dual-wavelength low-power laser effects on infected pressure ulcers.

The author name Maria Maria Côrtes Thomé Lima was incorrectly captured in the original article. The correct author name should be Andrezza Maria Côrtes Thomé Lima. The original article has been corrected.

Photobiomodulation by dual-wavelength low-power laser effects on infected pressure ulcers.

The aim of this study was to evaluate the effects of photobiomodulation (PBM) by dual-wavelength low-power lasers on the healing and bacterial bioburden of pressure ulcer (PU) models. Twenty-five male Swiss mice were divided into five equal groups. Ischemia reperfusion cycles were employed to cause PU formation by the external application of magnetic plates. Immediately after wounding, a suspension of Pantoea agglomerans was applied at the base of all the wounds of the infected groups, using a calibrated pipette. PBM (simultaneous emission at 660 and 808 nm, 142.8 J/cm2, in continuous wave emission mode) was applied to the PUs for 14 sessions. The animals were euthanized 14 days after PU induction, and their tissues were analyzed for wound contraction and reepithelialization, epidermis thickness, bacterial survival, and IL-1ß and IL-10 mRNA level evaluations. The PU areas appeared larger in the mice from the infected groups than in those in the laser group 4 days after PU induction and presented incomplete reepithelialization 14 days after PU induction. However, the PBM accelerated the wound healing in the infected + laser group compared with the infected group 11 and 14 days following the PU induction. The infected and irradiated PUs exhibited a thinner neo-epidermis than those in the infected group, and the bacterial survival decreased in the laser group; the relative expression IL-1ß mRNA levels demonstrated an increasing tendency while the relative expression IL-10 mRNA levels demonstrated a decreasing tendency in the infected + laser and laser groups. These results suggest that PBM improves healing by killing or inhibiting bacteria in PUs as well as by accelerating the wound healing, resulting in tissue repair.

Índice de massa corporal associado às caractéristicas das puérperas e dos neonatos / Body mass index associated with characteristics of postpartum patients and newborns / Índice de masa corporal asociado a las características de las puérperas y de los neonatos

Resumo Introdução O índice de massa corporal (IMC) pré-gestacional inadequado acarreta riscos maternos/fetais. Objetivos Identificar o IMC pré-gestacional e associá-lo com os dados sociodemográficos e obstétricos das puérperas; e identificar o IMC pré-gestacional e o ganho de peso na gravidez relacionados às características dos neonatos. Materiais e Métodos Estudo quantitativo, descritivo, desenvolvido em hospital referência, com 187 binômios. Dados foram coletados da carteirinha do pré-natal e da Declaração de Nascido Vivo. Devido à ausência de distribuição gaussiana, as variáveis contínuas foram comparadas, utilizando-se testes não paramétricos (Mann-Whitney ou Kruskal-Wallis). As amostras pareadas foram comparadas utilizando-se o teste de Wilcoxon pareado. Para comparação das variáveis categóricas, utilizou-se o teste exato de Fisher ou o teste qui-quadrado de Pearson. Resultados O IMC pré-gestacional variou de 16 a 53kg/m 2 , média 25,0 ±5,9kg/m 2 ; 41,2% com sobrepeso e mulheres obesas; a média do ganho de peso gestacional foi 11Kg ±30Kg; a média da idade de 26 anos. Houve aumento progressivo do peso de acordo com o aumento da idade (P=0,009); mulheres obesas foram mais propensas a serem internadas por Síndrome Hipertensiva Gestacional (P=0,003) e por hipertensão arterial crônica (P=0,026); entre as com IMC elevado 24,0% eram primíparas e 23,5% multípara; a média do peso dos neonatos foi 3146,8g ±559,7g. O peso dos neonatos das obesas foi superior (P=0,034). Houve correlação positiva entre o IMC materno pré-gestacional e o peso do RN ao nascimento (rho-0,219; P=0,003). Discussão Os resultados demostraram aumento de peso nas gestantes corroborando com outras pesquisas da literatura. Conclusões A avaliação do estado nutricional deve acontecer no planejamento da gestação para evitar futuras complicações.

Abstract Introduction An inadequate pregestational Body Mass Index (BMI) leads to maternal/fetal risks. Objectives To identify the pregestational BMI to link it to the sociodemographic and obstetrical data of postpartum patients as well as to identify how the pregestational BMI and weight gain during pregnancy can be related to the characteristics of newborns. Materials and Methods A quantitative, descriptive study was conducted in a referral hospital for 187 pairs. The data were collected from the maternity notes and the Certificates of Live Birth. Due to the absence of Gaussian distribution, continuous variables were compared using non-parametric tests (Mann-Whitney or Kruskal-Wallis). Paired samples were compared using the Wilcoxon test for paired data. Fisher's exact test or Pearson's chi-square test were used for comparing categorical variables. Results Pregestational BMI ranged from 16 to 53kg/m 2 , mean 25.0 ±5.9kg/m 2 ; 41.2% overweight and obese women; the average of pregestational weight gain was 11Kg ±30Kg; mean age was 26 years. A progressive weight gain was observed in relation to the increase in age (P=0.009); obese women were more likely to be hospitalized for Gestational Hypertensive Syndrome (P=0.003) and Chronic Hypertension (P=0.026); among women with a high BMI, 24.0% were primiparous while 23.5% were multiparous; the average weight of newborns was 3146.8g ±559.7g. Newborn weight of obese women was higher (P=0.0034). A positive correlation was observed between maternal pregestational BMI and the newborn weight at birth (rho-0.219; P=0.003). Discussion and Conclusions The assessment of the nutritional status should be made during the planning stage of gestation in order to prevent future complications.

Resumen Introducción Un Índice de Masa Corporal (IMC) pregestacional inadecuado conlleva riesgos maternos/fetales. Objetivos Identificar el IMC pregestacional y vincularlo a los datos sociodemográficos y obstétricos de las puérperas; e identificar el IMC pregestacional y el aumento de peso durante el embarazo relacionados con las características de los neonatos. Materiales y Métodos Estudio cuantitativo, descriptivo, desarrollado en un hospital de referencia, con 187 binomios. Los datos fueron recolectados a partir de la libreta prenatal y de la Declaración de Nacido Vivo. Debido a la ausencia de distribución gaussiana, se compararon las variables continuas, utilizando pruebas no paramétricas (Mann-Whitney o Kruskal-Wallis). Las muestras pareadas fueron comparadas utilizando la prueba de Wilcoxon para datos pareados. Para comparar las variables categóricas, se utilizó la prueba exacta de Fisher o la prueba chi-cuadrado de Pearson. Resultados El IMC pre-gestacional varió de 16 a 53kg/m 2 , promedio 25,0 ±5,9kg/m 2 ; 41,2% con sobrepeso y mujeres obesas; el promedio de aumento del peso gestacional fue de 11Kg ±30Kg; el promedio de edad fue de 26 años. Se observó un aumento progresivo del peso de acuerdo con el aumento de la edad (P=0,009); las mujeres obesas más propensas a ser hospitalizadas por Síndrome Hiperintensiva Gestacional (P=0,003) y por hipertensión arterial crónica (P=0,026); entre las mujeres con IMC elevado 24,0% eran primíparas y 23,5% multíparas; el promedio de peso de los neonatos fue de 3146,8g ±559,7g. El peso de los neonatos de las obesas fue superior (P=0,034). Se observó una correlación positiva entre el IMC materno pre-gestacional y el peso del RN al nacer (rho-0,219; P=0,003). Discusión Los resultados demostraron un aumento de peso en las madres gestantes, lo que corrobora las investigaciones de la literatura. Conclusiones La evaluación del estado nutricional se debe realizar en la fase de planeación de la gestación con el fin de evitar complicaciones futuras.

Subcutaneous immunotherapy induces alterations in monocytes and dendritic cells homeostasis in allergic rhinitis patients.

BACKGROUND: Specific subcutaneous immunotherapy (SCIT) can achieve long-term remission in patients with allergic rhinitis (AR) through complex and still unknown mechanisms. The aim of this study is to evaluate the effect of SCIT over CD16+ and CD16- monocytes, myeloid (mDCs) and plasmacytoid dendritic cells (pDCs) in patients with AR, comparatively to pharmacological standard treatment (non-SIT). METHODS: The relative frequency and absolute number of monocytes and DC subsets, the frequency of these cells producing TNFα after in vitro stimulation with Dermatophagoides pteronyssinus (Dpt) extract, and the expression levels of receptor-bound IgE or IgG were assessed by flow cytometry, in peripheral blood samples from 23 healthy individuals (HG) and 43 participants with AR mono-sensitized to Dpt; 10 with non-SIT treatment and 33 under SCIT, just before (SCIT-T0) and 4 h after administration (SCIT-T4). Moreover, IFNα mRNA expression was evaluated in purified pDCs, by qRT-PCR. RESULTS: After SCIT administration we observed a strong decrease of circulating pDCs, although accompanied by higher levels of IFNα mRNA expression, and an increase of circulating CD16+ monocytes. AR participants under SCIT exhibited a higher expression of receptor-bound IgE in all cell populations that expressed the high affinity receptor for IgE (FcεRI) and a higher frequency of CD16+ monocytes producing TNFα. Conversely, we observed a decrease in the frequency of mDCs producing TNFα in AR under SCIT, similar to the observed in the control group. CONCLUSIONS: SCIT seems to induce numeric, phenotypic, and functional changes in circulating monocytes and dendritic cells, contributing at least in part to the well described immunological alterations induced by this type of immunotherapy.

Patient Health Questionnaire-9 versus Edinburgh Postnatal Depression Scale in screening for major depressive episodes: a cross-sectional population-based study.

BACKGROUND: Major depressive episodes (MDE) are frequent at the population level and are generally associated with severe symptoms that impair performance of activities of daily living of individuals suffering from this condition. The aim of this study was to compare the accuracy of two tests that separately showed suitable properties in screening for MDE: the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS). METHODS: In a previous study, the sensitivity and specificity of the PHQ-9 and the EPDS in screening for MDE were compared with a structured diagnostic interview conducted by psychiatrics and psychologists using the Mini International Neuropsychiatric Interview as the gold standard. In a sample of adults living in the community in Pelotas, Brazil, the PHQ-9 and EPDS were applied at the same interview and the gold standard on a median of 17 days later. The interviews were carried out at the participant's home. RESULTS: 447 Individuals (191 men and 256 women) were assessed. The PHQ-9 and the EPDS results were concordant in 87.5% of the respondents, with a moderate agreement beyond what was expected by chance alone (kappa = 0.61). The areas below the ROC curves were not statistically different (82.1% for PHQ-9 and 83.5% for EPDS) (p = 0.291), thus indicating that the two tests had similar moderate accuracy. CONCLUSIONS: PHQ-9 and EPDS may be applied with equal confidence in screening for MDE in the community.

Patient health questionnaire-9 versus Edinburgh postnatal depression scale in screening for major depressive episodes: a cross-sectional population-based study.

BACKGROUND: Major depressive episodes (MDE) are frequent at the population level and are generally associated with severe symptoms that impair performance of activities of daily living of individuals suffering from this condition. The aim of this study was to compare the accuracy of two tests that separately showed suitable properties in screening for MDE: the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh postnatal depression scale (EPDS). METHODS: In a previous study, the sensitivity and specificity of the PHQ-9 and the EPDS in screening for MDE were compared with a structured diagnostic interview conducted by psychiatrics and psychologists using the Mini International Neuropsychiatric Interview as the gold standard. In a sample of adults living in the community in Pelotas, Brazil, the PHQ-9 and EPDS were applied at the same interview and the gold standard on a median of 17 days later. The interviews were carried out at the participant's home. RESULTS: 447 individuals (191 men and 256 women) were assessed. The PHQ-9 and the EPDS results were concordant in 87.5 % of the respondents, with a moderate agreement beyond what was expected by chance alone (kappa = 0.61). The areas below the ROC curves were not statistically different (82.1 % for PHQ-9 and 83.5 % for EPDS) (p = 0.291), thus indicating that the two tests had similar moderate accuracy. CONCLUSIONS: PHQ-9 and EPDS may be applied with equal confidence in screening for MDE in the community.

Conhecimento sobre os efeitos dos contraceptivos hormonais por acadêmicas da saúde / Knowledge on the effects of hormonal contraceptives by students of health area

Objetivo: identificar o conhecimento de acadêmicas da saúde sobre os efeitos colaterais relacionados à sexualidadecausados por métodos contraceptivos orais. Método: estudo quantitativo e prospectivo com 262 acadêmicas deCursos de Graduação em Enfermagem e Medicina. Para análise foram aplicados testes de Correlação de Spearman,Qui-Quadrado de Fisher e frequência. Resultados: as acadêmicas conhecem que a contracepção hormonal oralpode manifestar efeito sobre a sexualidade. A pílula é utilizada por 75,5% das acadêmicas e manifestaram-se efeitoscolaterais em 66,8%. A diminuição da libido destacou-se em 15,8% e mostrou relação com a faixa etária, númerode parceiros sexuais no último ano e meio de indicação da pílula. Frente aos efeitos colaterais, 57,2% não tomaramnenhuma atitude. Conclusão: a maior parte das acadêmicas que utilizava métodos contraceptivos soube identificaros efeitos colaterais relacionados a esse método, sendo os mais citados, alteração do fluxo menstrual, sensibilidademamária, cefaleia e sangramentos fora do período menstrual.

Objective: to identify the knowledge of the students of health area about the side effects related to sexuality caused byoral contraceptives. Method: quantitative and prospective study with 262 undergraduate students in Nursing andMedicine. Spearman’s Correlation, Fisher’s Chi-Square and frequency were used for analysis. Results: the studentsare aware that oral hormonal contraception may have an effect on sexuality. The pill is used by 75.5% of the studentsand had side effects in 66.8%. The decrease in libido stood out in 15.8% and showed relation with the age group,number of sexual partners in the last year and through the indication of the pill. Faced with the side effects, 57.2%took no action. Conclusion: most of the women who used contraceptive methods were able to identify the side effectsrelated to this method, being the most cited, altered menstrual flow, breast sensitivity, headache and bleeding outside the menstrual period.

Objetivo: identificar los conocimientos de las académicas de la salud acerca de los efectos secundarios relacionados conla sexualidad causada por los anticonceptivos orales. Método: estudio prospectivo y cuantitativo con 262 académicasde los cursos de Pregrado en enfermería y medicina. Para el análisis se aplicaron la prueba de correlación de Spearman, chi-cuadrado y la frecuencia de Fisher. Resultados: las académicas saben que el anticonceptivo hormonaloral puede manifestarse con efecto sobre la sexualidad. La píldora es utilizada por el 75,5% de las académicas yexpresa sus efectos secundarios en el 66,8%. A disminución del libido se destacó en un 15,8% y se relacionó conla edad, número de parejas sexuales en el último año y medio de indicación de la píldora. Frente a los efectoscolaterales, del 57,2%, no se tomó ninguna acción. Conclusión: a mayor parte de las académicas que utilizan losmétodos anticonceptivos eran capaces de identificar los efectos colaterales relacionados con este método, siendo losmás comunes, cambios en el flujo menstrual, sensibilidad en los senos, dolor de cabeza y sangramiento fuera delperíodo menstrual.

Countertransference and therapeutic alliance in the early stage of adult psychodynamic psychotherapy.

OBJECTIVES: The primary objective of this study was to assess the relationship between countertransference (CT) and therapeutic alliance (TA) during the early stages of psychodynamic psychotherapy. A secondary objective is to assess associations between CT and variables related to therapist and patient and between CT and other patient variables investigated, which were defense mechanisms, symptomology and functionality. METHODOLOGY: This was a cross-sectional study that enrolled 30 patients treated by 17 different therapists at the psychotherapy clinics of two psychiatry centers. Assessments of each patient-therapist pair were conducted between their fourth and 10th sessions. RESULTS: The CT distance domain exhibited a moderate negative correlation with TA, particularly its sub-dimension representing the patient's capacity for work in therapy. Moderate positive correlations were observed between CT distance and the splitting defense mechanism and between CT closeness and suppression defenses, in addition to moderate negative correlation between CT indifference and the fantasy defense mechanism. Another finding was higher scores for CT indifference in association with socioeconomic classes D and E. CONCLUSIONS: The quality of CT may provide a source of information about TA. A high degree of CT distance represents a low level of TA, particularly with relation to the patient's working capacity, although presence of the splitting defense mechanism can affect CT, to the extent that it constitutes a confounding variable. The concept of CT is useful to psychotherapists, providing a source of information about the patient's internal world and about certain elements of therapy, such as the quality of TA, which is important for good treatment results.

Knowledge of supplemental folic acid during pregnancy / Conocimiento de la suplementación de ácido fólico en la gestación / Conhecimento da suplementação de ácido fólico na gestação

Objective.To identify the use of folic acid during pregnancy, as well as the new mothers´ knowledge about folic acid. Methodology. Quantitative, descriptive exploratory, and prospective study. A total of 198 mothers were interviewed in the pediatric outpatient service of Hospital de Base Sao José do Rio Preto, Brazil. They have taken their children for neonatal screening and formally consented to participating in the study. The research project was approved by the Research Ethics Committee (350,287). A specific instrument was used for data collection. The data were entered into an appropriate spreadsheet and later statistically analyzed. Pearson´s chi-squared test, p <0.15, was used. Results. On average, the interviewed mothers were 25 years old and received less than two minimum wages. Most had prenatal in the first quartile and a mean of seven appointments, starting the use of folic acid from the 7th to the 9th week of gestational age. However, when asked about the importance of folic acid and its action, almost the majority was not able to answer. Conclusion. Although daily acid supplementation is recommended in prenatal care, this study found that consumption is inadequate, contributing to the increased risk of fetal malformation. Healthcare professionals, especially nurses, should develop educational activities for women about the use of folic acid in the pre-gestation period and in the first pregnancy trimester.

Objetivo. IdIdentificar el conocimiento y el uso durante el embarazo del ácido fólico. Metodología.Cuantitativo, exploratorio descriptivo y prospectivo. Se entrevistaron un total de 198 madres en el servicio de consulta externa de pediatría del Hospital de Base de Sao José do Rio Preto, Brasil quienes se habían llevado a sus hijos para el cribado neonatal y aceptado participar del estudio por consentimiento formal. El proyecto de investigación fue aprobado por el Comité Ético de Investigación (350.287). Se utilizó un instrumento específico para la recolección de datos. Asimismo, una hoja de cálculo para la transcripción de datos; después, se analizaron estadísticamente. Prueba Person's Chi-cuadrado se utilizó p <0,15. Resultados. Las puérperas entrevistadas tuvieron una media de 25 años, el 61.5% ganaba menos de dos salarios mínimos. El 96.5% realizó control prenatal; el 18.2% de las gestantes inició control tardíamente, entre el segundo y tercer trimestre de embarazo. El 81.3% de las mujeres consumió ácido fólico en la gestación; cuatro de cada cinco en los tres primeros meses de embarazo. Cuando se preguntó sobre la importancia del ácido fólico y de su acción, la mayoría de las mujeres no supo responder. Conclusión. Aunque la suplementación diaria con ácidofólico sea recomendada en el control prenatal, se verificó en este estudio que su consumo es inadecuado, lo que contribuye al aumento del riesgo de malformación fetal. El profesional del área de la salud y, especialmente, el enfermero deben desarrollar actividades educativas para las mujeres en cuanto al uso de ácido fólico en el período pregestacionacional y durante el primer trimestre del embarazo.

Objetivo.Identificar o uso do ácido fólico durante a gestação e o conhecimento de puérperas sobre o ácido fólico. Metodologia. Estudo quantitativo, descritivo exploratório e prospectivo. Entrevistou 198 puérperas, no ambulatório da pediatria do Hospital de Base, São José do Rio Preto, Brasil, que trouxerem seus filhos para triagem neonatal e aceitaram por escrito participar da pesquisa. O projeto de pesquisa foi aprovado pelo comitê de ética em pesquisa (350.287). A coleta de dados foi realizada com um instrumento específico. Os dados foram transcritos para uma planilha e analisados estatisticamente. Utilizou o teste de Qui-Quadrado de Person, p<0,15. Resultados. Em média, as puérperas entrevistadas possuem 25 anos e ganham menos de dois salários mínimos. A maioria realizou o pré-natal, no primeiro trimestre e tiveram uma media de sete consultas, com o início do uso de ácido fólico na idade gestacional de sete a nove semanas. Contudo quando questionadas sobre a importância do ácido fólico e sua ação, quase que a maioria significativa não soube responder. Conclusão. Embora a suplementação com ácido fólico diária seja recomendado no pré-natal, verificou-se que seu consumo foi inadequado, contribuindo para o aumento do risco de malformação fetal. O profissional da área da saúde, especialmente os enfermeiros, devem desenvolver atividades educativas para as mulheres quanto ao uso de ácido fólico de durante o período pré-gestacional e primeiro trimestre da gravidez.

Countertransference and therapeutic alliance in the early stage of adult psychodynamic psychotherapy / Contratransferência e aliança terapêutica no início da psicoterapia psicodinâmica de adultos

Objectives:The primary objective of this study was to assess the relationship between countertransference (CT) and therapeutic alliance (TA) during the early stages of psychodynamic psychotherapy. A secondary objective is to assess associations between CT and variables related to therapist and patient and between CT and other patient variables investigated, which were defense mechanisms, symptomology and functionality.Methodology: This was a cross-sectional study that enrolled 30 patients treated by 17 different therapists at the psychotherapy clinics of two psychiatry centers. Assessments of each patient-therapist pair were conducted between their fourth and 10th sessions.Results: The CT distance domain exhibited a moderate negative correlation with TA, particularly its sub-dimension representing the patient's capacity for work in therapy. Moderate positive correlations were observed between CT distance and the splitting defense mechanism and between CT closeness and suppression defenses, in addition to moderate negative correlation between CT indifference and the fantasy defense mechanism. Another finding was higher scores for CT indifference in association with socioeconomic classes D and E.Conclusions: The quality of CT may provide a source of information about TA. A high degree of CT distance represents a low level of TA, particularly with relation to the patient's working capacity, although presence of the splitting defense mechanism can affect CT, to the extent that it constitutes a confounding variable. The concept of CT is useful to psychotherapists, providing a source of information about the patient's internal world and about certain elements of therapy, such as the quality of TA, which is important for good treatment results.

Objetivos: O objetivo principal desta pesquisa foi avaliar a relação entre a contratransferência (CT) e a aliança terapêutica (AT) no início da psicoterapia psicodinâmica. O objetivo secundário é avaliar a associação da CT com as variáveis da dupla e da CT com as demais variáveis do paciente avaliadas, que foram os mecanismos de defesa, sintomatologia e funcionalidade.Metodologia:Trata-se de um estudo transversal com 30 pacientes do ambulatório de psicoterapia de dois serviços de psiquiatria, atendidos por 17 terapeutas. As avaliações ocorreram entre quarto e décimo encontros da dupla.Resultados:A dimensão da CT distância apresentou correlação negativa moderada com a AT, especialmente sua dimensão que representa a capacidade de trabalho em terapia do paciente. Foram verificadas correlações moderadas positivas entre CT distância e cisão e entre CT proximidade e supressão, além da correlação moderada negativa da CT indiferença com fantasia. Outro dado encontrado foi a presença de maiores níveis da CT indiferença diante de pacientes da classe socioeconômica D e E.Conclusões:A qualidade da CT pode servir de fonte de informações sobre a AT. A presença de alta CT que indica distância está relacionada a baixa AT, sobretudo em relação a capacidade de trabalho do paciente, ainda que a presença de cisão pode influenciar a CT, de forma que representa uma variável de confusão. A CT é um conceito útil ao psicoterapeuta, servindo como fonte de informações sobre o mundo interno do paciente e sobre elementos da psicoterapia, como a qualidade da AT, importante para os bons resultados dos tratamentos.

Knowledge of supplemental folic acid during pregnancy.

OBJECTIVE: To identify the use of folic acid during pregnancy, as well as the new mothers´ knowledge about folic acid. METHODOLOGY: Quantitative, descriptive exploratory, and prospective study. A total of 198 mothers were interviewed in the pediatric outpatient service of Hospital de Base Sao José do Rio Preto, Brazil. They have taken their children for neonatal screening and formally consented to participating in the study. The research project was approved by the Research Ethics Committee (350,287). A specific instrument was used for data collection. The data were entered into an appropriate spreadsheet and later statistically analyzed. Pearson´s chi-squared test, p <0.15, was used. RESULTS: On average, the interviewed mothers were 25 years old and received less than two minimum wages. Most had prenatal in the first quartile and a mean of seven appointments, starting the use of folic acid from the 7th to the 9th week of gestational age. However, when asked about the importance of folic acid and its action, almost the majority was not able to answer. CONCLUSION: Although daily acid supplementation is recommended in prenatal care, this study found that consumption is inadequate, contributing to the increased risk of fetal malformation. Healthcare professionals, especially nurses, should develop educational activities for women about the use of folic acid in the pre-gestation period and in the first pregnancy trimester.