Neurotoxicity of crack cocaine exposure: evidence from a systematic review of in vitro and in vivo studies.

Several studies suggest that crack cocaine users exhibit higher prevalence of both psychiatric and psychosocial problems, with an aggressive pattern of drug use. Nevertheless, few experimental studies attempted to verify the neurotoxicity after crack cocaine exposure, especially when compared with other routes of cocaine administration. This systematic review aimed to verify whether in vitro and/or in vivo crack cocaine exposure is more neurotoxic than cocaine exposure (snorted or injected). A search was performed in the PubMed, EMBASE, Scopus, Web of Science, and LILACS databases for in vitro and in vivo toxicological studies conducted with either rats or mice, with no distinction with regard to sex or age. Other methods including BioRxiv, BDTD, Academic Google, citation searching, and specialist consultation were also adopted. Two independent investigators screened the titles and abstracts of retrieved studies and subsequently performed full-text reading and data extraction. The quality of the included studies was assessed by the Toxicological data Reliability assessment Tool (ToxRTool). The study protocol was registered with the Prospective Registry of Systematic Reviews (PROSPERO; CRD42022332250). Of the twelve studies included, three were in vitro and nine were in vivo studies. According to the ToxRTool, most studies were considered reliable either with or without restrictions, with no one being considered as not reliable. The studies found neuroteratogenic effects, decreased threshold for epileptic seizures, schizophrenic-like symptoms, and cognitive deficits to be associated with crack cocaine exposure. Moreover, both in vitro and in vivo studies reported a worsening in cocaine neurotoxic effect caused by the anhydroecgonine methyl ester (AEME), a cocaine main pyrolysis product, which is in line with the more aggressive pattern of crack cocaine use. This systematic review suggests that crack cocaine exposure is more neurotoxic than other routes of cocaine administration. However, before the scarcity of studies on this topic, further toxicological studies are necessary.

High-frequency ultrasonography for subungual glomus tumor evaluation - imaging findings.

OBJECTIVE: This article aimed to describe the common imaging features of subungual glomus tumors. METHODS: The study involved data collected between January 2019 and December 2022. Twenty-three patients with a total of 31 glomus tumors underwent high-frequency ultrasound examinations with a 24-MHz probe. Two experienced radiologists independently evaluated the images, and only data from the more experienced radiologist were used for subsequent analyses. RESULTS: The average size of the tumors was 4.6 mm, and most of them appeared homogeneously hypoechogenic (90.3%). Bone remodeling of the distal phalanx was observed in 87.1% of cases, with an average axial circumference loss of 0.8 mm, indicating the slow and expansive growth of glomus tumors. Intense vascularization was found in 54.8% of cases on Doppler images, and the stalk sign, reflecting the vascular origin of the tumor, was present in 64.5% of cases. The most common clinical feature was pain, reported in 84.6% of cases, with a mean pain scale score of 7.0, indicating a negative impact on patients' lives despite being benign tumors. CONCLUSION: The study concludes that ultrasound evaluation is highly useful for diagnosing glomus tumors, especially when multiple findings, such as bone remodeling, hypervascularization, and the stalk sign, are present. This method allows for accurate diagnosis, observation of periungual structures, and proper surgical planning, ultimately reducing recurrence rates.

Imaging features for the evaluation of skin and nail infections.

Clinical manifestations of dermatological and musculoskeletal conditions can sometimes overlap, leading to confusion in diagnosis. Patients with nail and skin infections may undergo imaging examinations with suspicions of muscle, tendon, or joint injuries. Dermatological infections often involve soft tissues and musculoskeletal structures, and their etiology can range from fungi, bacteria, viruses, to protozoa. Relying solely on physical examination may not be sufficient for accurate diagnosis and treatment planning, necessitating the use of complementary imaging exams. The objective of this paper is to present and discuss imaging findings of the main infectious conditions affecting the nail apparatus and skin. The paper also highlights the importance of imaging in clarifying diagnostic uncertainties and guiding appropriate treatment for dermatological conditions.

Biomodelling and 3D technologies: A novel technique for subungual glomus tumor evaluation.

Subungual glomus tumors often remain undiagnosed for several years with patients seeing an average of 2.5 dermatologists before the diagnosis is confirmed. We describe the use of biomodelling and 3D technologies that allows the detection of tumoral recurrences more easily, as well as providing supplementary information for the radiologist report, such as select anatomical structure analysis, images with 360° rotation and visualization in transparency mode for detailed anatomic analysis.

Nutritional counselling in adults promoting adherence to the Mediterranean diet as adjuvant in the treatment of major depressive disorder (INDEPT): a randomized open controlled trial study protocol.

BACKGROUND: Major Depressive Disorder (MDD) is a leading cause of disability worldwide. Approximately one-third of patients with MDD do not respond to treatment, and often exhibit elevated inflammation biomarkers, which are associated with worse prognosis. Previous research has linked healthier dietary patterns, such as the Mediterranean Diet (MedDiet), with a lower risk of MDD and symptoms of depression, potentially due to their anti-inflammatory properties. The aim of this study is to evaluate the effectiveness of a nutritional counselling intervention promoting MedDiet to alleviate symptoms of depression in adults recently diagnosed with MDD and presenting with elevated inflammation biomarkers. METHODS: This study is a randomized controlled trial (RCT) that will recruit adults from outpatient clinics, between the ages of 18 and 70 years who have been diagnosed with MDD and are currently receiving treatment with the first prescribed antidepressant, and who exhibit elevated inflammation biomarkers (interleukin-6 and/or C-reactive protein). The control group will receive treatment-as-usual (TAU) only. The primary outcome of the study will be the change in symptoms of depression, as measured by the Beck Depression Inventory 2 (BDI-II), after 12 weeks of intervention. Data analysis will follow an intention-to-treat approach. Secondary outcomes will include changes in inflammation biomarkers, quality of life, adherence to the MedDiet, and cost-effectiveness of nutritional counselling. All outcomes will be assessed at baseline, after the 12-week intervention, and at 6- and 12-months post-baseline. DISCUSSION: This study will be the first RCT to evaluate the effect of a nutritional intervention with anti-inflammatory properties, as an adjuvant in the treatment of MDD, in individuals diagnosed with MDD and elevated inflammation biomarkers. The results of this study may contribute to the development of more effective and personalized interventions for MDD patients with elevated inflammation biomarkers.

Omics data reveals the phenolic fingerprint of Brazilian whole wheat flours of different technological qualities.

Common wheat (Triticum aestivum) is one of the most consumed staple foods used for bakery products. Outer layers of grain present a great diversity of bioactive compounds, especially phenolic compounds (PC). Free and bound PC were extracted from eight genotypes of whole wheat flours (WWF) presenting different technological classifications. These extracts were comprehensively characterized through untargeted metabolomics applying ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MSE) and spectrophotometric analyses. Chemical composition and colorimetry were also determined by classical analyses. Thirty-eight PC were tentatively identified by UHPLC-MSE belonging to three classes (phenolic acids, flavonoids, and other polyphenols), some of them identified in all WWF samples. Bound hydroxycinnamic acids were the main PC found in WWF, especially the trans-ferulic acid and its isomer. No difference was found in starch and protein contents, whereas low-quality flours showed a higher ash content than the superior and medium-quality flours. Total phenolic content (TPC) ranged between 124.5 and 171.4 mg GAE/100 g WWF, which bound PC were responsible for 60% of TPC. Omics data and multivariate statistical analyses were successfully applied to discern the phenolic profile of WWF from different genotypes and technological qualities. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05665-8.

Anatomy and Diseases of the Greater Wings of the Sphenoid Bone.

The greater wings of the sphenoid bone (GWS) comprise the components of the sphenoid bone that make up most of the posterior orbital wall and form the anterior and medial parts of the floor of the middle cranial fossa. Many important skull base foramina, which transmit vital neurovascular structures, are present in these paired wings on either side of the central body of the sphenoid bone. A wide variety of diseases can affect the GWS, ranging from benign osseus lesions to malignant primary and secondary bone abnormalities. The complex three-dimensional curved (winged) shape of the GWS and the wide array of pathologic entities that affect this bone can make it challenging for the radiologist to report the imaging findings accurately, especially in relation to the important skull base foramina. The authors describe a systematic approach to understanding the three-dimensional anatomy of the GWS and review important diseases, with the aid of imaging examples. Useful imaging "pearls" that can help in making specific diagnoses are provided throughout the article. ©RSNA, 2022.

Relationship between Phase Angle and Objective and Subjective Indicators of Nutritional Status in Cancer Patients: A Systematic Review.

To investigate the relationship between phase angle (PA) and objective and subjective indicators of nutritional status in cancer patients, as well as to identify cutoff points for PA, to detect malnutrition in these patients. The study was a systematic review, carried out following the guidelines of the Preferred Reporting Items for Systematic Reviews and meta-analyses (PRISMA). Literature search was performed for two authors, in indexed databases, including the National Library of Medicine, Bethesda, MD (PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), and Scopus (Elsevier). We used the checklist from the Joanna Briggs Institute for assessing the risk of bias. The review was registered with the Systematic Review Registration (PROSPERO), number CRD42020134324. In total, nine papers were eligible. PA was correlated with several objective and subjective indicators of nutritional status in most cases. Cutoff point values for the PA, capable of detecting malnutrition, varied from 4.73° to 6°, despite the modest diagnostic accuracy. We assume that PA may be considered an indicator of nutritional status, when complementing additional data and assisting health practitioners in evaluating individuals with malignant neoplasms. However, a single cutoff point with fair and concomitant sensitivity and specificity was not identified.

Risk factors for sick leave in Brazilian oil industry workers.

OBJECTIVE: Studies point to a complex and multifactorial aetiology for sickness absence, but there is still insufficient evidence on how occupational and non-occupational risk factors contribute to this phenomenon. This study aimed to identify occupational and non-occupational factors related to sickness absence in oil industry workers, as well as their population attributable fractions (PAF). METHODS: A retrospective cohort study of 2028 oil industry workers was conducted in the state of Bahia, Brazil, between January 1, 2012 and December 31, 2016. Study data were obtained from workers´ medical register. The dependent variable was the first event of sick leave for five or more days, and the independent variables were gender, age, years of work, type of work activity, level of education, work schedule, awkward working postures, body mass index, smoking, physical activity and alcohol consumption. Cox regression analysis identified risk factors to the outcome and PAF were calculated. RESULTS: Being female (HR 1.79), being older (HR 1.44), non-graduated ones (HR 1.44), being of operational staff (HR 1.18), overweight (HR 1.13), obesity (HR 1.39), smoking (HR 1.61) and former smoking (HR 1.30) were risk factors for sickness absence in this cohort. Of all sickness absence in the study population, 6% could be attributed to overweight, 10% to obesity, and 8% to smoking. CONCLUSION: To prevent sick leave, we recommend programs focused on combating smoking and encouraging healthy habits, aiming at weight control and the prevention of chronic diseases. Population attributable fractions point that a universal approach, aimed at the total population will be more cost-effective than health promotion programmes restricted for high-risk populations.

Discordance between human sperm quality and telomere length following differential gradient separation/swim-up.

BACKGROUND: Strong evidence has suggested an important role of telomeres in meiosis, fertilization, and embryo development. PURPOSE: To determine if sperm telomere length (STL) in sperm purified by differential gradient centrifugation followed by swim-up (selected STL) is correlated with sperm quality and clinical outcomes. METHODS: Relative selected STL was assessed by quantitative polymerase chain reaction (Q-PCR) in 78 consecutive assisted reproductive technology (ART) treatments during 2017. Statistical analyses were performed in the totality of patients, and in normozoospermic and non-normozoospermic patients. These included correlations between selected STL and sperm quality parameters, embryological parameters (multivariable linear regression), and clinical parameters (multivariable logistic regression). RESULTS: No significant correlations were found between selected STL and sperm quality in the total population. However, selected STL was significantly correlated with total sperm count (r = 0.361; P = 0.039) and sperm DNA fragmentation-post-acrosomal region pattern (r = - 0.464; P = 0.030) in normozoospermic patients. No relation was observed between selected STL and clinical outcomes in any clinical group. CONCLUSIONS: As the correlations observed in normozoospermic patients were not representative of the whole heterogeneous population, differences in the sperm characteristics of the study population may lead to discrepant results when evaluating the association of STL with sperm quality. Since the total population selected STL was not related with sperm quality and with clinical outcomes, results do not support the use of selected STL measurement to evaluate the reproductive potential of the male patient or to predict the success rates of ART treatments.

In vitro human cord blood platelet lysate characterisation with potential application in wound healing.

Platelets contain abundant growth factors and cytokines that have a positive influence on the migration and proliferation of different cell types by modulating its physiopathological processes. As it is known that human umbilical cord blood platelet lysate (UCB-PL) contains a supraphysiological concentration of growth factors, in the present study, we investigated its effectiveness in wound-healing processes. Human UCB-PL was obtained by the freeze/thaw of platelet concentrate (1.1 × 109 platelets/L), and its effect was evaluated on human or mouse endothelial cells, monocytes, fibroblasts, and keratinocytes in different concentrations. Human UCB-PL was observed to have high levels of pro-angiogenic growth factor than peripheral blood platelet-rich plasma. Among the cell lines, different concentrations of human UCB-PL were necessary to influence their viability and proliferation. For L929 cells, 5% of total volume was necessary, while for human umbilical vein endothelial cell, it was 10%. Cell migration on monocytes was increased with respect to the positive control, and scratch closure on keratinocytes was increased with respect to serum-free medium with only 10% of human UCB-PL. We concluded that the human UCB-PL may be useful to produce a large amount of standard platelet concentrates sufficient for several clinical-scale expansions avoiding inter-individual variability, which can also be used as a functional tool for clinical regenerative application for wound healing.

Facilitating the Delivery of Cognitive Remediation in First-Episode Psychosis: Pilot Study of a Home-Delivered Web-Based Intervention.

We explored the adherence to a home-delivered, computer-based, cognitive remediation protocol in a first-episode psychosis outpatient cohort. Seventeen patients underwent a cognitive training protocol for 6 months using an online platform accessible from their home under the supervision of a qualified neuropsychologist. Neuropsychological, psychopathological, and functional data were collected at baseline and postintervention, whereas qualitative appraisal of the intervention was assessed monthly. Overall, participants' evaluation of the program was positive. This was reflected in a good adherence rate with 12 (70%) of 17 patients completing 80% of the prescribed sessions. Exploratory analysis revealed significant improvements in sustained attention (p = 0.020) and verbal memory (p = 0.018). A decrease in negative symptoms and an improvement on the Clinical Global Impression were also found (p = 0.009). We believe these are encouraging results to further explore the adopted delivery approach, which could facilitate access to cognitive training earlier and to a larger group of patients.

Orthorexia nervosa in a sample of Portuguese fitness participants.

PURPOSE: Orthorexia Nervosa (ON) is described as an obsessive behaviour motivated by great concern for following a healthy diet. Although it was first described in 1997, ON remains inconspicuous and poorly characterized in the literature. The aims of this study were to evaluate the prevalence of ON in a sample of ambulatory individuals and to investigate their common characteristics, attempting to better characterize this entity. METHODS: A non-random sample of 193 adult gym members answered a questionnaire based on a Portuguese version of ORTO-15, supplemented with additional questions. Possible associations between the different variables and pathological scores on ORTO-15 were analysed using logistic regression models. RESULTS: ON behaviour was documented in 51.8% of the sample, mean age 30.96 years (± 1.03 years), and this condition tended to be correlated with younger ages. Physical appearance and frequent exercising were also associated with ON, while no correlation between orthorexic tendencies and both gender and educational field was found. Furthermore, consumption of special food, dissatisfaction with physical appearance and frequent exercising could predict the presence of ON in the sample. CONCLUSIONS: Despite the use of a convenience sample, results place us in a different perspective, considering the idea that orthorexic individuals are exclusively concerned about pursuing a pure diet. The presence of ON was associated with other non-dietary behaviours allied to a healthy lifestyle and aesthetic concerns. LEVEL OF EVIDENCE: Level V: Descriptive study.

New Onset Diabetes and Non-Alcoholic Fatty Liver Disease after Liver Transplantation.

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is an emerging cause of graft dysfunction after liver transplantation (LT) frequently related to the development of new onset diabetes after LT (NODAT). This study was undertaken to evaluate the frequencies of NODAT and NAFLD after LT, to investigate their major risk factors and the impact of de novo or recurrent NAFLD in graft function. MATERIAL AND METHODS: 119 patients submitted to LT were prospectively evaluated. RESULTS: After 4 ± 1 years, NODAT, recurrent and de novo NAFLD were observed in 31%, 56% and 43% of the subjects, respectively. Only 3 patients had non-alcoholic steatohepatitis (NASH) without fibrosis. Other risk factors for NAFLD such as arterial hypertension (AHT), metabolic syndrome (MS), hypertriglyceridemia and obesity were seen in 51%, 50%, 35% and 24% of the subjects, respectively. In addition, insulin resistance (IR), assessed by HOMA-IR and ß-cell dysfunction, determined by HOMA-ß, were observed in 16% and 94% of the patients, respectively. Occurrence of NODAT was associated with male gender, higher waist circumference, higher HOMA-IR and lower HOMA-ß values. No correlation was found between NAFLD and NODAT, MS, hypertriglyceridemia, obesity and HOMAIR and HOMA-ß levels. CONCLUSIONS: NODAT, recurrent and de novo NAFLD are common after LT but are not associated with signs of graft dysfunction, possibly due to the low frequency of IR and NASH. No correlation is observed between NAFLD and NODAT, MS, hypertriglyceridemia, obesity and IR. ß-cell dysfunction and diabetes, however, are seen in most of the patients, possibly due to calcineurin inhibitor toxicity.

Antimicrobial and Antiproliferative Activity of Bauhinia forficata Link and Cnidoscolus quercifolius Extracts commonly Used in Folk Medicine.

BACKGROUND: Bauhinia forficata and Cnidoscolus quercifolius plants are commonly used in folk medicine. However, few studies have investigated their therapeutic potential. AIM: Herein, we evaluated the antimicrobial activity of B. forficata and C. quercifolius extracts against microorganisms of clinical relevance and their antiproliferative potential against tumor cells. MATERIALS AND METHODS: The following tests were performed: Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)/minimum fungicidal concentration (MFC), inhibition of biofilm adhesion, and effects on cell morphology. Antiproliferative tests were carried out with human keratinocytes and six tumor lines. RESULTS: Bauhinia forficata showed antimicrobial activity only against C. albicans with MIC of 15.62 ug/mL and MFC higher than 2000 ug/mL. It also inhibited biofilm adhesion and caused alterations in cell morphology. Cnidoscolus quercifolius showed no significant activity (MIC > 2.0 mg/mL) against the strains. Bauhinia forficata and C. quercifolius extracts showed cytostatic activity against the tumor cells. CONCLUSION: Bauhinia forficata has promising anti-Cand/da activity and should be further investigated for its therapeutic potential. CLINICAL SIGNIFICANCE: The use of medicinal plants in the treatment of infectious processes has an important function nowadays, due to the limitations of the use of synthetic antibiotics available, related specifically to the microbial resistance emergence.

Validation of the Portuguese version of the Psychotic Symptom Rating Scales (PSYRATS).

The Psychotic Symptom Rating Scales (PSYRATS) is a clinical assessment tool that focuses on the detailed measurement of delusions and hallucinations in patients with psychosis. The goal of this study was to examine the psychometric properties of the Portuguese version of the PSYRATS. A sample of 92 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms was assessed using the PSYRATS and the Positive and Negative Syndrome Scale (PANSS). Good inter-rater reliability, test-retest reliability, concurrent validity and internal consistency were found. Factor analysis of the auditory hallucinations scale items disclosed a four-factor solution: emotion characteristics and disruption factor (factor 1), a physical characteristics factor (factor 2), a control characteristics factor (factor 3) and a cognitive attribution factor (factor 4). Regarding the delusions scale items, a two-factor solution was found: cognitive interpretation and disruption factor (factor 1) and an emotional characteristics (factor 2). The Portuguese version of the PSYRATS partially replicates previously published results in other countries.