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1.
Artículo en Inglés | MEDLINE | ID: mdl-39079061

RESUMEN

BACKGROUND: Social and economic factors, such as food insecurity, contribute to long coronavirus disease (COVID). During the pandemic, a significant rise in food insecurity was observed, both in Brazil and worldwide. We aimed to investigate the association between food insecurity and long COVID in Brazilian adults. METHODS: Cross-sectional study nested within the Prospective study About Mental and Physical Health in Adults (PAMPA) Cohort. Participants completed an online questionnaire in June 2022. We assessed food insecurity using the Brazilian Scale of Food Insecurity. Long COVID was defined as any post-coronavirus disease 2019 symptoms that persisted for at least 3 months after infection. RESULTS: A total of 956 participants were included (74.0% female, median age 36 (Interquartile Range [IQR] (29-45.7). The prevalence of food insecurity was 29.4%, and 77.8% had long COVID. Food insecurity was associated with an increased probability of long COVID (prevalence ratio [PR]: 1.15, 95% confidence interval [CI]: 1.08-1.22). Participants in food insecurity situations had a higher likelihood of experiencing neurological (PR: 1.19, 95% CI: 1.10-1.28), pulmonary (PR: 1.33, 95% CI: 1.17-1.52) and gastrointestinal (PR: 1.57, 95% CI: 1.31-1.88) symptoms after infection. CONCLUSIONS: Food insecurity was associated with long COVID. Governments must plan public policies to mitigate the effects of long COVID and food insecurity.

2.
Appetite ; 202: 107626, 2024 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-39127348

RESUMEN

In the transition period from breastfeeding to the introduction of complementary feeding, the choice of food is extremely important for the child's development as many factors may be related. This study aims to investigate, through a systematic review and qualitative meta-synthesis, influence in the selection of foods in the introduction of complementary foods for children, including qualitative studies without language or publication period restrictions. Searches were performed in PubMed, LILACS, SciELO, Cinahl, Embase, Web of Science, and Scopus. Initially, 12,489 articles were selected for tittle reading, 13 were included in the review. Four analytical themes related to factors influencing complementary feeding were identified: family socioeconomic conditions, cultural and family aspects, guidance and advice from health professionals, and factors inherent to the infant. Economic factors, such as the opportunity to offer foods not consumed during the parents' childhood, were emphasized. The influence of grandmothers' opinions and community beliefs and traditions were considered. Trust in pediatricians and community health agents' advice, although considered, conflicted with cultural and family traditions. Mothers/caregivers often preferred to offer foods the child shows preference for, rather than introducing new flavors. The findings underscore the need for a better understanding of qualitative aspects.


Asunto(s)
Lactancia Materna , Preferencias Alimentarias , Fenómenos Fisiológicos Nutricionales del Lactante , Femenino , Humanos , Lactante , Lactancia Materna/psicología , Conducta de Elección , Preferencias Alimentarias/psicología , Alimentos Infantiles , Madres/psicología , Investigación Cualitativa , Factores Socioeconómicos
3.
Eur Spine J ; 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38775819

RESUMEN

OBJECTIVE: We aimed to prospectively evaluate the association between leisure-time physical activity and outcomes related to low back pain (LBP), such as pain intensity and daily activity limitation. METHODS: We analyzed data from the PAMPA (Prospective Study about Mental and Physical Health) cohort, a longitudinal study with adults residing in Southern Brazil. Participants answered an online-based, self-administered questionnaire. Physical activity was assessed as minutes per week, and those who reported engaging in 150 min/week or more were considered active. We also assessed the types of activities participants engaged. Pain intensity was assessed with a numeric pain rating scale (from 0 to 10), and participants reported whether their pain restricted their daily activities. Generalized linear models were used to investigate the association between physical activity and LBP outcomes. RESULTS: Data from 991 individuals (82.7% women) aged 38.9 ± 13.9 were analyzed. Pain intensity was higher in those inactive in waves one (ß: 0.54; 95 % CI 0.23, 0.86), three (ß: 0.38; 95% CI 0.02, 0.75), and four (ß: 0.48; 95% CI 0.06, 0.90). Also, being physically inactive at wave one was associated with a higher probability of daily activity limitation at waves two (IRR 1.77; 95% CI 1.27; 2.46), three (IRR 1.63; 95% CI 1.17, 2.29), and four (IRR 1.73; 95% CI 1.20, 2.50). CONCLUSION: Not practicing at least 150 min/week of physical activity resulted in higher levels of pain and an increased risk of daily activity limitation in individuals with LBP. Moreover, various forms of activities have shown to be advantageous in alleviating pain among this group.

4.
Dent Traumatol ; 2024 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-38641923

RESUMEN

Dental traumas in sports are common and have physical, social, psychological, and economic impacts. The aim of this study was to determine, through a systematic review, the prevalence of dental trauma in contact and non-contact sports. This review was submitted to PROSPERO (CRD42023421206). Included studies addressed the prevalence of dental trauma in young athletes and adults above 18 years, excluding reviews, editorials, symposiums, or those evaluating athletes under 18 years. A literature search was conducted using the databases PubMed, Web of Science, Scopus, Embase, LIVIVO, SPORTDiscus, Dentistry & Oral Sciences Source (via EBSCO), and Lilacs and BBO, as well as gray literature. Bias risk was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist. Data were synthesized considering study characteristics, population, sport, and outcomes. R Statistics software was used for all meta-analyses. A total of 1707 articles were identified. After applying eligibility criteria, eight were selected. Three studies, not previously observed, were later added after reading four systematic reviews on a similar topic. Fourteen contact sports and five non-contact sports were analyzed. The prevalence of dental trauma was 11.38% in contact sports and 5.24% in non-contact sports. Regardless of the type of sport, athletes face risks of dental trauma, with contact sports showing higher prevalence. The use of mouthguards is essential across all contact and non-contact sports as a preventive measure.

5.
Microb Pathog ; 181: 106171, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37244490

RESUMEN

Urinary tract infections (UTIs) are common human infections that compromise women's health around the world, even though they can affect men and women of all ages. Bacterial species are the primary causative agents of UTIs, while Staphylococcus saprophyticus, a gram-positive bacterium, is especially important for uncomplicated infections in young women. Despite the number of antigenic proteins identified in Staphylococcus aureus and other bacteria of the genus, there is no immunoproteomic study in S. saprophyticus. In this context, since pathogenic microorganisms secrete important proteins that interact with hosts during infection, the present work aims to identify the exoantigens from S. saprophyticus ATCC 15305 by immunoproteomic and immunoinformatic approaches. We identified 32 antigens on the exoproteome of S. saprophyticus ATCC 15305 by immunoinformatic tools. By using 2D-IB immunoproteomic analysis, it was possible to identify 3 antigenic proteins: transglycosylase IsaA, enolase and the secretory antigen Q49ZL8. In addition, 5 antigenic proteins were detected by immunoprecipitation (IP) approach, where the most abundant were bifunctional autolysin and transglycosylase IsaA proteins. The transglycosylase IsaA was the only protein detected by all the tools approaches used in this study. In this work it was possible to describe a total of 36 S. saprophyticus exoantigens. Immunoinformatic analysis allowed the identification of 5 exclusive linear B cell epitopes from S. saprophyticus and 5 epitopes presenting homology with other bacteria that cause UTIs. This work describes, for the first time, the profile of exoantigens secreted by S. saprophyticus and can contribute to the identification of new diagnostic targets of UTIs, as well as to develop vaccines and immunotherapies against bacterial urinary infections.


Asunto(s)
Infecciones Estafilocócicas , Infecciones Urinarias , Masculino , Humanos , Femenino , Staphylococcus saprophyticus , Epítopos , Infecciones Estafilocócicas/microbiología , Infecciones Urinarias/microbiología , Staphylococcus aureus
6.
J Clin Psychopharmacol ; 43(4): 339-349, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37335211

RESUMEN

BACKGROUND: Serotonergic hallucinogens and cannabinoids may alter the recognition of emotions in facial expressions (REFE). Cannabidiol (CBD) attenuates the psychoactive effects of the cannabinoid-1 agonist tetrahydrocannabinol. Ayahuasca is a dimethyltryptamine-containing hallucinogenic decoction. It is unknown if CBD may moderate and attenuate the effects of ayahuasca on REFE. PROCEDURES: Seventeen healthy volunteers participated in a 1-week preliminary parallel-arm, randomized controlled trial for 18 months. Volunteers received a placebo or 600 mg of oral CBD followed by oral ayahuasca (1 mL/kg) 90 minutes later. Primary outcomes included REFE and empathy tasks (coprimary outcome). Tasks were performed at baseline and 6.5 hours, 1 and 7 days after the interventions. Secondary outcome measures included subjective effects, tolerability, and biochemical assessments. RESULTS: Significant reductions (all P values <0.05) only in reaction times were observed in the 2 tasks in both groups, without between-group differences. Furthermore, significant reductions in anxiety, sedation, cognitive deterioration, and discomfort were observed in both groups, without between-group differences. Ayahuasca, with or without CBD, was well tolerated, producing mainly nausea and gastrointestinal discomfort. No clinically significant effects were observed on cardiovascular measurements and liver enzymes. CONCLUSIONS: There was no evidence of interactive effects between ayahuasca and CBD. The safety of separate and concomitant drug intake suggests that both drugs could be applied to clinical populations with anxiety disorders and in further trials with larger samples to confirm findings.


Asunto(s)
Banisteriopsis , Cannabidiol , Humanos , Cannabidiol/efectos adversos , Cognición Social , Estudios de Factibilidad , Dronabinol/farmacología , Agonistas de Receptores de Cannabinoides , Método Doble Ciego
7.
Eur Arch Psychiatry Clin Neurosci ; 273(7): 1527-1542, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36947216

RESUMEN

Ibogaine is a psychoactive alkaloid derived from the west-African shrub Tabernanthe iboga. Western cultures are increasing the interest for the substance due to its claimed anti addictive properties, although the evidence supporting this effect is still preliminary. The use of ibogaine often occurs with no medical supervision in uncontrolled settings, and its use has been associated with several reports of severe adverse events. This review aims to evaluate the clinical studies of ibogaine, with a focus on administration settings, to elucidate specific criteria that may promote safer contexts for ibogaine use. A systematic review of the literature was conducted based on PRISMA guidelines. PubMed, Scielo, ClinicalTrials.gov and Core.ac.uk electronic databases were searched, and clinical studies published until November 17, 2022, were retrieved. The final synthesis included 12 sources. Information about general characteristics of the studies, adverse effects, screening of participants and setting characteristics were summarized and discussed. It is concluded that the use of controlled settings, supported by trained professionals and equipment allowing for rigorous medical, psychiatric, and cardiac monitoring, are essential to promote the safety of patients receiving ibogaine.


Asunto(s)
Conducta Adictiva , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Ibogaína , Humanos , Ibogaína/efectos adversos
8.
BMC Public Health ; 23(1): 1101, 2023 06 07.
Artículo en Inglés | MEDLINE | ID: mdl-37286989

RESUMEN

Health counseling is a prevention and health promotion action, especially in the context of a pandemic, for both preventing disease and maintaining health. Inequalities may affect receipt of health counseling. The aim was to provide an overview of the prevalence of receiving counseling and to analyze income inequality in the receipt of health counseling. METHODS: This was a cross-sectional telephone survey study with individuals aged 18 years or older with diagnosis of symptomatic COVID-19 using RT-PCR testing between December 2020 and March 2021. They were asked about receipt of health counseling. Inequalities were assessed using the Slope Index of Inequality (SII) and Concentration Index (CIX) measures. We used the Chi-square test to assess the distribution of outcomes according to income. Adjusted analyses were performed using Poisson regression with robust variance adjustment. RESULTS: A total of 2919 individuals were interviewed. Low prevalence of health counseling by healthcare practitioner was found. Participants with higher incomes were 30% more likely to receive more counseling. CONCLUSIONS: These results serve as a basis for aggregating public health promotion policies, in addition to reinforcing health counseling as a multidisciplinary team mission to promote greater health equity.


Asunto(s)
COVID-19 , Equidad en Salud , Adulto , Humanos , Brasil/epidemiología , COVID-19/epidemiología , Estudios Transversales , Disparidades en el Estado de Salud , Prevalencia , Factores Socioeconómicos , Adolescente
9.
Caries Res ; 57(2): 95-105, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36858032

RESUMEN

The objective of this systematic review was to analyze the quality of the food frequency instruments/scales used in dentistry while considering their psychometric properties. The databases consulted were PubMed (August 7, 2020), Scopus (August 27, 2020), Web of Science (August 27, 2020), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Dentistry and Oral Sciences Source (via EBSCO) (August 28, 2020), LILACS and BBO (August 25, 2020), gray literature: Proquest (October 1, 2020), Capes Theses Bank (October 1, 2020), Brazilian Digital Library of Theses and Dissertations (October 1, 2020), Google Scholar (October 2, 2020), and proceedings of the International Association for Dental Research (IADR) (October 10, 2020). All databases were updated on December 12, 2022. Articles were initially selected by reading the 6,421 titles and 13 abstracts selected, followed by reading the 8 articles included for full text reading to confirm the eligibility criteria, with the aid of Rayyan software. Databases of the construction and/or validation of instruments/scales for assessing food consumption for use in dentistry (in clinical contexts and/or epidemiological studies), with or without assessment of their psychometric properties, were included. Review studies, letters to editors, and research protocols were excluded. Risk of bias assessment was performed according to the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. The extracted data were author, country, instrument language, sample, assessment instrument, instrument structure, type of food, instruments compared with the clinical condition, adaptation of an existing instrument, and psychometric properties evaluated. The selection, risk of bias analysis, and data extraction processes were performed by two independent evaluators. Seven studies were identified. The instruments available in the literature were in English, Japanese, Creole, and Malay. Only one study performed translation and cross-cultural validation of an instrument, whereas the others were construction studies. One study did not assess psychometric properties. Regarding the quality assessment and general classification of the studies by the COSMIN checklist, all were considered "inadequate," with reliability (test-retest) being the most validated psychometric property; only one study carried out the validation of all psychometric properties measured in COSMIN. Regarding the quality of the instruments presented, all the studies were classified as "inadequate" in the general assessment. Advances are needed in the validation process.


Asunto(s)
Odontología , Humanos , Reproducibilidad de los Resultados , Psicometría/métodos , PubMed , Encuestas y Cuestionarios
10.
BMC Health Serv Res ; 23(1): 542, 2023 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-37231427

RESUMEN

BACKGROUND: Evidence on inequalities in the health services use is important for public policy formulation, even more so in a pandemic context. The aim of this study was to evaluate socioeconomic inequities in the specialized health use services according to health insurance and income, following COVID-19 in individuals residing in Southern Brazil. METHODS: This was a cross-sectional telephone survey with individuals aged 18 years or older diagnosed with symptomatic COVID-19 using the RT-PCR test between December 2020 and March 2021. Questions were asked about attendance at a health care facility following COVID-19, the facilities used, health insurance and income. Inequalities were assessed by the following measures: Slope Index of Inequality (SII) and Concentration Index (CIX). Adjusted analyses were performed using Poisson regression with robust variance adjustment using the Stata 16.1 statistical package. RESULTS: 2,919 people (76.4% of those eligible) were interviewed. Of these, 24.7% (95%CI 23.2; 36.3) used at least one specialized health service and 20.3% (95%CI 18.9; 21.8) had at least one consultation with specialist doctors after diagnosis of COVID-19. Individuals with health insurance were more likely to use specialized services. The probability of using specialized services was up to three times higher among the richest compared to the poorest. CONCLUSIONS: There are socioeconomic inequalities in the specialized services use by individuals following COVID-19 in the far south of Brazil. It is necessary to reduce the difficulty in accessing and using specialized services and to extrapolate the logic that purchasing power transposes health needs. The strengthening of the public health system is essential to guarantee the population's right to health.


Asunto(s)
COVID-19 , Disparidades en Atención de Salud , Humanos , Factores Socioeconómicos , Brasil/epidemiología , Estudios Transversales , COVID-19/epidemiología , Servicios de Salud
11.
BMC Musculoskelet Disord ; 24(1): 685, 2023 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-37644443

RESUMEN

BACKGROUND: The COVID-19 pandemic necessitated the reorganization of health services to cater to the needs of individuals affected by the virus. OBJECTIVE: This study aimed to examine the association between musculoskeletal pain during and after SARS-CoV-2 infection and the utilization of health services among adults in southern Brazil.  METHODS: A cross-sectional study was conducted with individuals aged 18 years and older, who were diagnosed with COVID-19 between December 2020 and March 2021. Questionnaires were electronically collected using tablets through the REDCap platform via phone calls. The health service utilization outcomes assessed included Primary Health Care, general practitioners, private emergency care, and specialized services. The exposure variable was the presence of musculoskeletal pain during and after SARS-CoV-2 infection in different regions, such as cervical, upper limbs, thoracic, lumbar, and lower limbs. Poisson regression analysis was employed to assess the relationship between health service utilization during and after SARS-CoV-2 infection and musculoskeletal pain during and after the infection with SARS-CoV-2 among adults in southern Brazil. Data were analyzed using the Stata 16.1 statistical package.  RESULTS: A total of 2,919 individuals were interviewed. Overall, individuals with musculoskeletal pain were found to utilize health services approximately 15 percentage points higher when compared to those without musculoskeletal pain. In adjusted analysis, individuals who reported musculoskeletal pain during and after SARS-CoV-2 infection were up to twice as likely to use health services. Among them, the emergency care unit was the most frequently used service, particularly in those with pain in the lower limbs (RP=2.19, 95% CI 1.66-2.87) and thoracic region (RP=2.04, 95% CI 1.47-2.84). Notably, the highest magnitudes of association were observed with emergency care units, specialist doctors, and specialized services, especially neurologists, who were two to three times more likely to be sought, followed by pulmonologists.  CONCLUSION: Health service utilization was significantly associated with musculoskeletal pain during and after SARS-CoV-2 infection. All regions, except for the cervical region, showed a correlation with the use of Primary Health Care. The thoracic region featured an association with pulmonologists and emergency room utilization. Additionally, health services like emergency care units, specialist doctors, and specialized services, including cardiologists and neurologists, were commonly utilized across all regions in southern Brazil.


Asunto(s)
COVID-19 , Dolor Musculoesquelético , Adulto , Humanos , Estudios Transversales , Dolor Musculoesquelético/diagnóstico , Dolor Musculoesquelético/epidemiología , Dolor Musculoesquelético/terapia , Pandemias , COVID-19/epidemiología , COVID-19/terapia , SARS-CoV-2 , Aceptación de la Atención de Salud
12.
Molecules ; 28(6)2023 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-36985814

RESUMEN

Leishmania infantum is the etiological agent of visceral leishmaniasis (VL) in South America, the Mediterranean basin, and West and Central Asia. The most affected country, Brazil, reported 4297 VL cases in 2017. L. infantum is transmitted by female phlebotomine sand flies during successive blood meals. There are no validated vaccines to prevent the infection and the treatment relies on drugs that often present severe side effects, which justify the efforts to find new antileishmanial drugs. Cinnamic acid derivatives have shown several pharmacological activities, including antiparasitic action. Therefore, in the present study, the biological evaluation of cinnamic acid and thirty-four derivatives against L. infantum is reported. The compounds were prepared by several synthesis methods and characterized by spectroscopic techniques and high-resolution mass spectrometry. The results revealed that compound 32 (N-(4-isopropylbenzyl)cinnamamide) was the most potent antileishmanial agent (IC50 = 33.71 µM) with the highest selectivity index (SI > 42.46), followed by compound 15 (piperonyl cinnamate) with an IC50 = 42.80 µM and SI > 32.86. Compound 32 was slightly less potent and nineteen times more selective for the parasite than amphotericin B (MIC = 3.14 uM; SI = 2.24). In the molecular docking study, the most likely target for the compound in L. infantum was aspartyl aminopeptidase, followed by aldehyde dehydrogenase, mitochondrial. The data obtained show the antileishmanial potential of this class of compounds and may be used in the search for new drug candidates against Leishmania species.


Asunto(s)
Antiprotozoarios , Leishmania infantum , Leishmaniasis Visceral , Femenino , Humanos , Simulación del Acoplamiento Molecular , Antiprotozoarios/química , Leishmaniasis Visceral/tratamiento farmacológico , Cinamatos/farmacología , Cinamatos/uso terapéutico , Brasil
13.
Molecules ; 28(3)2023 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-36771132

RESUMEN

Kinetoplastida is a group of flagellated protozoa characterized by the presence of a kinetoplast, a structure which is part of a large mitochondria and contains DNA. Parasites of this group include genera such as Leishmania, that cause disease in humans and animals, and Phytomonas, that are capable of infecting plants. Due to the lack of treatments, the low efficacy, or the high toxicity of the employed therapeutic agents there is a need to seek potential alternative treatments. In the present work, the antiparasitic activity on Leishmania infantum and Phytomonas davidi of 23 essential oils (EOs) from plants of the Lamiaceae and Asteraceae families, extracted by hydrodistillation (HD) at laboratory scale and steam distillation (SD) in a pilot plant, were evaluated. The chemical compositions of the EOs were determined by gas chromatography-mass spectrometry. Additionally, the cytotoxic activity on mammalian cells of the major components from the most active EOs was evaluated, and their anti-Phytomonas and anti-Leishmania effects analyzed. L. infantum was more sensitive to the EOs than P. davidi. The EOs with the best anti-kinetoplastid activity were S. montana, T. vulgaris, M. suaveolens, and L. luisieri. Steam distillation increased the linalyl acetate, ß-caryophyllene, and trans-α-necrodyl acetate contents of the EOs, and decreased the amount of borneol and 1,8 cineol. The major active components of the EOs were tested, with thymol being the strongest anti-Phytomonas compound followed by carvacrol. Our study identified potential treatments against kinetoplastids.


Asunto(s)
Aceites Volátiles , Plantas Medicinales , Trypanosomatina , Humanos , Animales , Aceites Volátiles/química , Vapor , Timol/análisis , Aceites de Plantas/química , Mamíferos
14.
Chembiochem ; 23(20): e202200166, 2022 10 19.
Artículo en Inglés | MEDLINE | ID: mdl-35843872

RESUMEN

BIA 10-2474 is a time-dependent inhibitor of fatty acid amide hydrolase (FAAH) that was under clinical development for the treatment of neurological conditions when the program was terminated after one subject died and four were hospitalized with neurological symptoms during a first-in-human clinical study. The present work describes the mechanism of FAAH inhibition by BIA 10-2474 as a target-specific covalent inhibition, supported by quantum mechanics and molecular modelling studies. The inhibitor incorporates a weakly reactive electrophile which, upon specific binding to the enzyme's active site, is positioned to react readily with the catalytic residues. The reactivity is enhanced on-site by the increased molarity at the reaction site and by specific inductive interactions with FAAH. In the second stage, the inhibitor reacts with the enzyme's catalytic nucleophile to form a covalent enzyme-inhibitor adduct. The hydrolysis of this adduct is shown to be unlikely under physiological conditions, therefore leading to irreversible inactivation of FAAH. The results also reveal the important role played by FAAH Thr236 in the reaction with BIA 10-2474, which is specific to FAAH and is not present in other serine hydrolases. It forms a hydrogen bond with the imidazole nitrogen of the inhibitor and helps lowering the activation free energy of the first step of the reaction, by pre-orienting and stabilizing the inhibitor in a near-reactive configuration. In the second step, Thr236 can also serve as a mechanistic alternative to protonate the leaving group.


Asunto(s)
Amidohidrolasas , Inhibidores Enzimáticos , Humanos , Amidohidrolasas/química , Inhibidores Enzimáticos/química , Serina/química , Imidazoles , Nitrógeno
16.
Eur Arch Psychiatry Clin Neurosci ; 272(4): 541-556, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33914164

RESUMEN

Ayahuasca is a hallucinogenic/psychedelic traditionally used for ritual and therapeutic purposes. One such therapeutic use is related to Substance Use Disorders (SUDs). A previous systematic review of preclinical and human studies published until 2016 suggested that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. To conduct an update of this previous review. A systematic review of quantitative studies which analyzed the effects of ayahuasca and its alkaloids on drug use (primary outcome) and other measures (secondary outcomes) related to SUDs was conducted, including articles from 2016 to 2020. Nine studies (four preclinical, five observational) were included in the review. Preclinical studies in rodents reported reductions in amphetamine self-administration and anxiety, and in alcohol- and methylphenidate-induced conditioned place preference. Observational studies among healthy ritual ayahuasca users and patients with SUDs reported reductions in drug use, anxiety, and depression, and increases in quality of life and well-being. We replicated the findings of the previous review suggesting that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. However, translation of preclinical data to humans is limited, observational studies do not allow us to infer causality, and there is a lack of standardization on ayahuasca doses. Although promising, randomized, controlled trials are needed to better elucidate these results. The PROSPERO ID for this study is CRD42020192046.


Asunto(s)
Alcaloides , Banisteriopsis , Alucinógenos , Trastornos Relacionados con Sustancias , Alcaloides/farmacología , Alcaloides/uso terapéutico , Alucinógenos/farmacología , Alucinógenos/uso terapéutico , Humanos , Calidad de Vida , Trastornos Relacionados con Sustancias/tratamiento farmacológico
17.
Hum Psychopharmacol ; 37(4): e2834, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35107855

RESUMEN

OBJECTIVE: To assess endocannabinoid (anandamide, AEA; 2-arachidonoylglycerol, 2-AG) plasma levels in healthy volunteers and in volunteers with social anxiety disorder (SAD) after a single oral dose of ayahuasca or placebo. METHODS: Post hoc analysis of endocannabinoid plasma levels (baseline, 90 and 240 min after drug intake) from two parallel-group, randomized, placebo-controlled trials. In Study 1, 20 healthy volunteers ingested ayahuasca (average 1.58 mg/ml dimethyltryptamine (DMT)) or placebo, and in Study 2, 17 volunteers with SAD received ayahuasca (average 0.680 mg/ml DMT) or placebo. RESULTS: A significant difference was observed in AEA concentrations in Study 2 after ayahuasca intake (Χ2 (2) = 6.5, p = 0.03, Friedman test), and near significant differences (increases) were observed between baseline and 90 (Z = 0, p = 0.06, Wilcoxon test) and 240 (Z = 10, p = 0.06) minutes after ayahuasca intake. CONCLUSIONS: Although our findings suggest that ayahuasca could modulate AEA levels in SAD patients, the high interindividual variability in both trials and the small samples preclude definitive conclusions. More research with larger samples is needed to better understand the effects of ayahuasca and other hallucinogens in the endocannabinoid system.


Asunto(s)
Banisteriopsis , Alucinógenos , Fobia Social , Endocannabinoides , Voluntarios Sanos , Humanos , N,N-Dimetiltriptamina/farmacología , Fobia Social/tratamiento farmacológico
18.
J Clin Psychopharmacol ; 41(3): 267-274, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33843820

RESUMEN

BACKGROUND: The recognition of emotions in facial expressions (REFE) is a core aspect of social cognition. Previous studies with the serotonergic hallucinogens lysergic acid diethylamide and psilocybin showed that these drugs reduced the recognition of negative (fear) faces in healthy volunteers. This trial assessed the acute and prolonged effects of a single dose of ayahuasca on the REFE. METHODS: Twenty-two healthy volunteers participated in a pilot, proof-of-concept, randomized trial. Study variables included a REFE task performed before and 4 hours after drug intake, subjective effects (self-reports/observer impressions), tolerability measures (cardiovascular measures, self-reports), and brain-derived neurotrophic factor plasma levels. The REFE task was applied again 1, 7, 14, and 21 days and 3 months after drug intake. Stability of ayahuasca alkaloids during the study was also assessed (room temperature, 18 months). FINDINGS: Compared with placebo, ayahuasca did not modify the REFE. No significant effects were observed on cardiovascular measures and brain-derived neurotrophic factor levels. Volunteers reported visual effects, tranquility/relaxation, and well-being, with few reports of transient anxiety/confusion. Ayahuasca was well tolerated, producing mainly nausea, gastrointestinal discomfort, and vomiting. A significant time-dependent deterioration of alkaloids was observed, especially for dimethyltryptamine. CONCLUSIONS: Absence of significant effects on the REFE task could be due to lack of effects of ayahuasca (at the doses used), alkaloid degradation, learning effects, and the high educational level of the sample. Further trials with different samples are needed to better understand the effects of ayahuasca and other serotonergic hallucinogens on the REFE. Future trials should improve methods to guarantee the stability of ayahuasca alkaloids.


Asunto(s)
Banisteriopsis/química , Reconocimiento Facial/efectos de los fármacos , Alucinógenos/farmacología , Preparaciones de Plantas/farmacología , Adulto , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Prueba de Estudio Conceptual , Factores de Tiempo , Adulto Joven
19.
J Clin Psychopharmacol ; 41(5): 540-550, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34166299

RESUMEN

BACKGROUND: Ayahuasca is a classic hallucinogen with anxiolytic and antidepressive properties. Anecdotal evidence also suggests that it improves performance (eg, singing, speech). This controlled trial assessed the effects of ayahuasca on speech performance and anxiety in individuals with social anxiety disorder. METHODS: Seventeen volunteers with social anxiety disorder participated in a pilot, proof-of-concept, randomized, parallel-group trial. Self-perception of performance during a public-speaking test was assessed with the Self-statements During Public Speaking Scale primary outcome). Secondary outcomes included anxiety/subjective effects (Visual Analog Mood Scale; Bodily Symptoms Scale), recognition of emotions in facial expressions (REFE), tolerability measures (cardiovascular measures, self-reports), and brain-derived neurotrophic factor plasma levels. Effects on anxiety and REFE were assessed again 7, 14, and 21 days postdrug. FINDINGS: Compared with placebo, ayahuasca significantly improved self-perception of speech performance (Self-statements During Public Speaking Scale) and increased somatic symptoms (Bodily Symptoms Scale). There was also a significant time × group interaction in the cognitive deterioration Visual Analog Mood Scale factor and a significant effect of time in the REFE task, especially in reaction time. Other measures were not significantly modified. Ayahuasca was well tolerated, producing mainly nausea, gastrointestinal discomfort, and vomiting. CONCLUSIONS: Ayahuasca improved self-perception of speech performance in socially anxious individuals. These effects occurred independent of task-related anxiety and REFE, suggesting that ayahuasca could specifically improve the cognitive aspect of speech performance. Further studies should try to unveil the mechanisms involved in the effects of ayahuasca and to better understand its effects on anxiety.


Asunto(s)
Ansiolíticos/uso terapéutico , Banisteriopsis , Fobia Social/tratamiento farmacológico , Autoimagen , Habla , Adulto , Ansiolíticos/efectos adversos , Banisteriopsis/efectos adversos , Femenino , Humanos , Masculino , Proyectos Piloto , Adulto Joven
20.
Bioorg Med Chem Lett ; 49: 128289, 2021 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-34311084

RESUMEN

Leishmaniasis is an infectious disease with several limitations regarding treatment schemes. This work reports the anti-Leishmania activity of spiroacridine compounds against the promastigote (IC50 = 1.1 to 6.0 µg / mL) and amastigote forms of the best compounds (EC50 = 4.9 and 0.9 µg / mL) inLeishmania (L.) infantumand proposes an in-silico study with possible selective therapeutic targets for L. infantum. The substituted dimethyl-amine compound (AMTAC 11) showed the best leishmanicidal activity in vitro, and was found to interact with TryRandLdTopoI. comparisons with standard inhibitors were performed, and its main interactions were elucidated. Based on the biological assessment and the structure-activity relationship study, the spiroacridine compounds appear to be promisinganti-leishmaniachemotherapeutic agents to be explored.


Asunto(s)
Acridinas/farmacología , Compuestos de Espiro/farmacología , Tripanocidas/farmacología , Acridinas/síntesis química , Acridinas/metabolismo , Acridinas/toxicidad , ADN-Topoisomerasas de Tipo I/metabolismo , Eritrocitos/efectos de los fármacos , Leishmania infantum/efectos de los fármacos , Ligandos , Simulación del Acoplamiento Molecular , Estructura Molecular , NADH NADPH Oxidorreductasas/metabolismo , Pruebas de Sensibilidad Parasitaria , Unión Proteica , Proteínas Protozoarias/metabolismo , Compuestos de Espiro/síntesis química , Compuestos de Espiro/metabolismo , Compuestos de Espiro/toxicidad , Relación Estructura-Actividad , Tripanocidas/síntesis química , Tripanocidas/metabolismo , Tripanocidas/toxicidad
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