Elevated diastolic blood pressure in insulin-resistant polycystic ovarian syndrome patients.

OBJECTIVE: The purpose of this study was to further understand interrelationships between insulin resistance in PCOS and elevated diastolic blood pressure. DESIGN: A prospective case control study. PARTICIPANTS: Fifty normal women and 43 PCOS patients, 16 of them with insulin resistance. SETTING: Academic Institution. INTERVENTIONS: Clinical, anthropometric and ultrasonographic features of PCOS were assessed, as were blood levels for luteinizing hormone, follicle-stimulating hormone, androstenedione, DHEAS, and basal insulin. A lipid profile and an oral glucose tolerance test (OGTT) were also performed. MAIN OUTCOME MEASURES: To demonstrate the effect of insulin resistance on blood pressure in patients with PCOS. RESULTS: Patients with PCOS and those with PCOS plus insulin resistance (IR) had significantly elevated levels of plasma androgen but only those with IR showed greater body mass index and waist: hip ratios than PCOS or control. PCOS plus IR differed significantly in their response to OGTT when compared to PCOS or control. Alterations in lipid profile were shown to be atherogenic. Patients with PCOS plus IR demonstrated a significant elevation of diastolic blood pressure when compared to PCOS alone or controls. CONCLUSIONS: We hypothesize that hyperlipidemia and IR may be involved in the pathophysiologic features of the elevated diastolic blood pressure in PCOS patients.

More than words: Speech production in first-episode psychosis predicts later social and vocational functioning.

Background: Several disturbances in speech are present in psychosis; however, the relationship between these disturbances during the first-episode of psychosis (FEP) and later vocational functioning is unclear. Demonstrating this relationship is critical if we expect speech and communication deficits to emerge as targets for early intervention. Method: We analyzed three 1-min speech samples using automated speech analysis and Bayes networks in an antipsychotic-naive sample of 39 FEP patients and followed them longitudinally to determine their vocational status (engaged or not engaged in employment education or training-EET vs. NEET) after 6-12 months of treatment. Five baseline linguistic variables with prior evidence of clinical relevance (total and acausal connectives use, pronoun use, analytic thinking, and total words uttered in a limited period) were included in a Bayes network along with follow-up NEET status and Social and Occupational Functioning Assessment Scale (SOFAS) scores to determine dependencies among these variables. We also included clinical (Positive and Negative Syndrome Scale 8-item version (PANSS-8)), social (parental socioeconomic status), and cognitive features (processing speed) at the time of presentation as covariates. Results: The Bayes network revealed that only total words spoken at the baseline assessment were directly associated with later NEET status and had an indirect association with SOFAS, with a second set of dependencies emerging among the remaining linguistic variables. The primary (speech-only) model outperformed models including parental socioeconomic status, processing speed or both as latent variables. Conclusion: Impoverished speech, even at subclinical levels, may hold prognostic value for functional outcomes and warrant consideration when providing measurement based care for first-episode psychosis.

Immunohistochemical Expression of the Tumor Suppressor Protein p16INK4a in Cervical Adenocarcinoma.

Objective To evaluate the diagnostic utility of the p16ink4a protein expression as a marker for adenocarcinoma of the cervix. Methods In a cross-sectional study, p16ink4a expression was evaluated in 30 cervical biopsies from patients diagnosed with invasive adenocarcinoma from 2 reference clinics in Brazil, and compared with 18 biopsies of endocervical polyps (control cases). The performance of the tests for p16ink4a was evaluated using a conventional contingency table, and the Kappa (κ) index was used to evaluate the agreement of the marker with the tissue diagnosis. Results In total, 66% of the invasive adenocarcinoma cases were positive for p16ink4a. All of the adenomatous polyps cases used as negative controls were shown to be negative for p16ink4a. The marker showed a high sensitivity and a high negative predictive value. The Kappa index was good for p16ink4a (κ = 0.6). Conclusion Considering the strong association between the p16ink4a marker and the cervical adenocarcinoma, its use represents an important tool for reducing incorrect diagnoses of adenocarcinoma and thereby avoiding overtreatment.

Revisão sistemática de instrumentos de atitudes em relação aos idosos e ao envelhecimento / Systematic review of instruments of attitudes towards the older persons and aging / Revisión sistemática de instrumentos de actitudes hacia las personas mayores y el envejecimiento

Esta pesquisa teve como objetivo realizar uma revisão sistemática da literatura a fim de identificar e caracterizar os estudos e instrumentos disponíveis nas bases de dados Scielo, PePsic, Lilacs e PsycArticles, que avaliam as atitudes em relação aos idosos e ao envelhecimento. Foram utilizadas 42 combinações entre os seguintes descritores nos idiomas português, inglês e espanhol: "idosos OR velhice AND preconceito, atitude, discriminação, ageismo, estigma, idadismo e escala". Foram selecionados para análise 31 artigos sendo identificados 18 instrumentos. Os resultados evidenciaram que o interesse dos estudos sobre as atitudes em relação aos idosos e ao envelhecimento se concentram entre os anos de 2015 e 2019, com predomínio da análise da dimensão cognitiva da atitude. Essa temática vem sendo estudada de forma interdisciplinar. Recomenda-se o desenvolvimento de instrumentos que avaliem os demais aspectos das atitudes, além do cognitivo, bem como as experiências de discriminação sofridas por idosos e outros grupos etários. (AU)

Esta pesquisa teve como objetivo realizar uma revisão sistemática da literatura a fim de identificar e caracterizar os estudos e instrumentos disponíveis nas bases de dados Scielo, PePsic, Lilacs e PsycArticles, que avaliam as atitudes em relação aos idosos e ao envelhecimento. Foram utilizadas 42 combinações entre os seguintes descritores nos idiomas português, inglês e espanhol: "idosos OR velhice AND preconceito, atitude, discriminação, ageismo, estigma, idadismo y escala". Foram selecionados para análise 31 artigos sendo identificados 18 instrumentos. Os resultados evidenciaram que o interesse dos estudos sobre as atitudes em relação aos idosos e ao envelhecimento se concentram entre os anos de 2015 e 2019, com predomínio da análise da dimensão cognitiva da atitude. Essa temática vem sendo estudada de forma interdisciplinar. Recomenda-se o desenvolvimento de instrumentos que avaliem os demais aspectos das atitudes, além do cognitivo, bem como as experiências de discriminação sofridas por idosos e outros grupos etários. (AU)

This study aimed to perform a systematic literature review in order to identify and characterize the instruments that assess attitudes towards older adults and aging, available in the SciELO, PePSIC, LILACS and PsycArticles databases. A total of 42 combinations of the following descriptors were used in Portuguese, English and Spanish: "aged OR old age AND prejudice, attitude, discrimination, ageism, stigma and scale". The search lead to 31 articles being selected for analysis and 18 instruments were identified. The results showed that studies on attitudes towards older adults and aging were concentrated between the years 2015 and 2019, with a predominance of the analysis of the cognitive dimension of the attitude. This theme has been studied in an interdisciplinary way. Instruments should be developed that assess the other aspects of attitudes, in addition to the cognitive dimension, as well as the experiences of discrimination suffered by older adults and other age groups. (AU)

Reinserção de idosos no mercado de trabalho: uma etnografia de tela do filme Um Sr. Estagiário / Reinsertion of old people at work: study about the old in the movie The Intern

O objetivo dessa pesquisa é problematizar o processo de reinserção de idosos no mercado de trabalho através da etnografia de tela do filme Um Sr. Estagiário". Trata-se de um estudo com delineamento qualitativo, descritivo e exploratório. Para tanto, foi utilizada a etnografia de tela do filme Um Sr. estagiário para alcançar de modo mais intenso o contexto analisado. Os resultados apresentaram as seguintes categorias: 1) Interações entre a reinserção de idosos no mercado de trabalho e novas tecnologias, 2) Processos intergeracionais e 3) Resiliência na velhice. Conclui-se que a reinserção de idosos ao mercado de trabalho é um desafio cultural que engloba perspectivas econômicas e aspectos biopsicossociais da pessoa idosa.

The objective of this research is to problematize the process of reinsertion of the elderly in the labor market through the screen ethnography of the film The Intern. It is a study with qualitative, descriptive and exploratory design. In order to do so, the screen ethnography of the movie The Intern was used to reach a more intense context. The results presented the following categories: 1) Interactions between the reinsertion of the elderly in the labor market and new technologies, 2) Intergenerational processes and 3) Resilience in old age. It is concluded that the reintegration of the elderly into the labor market is a cultural challenge that encompasses economic perspectives and biopsychosocial aspects of the elderly.

Afetos e percepções de idosos universitários acerca do mercado de trabalho na velhice / Affects and perceptions of university students about the labor market in Old Age / Afectos y percepciones de los ancianos universitarios acerca del mercado de trabajo en la vejez

Este estudo objetivou compreender os sentimentos e emoções vividos por estudantes universitários em processo de envelhecimento diante da possibilidade de reinserção no mercado de trabalho. Para tanto, em caráter exploratório, utilizou-se o método dos mapas afetivos em pessoas com idade que variavam entre 51 a 71 anos de idade. Os resultados apontam a vivência da velhice sendo potencializada nos diversos espaços em que se insere, e que se pode considerar que as relações interpessoais são importantes para a qualidade de vida pessoal e profissional dos idosos. Contudo, ainda se percebe o estigma frente a pessoa idosa, promovendo uma visão distorcida e preconceituosa do que seja a velhice.

This study aimed to understand the feelings and emotions experienced by university students in the process of aging facing the possibility of reintegration into the labor market. For this purpose, the method of affective maps was used in an exploratory character in people with ages ranging from 51 to 71 years of age. The results point out the experience of Old Age being potentiated in the various spaces in which it is inserted, and that interpersonal relationships can be considered to be important for the personal and professional quality of life of the elderly. However, stigma is still perceived in the elderly, promoting a distorted and prejudiced view of Old Age.

Este objetivó comprender los sentimientos y emociones vividos por estudiantes universitarios en proceso de envejecimiento ante la posibilidad de reinserción en el mercado de trabajo. Para ello, en carácter exploratorio, se utilizó el método de los mapas afectivos en personas con edad que variaban entre 51 y 71 años de edad. Los resultados apuntan a la vivencia de la vejez siendo potencializada en los diversos espacios en que se inserta, y que se puede considerar que las relaciones interpersonales son importantes para la calidad de vida personal y profesional de los ancianos. Sin embargo, aún se percibe el estigma frente a la persona mayor, promoviendo una visión distorsionada y preconcebida de lo que es la vejez.

Relationship between L-DOPA-induced reduction in motor and exploratory activity and degree of DAT binding in the rat.

PURPOSE: The present study assessed the influence of L-DOPA administration on neostriatal dopamine (DA) transporter (DAT) binding in relation to motor and exploratory behaviors in the rat. METHODS: Rats received injections of 5 mg/kg L-DOPA, 10 mg/kg L-DOPA or vehicle. Motor and exploratory behaviors were assessed for 30 min in an open field prior to administration of [(123)I]FP-CIT. Dopamine transporter binding was measured with small animal single-photon emission computed tomography (SPECT) 2 h after radioligand administration for 60 min. RESULTS: Both L-DOPA doses significantly reduced DAT binding and led to significantly less head-shoulder motility and more sitting relative to vehicle. Moreover, 10 mg/kg L-DOPA induced less distance traveled and ambulation than 5 mg/kg L-DOPA. Analysis of time-behavior (t-b) curves showed that L-DOPA-treated animals relative to vehicle exhibited (1) a faster rate of increase in duration of sitting; (2) a slower rate of increase in duration of head-shoulder motility; and (3) a slower rate of decrease in frequency of head-shoulder motility. CONCLUSIONS: The reductions of striatal DAT binding after L-DOPA challenges reflected elevated concentrations of synaptic DA. L-DOPA-treated animals showed less head-shoulder motility and more sitting than vehicle-treated animals, indicating an association between less behavioral activity and increased availability of striatal DA. The faster increase of sitting duration to a higher final level and the slower increase of head-shoulder motility to a lower final level relative to controls may be interpreted in terms on behavioral habituation to a novel environment.

Comparación de tres métodos de recuento de Staphylococcusaureus en queso fresco de expendio en los mercados populares de la ciudad de La Paz-Bolivia / Comparison of three methods of counting Staphylococcus aureus in fresh cheese for sale in the central markets of the city of La Paz-Bolivia

Staphylococcus aureus puede contaminar una gran gama de alimentos, constituyéndose el queso fresco en un buen medio diferencial y selectivo para el desarrollo de este microorganismo. La intoxicación estafilocóccica trasmitida por alimentos, resulta de la ingesta de enterotoxina termoestable preformada en el alimento que fue generada por una cepa toxigénica de Staphylococcus aureus llegando a constituirse en un riesgo para la salud de los consumidores. El presente estudio tiene el objetivo de comparar tres métodos: i) ISO 6888-1:2003 ii) NB 32004:2004 y iii) Placas secas rehidratables (Placas Petrifilm) para el recuento de Staphylococcus aureus en queso fresco de expendio en los mercados populares de la ciudad de La Paz. La comparación entre el método de cultivo convencional empleando medio Agar Baird Parker y el método alternativo por placa seca rehidratable fue hecha por medio del muestreo al azar de 30 muestras de queso fresco, el análisis fue hecho por los tres métodos métodos, donde por el método de placa seca rehidratable 10 muestras se encontraban dentro de norma y 20 se encontraban fuera de norma; por medio del método de cultivo convencional 22 muestras se encontraban en norma y 8 fuera de norma. Concluyendo que el método de placa seca rehidratable es más sensible y fácil de aplicar en comparación con el método convencional según norma Bolivia y norma ISO.

Staphylococcus aureus can contaminate a wide range of foods, constituting fresh cheese in a good differential and selective medium for the development of this microorganism. Staphylococcal foodborne poisoning results from the intake of thermostable enterotoxin preformed in the food that was generated by a toxigenic strain of Staphylococcus aureus, becoming a risk to the health of consumers. The present study has the objective of comparing three methods: i) ISO 6888-1: 2003 ii) NB 32004: 2004 and iii) Dry rehydratable plates (Petrifilm plates) for the recount of Staphylococcus aureus in fresh cheese for sale in popular markets from the city of La Paz. The comparison between the conventional culture method using Baird Parker Agar medium and the alternative method by rehydratable dry plate was made by random sampling of 30 samples of fresh cheese, the analysis was done by the three methods methods, where by the method dry rehydratable plate 10 samples were within norm and 20 were out of norm; By means of the conventional cultivation method, 22 samples were in standard and 8 out of norm. Concluding that the rehydratable dry plate method is more sensitive and easier to apply compared to the conventional method according to the Bolivia standard and ISO standard.

Evaluación de los indicadores de desempeño de 3M Petrifilm Staph Express (STX) frente a la norma ISO 6888-1: 2003 en el recuento de Staphylococcus aureus en quesos frescos por contaminación artificial / Evaluation of the performance indicators of 3M Petrifilm Staph Express (STX) against the ISO 6888-1: 2003 standard in the count of Staphylococcus aureus in fresh cheeses by artificial contamination

Staphylococcus aureus puede contaminar una gran gama de alimentos, siendo los quesos frescos un medio diferencial y selectivo para el desarrollo de este microorganismo, llegando a la producción de enterotoxina termoestable ocasionando una intoxicación estafilocóccica trasmitida por alimentos. El empleo del método 3M Petrifilm Staph Express (STX) supone considerables ventajas frente al método convencional o de referencia, facilitando y favoreciendo muchos aspectos técnicos y económicos, dentro de ellos tenemos la optimización de tiempo en cuanto se refiere a la preparación de medios de cultivo, necesidad de equipamiento, requerimiento de infraestructura, menor requerimiento de personal y la disminuye los costos del uso de consumo eléctrico, disminuye la generación de residuos sólidos, entre otros. La comparación entre el método alternativo frente al método convencional fue hecha por medio de la contaminación artificial de una matriz libre de S. aureus y un recuento bajo de microbiota acompañante, donde se establecieron diferentes niveles de contaminación, evaluándose los indicadores de desempeño (exactitud relativa, precisión relativa, linealidad, curva de calibración y límite de cuantificación). En indicador de exactitud relativa se obtuvo un 95,6% de recuperación para el nivel más bajo (aproximadamente 8 UFC/g) y 98,7% de recuperación para el nivel de contaminación más alto (aproximadamente 5300 UFC/g), teniendo un rango de 70 a 120% de aceptación. Para la precisión relativa se calcularon la RSD de todos los niveles ensayados, obteniéndose datos que aceptan la precisión relativa del método de placa seca rehidratable porque los valores fueron menores al RSD teórico calculado. El límite de detección fue ensayado con <10UFC/g obteniéndose un CV de 1,16%. Por los resultados obtenidos podemos concluir que el método 3M Petrifilm Staph Express (STX) cumple con los indicadores de desempeño frente a la norma ISO 6888-1:2003.

Staphylococcus aureus can contaminate a wide range of foods, being fresh cheeses a differential and selective medium for the development of this microorganism, reaching the production of thermostable enterotoxin causing a staphylococcal intoxication transmitted by food. The use of the 3M Petrifilm Staph Express (STX) method has considerable advantages over the conventional or reference method, facilitating and favoring many technical and economic aspects, within them we have the optimization of time as regards the preparation of culture media, need for equipment, infrastructure requirements, lower personnel requirements and decreases the costs of the use of electricity consumption, decreases the generation of solid waste, among others. The comparison between the alternative method and the conventional method was made by means of the artificial contamination of a free matrix of S. aureus and a low accompanying microbiota count, where different levels of contamination were established, evaluating the performance indicators (relative accuracy, relative precision, linearity, calibration curve and limit of quantification). In the relative accuracy indicator, 95.6% recovery was obtained for the lowest level (approximately 8 CFU / g) and 98.7% recovery for the highest level of contamination (approximately 5300 CFU / g), with a range of 70 to 120% acceptance. For the relative precision, the RSD of all the tested levels was calculated, obtaining data that accept the relative accuracy of the dry rehydratable plate method because the values were lower than the calculated theoretical RSD. The limit of detection was tested with <10 CFU /g, obtaining a CV of 1.16%. Based on the results obtained, we can conclude that the 3M Petrifilm Staph Express (STX) method complies with the performance indicators against the ISO 6888-1: 2003 standard.

Immunohistochemical Expression of the Tumor Suppressor Protein p16 INK4a in Cervical Adenocarcinoma / Expressão imunhistoquímica da proteína de supressão tumoral p16 INK4a em adenocarcinoma cervical

ABSTRACT Objective: To evaluate the diagnostic utility of the p16ink4a protein expression as a marker for adenocarcinoma of the cervix. Methods: In a cross-sectional study, p16ink4a expression was evaluated in 30 cervical biopsies from patients diagnosed with invasive adenocarcinoma from 2 reference clinics in Brazil, and compared with 18 biopsies of endocervical polyps (control cases). The performance of the tests for p16ink4a was evaluated using a conventional contingency table, and the Kappa (k) index was used to evaluate the agreement of the marker with the tissue diagnosis. Results: In total, 66% of the invasive adenocarcinoma cases were positive for p16ink4a. All of the adenomatous polyps cases used as negative controls were shown to be negative for p16ink4a. The marker showed a high sensitivity and a high negative predictive value. The Kappa index was good for p16ink4a (k 1/4 0.6). Conclusion: Considering the strong association between the p16ink4a marker and the cervical adenocarcinoma, its use represents an important tool for reducing incorrect diagnoses of adenocarcinoma and thereby avoiding overtreatment.

RESUMO Objetivo: Avaliar a utilidade diagnóstica da expressão da proteína p16ink4a como marcador de adenocarcinoma do colo. Métodos: Em estudo transversal, a expressão de p16ink4a foi avaliada em 30 biópsias cervicais de pacientes diagnosticadas com adenocarcinoma invasivo de colo uterino provenientes de dois serviços de referência no Brasil, comparando com achados em 18 biópsias de pólipos endocervicais (grupo de controle). Para avaliar a performance do teste, foi utilizada tabela de contingência convencional, e para avaliar a concordância com o diagnóstico, foi aplicado o índice de Kappa (k). Resultados: No total, 66% dos casos de adenocarcinoma invasivo foram positivos para p16ink4a. Todos os pólipos adenomatosos foram negativos para p16ink4a. O marcador mostrou uma alta sensibilidade e alto valor preditivo negativo. O índice de Kappa foi bom para p16ink4a (k 1/4 0.6). Conclusion: Considerando a forte associação entre o marcador p16ink4a e o adenocarcinoma cervical, seu uso representa uma ferramenta importante para reduzir o risco de diagnóstico incorreto de adenocarcinoma e, por conseguinte, evitar o excesso de tratamentos.

Is screening for anal squamous intraepithelial lesions in women with genital human papillomavirus intraepithelial lesions necessary? / Há necessidade de rastreio para lesão intraepitelial anal em mulheres com lesões intraepiteliais genitais por papilomavírus humano?

Parece haver uma relação bastante estreita entre lesões genitais e anais associadas ao papilomavírus humano (HPV), bem como sua relação com a patogênese de neoplasias nesses sítios. Objetivo: Avaliar a existência de dados publicados que sugiram a necessidade de rastreio para lesão intraepitelial anal entre mulheres com lesões genitais associadas ao HPV. Métodos: Foi realizada uma revisão sistemática de pesquisas originais publicadas entre 2001 e 2014 nos bancos de dados: PubMed, High Wire, Biblioteca Cochrane e Google Acadêmico. As palavras-chaves para busca foram: "rastreio" ou "detecção precoce de câncer" e "anus" ou "anus diseases" ou "anus neoplasms" e "woman" ou "women" e "HPV" ou "DNA probes, HPV". Resultados: A busca inicial retornou 1203 artigos. Após a publicação dos critérios de exclusão e inclusão e da análise dos revisores, restaram 15 trabalhos que foram empregados para compor a presente revisão. Grande parte dos estudos apontou que mulheres com lesões genitais pelo HPV apresentavam maior risco de lesões anais em comparação com mulheres normais. Verificou-se também a relação entre neoplasia genital e infecção anal por tipos oncogênicos do HPV e o papel do vírus no desenvolvimento do câncer anal. Conclusão: O rastreio de lesões em mulheres com lesões genitais por HPV deve ser indicado. O método mais adequado para tal ainda deve ser mais bem estudado.

Thre seems to be a fairly close relationship between genital and anal lesions associated with human papilomavirus (HPV) and with the pathogenesis of malignancies in such sites. Objective: This review seeks to analyze published papers that suggest the necessity for anal intraepithelial lesions screening in women with HPV genital intraepithelial lesions. Methods: A systematic review of original research published between 2001 and 2014 was performed in the databases PubMed, High Wire, Cochrane Library and Scholar Google. The keywords for the search were: "screening" or "early detection of cancer" and "anus" or "anus diseases" or "neoplasms anus" and "woman" or "women" and "HPV" or "DNA probes, HPV". Results: 1203 articles were selected in ht e first search. After the reviewers applied exclusion and inclusion criteria and analyzed the papers, 15 were selected to compose this review. Most of them showed higher rates of anal intraepithelial lesions in women with genital intraepithelial lesions than in regular women. We also found a correlation between genital neoplasms and anal infection by oncogenic HPV types and the role of the virus in the pathogenesis of anal cancer. Conclusion: Screening for anal lesions in women with HPV genital lesions should be indicated, and further studies are required to determine the best methods.

Qual o papel do Toll-Like Receptor (TLR) na indução de lesão de tuba uterina nas infecções por Chlamydia Trachomatis? / What is the role of Toll-Like Receptor (TLR) in the induction of tubal damages caused by Chlamydia Trachomatis infection?

A suscetibilidade à infecção por C. trachomatis, curso, complicações e resolução da doença depende do tipo da bactéria, de fatores ambientais eda genética do paciente. Entre as mulheres uma forma frequente da infecção é a endocervicite, que pode se complicar com salpingite com consequente lesãotubária. Acredita-se que as complicações a longo prazo desta infecção ocorrem via heat shock protein HSP 60 e toll-like receptors (TLR)...

The susceptibility, course, complications and outcome of Chlamydia trachomatis infection depends on the type of bacteria, environmentalfactors and host genetic factors. Among women, the most common infection is cervicitis that can be complicated by salpingitis leading to tubal damage.It is believed that long-term complications occur via HSP 60 and toll-like receptors...