Design of Liquid Formulation Based on F127-Loaded Natural Dimeric Flavonoids as a New Perspective Treatment for Leishmaniasis.

Infectious and Parasitic Diseases (IPD) remain a challenge for medicine due to several interconnected reasons, such as antimicrobial resistance (AMR). American tegumentary leishmaniasis (ATL) is an overlooked IPD causing persistent skin ulcers that are challenging to heal, resulting in disfiguring scars. Moreover, it has the potential to extend from the skin to the mucous membranes of the nose, mouth, and throat in both humans and various animals. Given the limited effectiveness and AMR of current drugs, the exploration of new substances has emerged as a promising alternative for ATL treatment. Arrabidaea brachypoda (DC). Bureau is a native Brazilian plant rich in dimeric flavonoids, including Brachydin (BRA), which displays antimicrobial activity, but still little has been explored regarding the development of therapeutic formulations. In this work, we present the design of a low-cost liquid formulation based on the use of Pluronic F127 for encapsulation of high BRA concentration (LF-B500). The characterization techniques revealed that BRA-loaded F127 micelles are well-stabilized in an unusual worm-like form. The in vitro cytotoxicity assay demonstrated that LF-B500 was non-toxic to macrophages but efficient in the inactivation of forms of Leishmania amazonensis promastigotes with IC50 of 16.06 µg/mL. The results demonstrated that LF-B500 opened a new perspective on the use of liquid formulation-based natural products for ATL treatment.

Utero-Cutaneous Fistula in Ruminants: Characterization of the First Cases in Ewes and Cows.

Reports on UCF in animals are still lacking in veterinary literature. Detailed clinical signs, laboratory findings, and follow-up information from the first cases of UCF in two ewes and two cows are provided. The cases occurred over a 12-year period. All ruminants presented a fistulous tract or perforated wound on the right ventral abdomen, emitting a foul-smelling secretion possibly associated with macerated fetal parts or placental remains. Laboratory findings included anemia, leukocytosis by neutrophilia, and hyperfibrinogenemia in one ewe, and hyperfibrinogenemia in one cow. Ovariohysterectomy and fistulectomy were performed in one ewe, while the other three ruminants were submitted for the removal of fetal parts and placental remains through the UCF. Two ewes died within 12-48 h, and the two Nelore cows had an uneventful recovery, achieving secondary intention healing within 30 to 35 days. As a never-reported or unnoticed disease of the reproductive tract, UCF is an unusual consequence of dead fetus retention in an end-stage pregnancy and a potentially life-threatening condition in ruminants, especially ewes. Further broad studies in large herds of cattle and small ruminant flocks must be conducted to estimate the incidence of UCF and ensure improvements in the diagnosis and knowledge of pathogenesis, aiming at prevention.

Interaction of triblock copolymers (Pluronic®) with DMPC vesicles: a photophysical and computational study.

Pluronic/lipid mix promises stealth liposomes with long circulation time and long-term stability for pharmaceutical applications. However, the influence of Pluronics on several aspects of lipid membranes has not been fully elucidated. Herein it was described the effect of Pluronics on the structured water, alkyl chain conformation, and kinetic stability of dimyristoylphosphatidylcholine (DMPC) liposomes using interfacial and deeper fluorescent probes along with computational molecular modeling data. Interfacial water changed as a function of Pluronics' hydrophobicity with polypropylene oxide (PPO) anchoring the copolymers in the lipid bilayer. Pluronics with more than 30-40 PO units had facilitated penetration at the bilayer while shorter PPO favored a more interfacial interaction. Low Pluronic concentrations provided long-term stability of vesicles by steric effects of polyethylene oxide (PEO), but high amounts destabilized the vesicles as a sum of water-bridge cleavage at the polar head group and the reduced alkyl-alkyl interactions among the lipids. The high kinetic stability of Pluronic/DMPC vesicles is a proof-of-concept of its advantages and applicability in nanotechnology over conventional liposome-based pharmaceutical products for future biomedical applications.

The effect of erythrosine-B on the structuration of poloxamer 407 and cellulose derivative blends: In silico modelling supporting experimental studies.

Erythrosine is a dye approved for medical use that has shown promising photodynamic activity, allowing for the inactivation of microorganisms and activity against malignant cells. Despite the great photodynamic potential, erythrosine exhibits hydrophilicity, negatively impacting its action in biological membranes. Therefore, the incorporation of erythrosine in micellar polymeric systems, such as poloxamers, may overcome this limitation. Moreover, using bioadhesive and thermoresponsive polymers to combine in situ gelation and bioadhesion may enhance retention of this topically applied drug. In this work, mucoadhesive and thermoresponsive micellar systems were prepared containing erythrosine in two states: the native form (ERI) and the disodium salt (ERIs). The systems were evaluated based on the effect of ERI/ERIs on the micellar structure of the binary polymer mixtures. Optimised combinations of poloxamer 407 (polox407) and mucoadhesive sodium carboxymethylcellulose (NaCMC) or hydroxypropyl methylcellulose (HPMC) were used as micellar systems for ERI or ERIs delivery. The systems were studied with respect to theoretical interactions, qualitative composition, morphology, and micellar properties. In silico modelling indicated a higher interaction of the drug with poly(ethylene oxide) (PEO) than poly(propylene oxide) (PPO) fragments of polox407. Systems containing NaCMC displayed a repulsive effect in the presence of erythrosine, due to the polymer's charge density. Both systems could convert the photosensitizer in its monomeric form, ensuring photodynamic activity. In these mixtures, crystallinity, critical micellar temperature and enthalpy of polox407 micellisation were reduced, and micellar size, evaluated by transmission electron microscopy (TEM), showed low impact of ERI/ERIs in HPMC preparations. Aiming toward photodynamic applications, the findings showed how ERI or ERIs can affect the micellar formation of gels composed of 17.5% (w/w) polox407 and 3% (w/w) HPMC or 1% (w/w) NaCMC, important for understating their behaviour and future utilisation as erythrosine delivery systems.

Interaction between mucoadhesive cellulose derivatives and Pluronic F127: Investigation on the micelle structure and mucoadhesive performance.

Systems composed of bioadhesive and thermoresponsive polymers can combine in situ gelation with bio/mucoadhesion, enhancing retention of topically applied drugs. The effect of bioadhesive sodium carboxymethylcellulose (NaCMC) and hydroxypropyl methylcellulose cellulose (HPMC) on the properties of thermoresponsive Pluronic® F127 (F127) was explored, including micellization and the mucoadhesion. A computational analysis between these polymers and their molecular interactions were also studied, rationalising the design of improved binary polymeric systems for pharmaceutical and biomedical applications. The morphological characterization of polymeric systems was conducted by SEM. DSC analysis was used to investigate the crystallization and micellization enthalpy of F127 and the mixed systems. Micelle size measurements and TEM micrographs allowed for investigation into the interference of cellulose derivatives on F127 micellization. Both cellulose derivatives reduced the critical micellar concentration and enthalpy of micellization of F127, altering hydrodynamic diameters of the aggregates. Mucoadhesion performance was useful to select the best systems for mucosal application. The systems composed of 17.5% (w/w) F127 and 3% (w/w) HPMC or 1% (w/w) NaCMC are promising as topical drug delivery systems, mainly on mucosal surfaces. They were biocompatible when tested against Artemia salina, and also able to release a model of hydrophilic drug in a controlled manner.

pH interferes in photoinhibitory activity of curcumin nanoencapsulated with pluronic® P123 against Staphylococcus aureus.

Microbial contamination control is a public health concern and challenge for the food industry. Antimicrobial technologies employing natural agents may be useful in the food industry for these purposes. This work aimed to investigate the effect of photodynamic inactivation using curcumin in Pluronic® P123 nanoparticles (Cur/P123) at different pH and blue LED light against Staphylococcus aureus. Bacterial photoinactivation was conducted using different photosensitizer concentrations and exposure times at pH 5.0, 7.2 and 9.0. A mixture design was applied to evaluate the effects of exposure time (dark and light incubation) on the photoinhibitory effect. S. aureus was completely inactivated at pH 5.0 by combining low concentrations of Cur/P123 (7.80-30.25 µmol/L) and light doses (6.50-37.74 J/cm2). According to the mathematical model, dark incubation had low significance in bacterial inactivation at pH 5.0 and 9.0. No effect in bacterial inactivation was observed at pH 7.2. Cur/P123 with blue LED was effective in inactivating S. aureus. The antimicrobial effect of photodynamic inactivation was also pH-dependent.

Influence of water volume reduction on the phytoplankton dynamics in a semi-arid man-made lake: A comparison of two morphofunctional approaches.

Significant reductions in the water levels of lakes are influenced by droughts and freshwater demands, especially in semi-arid regions, where hydric stress is greater. The aim of this study was to investigate the dynamics of phytoplankton during two different water volume periods resulting from an extended drought in a semi-arid lake. Another objective was to compare two functional approaches to test which one of these best captures phytoplankton variability as a function of environmental variability. Multivariate analyses performed using the Reynolds Functional Groups (RFG) and Morphology-Based Functional Groups (MBFG) classification schemes indicated two periods, high and a low water volume. The results demonstrated the importance of light availability on phytoplankton assemblages as these two periods showed significant differences in water transparency and phytoplankton composition. During extended droughts the reduction in water volume enhances the development of bloom-forming cyanobacteria through the limitation of light in a eutrophic man-made lake. Moreover, both functional traits approaches demonstrated the effect of light availability on phytoplankton assemblage composition and can be applied in similar systems. However, the RFG classification provides more information and allows a more detailed description of the algal assemblages.

Chilled raw milk quality: a case study in Zona da Mata region, Minas Gerais State, Brazil / Qualidade do leite cru refrigerado: um estudo de caso na região da Zona da Mata de Minas Gerais

ABSTRACT: This paper aimed to analyze the evolution of the quality of raw milk produced by producers in the Zona da Mata region, in the state of Minas Gerais, between 2012 and 2018. For this purpose, we used the linear mixed-effects model to analyze the monthly evolution of the results of milk composition indicators (fat, protein, and defatted dry extract - DDE), somatic cell count - SCC, and total bacterial count - TBC, from the official monthly registry of 94 milk producers, suppliers of a region's dairy. Results indicate a continuous reduction in the milk composition indicators between 2014 and 2018. For the SCC and TBC indicators, we identified only one-off reductions. The supply of a larger volume of milk was associated with increased TBC. Seasonality influenced all quality indicators analyzed. According to these results, we concluded that the analyzed quality of chilled raw milk offered by producers was proven worse from 2012 to 2018, despite the actions implemented by the National Milk Quality Improvement Program - PNMQL.

RESUMO: Este artigo objetivou analisar a evolução da qualidade do leite cru refrigerado produzido por produtores da região da Zona da Mata, do Estado de Minas Gerais, entre os anos de 2012 e 2018. Para tal, foi utilizado o modelo linear de efeitos mistos, a fim de analisar a evolução mensal dos resultados de indicadores de composição do leite (gordura, proteína e extrato seco desengordurado - ESD), contagem de células somáticas - CCS, e contagem bacteriana total - CBT, provenientes de análises oficiais mensais de 94 produtores de leite, fornecedores de um laticínio da região. Os resultados indicaram uma redução contínua dos indicadores de composição do leite entre os anos de 2014 e 2018. Para os indicadores de CCS e CBT foram observadas apenas reduções pontuais. O fornecimento de um maior volume de leite foi associado ao aumento da CBT. A sazonalidade influenciou todos os indicadores de qualidade analisados. De posse desses resultados, pode-se afirmar que, apesar das ações implementadas pelo Programa Nacional de Melhoria de Qualidade do Leite - PNMQL, a qualidade do leite cru refrigerado, proveniente dos produtores avaliados, piorou ao longo do período em análise.

Design of a nanostructured mucoadhesive system containing curcumin for buccal application: from physicochemical to biological aspects.

Mucoadhesive nanostructured systems comprising poloxamer 407 and Carbopol 974P® have already demonstrated good mucoadhesion, as well as improved mechanical and rheological properties. Curcumin displays excellent biological activity, mainly in oral squamous cancer; however, its physicochemical characteristics hinder its application. Therefore, the aim of this study was to develop nanostructured formulations containing curcumin for oral cancer therapy. The photophysical interactions between curcumin and the formulations were elucidated by incorporation kinetics and location studies. They revealed that the drug was quickly incorporated and located in the hydrophobic portion of nanometer-sized polymeric micelles. Moreover, the systems displayed plastic behavior with rheopexy characteristics at 37 °C, viscoelastic properties and a gelation temperature of 36 °C, which ensures increased retention after application in the oral cavity. The mucoadhesion results confirmed the previous findings with the nanostructured systems showing a residence time of 20 min in porcine oral mucosa under flow system conditions. Curcumin was released after 8 h and could permeate through the porcine oral mucosa. Cytotoxicity testing revealed that the formulations were selective to cancer cells over healthy cells. Therefore, these systems could improve the physicochemical characteristics of curcumin by providing improved release and permeation, while selectivity targeting cancer cells.

Biomedical Platform Development of a Chlorophyll-Based Extract for Topic Photodynamic Therapy: Mechanical and Spectroscopic Properties.

Photodynamic therapy (PDT) is a therapeutic modality that has shown effectiveness in the inactivation of cancer cell lines and microorganisms. Treatment consists of activating the photosensitizer (PS) upon light irradiation of adequate wavelength. After reaching the excited state, the PS can handle the intersystem conversion through energy transfer to the molecular oxygen, generating reactive oxygen species. This especially applies to singlet oxygen (1O2), which is responsible for the selective destruction of the sick tissue. Photosensitizing compounds (chlorophylls and derivatives) existing in the spinach extract have applicability for PDT. This study aimed to develop and characterize the thermoresponsive bioadhesive system composed of Pluronic F127 20.0%- and Carbopol 934P 0.2% (w/w) (FC)-containing chlorophyll-based extract 0.5% (w/w) (FC-Chl). Mechanical and rheological properties, in vitro release, sol-gel transition temperature, and ex vivo permeability of the spinach extract PS components (through pig ear skin) were investigated. Furthermore, photodynamic activity of the system was accessed through uric acid and time-solved measurements. The sol-gel transition temperature obtained for the FC-Chl system was 28.8 ± 0.3 °C. Rheological and texture properties of the platform were suitable for use as a dermatological system, exhibiting easy application and good characteristics of retention in the place of administration. In vitro release studies showed the presence of two distinct mechanisms that reasonably obey the zero-order and first-order kinetics models. PS components presented skin permeability and reached a permeation depth of 830 µm (between the epidermis and dermis). The photodynamic evaluation of the FC-Chl system was effective in the degradation of uric acid. The quantum yield (ΦΔ1O2) and life time (τ1O2) of singlet oxygen showed similar values for the spinach extract and the isolated chlorophyll a species in ethanol. These results allowed for the classification of the FC-Chl platform as potentially useful for the delivery of the chlorophyll-based extract in the topic PDT, suggesting that it is worthy for in vivo evaluation.

The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review.

PURPOSE OF REVIEW: This article reviewed very recent papers (2016) discussing or bringing clinical evidences of the possible common pathways leading to diabetic foot syndrome (DFS) and increased mortality rates. RECENT FINDINGS: Diabetic patients with diabetic foot syndrome have a mortality rate greater than twofold when compared with non-ulcerated diabetics. In addition, the 5-year mortality rate following amputation is estimated at 39-68%, a life expectancy comparable to aggressive types of cancer or advanced congestive heart failure. The majority of patients with diabetic foot ulcer also present insulin resistance, central obesity, dyslipidemia, and hypertension that characterize the metabolic syndrome that, in turn, is associated with an elevated risk of major cardiovascular events. Sensory neuropathy is the primary cause of more the 60% of diabetic foot ulcer. Diabetic peripheral neuropathy is a microvascular complication of diabetes mellitus and in type 2 diabetes, not only hyperglycemia but also other metabolic alterations and persistent inflammatory status due to adiposity play a major role in axon injury. Elevated triglycerides have been showed to be an independent risk factor for lower extremity amputation in diabetic patients. Also, toxic adiposity, oxidative stress, mitochondrial dysfunction, activation of the polyol pathway, accumulation of advanced glycation end products (AGEs), and elevation of inflammatory markers are also implicated in diabetic vascular disease and neuropathy. The hypotheses that the association between DFS and increased rates of mortality reflects the progression of micro- and macrovascular complications are reinforced by the additional association of DFU to renal failure and retinopathy.

A methodology for definition of rural spaces: an implementation in Brazil / Uma metodologia para definição de espaços rurais: uma implementação no Brasil

ABSTRACT: Rural spaces definitions are differentiated in several countries. The Organization for Economic Co-operation and Development (OECD) has standardized a rural definition by regional typology. The OECD regional typology set areas as Predominantly Urban, Intermediate, or Predominantly Rural. This paper analyses the application of OECD regional typology in Brazilian territory. The research used the OECD methodology, with support of GIS software, to define the rural areas in Brazil. The mostly segmented data from Brazilian Census of 2010 are used in contrast to others studies. The paper concludes that Brazil is more urban than official estimates and OECD reports. According to paper results, 87.48% of Brazilian population is urban and only one Territorial Level 3 region was classified as predominantly rural.

RESUMO: As definições de espaços rurais são diferenciadas em vários países. A Organization for Economic Co-operation and Development (OECD) tem padronizado uma definição de rural através da sua tipologia regional. A tipologia regional da OECD define áreas como Predominantemente Urbanas, Intermediárias ou Predominantemente Rurais. O presente artigo analisa a aplicação da tipologia da OECD no território brasileiro. A pesquisa usou a metodologia proposta pela OECD, com o suporte de software GIS, para definir as áreas rurais presentes no Brasil. Utilizando os dados mais desagregados disponíveis dos Censos Brasileiros de 2010, este artigo se diferencia de outros estudos desse âmbito. As conclusões apontam para um Brasil mais urbano do que as estimativas oficiais e os relatórios da OECD. De acordo com os resultados, 87,48% da população brasileira seria urbana e apenas uma mesorregião seria classificada como Predominantemente Rural.

Um Diagnóstico da Distribuição Espacial da Atenção Primária à Saúde no Sudeste Brasileiro / A Spatial Distribution Diagnostic of Primary Health Care in Brazilian Southeastern

O Estado como provedor do bem público busca disseminar a saúde entre seus habitantes, sendo que uma das principais formas de realizar isso é por meio da Atenção Primária à Saúde. Esse contexto contribuiu para o escopo deste artigo, cujo objetivo é verificar a distribuição espacial da Atenção Primária à Saúde, no âmbito do sudeste brasileiro. Com uma abordagem teórica, discorreu-se sobre a equidade na gestão da saúde pública e os modelos da administração pública e a relação com a equidade. Para o cumprimento de tal objetivo, utilizou-se uma abordagem quantitativa, por estatística espacial utilizando o I de Moran e o Local Indicators of Spatial Association, e, em complemento, estatística nãoparamétrica. Os resultados apontaram para uma inequidade e uma inigualada distribuição da Atenção Primária à Saúde na região. Além de apontar o que oferece indícios de inequidade nos recursos, evidenciando assim que são importantes intervenções e ações proativas na gestão da atenção primária à saúde.

The state as a provider of public health seeks to disseminate it between its inhabitants, one of the main ways to accomplish this is by the Primary Health Care. This scenario contributed to the scope of this paper, which aims to investigate the distribution and equity in Primary Health Care in the Brazilian southeast. With a theoretical approach this elaborates on equity in health management and models of public administration and the relation with equity. Authors who discuss on the subject was consulted. For compliance of this objective, it was used a quantitative approach through spatial statistics Moran?s I and Local Indicators of Spatial Association, and in addition to non-parametric statistics. The results pointed to inequity and not-equaled distribution of Primary Health Care in the region. The results pointed to an uneven distribution in the region. What provides indications of inequity in resources, thus showing that interventions and proactive actions are important in the management of primary health care.

Análise da distribuição espacial das estruturas voltadas à atenção primária à saúde do sudeste brasileiro / Analyzing the spatial distribution of buildings for Primary Health Care in southeastern Brazil

O Estado como provedor do bem público busca disseminar a saúde entre seus habitantes, e uma das principais formas de realizar isso é por meio da Atenção Primária à Saúde. Esse contexto contribuiu para o escopo deste artigo, cujo objetivo foi investigar o padrão de distribuição e equidade nas estruturas voltadas para a Atenção Primária à Saúde no âmbito do sudeste brasileiro. Com uma abordagem teóricas e discorreu sobre a equidade na gestão da saúde pública e os modelos da administração pública e a relação com a equidade. Os principais autores da área foram considerados na composição das evidências empíricas necessárias à compreensão desse fenômeno. Para o cumprimento de tal objetivo,utilizou-se uma abordagem quantitativa, por meio de estatística espacial utilizando principalmente o I de Moran e o Local Indicators of Spatial Association. Os resultados apontaram para uma distribuição desigual na região. O que oferece indícios de iniquidade na alocação de recursos, evidenciando assim que são importantes intervenções e ações proativas na gestão da atenção primária à saúde...

The State, as a provider of public health, seeks to disseminate it among its inhabitants, with one of the main ways to accomplish this being Primary Health Care. This scenario contributed to the scope of this paper, which aims to investigate the pattern of distribution and equity of the infrastructure available to provide Primary Health Care in the Brazilian southeast region. The article has as theoretical approach the equity in health management, and the models of public administration, and its relation with equity.The main authors who discuss on the subject were considered as empirical contributions to under stand this phenomenon. The quantitative approach through spatial statistics, especially Moran's I and Local Indicators of Spatial Association were used to conduct the analysis. The results pointed to an uneven distribution in the region, providing indications of inequity in the allocation of resources, thus showing that interventions and proactive actions are important to improve the performance of primary health care management...

Formulation of Aluminum Chloride Phthalocyanine in Pluronic(™) P-123 and F-127 Block Copolymer Micelles: Photophysical properties and Photodynamic Inactivation of Microorganisms.

Aluminum Chloride Phthalocyanine (AlPcCl) can be used as a photosensitizer (PS) for Photodynamic Inactivation of Microorganisms (PDI). The AlPcCl showed favorable characteristics for PDI due to high quantum yield of singlet oxygen (ΦΔ ) and photostability. Physicochemical properties and photodynamic inactivation of AlPcCl incorporated in polymeric micelles of tri-block copolymer (P-123 and F-127) against microorganisms Staphylococcus aureus, Escherichia coli and Candida albicans were investigated in this work. Previously, it was observed that the AlPcCl undergoes self-aggregation in F-127, while in P-123 the PS is in a monomeric form suitable for PDI. Due to the self-aggregation of AlPcCl in F-127, this formulation did not show any effect on these microorganisms. On the other hand, AlPcCl formulated in P-123 was effective against S. aureus and C. albicans and the death of microorganisms was dependent on the PS concentration and illumination time. Additionally, it was found that the values of PS concentration and illumination time to eradicate 90% of the initial population of microorganisms (IC90 and D90 , respectively) were small for the AlPcCl in P-123, showing the effectiveness of this formulation for PDI.

Os modos de vida dos agricultores pluriativos nas aldeias minhotas do noroeste de Portugal / The way of life of pluriactivity farmers in Minho villages in Northwest Portugal

Este artigo teve por objetivo analisar o modo de vida do agricultor pluriativo, uma categoria em expansão na agricultura praticada não apenas nas aldeias minhotas do noroeste de Portugal, lócus deste estudo, mas em grande parte do mundo ocidental. Utilizou-se a aplicação de um survey, cross-sectional, aplicado a famílias de agricultores exclusivamente agrícolas e pluriativos, em 50% das freguesias da vila escolhida para este estudo. Os resultados da pesquisa revelaram a urbanização do modo de vida dos agricultores pluriativos e inclusive dos que viviam exclusivamente da agricultura, apontando, contudo, para a compatibilidade da agricultura com este modo de vida mais tecnologizado e integrado à dinâmica das vilas e cidades.

This article aimed to analyze the lifestyle of the pluriactive farmer. This is a growing category in the agricultural practices not only held in the Minho villages in northwestern Portugal, which is the locus for this study, but also vastly found in the eastern world. A cross-sectional survey was conducted, which was applied exclusively to pluriactive, agricultural families, in 50% of the civil parishes of the chosen village. The results of this research made evident the urbanization in the lifestyle of the pluriactive farmer including those who used to live solely off agriculture. However, this study points out to the compatibility of agriculture with a lifestyle that is more technological, more integrated with the village and the city dynamics.

Reliability and internal consistency of questionnaire for evaluating weight cycling in Southern Brazil.

AIMS AND OBJECTIVES: To determine the reliability and internal consistency of a questionnaire that was designed to assess weight cycling. BACKGROUND: A large part of the obese population attempt to lose weight. Of those who had lost at least 10% of their initial weight, 33·5% regained weight. This weight loss and regain is termed 'weight cycling'. So far, no available validated instruments exist that are capable of identifying these patients. DESIGN: A quantitative study for the validation of a questionnaire. METHODS: The selected patients received a phone call from the researchers. On that occasion, they answered a questionnaire that contained eight questions about their current weight, their weight at 18 years of age and their history of weight cycling over the past two years. Approximately 20 days after the first phone call, the patients were re-contacted and asked to respond again to the proposed questionnaire. The internal consistency and reliability were examined through a kappa index and a chi-squared test. The questions that showed evidence of reliability and consistency composed the final questionnaire. RESULTS: The final questionnaire consisted of six questions. An analysis of the test-retest kappa coefficient was moderate or greater for four of the six objective questions. One of the two quantitative questions showed a strong correlation for the test/retest reliability, and the other showed a strong correlation with the gold standard. An analysis of the internal consistency between a composition of questions 5 and 6 with question 4 showed moderate agreement, which increased when it was adjusted for the same cut-off point. The agreement between patients classified as 'weight cyclers' was higher than 80% in both tests. CONCLUSIONS: The Questionnaire to Assess Weight Cycling provided evidence of reliability and internal consistency. RELEVANCE TO CLINICAL PRACTICE: Evaluating weight cycling.

Association between primary headaches and depression in young adults in southern Brazil / Estudo da relação entre enxaqueca primária e depressão em jovens da região sul do Brasil

OBJECTIVE: To verify the association between depression and headache in young adults, as well as to identify the features of headache associated with depression and the influence of this mood disorder on headache-related disability. METHODS: A cross-sectional study with self-administered questionnaires about headache and depression was conducted at the Universidade de Caxias do Sul. Beck Depression Inventory (BDI) and Migraine Disability Assessment (MIDAS) were used to evaluate depressive symptoms and headache-related disability, respectively. Depression was considered if BDI > 15. RESULTS: A thousand and thirteen young adults were included in the study. A clear relationship was observed between headache and depression among the participants. Multivariate analyses demonstrated that nausea or vomiting related to headache and higher headacherelated disability scores were independent factors associated with depression. Migraine was more associated with depression than the other types of headache. CONCLUSION: The results demonstrate an association between headache and depression. Depressive symptoms are more likely to be found in young adults with more disabling headaches.

OBJETIVO: Verificar a associação entre depressão e cefaleia em adultos jovens, assim como identificar as características da cefaleia relacionadas com depressão e a influência da depressão na incapacidade decorrente da cefaleia. MÉTODOS: Estudo transversal com questionários autoadministrados sobre cefaleia e depressão foi conduzido na Universidade de Caxias do Sul. O Inventário de Depressão de Beck (BDI) e o questionário de avaliação da incapacidade por enxaqueca (MIDAS) foram utilizados para avaliação dos sintomas depressivos e incapacidade, respectivamente. Depressão foi definida como BDI > 15. RESULTADOS: Foram incluídos no estudo 1.013 adultos jovens. Observou-se uma clara relação entre cefaleia e depressão entre os participantes. Análisesmultivariadas demonstraramque náuseas ou vômitos relacionados à cefaleia e incapacidade decorrente da dor foram fatores independentes associados à depressão. Enxaqueca foi mais associada com depressão que os outros tipos de cefaleia. CONCLUSÃO: Os resultados demonstram associação entre cefaleia e depressão. Sintomas depressivos são mais comuns em adultos jovens com cefaleias mais incapacitantes.

Association between primary headaches and depression in young adults in southern Brazil.

OBJECTIVE: To verify the association between depression and headache in young adults, as well as to identify the features of headache associated with depression and the influence of this mood disorder on headache-related disability. METHODS: A cross-sectional study with self-administered questionnaires about headache and depression was conducted at the Universidade de Caxias do Sul. Beck Depression Inventory (BDI) and Migraine Disability Assessment (MIDAS) were used to evaluate depressive symptoms and headache-related disability, respectively. Depression was considered if BDI ≥ 15. RESULTS: A thousand and thirteen young adults were included in the study. A clear relationship was observed between headache and depression among the participants. Multivariate analyses demonstrated that nausea or vomiting related to headache and higher headache-related disability scores were independent factors associated with depression. Migraine was more associated with depression than the other types of headache. CONCLUSION: The results demonstrate an association between headache and depression. Depressive symptoms are more likely to be found in young adults with more disabling headaches.