Evaluation of the blood-oxygen-level-dependent (BOLD) sequence with 3 Tesla device in renal transplant patients in the assessment of early allograft disfunction, correlated with biopsy.

OBJECTIVE: To evaluate the ability of blood-oxygen-level-dependent (BOLD) magnetic resonance imaging at 3 Tesla to measure tissue oxygen bioavailability based on R2* values, and to differentiate between acute tubular necrosis and acute rejection compared to renal biopsy (gold standard). METHODS: A prospective, single-center study, with patients submitted to renal transplantation between 2013 and 2014, who developed graft dysfunction less than 4 weeks after transplantation. All patients were submitted to abdominal magnetic resonance imaging at 3 Tesla using the same protocol, followed by two BOLD sequences and kidney biopsy. RESULTS: Twelve male (68.75%) and three female (31.25%) patients were included. A total of 19 percutaneous renal biopsies were performed (four patients required a second biopsy due to changes in clinical findings). Pathological findings revealed ten cases of acute tubular necrosis, four cases of acute rejection, and five cases with other (miscellaneous) diagnoses. Comparison between the four groups of interest failed to reveal significant differences (p=0.177) in cortical R2* values, whereas medullary R2* values differed significantly (p=0.033), with lower values in the miscellaneous diagnoses and the acute tubular necrosis group. CONCLUSION: BOLD magnetic resonance imaging at 3 Tesla is a feasible technique that uses indirect tissue oxygen level measurements to differentiate between acute rejection and acute tubular necrosis in renal grafts.

Evaluation of the blood-oxygen-level-dependent (BOLD) sequence with 3 Tesla device in renal transplant patients in the assessment of early allograft disfunction, correlated with biopsy / Avaliação da sequência dependente do nível de oxigênio no sangue (BOLD) com dispositivo 3 Tesla em pacientes transplantados renais na avaliação da disfunção de enxerto precoce, correlacionada com biópsia

ABSTRACT Objective To evaluate the ability of blood-oxygen-level-dependent (BOLD) magnetic resonance imaging at 3 Tesla to measure tissue oxygen bioavailability based on R2* values, and to differentiate between acute tubular necrosis and acute rejection compared to renal biopsy (gold standard). Methods A prospective, single-center study, with patients submitted to renal transplantation between 2013 and 2014, who developed graft dysfunction less than 4 weeks after transplantation. All patients were submitted to abdominal magnetic resonance imaging at 3 Tesla using the same protocol, followed by two BOLD sequences and kidney biopsy. Results Twelve male (68.75%) and three female (31.25%) patients were included. A total of 19 percutaneous renal biopsies were performed (four patients required a second biopsy due to changes in clinical findings). Pathological findings revealed ten cases of acute tubular necrosis, four cases of acute rejection, and five cases with other (miscellaneous) diagnoses. Comparison between the four groups of interest failed to reveal significant differences (p=0.177) in cortical R2* values, whereas medullary R2* values differed significantly (p=0.033), with lower values in the miscellaneous diagnoses and the acute tubular necrosis group. Conclusion BOLD magnetic resonance imaging at 3 Tesla is a feasible technique that uses indirect tissue oxygen level measurements to differentiate between acute rejection and acute tubular necrosis in renal grafts.

RESUMO Objetivo Avaliar a sequência de ressonância magnética blood-oxygen-level-dependent (BOLD) realizada em um equipamento 3 Tesla para medir a biodisponibilidade do oxigênio do tecido pelo valor de R2* na diferenciação de necrose tubular aguda e rejeição aguda, comparando à biópsia renal (padrão-ouro). Métodos Estudo unicêntrico, prospectivo, com pacientes submetidos a transplante renal de 2013 a 2014, que desenvolveram disfunção do enxerto menos de 4 semanas após o transplante. Todos os pacientes foram submetidos à ressonância magnética abdominal 3 Tesla com o mesmo protocolo, seguida de duas sequências BOLD e biópsia renal. Resultados Foram incluídos 12 homens (68,75%) e três mulheres (31,25%). Foram realizadas 19 biópsias renais percutâneas (quatro pacientes necessitaram de segunda biópsia devido à alteração nos achados clínicos). Os resultados histopatológicos incluíram dez casos de necrose tubular aguda, quatro de rejeição aguda e cinco casos de outros diagnósticos (miscelânea). A comparação entre os quatro grupos de interesse não mostrou diferenças significativas em relação ao R2* no córtex (p=0,177). Quanto ao R2* da medula, observaram-se diferenças significativas (p=0,033), com miscelânea e necrose tubular aguda apresentando valores mais baixos quando comparados aos demais. Conclusão A ressonância magnética BOLD 3 Tesla é uma técnica viável que indiretamente utiliza a concentração de oxigênio no tecido em enxertos renais e pode ser usada para a diferenciação entre rejeição aguda e necrose tubular aguda.

COVID-19 information exposure in digital media and implications for employees in the health care sector: findings from an online survey.

OBJECTIVE: To estimate coronavirus disease 2019-related information consumption and related implications for health care professionals (medical and nonmedical personnel) during the pandemic. METHODS: A cross-sectional on-line survey was distributed to employees of a major health care institution located in São Paulo, Brazil between April 3 and April 10, 2020. Data were analyzed using descriptive statistics. RESULTS: The sample comprised 2,646 respondents. Most participants (44.4%) reported excessive or almost excessive access to information about the novel coronavirus and 67.6% reported having increased their average time spent on social media. When asked how frequently they consider it was easy to determine the reliability of information, "sometimes" corresponded to 43.2% of the answers in contrast to 14.6% responding "always". Answers related to potential signs of information overload associated with the pandemic indicated that 31% of respondents felt stressed by the amount of information they had to keep up with almost every day or always. Overall, 80.0% of respondents reported having experienced at least one of the following symptoms: headache, eye twitching, restlessness or sleeping difficulty. The frequency of symptoms was higher among participants with a more negative information processing style regarding when dealing with large volumes of information relative to those with a positive information processing style. Likewise, symptoms were more frequently reported by participants who had increased their social media access relative to those reporting reduced access during the pandemic. CONCLUSION: Our survey provides a description of how health professionals consume COVID-19 related information during the pandemic, and suggests that excessive information exposure and high processing demands may impose psychological distress and affect mental health.

Chronic low back pain and sick-leave: a functional magnetic resonance study.

BACKGROUND: Chronic low back pain (CLBP) represents a problem in the occupational environment, often associated with disability, sick-leave demands, loss of productivity, anxiety, depression and high socioeconomic cost. The emergence of functional neuroimaging allowed new insights into brain structure and physiology in normality and chronic pain. While occupational related aspects are recognized as important risk factors for chronicity there have not been thus far evaluated by fMRI experiments. The overall objective of this study is to compare the neuronal correlates between groups of individuals CLBP with or without sick-leave demands. METHODS: A total of 74 individuals were divided into three groups: chronic low back pain with sick-leave demands [CLBP_L]; chronic low back pain without sick-leave demands [CLBP_NL]; individuals without pain or sick-leave demands [Control]. Functional magnetic resonance imaging was used to assess brain function during moderate acute pain stimulation task (thumb controlled pressure). RESULTS: After acute painful stimulation, a higher brain response was found in the anterior cingulate and superior and medium frontal gyrus was observed in CLBP_NL vs. CLBP_L (p <  0,001) and increased brain response in the frontal pole and paracingulate region in control vs. CLBP_L (p <  0.001) during acute pain stimulation. CONCLUSION: The modulation of acute pain participates in the mechanism propagating chronic pain perception. The lower activation in the superior frontal gyrus observed in the CLBP_L group compared to CLBP_NL, reinforces the idea of an already existing activation in this area.

Brain white matter microstructure in obese women with binge eating disorder.

OBJECTIVE: Research on potential brain circuit abnormalities in binge eating disorder (BED) is limited. Here, we assess white matter (WM) microstructure in obese women with BED. METHOD: Diffusion tensor imaging data were acquired, and tract-based spatial statistics used to examine WM in women with BED who were obese (n = 17) compared to normal-weight (NWC) (n = 17) and to women who were obese (OBC) (n = 13). Body mass index (BMI) was a covariate in the analyses. RESULTS: The BED group (vs. NWC) had greater axial diffusion (AD) in the forceps minor, anterior thalamic radiation, superior and inferior longitudinal fasciculus, that is, in pathways connecting fronto-limbic regions. Microstructures differences in AD between the BED and OBC groups were seen in fronto-limbic pathways extending to temporoparietal pathways. The BED (vs. OBC) group had greater fractional anisotropy in the forceps minor and greater AD in the superior longitudinal fasciculus, cingulate gyrus, and corpus callosum, consistent with fronto-tempoparietal pathways. CONCLUSION: Women with BED show WM alterations in AD in fronto-limbic and parietal pathways that are important in decision-making processes. As BMI was a covariate in the analyses, alterations in BED may be part of the pathology, but whether they are a cause or effect of illness is unclear.

Chronic low back pain and sick-leave: a functional magnetic resonance study

Abstract Background Chronic low back pain (CLBP) represents a problem in the occupational environment, often associated with disability, sick-leave demands, loss of productivity, anxiety, depression and high socioeconomic cost. The emergence of functional neuroimaging allowed new insights into brain structure and physiology in normality and chronic pain. While occupational related aspects are recognized as important risk factors for chronicity there have not been thus far evaluated by fMRI experiments. The overall objective of this study is to compare the neuronal correlates between groups of individuals CLBP with or without sick-leave demands. Methods A total of 74 individuals were divided into three groups: chronic low back pain with sick-leave demands [CLBP_L]; chronic low back pain without sick-leave demands [CLBP_NL]; individuals without pain or sick-leave demands [Control]. Functional magnetic resonance imaging was used to assess brain function during moderate acute pain stimulation task (thumb controlled pressure). Results After acute painful stimulation, a higher brain response was found in the anterior cingulate and superior and medium frontal gyrus was observed in CLBP_NL vs. CLBP_L ( p < 0,001) and increased brain response in the frontal pole and paracingulate region in control vs. CLBP_L ( p < 0.001) during acute pain stimulation. Conclusion The modulation of acute pain participates in the mechanism propagating chronic pain perception. The lower activation in the superior frontal gyrus observed in the CLBP_L group compared to CLBP_NL, reinforces the idea of an already existing activation in this area.(AU)

COVID-19 information exposure in digital media and implications for employees in the health care sector: findings from an online survey / Exposição às informações sobre COVID-19 em mídias digitais e suas implicações para funcionários do setor de saúde: resultados de uma pesquisa on-line

ABSTRACT Objective: To estimate coronavirus disease 2019-related information consumption and related implications for health care professionals (medical and nonmedical personnel) during the pandemic. Methods: A cross-sectional on-line survey was distributed to employees of a major health care institution located in São Paulo, Brazil between April 3 and April 10, 2020. Data were analyzed using descriptive statistics. Results: The sample comprised 2,646 respondents. Most participants (44.4%) reported excessive or almost excessive access to information about the novel coronavirus and 67.6% reported having increased their average time spent on social media. When asked how frequently they consider it was easy to determine the reliability of information, "sometimes" corresponded to 43.2% of the answers in contrast to 14.6% responding "always". Answers related to potential signs of information overload associated with the pandemic indicated that 31% of respondents felt stressed by the amount of information they had to keep up with almost every day or always. Overall, 80.0% of respondents reported having experienced at least one of the following symptoms: headache, eye twitching, restlessness or sleeping difficulty. The frequency of symptoms was higher among participants with a more negative information processing style regarding when dealing with large volumes of information relative to those with a positive information processing style. Likewise, symptoms were more frequently reported by participants who had increased their social media access relative to those reporting reduced access during the pandemic. Conclusion: Our survey provides a description of how health professionals consume COVID-19 related information during the pandemic, and suggests that excessive information exposure and high processing demands may impose psychological distress and affect mental health.

RESUMO Objetivo: Estimar o consumo de informações relacionadas com doença do novo coronavírus e seus efeitos em profissionais do setor da saúde durante a pandemia. Métodos: Um questionário on-line foi distribuído para funcionários de uma instituição de saúde em São Paulo, Brasil, entre 3 e 10 de abril de 2020. Os dados foram analisados com estatísticas descritivas. Resultados: Foram incluídos nas análises 2.646 participantes. A maioria (44,4%) reportou ter acessado uma quantidade excessiva ou próxima de excessiva sobre o novo coronavírus, e 67,6% reportaram ter aumentado seu tempo médio em mídias sociais. Quando perguntados se era fácil determinar o que era informação confiável, 43,2% responderam "às vezes", comparados com 14,6% que responderam "sempre". Sobre os possíveis sinais de sobrecarga de informação associada com a pandemia, 31% sempre ou quase todos os dias se sentiram estressados com a quantidade de informações que tinham que acompanhar. Entre os respondentes, 80,0% reportaram sentir pelo menos um sintoma como dor de cabeça, espasmos oculares, inquietação ou dificuldade para dormir. Participantes com um estilo mais negativo de lidar com muitas informações também reportaram maior proporção de sintomas que os participantes com estilo positivo. De forma semelhante, participantes que aumentaram seu acesso a mídias sociais reportaram maior proporção de sintomas do que os que diminuíram seu acesso durante a pandemia. Conclusão: Nossa pesquisa fornece uma descrição de como os indivíduos consomem informações relacionadas com a doença do novo coronavirus durante a pandemia e sugere que a exposição a uma quantidade excessiva de informações e as elevadas demandas podem impor sofrimento psicológico e afetar a saúde mental.

Pesquisas em cérebro e Práticas Contemplativas / Brain Research and Contemplative Practices

Introdução: Nos últimos anos tem havido um crescente interesse na investigação dos efeitos práticas de meditação na saúde mental e física. De alguma maneira, as habilidades treinadas durante as práticas meditativas, como o treinamento da atenção focada em um objeto específico, ou a monitoração dos padrões de pensamentos e emoções age modificando o funcionamento e a estrutura cerebrais. Recentemente, trabalhos na área de neuroimagem tem ajudado a elucidar possíveis mecanismo de ação das práticas meditativas no cérebro. Objetivo: revisar na literatura os estudos mais recentes sobre os efeitos da prática de meditação no cérebro e apresentar resultados de um protocolo com ressonância magnética funcional (fMRI) desenvolvido no Instituto do Cérebro do Hospital Israelita Albert Einstein (InCe-HIAE) sobre os efeitos da meditação na atenção. Método: revisão sobre estudos de neuroimagem funcional e estrutural e avaliação por fMRI de 39 sujeitos, 20 meditadores que realizam a prática há pelo menos 3 anos, por 3 vezes por semana e 20 sujeitos inexperientes em meditação. Resultados: estudos recentes têm mostrado alterações funcionais resultantes da prática de meditação, na atividade cerebral, bem como na estrutura do cérebro, como a espessura de áreas corticais. Nossos resultados preliminares corroboram com estes dados, mostrando que sujeitos que praticam meditação regularmente precisam recrutar menos áreas cerebrais, em especial frontais, do que pessoas inexperientes em meditação para ter o mesmo desempenho em uma tarefa atencional (o Stroop Word-Color Task). Conclusão: a prática de meditação pode trazer mudanças não apenas psicológicas, como mostram boa parte dos estudos, mas também modificações na fisiologia e anatomia cerebrais. Nosso estudo preliminar no InCe-HIAE indica que pessoas que praticam meditação regularmente podem apresentar um cérebro mais eficiente no desempenho de uma tarefa de atenção.