Quetiapine effect on depressive-like behaviors, oxidative balance, and inflammation in serum of rats submitted to chronic stress.

Major depressive disorder (MDD) etiology is still not completely understood, and many individuals resist the traditional treatments. Chronic exposure to stressful events can contribute to development and progression and be involved in biological changes underlying MDD. Among the biological mechanisms involved, inflammatory changes and oxidative balance are associated with MDD pathophysiology. Quetiapine, a second-generation antipsychotic, induces a better therapeutic response in individuals refractory to traditional treatments. The main objectives of this research were as follows: to evaluate the effect of chronic mild stress (CMS) on depressive-like behaviors, oxidative stress, and inflammation in adult rats; to evaluate the possible antidepressant, antioxidant, and anti-inflammatory effects of quetiapine. The animals were submitted to CMS protocols. At the end of the CMS, the animals were submitted to a chronic treatment for 14 days with the following drugs: quetiapine (20 mg/kg), imipramine (30 mg/kg), and escitalopram (10 mg/kg). At the end of the treatments, the animals were evaluated in the open field tests, anhedonia (splash test), and forced swimming. The animals were euthanized after the behavioral tests, and serum samples were collected. Myeloperoxidase (MPO) activity and interleukin-6 (IL-6) levels were analyzed. CMS induced an increase in depressive-like behaviors, and quetiapine significantly reduced these behaviors. MPO activity and IL-6 levels increased in the serum of animals submitted to CMS. Quetiapine significantly reduced MPO activity and IL-6 levels. These results corroborate other evidence, indicating that chronic stress is a relevant phenomenon in the etiology of depression and suggesting that quetiapine induces an antidepressant effect because it reduces oxidative and inflammatory mechanisms.

High levels of extracellular ATP lead to different inflammatory responses in COVID-19 patients according to the severity.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has significantly impacted the world and has driven many researchers into the pathophysiology of COVID-19. In the findings, there is a close association between purinergic signaling and the immune response. Then, this study aimed to evaluate alterations in the purinergic signaling in COVID-19 patients according to range severity. We divided the COVID-19 patients into moderate and severe cases following the guideless of NIH and WHO, together with clinical characteristics. The blood samples were collected to obtain PBMCs and platelets. We analyzed the ectonucleotidase activities through ATP, ADP, AMP, Ado hydrolysis, E-NTPDase1 (CD39), and 5'-NT (CD73) expression by flow cytometry in total leukocytes. The extracellular ATP was measured by bioluminescence, and cytokines were analyzed by flow cytometry. We observed a decrease in ATP hydrolysis and increased AMP hydrolysis in PBMCs for both groups. In severe cases, ATP hydrolysis was raised for the platelets, while ADP and AMP hydrolysis have risen significantly in both groups. Additionally, there was a significant increase in ADP hydrolysis in severe cases compared to moderate cases. In addition, we observed an increase in the ADA activity in platelets of moderate patients. Moderate and severe cases showed increased expression of CD39 and CD73 in total leukocytes. To finalize the purinergic signaling, extracellular ATP was increased in both groups. Furthermore, there was an increase in IL-2, IL-6, IL-10, and IL-17 in moderate and severe groups. Thus, for the first time, our findings confirm the changes in purinergic signaling and immune response in COVID-19, in addition to making it more evident that the severity range directly impacts these changes. Therefore, the therapeutic potential of the purinergic system must be highlighted and studied as a possible target for the treatment of SARS-CoV-2 disease. KEY MESSAGES: COVID-19 patients exhibit alterations in purinergic system and immune response. High levels of extracellular ATP lead to different inflammatory responses. CD39 and CD73 expression were increased in COVID-19 patients. Cytokines IL-2, IL-6, IL-10, and IL-17 also were altered in these patients. The purinergic system may be a possibility target to SARS-CoV-2 treatments.

Prevalence of burnout syndrome among nursing professionals in an emergency room and in an intensive care unit / Síndrome de burnout em profissionais de enfermagem de unidade de pronto atendimento e de terapia intensiva

ABSTRACT Objective: To identify the presence of burnout syndrome among nursing professionals in the emergency room and intensive care unit for adults of the University Hospital of Maringá. Methods: This is an exploratory and descriptive research study with a quantitative approach. It was developed by applying a questionnaire containing 22 questions from the Maslach Burnout Inventory instrument, which identifies the symptomatology dimensions of the burnout syndrome. Data analysis of the Maslach Burnout Inventory instrument was performed by adding up each dimension (Emotional Exhaustion, Depersonalization and Professional Fulfillment) of each questionnaire separately, according to the nursing professional's answers to each question. The values obtained were compared to the reference values of the Nucleus for Advanced Studies on Burnout Syndrome. Results: It was found that 31.36% of the nursing professionals at the University Hospital of Maringá emergency room had high Emotional Exhaustion, 30.92% had low Professional Fulfillment, and 39.25% had high Depersonalization. Regarding the nursing professionals in the Intensive Care Unit for Adults, 36.36% had high Emotional Exhaustion, 36.36% had low Professional Fulfillment, and 22.73% had high Depersonalization. Conclusion: The findings suggest that the Intensive Care Unit for Adults in the morning shift is the highest stressor and with a greater probability of the professionals developing burnout syndrome.

RESUMO Objetivo: Identificar a existência da síndrome de burnout entre os profissionais de enfermagem de pronto atendimento e unidade de terapia intensiva adulto do Hospital Universitário de Maringá. Métodos: Trata-se de pesquisa exploratória, descritiva e de abordagem quantitativa. O estudo foi desenvolvido por meio da aplicação de um questionário contendo 22 questões do instrumento Maslach Burnout Inventory, o qual identifica as dimensões sintomatológicas da síndrome de burnout. A análise dos dados do instrumento Maslach Burnout Inventory foi realizada por meio do somatório de cada dimensão (exaustão emocional, despersonalização e realização profissional) de cada questionário, separadamente, de acordo com as respostas que o profissional de enfermagem respondeu em cada questão. Os valores obtidos foram comparados com os valores de referência do Núcleo de Estudos Avançados sobre a Síndrome de Burnout. Resultados: Constatou-se que 31,36% dos profissionais de enfermagem do pronto atendimento do Hospital Universitário de Maringá apresentaram alta exaustão emocional, 30,92%, baixa realização profissional e 39,25%, alta despersonalização. Com relação aos profissionais de enfermagem da unidade de terapia intensiva adulto, 36,36% apresentaram alta exaustão emocional, 36,36%, baixa realização profissional e 22,73%, apresentaram alta despersonalização. Conclusão: Os resultados sugerem que o setor de unidade de terapia intensiva adulto do período matutino é o maior estressor e com maior probabilidade de os profissionais desenvolverem a síndrome de burnout.

Ketamine treatment protects against oxidative damage and the immunological response induced by electroconvulsive therapy.

BACKGROUND: Electroconvulsive therapy (ECT) is often recommended for major depressive disorder (MDD) for those who do not respond to the first and second antidepressant trials. A combination of two therapies could improve antidepressant efficacy. Thus, this study aimed to investigate the synergistic effects of ECT combined to antidepressants with a different mechanism of action. METHODS: Rats were treated once a day, for five days with ketamine (5 mg/kg), fluoxetine (1 mg/kg), and bupropion (4 mg/kg) alone or in combination with ECT (1 mA; 100 V). After, oxidative damage and antioxidant capacity were assessed in the prefrontal cortex (PFC) and hippocampus, and pro-inflammatory cytokines levels were evaluated in the serum. RESULTS: ECT alone increased lipid peroxidation in the PFC and hippocampus. In the PFC of rats treated with ECT in combination with fluoxetine and bupropion, and in the hippocampus of rats treated with ECT combined with ketamine and bupropion there was a reduction in the lipid peroxidation. The nitrite/nitrate was increased by ECT alone but reverted by combination with ketamine in the hippocampus. Superoxide dismutase (SOD) was increased by ECT and maintained by fluoxetine and bupropion in the PFC. ECT alone increased interleukin-1ß (IL-1ß) and the administration of ketamine was able to revert this increase showing a neuroprotective effect of this drug when in combination with ECT. CONCLUSION: The treatment with ECT leads to an increase in oxidative damage and alters the immunological system. The combination with ketamine was able to protect against oxidative damage and the immunological response induced by ECT.

Educação Popular e Saúde: O cuidado em saúde com o uso de plantas medicinais na cultura indígena kaigang / Popular Education and Health: Health care with the use of medicinal plants in kaigang indigenous culture

Este livro se propõe a resgatar a sabedoria do povo indígena Kaingang na essência de suas práticas, pelo conhecimento de uma complexidade tão instigante, como são "as plantas que curam". Nossa proposta é contribuir para o fortalecimento desse conhecimento ainda presente junto às comunidades indígenas, apresentando um diálogo entre saber popular e científico, numa abordagem genuína sobre o uso das plantas medicinais pelos povos indígenas da etnia Kaingang, acrescido de uma rica contextualização científica, mantendo, todavia, o cuidado de não se apropriar ou "tomar" para si o legado originário. Propõe-se também a construir pontes com saberes milenares, passados de geração em geração, que outorgam autonomia e resistência aos povos indígenas, os quais, por fatores sociais e políticos diversos, vêem cada dia mais sua existência ameaçada. Compreende-se que essa sabedoria transcende até mesmo o plano científico, ampliando para uma compreensão cosmológica, a qual, de forma sistêmica, integra saber popular, cultura, religiosidades, mitos e conhecimento, contribuindo, sobretudo, para a constituição de uma territorialidade, que ancestralmente produz uma cultura de resistência junto aos povos indígenas. Enseja-se assim, uma singela contribuição a uma cultura que insiste em re-existir, numa relação que pode tornar-se muito fecunda quando assume um diálogo emancipador, práxico e potencializador de ambos os saberes, com produção de novas sínteses.

LC/QTOF profile and preliminary stability studies of an enriched flavonoid fraction of Cecropia pachystachya Trécul leaves with potential antidepressant-like activity.

There is increasing interest in natural antioxidants that are candidates for the prevention of brain damage occurring in major depressive disorders. Cecropia pachystachya is a tropical tree species of Central and South America and a rich source of polyphenols, particularly flavonoids. The aim of this study was to characterize the flavonoid profile of an enriched flavonoid fraction of C. pachystachya (EFF-Cp) and evaluate the antidepressant-like effects of its acute administration in behavior, cytokine levels, oxidative stress and energy metabolism parameters. The EFF-Cp chemical characterization was performed by HPLC/DAD and LC/QTOF. The antidepressant-like effects were performed by the forced swimming test, splash test and open field test. EFF-Cp revealed 15 flavonoids, including seven new glycosyl flavonoids for C. pachystachya. Quantitatively, EFF-Cp showed isoorientin (43.46 mg/g), orientin (23.42 mg/g) and isovitexin (17.45 mg/g) as major C-glycosyl flavonoids. In addition, EFF-Cp at doses 50 and 100 mg/kg reduced the immobility time in the forced swimming test, without changing the locomotor activity and grooming time. In addition, EFF-Cp was able to prevent the oxidative damage in some brain areas. In conclusion, the results of this study suggest that EFF-Cp exerts antidepressant-like effects with its antioxidant properties.

Prevalência de transtornos ansiosos e algumas comorbidades em idosos: um estudo de base populacional / Prevalence of anxiety disorders and some comorbidities in elderly: a population-based study

RESUMO Objetivo Avaliar a prevalência de transtornos ansiosos e fatores associados em uma amostra populacional de idosos do Sul de Santa Catarina. Métodos Estudo transversal com base em dados populacionais, que avaliou 1.021 indivíduos idosos entre 60 e 79 anos. Foram realizadas entrevistas domiciliares para aferição de variáveis sobre transtornos ansiosos, por meio do questionário MINI, dados sociodemográficos, hipertensão arterial sistêmica (HAS), infarto agudo do miocárdio (IAM) e dosagem de colesterol. Resultados As prevalências entre os transtornos ansiosos foram de 22,0% para o transtorno de ansiedade generalizada (TAG); 14,8% para fobia social (FS); 10,5% para transtorno do pânico (TP); e 8,5% para o transtorno obsessivo-compulsivo (TOC). Além disso, 40,5% dos indivíduos apresentaram pelo menos um transtorno de ansiedade. A distribuição dos transtornos foi semelhante nos dois gêneros; TAG foi mais prevalente nos indivíduos de menor escolaridade; TOC foi mais presente em indivíduos casados ou em união estável. Em relação às variáveis clínicas, HAS foi associada à presença de TOC; FS foi associada com IAM; TOC e FS foram associados com HDL > 40 mg/dL. Conclusão Os dados demonstram que os quadros de ansiedade são muito frequentes em idosos da comunidade, se sobrepõem de forma significativa e estão associados a algumas variáveis clínicas cardiovasculares.

ABSTRACT Objective This study evaluated the prevalence of anxiety disorders and associated factors in a population sample of elderly from South of Santa Catarina. Methods Cross-sectional study based on population data, which evaluated 1,021 elderly individuals, between 60 and 79 years. Home interviews were conducted to measure the variables of anxiety disorders, through of the MINI questionnaire, sociodemographic data, systemic arterial hypertension (SAH), acute myocardial infarction (AMI) and serum cholesterol measurements. Results The prevalence among anxiety disorders were 22.0% for generalized anxiety disorder (GAD), 14.8% for social phobia (FS); 10.5% for panic disorder (PD); 8.5% for obsessive-compulsive disorder (OCD), and with only, at least one disorder 40.5%. The distribution of the disorders were similar in both genders, GAD was more prevalent among those with lower education; OCD was more prevalent in individuals who were married or in union stable. In relation to clinical variables, SAH was associated with the presence of OCD; FS was associated with AMI; FS and OCD were associated with HDL > 40 mg/dL. Conclusion The data demonstrate that anxiety conditions are very common in older adults, significantly overlap and are associated with cardiovascular clinical variables.

Depressive disorders and comorbidities among the elderly: a population-based study / Transtornos depressivos e algumas comorbidades em idosos: um estudo de base populacional

Objective The present study assessed the prevalence of depressive disorders and associated factors in a sample of elderly persons in the south of Santa Catarina. Methods A cross-sectional study based on population data was performed, evaluating 1021 elderly individuals aged between 60 and 79 years. Home interviews were carried out using the Portuguese version of the Mini International Neuropsychiatric Interview (MINI), in order to collect demographic data, information on hypertension and reports of acute myocardial infarction. The disorders studied were current depressive episode, dysthymia and a comorbidity of a depressive episode and dysthymia, representing double depression. The comparison of mean age and prevalence was made with the t-test and other associations were analyzed using the Chi-squared test. Results The prevalence of depression was 26.2%, while 5.5% of the sample suffered from dysthymia and 2.7% experienced double depression. Risk factors for depression were: nine or more years of schooling [PR = 1.44 (1.17 to 1.77); p <0.05] and being a current smoker [OR = 1.63 (1.30-2.05); p <0.05]. Dysthymia was associated with the male gender [OR = 6.46 (3.29 to 12.64); p <0.05], reports of hypertension [OR = 2.55 (1.53 to 4.24); p <0.05] and being either a current [OR = 1.86 (1.02 to 3.42); p <0.05] or past or former [OR = 2.89 (1.48 to 5.65); p <0.05] smoker. The same risk factors as for dysthymia were found for double depression: male [OR = 4.21 (1.80 to 9.81); p <0.05], reports of hypertension [OR = 8.11 (3.32 to 19.80); p <0.05], and being either a current [OR = 5.72 (1.64 to 19.93); p <0.05] or past [PR = 13.11 (3.75 to 45.86); p <0.05] smoker. Conclusions The present study shows that depressive disorders are a common phenomenon among the elderly. The results not only corroborated with other studies, but found slightly higher levels of depressive disorders among the elderly population.

Objetivo Avaliar a prevalência de transtornos depressivos e fatores associados em uma amostra de idosos no Sul de Santa Catarina. Método Estudo transversal com base de dados populacional, que avaliou 1.021 indivíduos idosos entre 60 e 79 anos. Foram realizadas entrevistas domiciliares com a versão em português do Mini International Neuropsychiatric Interview (MINI), coleta de dados sociodemográficos, informações sobre hipertensão arterial sistêmica, infarto agudo do miocárdio e tabagismo. Os transtornos estudados foram episódio depressivo atual, distimia e comorbidade entre episódio depressivo e distimia, caracterizando depressão dupla. A comparação das médias de idade e prevalências foi feita com o teste t Student, as demais associações foram analisadas pelo teste Qui-quadrado. Resultados A prevalência de depressão foi de 26,2%; distimia, 5,5%; e depressão dupla, 2,7%. Fatores de risco para depressão: nove anos ou mais de estudo [RP=1,44(1,17-1,77); p<0,05] e tabagismo atual [RP=1,63(1,30-2,05); p<0,05]. A distimia foi associada ao gênero masculino [RP=6,46(3,29-12,64); p<0,05], relato de hipertensão arterial [RP=2,55(1,53-4,24);p<0,05] e tabagismo, tanto atual [RP=1,86(1,02-3,42),p<0,05] quanto passado ou ex-tabagistas [RP=2,89(1,48-5,65); p<0,05]. Para a depressão dupla, repetiram os mesmos fatores de risco da distimia: gênero masculino [RP=4,21(1,80-9,81); p<0,05], relato de hipertensão arterial [RP=8,11(3,32-19,80); p<0,05], tabagismo atual [RP=5,72(1,64-19,93); p<0,05] e passado [RP=13,11(3,75-45,86); p<0,05]. Conclusão Os dados demonstram que quadros depressivos são fenômenos frequentes e atingem um percentual significativo de idosos. Adicionalmente, os transtornos depressivos foram associados a fatores sociodemográficos e doenças crônicas, como nível de escolaridade, tabagismo e hipertensão arterial.

Antioxidant Therapy Alters Brain MAPK-JNK and BDNF Signaling Path-ways in Experimental Diabetes Mellitus.

This study was designed to investigate the effects of treatment with the antioxidants N-acetylcysteine (NAC) and deferoxamine (DFX) in intracellular pathways in the brain of diabetic rats. To conduct this study we induced diabetes in Wistar rats with a single injection of alloxan, and afterwards rats were treated with NAC or DFX for 14 days. Following treatment completion, the immunocontent of c-Jun N-terminal kinase (JNK), mitogen-activated protein kinase-38 (MAPK38), brain-derived neurotrophic factor (BDNF), and protein kinases A and C (PKA and PKC) were determined in the prefrontal cortex (PFC), hippocampus, amygdala and nucleus accumbens (NAc). DFX treatment increased JNK content in the PFC and NAc of diabetic rats. In the amygdala, JNK was increased in diabetics treated with saline or NAC. MAPK38 was decreased in the PFC of control and in diabetic rats treated with NAC or DFX; and in the NAc in all groups. PKA was decreased in the PFC with DFX treatment. In the amygdala, PKA content was increased in diabetic rats treated with either saline or NAC, compared to controls; and it was decreased in either NAC or DFX-treated groups, compared to saline-treated diabetic animals. In the NAc, PKA was increased in NAC-treated diabetic rats. PKC was increased in the amygdala of NAC-treated diabetic rats. In the PFC, the BDNF levels were decreased following treatment with DFX in diabetic rats. In the hippocampus of diabetic rats the BDNF levels were decreased. However, treatment with DFX reversed this effect. In the amygdala the BDNF increased with DFX in non-diabetic rats. In the NAc DFX treatment increased the BDNF levels in diabetic rats. In conclusion, both diabetes and treatment with antioxidants were able to alter intracellular pathways involved in the regulation of cell survival in a brain area and treatment-dependent fashion.