Relationship of hemoglobin levels with outcomes in deceased donor kidney transplant: a retrospective cohort study / Relação dos níveis de hemoglobina com desfechos em transplante renal de doador falecido: um estudo de coorte retrospectivo

ABSTRACT Introduction: Anemia is frequent in patients undergoing replacement therapy for kidney failure. Anemia in the pre- and post-transplantation period might be related to kidney transplant outcomes. The current study therefore sought to assess the relationship between anemia, delayed allograft function (DGF), chronic kidney allograft dysfunction (CAD), and death from any cause following kidney transplantation from a deceased donor. Methods: This was a retrospective study with 206 kidney transplant patients of deceased donors. We analyzed deceased donors' and kidney transplant patients' demographic data. Moreover, we compared biochemical parameters, anemia status, and medicines between DGF and non-DGF groups. Afterward, we performed a multivariate analysis. We also evaluated outcomes, such as CAD within one year and death in ten years. Results: We observed a lower frequency of pre-transplant hemoglobin concentration (Hb) but higher frequency of donor-serum creatinine and red blood transfusion within one week after transplantation in the group with DGF. In addition, there was an independent association between Hb concentration before transplantation and DGF [OR 0.252, 95%CI: 0.159-0.401; p < 0.001]. There was also an association between Hb concentration after six months of kidney transplantation and both CAD [OR 0.798, 95% CI: 0.687-0.926; p = 0.003] and death from any cause. Conclusion: An association was found between pre-transplantation anemia and DGF and between anemia six months after transplantation and both CAD and death by any cause. Thus, anemia before or after transplantation affects the outcomes for patients who have undergone kidney transplantation from a deceased donor.

RESUMO Introdução: A anemia é frequente em pacientes submetidos à terapia substitutiva para insuficiência renal. A anemia nos períodos pré e pós-transplante pode estar relacionada aos desfechos do transplante renal. Portanto, o presente estudo buscou avaliar a relação entre anemia, função retardada do enxerto (FRE), disfunção crônica do enxerto renal (DCE) e óbito por qualquer causa após transplante renal de doador falecido. Métodos: Este foi um estudo retrospectivo com 206 pacientes transplantados renais de doadores falecidos. Analisamos dados demográficos de doadores falecidos e pacientes transplantados renais. Além disso, comparamos parâmetros bioquímicos, status de anemia e medicamentos entre os grupos FRE e não-FRE. Posteriormente, realizamos uma análise multivariada. Também avaliamos desfechos, como DCE em um ano e óbito em dez anos. Resultados: Observamos menor frequência de concentração de hemoglobina (Hb) pré-transplante, mas maior frequência de creatinina sérica do doador e transfusão de hemácias no período de uma semana após o transplante no grupo FRE. Além disso, houve associação independente entre a concentração de Hb antes do transplante e a FRE [OR 0,252; IC 95%: 0,159-0,401; p < 0,001]. Houve também associação entre a concentração de Hb após seis meses de transplante renal e ambos, DCE [OR 0,798; IC95%: 0,687-0,926; p = 0,003] e óbito por qualquer causa. Conclusão: Encontrou-se uma associação entre anemia pré-transplante e FRE e entre anemia seis meses após o transplante e ambos, DCE e óbito por qualquer causa. Assim, a anemia antes ou após o transplante afeta os desfechos de pacientes que foram submetidos a transplante renal de doador falecido.

Chemical profiles and bioactivities of polyphenolic extracts of Lavandula stoechas L., Artemisia dracunculus L. and Ocimum basilicum L.

This study assessed the chemical profiles and bioactivities of the infusions, decoctions and hydroethanolic extracts of tarragon, basil and French lavender. The extracts were chemically characterised (HPLC-DAD-ESI/MS) and their bioactivities were evaluated in vitro. All extracts revealed antimicrobial, antifungal and antioxidant properties. French lavender extracts showed higher total phenolic content, regardless of the extraction method used, and antioxidant and antitumour capacities, but no anti-inflammatory action. All basil and two of the tarragon extracts revealed anti-inflammatory power. Thus, tarragon, basil and French lavender extracts may be considered for inclusion in foods, as preservatives or functional ingredients. Nonetheless, further studies must be conducted to evaluate the pharmacokinetic parameters of the bioactive compounds.

Oestradiol and osteoclast differentiation: Effects on p53 and mitochondrial metabolism.

BACKGROUND: Oestrogen deficiency increases bone resorption, contributing to osteoporosis development. Yet, the mechanisms mediating the effects of oestrogen on osteoclasts remain unclear. This study aimed to elucidate the early metabolic alteration induced by RANKL, the essential cytokine in osteoclastogenesis and 17-beta-oestradiol (E2) on osteoclast progenitor cells, using RAW 264.7 macrophage cell line and primary bone marrow-derived macrophages as biological models. RESULTS: This research demonstrated that, in osteoclast precursors, RANKL stimulates complex I activity, oxidative phosphorylation (OXPHOS) and mitochondria-derived ATP production as early as 3 h of exposure. This effect on mitochondrial bioenergetics is associated with an increased capacity to oxidize TCA cycle substrates, fatty acids and amino acids. E2 inhibited all effects of RANKL on mitochondria metabolism. In the presence of RANKL, E2 also decreased cell number and stimulated the mitochondrial-mediated apoptotic pathway, detected as early as 3 h. Further, the pro-apoptotic effects of E2 during osteoclast differentiation were associated with an accumulation of p392S-p53 in mitochondria. CONCLUSIONS: These findings elucidate the early effects of RANKL on osteoclast progenitor metabolism and suggest novel p53-mediated mechanisms that contribute to postmenopausal osteoporosis.

Characterization and bioactivities of coffee husks extract encapsulated with polyvinylpyrrolidone.

Coffee processing generates large amounts of residues of which a portion still has bioactive properties due to their richness in phenolic compounds. This study aimed to obtain a coffee husks extract (CHE) and to encapsulate it (ECHE) with polyvinylpyrrolidone using a one-step procedure of solid dispersion. The extraction and encapsulation yields were 9.1% and 92%, respectively. Thermal analyses revealed that the encapsulation increased the thermal stability of CHE and dynamic light scattering analyses showed a bimodal distribution of size with 81% of the ECHE particles measuring approximately 711 nm. Trigonelline and caffeine were the main alkaloids and quercetin the main phenolic compound in CHE, and the encapsulation tripled quercetin extraction. The total phenolics content and the antioxidant activity of ECHE, assayed with three different procedures, were higher than those of CHE. The antioxidant activity and the bioaccessibility of the phenolic compounds of ECHE were also higher than those of CHE following simulated gastrointestinal digestion (SGID). Both CHE and ECHE were not toxic against Alliumcepa cells and showed similar capacities for inhibiting the pancreatic α-amylase in vitro. After SGID, however, ECHE became a 1.9-times stronger inhibitor of the α-amylase activity in vitro (IC50 = 8.5 mg/mL) when compared to CHE. Kinetic analysis revealed a non-competitive mechanism of inhibition and in silico docking simulation suggests that quercetin could be contributing significantly to the inhibitory action of both ECHE and CHE. In addition, ECHE (400 mg/kg) was able to delay by 50% the increases of blood glucose in vivo after oral administration of starch to rats. This finding shows that ECHE may be a candidate ingredient in dietary supplements used as an adjuvant for the treatment of diabetes.

Chest Computed Tomography for Lymphoma Staging: A Wasted Opportunity for Cardiovascular Risk Stratification?

AIM: Patients with a lymphoma diagnosis undergo non-gated chest computed tomography (CT) scans as part of cancer diagnosis or staging. Although coronary artery calcification (CAC) is traditionally evaluated on dedicated cardiac CT, CAC can also be detected on standard chest CT. This exploratory study aimed to determine the prognostic value of CAC detected on non-gated chest CT and to report its use on clinical practice. METHOD: Consecutive patients with a lymphoma diagnosis who performed non-contrasted non-gated chest CT for cancer diagnosis or staging were included and retrospectively evaluated. Coronary artery calcification was evaluated by quantitative (Agatston score) and qualitative (visual) assessment. RESULTS: Fifty-seven patients were included in this study (mean age 61±15 years; 58% male). Coronary artery calcification was identified in 22 patients (39%), most of them with multi-vessel involvement. Coronary artery calcification was qualitatively classified as mild, moderate and severe in 11%, 19% and 9% patients, respectively. This study suggested that moderate or severe CAC was an independent predictor of all-cause mortality (odds ratio 3, 95% confidence interval 2-11; p=0.04) after adjusting for cardiovascular risk factors and lymphoma staging. Regarding quantitative evaluation, a higher CAC score was also associated with higher mortality. While significant CAC was identified in 22 patients, it was only reported in four patients. CONCLUSIONS: The preliminary findings of this hypothesis-generating study support the investigation of CAC identified by chest CT for diagnosis/staging of cancer as a risk modifier in the global risk assessment of patients with lymphoma. The unrecognition and underreporting of this finding may represent a wasted opportunity to detect subclinical coronary atherosclerosis in these patients and may help in guiding preventive cardiology care.

Association between Leukemic Evolution and Uncommon Chromosomal Alterations in Pediatric Myelodysplastic Syndrome.

Background: Pediatric myelodysplastic syndrome (pMDS) is a group of rare clonal neoplasms with a difficult diagnosis and risk of progression to acute myeloid leukemia (AML). The early stratification in risk groups is essential to choose the treatment and indication for allogeneic hematopoietic stem cell transplantation (HSCT). According to the Revised International Prognostic Scoring System, cytogenetic analysis has demonstrated an essential role in diagnosis and prognosis. In pMDS, abnormal karyotypes are present in 30-50% of the cases. Monosomy 7 is the most common chromosomal alteration associated with poor prognosis. However, the rarity of specific cytogenetic alterations makes its prognosis uncertain. Thus, this study aimed to describe uncommon cytogenetic alterations in a cohort of 200 pMDS patients and their association with evolution to AML. Methods: The cytogenetic analysis was performed in 200 pMDS patients by G-banding and fluorescence in situ hybridization between 2000 to 2022. Results: Rare chromosome alterations were observed in 7.5% (15/200) of the cases. These chromosome alterations were divided into four cytogenetic groups: hyperdiploidy, biclonal chromosomal alterations, translocations, and uncommon deletions representing 33.3%, 33.3%, 20%, and 13.3%, respectively. Most of these patients (10/15) were classified with advanced MDS (MDS-EB and MDS/AML) and the initial subtype was present in five patients (RCC). The leukemic evolution was observed in 66.66% (10/15) of the patients. Most patients had poor clinical outcomes and they were indicated for HSCT. Conclusion: The study of uncommon cytogenetic alterations in pMDS is important to improve the prognosis and guide early indication of HSCT.

A experiência de atendimento de um grupo terapêutico durante a graduação: a obstaculização pelo pacto denegativo / La experiencia de asistir a un grupo terapéutico durante la graduación: el obstáculo causado por el pacto negativo / The experience of attending a therapeutic group during graduation: the obstacle caused by the negative pact

Grupos psicoterapêuticos encontram crescente receptividade nos serviços públicos e privados de saúde. Eles conjugam a expansão da capacidade de atendimento com atuação clínica crítica e propositiva frente ao individualismo da sociedade contemporânea. É importante assim pensarmos os desafios da formação dos psicólogos para este trabalho. Este artigo parte de uma dificuldade encontrada por estagiários de 4° e 5° ano do curso de psicologia, na condução de um grupo psicoterapêutico. Coloca-se como objetivo analisar a relação entre um pacto denegativo que obstaculiza o processo terapêutico com as experiências iniciais de atendimento dos estagiários. Aspectos vivenciados serão apresentados e debatidos à luz da teoria. Descreve-se a existência de um pacto denegativo neste grupo, que se opõe ao processo terapêutico dos pacientes e complexifica o desenvolvimento dos estagiários ao desafiar a confiança em suas percepções e associações, dificultando a realização de intervenções. Conclui-se que o pacto denegativo que obstaculiza o grupo se apresenta, a princípio, como um desafio aos estagiários, porém, mediante o apoio na relação entre os estagiários e supervisão é possível transformar este desafio em fonte de aprendizado.

Grupos psicoterapéuticos son cada vez más recibidos en los servicios de salud. Combinan la expansión de la capacidad de servicio con una acción clínica crítica y decidida frente al individualismo de la sociedad contemporánea. Es importante pensar en los desafíos de formar psicólogos para este trabajo. Este artículo se basa en una dificultad que enfrentan los pasantes de 4° y 5° año de psicología al momento de conducir un grupo psicoterapéutico. El objetivo es analizar la relación entre un pacto negativo que obstruye el proceso terapéutico y las experiencias de cuidado de los internos. Se debatirán experiencias y la teoría. Se describe la existencia de un pacto negativo, que se opone al proceso terapéutico de los pacientes e intensifica el desafío de los alumnos al desafiar la confianza en sus percepciones y asociaciones, lo que dificulta la realización de intervenciones. Se concluye que el pacto negativo que obstaculiza al grupo se presenta, en un primer momento, como un reto para los aprendices, sin embargo, a través del apoyo en la relación entre los aprendices y la supervisión es posible transformar este reto en una fuente de aprendizaje.

Psychotherapeutic groups are increasingly employed in health services. They combine the expansion of the service capacity with critical and purposeful clinical action in face of the individualism of contemporary society. It is important to think about the challenges of training psychologists for this work. This article is based on a difficulty encountered by 4th and 5th year psychology students, acting as trainees, when conducting a psychotherapeutic group. The objective is to analyze the relationship between a denegative pact that obstructs the therapeutic process and the trainees' initial clinical experience. This text debates aspects of this practice in light of theory. It describes a denegative pact in this group, which opposes the patients' therapeutic process and intensifies the trainees' challenge by challenging the trust in their perceptions and associations, making it more difficult for them to find spaces to intervene. It concludes that the negative pact that hinders the group presents itself, in principle, as a challenge to the trainees, however, through support in the relationship between the trainees and supervision it is possible to transform this challenge into a source of learning.

Effective Management of Giant Ventral Hernias: A Comprehensive Approach Combining Preoperative Botulinum Toxin Application, Modified Ramírez's Component Separation, and Rives-Stoppa Hernioplasty.

Introduction  Giant ventral hernias are a surgical challenge due to their size and the need for a specialized approach during repair. Over the decades, abdominal wall surgery has evolved into a sophisticated field with a wide range of techniques aimed at improving patient outcomes. However, there is no universally accepted method suitable for repairing all giant ventral hernias. Surgeons must rely on a combination of techniques, choosing the approach that best matches their expertise, available resources, and the individual patient's specific needs. This article explores the effective use of a combination of techniques, including preoperative botulinum toxin application, modified Ramírez's component separation, and Rives-Stoppa hernioplasty, yielding excellent results and minimizing recurrences. Objective  This study aims to provide a comprehensive literature review of giant ventral hernias. Additionally, we aim to share our experience in managing and repairing giant ventral hernias using a multi-modal approach, combining various surgical techniques with a focus on patient safety, reduced recurrence rates, and improved quality of life. Methods Between October 1, 2019, and October 1, 2021, six patients with giant ventral hernias were enrolled at our department of surgery. They received preoperative botulinum toxin A (BT) application, underwent corrective surgery involving modified component separation following the Ramírez method, and received Rives-Stoppa hernioplasty. Follow-up was conducted for at least six months. Results Six patients were included in the study: three women and three men. They had an average age of 53.6 years and an average body mass index of 31.8 kg/m2. The most common location of the hernia defect was supra and infraumbilical, among 66% of cases. The primary adverse effect associated with BT application was abdominal distension, reported in 33% of patients. No postoperative complications, such as abscesses or seromas, were observed. After the surgical procedure, the average hospital stay was 2.6 days, and no recurrences were noted within six months post-surgery. Conclusion  The proposed method, which involves a combination of techniques, has demonstrated promising results based on our experience. However, to solidify these findings and better understand the full scope of this approach, further comprehensive statistical studies involving larger populations are essential. These studies will not only validate our results but also provide valuable insights for optimizing the management of giant ventral hernias.

Intervenção viabilizada por WhatsApp® para promoção da adesão às medidas preventivas na pandemia da COVID-19: um estudo piloto / Intervention made possible by WhatsApp® to promote adherence to preventive measures in the COVID-19 pandemic: a pilot study

Analisar o potencial de eficácia do envio de mensagens validadas (texto e imagens), via WhatsApp®, na promoção da adesão ao uso de máscaras, distanciamento social e associar às variáveis sociodemográficas. Trata-se de um estudo com desenho quase-experimental, do tipo pré e pós-teste com 132 participantes, acompanhados por 60 dias. As mensagens foram enviadas semanalmente junto com os formulários de adesão. Ao final da intervenção os participantes responderam ao questionário de satisfação da pesquisa. Foram realizados testes de comparação e análises descritivas. Os achados deste estudo demonstraram impacto positivo da intervenção no envio de mensagens validadas, via WhatsApp®, na adesão ao uso de máscaras e distanciamento social durante a pandemia da COVID-19. A intervenção proposta neste estudo apresenta potencial de eficácia para adesão às medidas preventivas contra o vírus do SARS-CoV-2 e constitui uma ferramenta valiosa para profissionais de saúde atuarem no combate à pandemia.

To analyze the potential efficacy of sending validated messages (text and images) via WhatsApp® in promoting adherence to the use of masks and social distancing and to evaluate its association with the sociodemographic variables. This is a study with a quasi-experimental design, of the pre and post test type. 132 participants were enrolled and followed up for 60 days. Validated messages were sent weekly along with the forms referring to adherence. At the end of the intervention, they answered the survey satisfaction questionnaire. Descriptive analyzes and tests were carried out to compare measures of adherence to mask use and social distancing. The findings of this study demonstrated the positive impact of the intervention in sending validated messages via WhatsApp® on adherence to the use of masks and social distancing during the COVID-19 pandemic. The intervention proposed in this study has potential efficacy for adherence to preventive measures against the SARS-CoV-2 virus and constitutes a valuable tool for health professionals to act in the fight against the COVID-19 pandemic.

Expression of NORAD correlates with breast cancer aggressiveness and protects breast cancer cells from chemotherapy.

The recently discovered human lncRNA NORAD is induced after DNA damage in a p53-dependent manner. It plays a critical role in the maintenance of genomic stability through interaction with Pumilio proteins, limiting the repression of their target mRNAs. Therefore, NORAD inactivation causes chromosomal instability and aneuploidy, which contributes to the accumulation of genetic abnormalities and tumorigenesis. NORAD has been detected in several types of cancer, including breast cancer, which is the most frequently diagnosed and the second-leading cause of cancer death in women. In the present study, we confirmed upregulated NORAD expression levels in a set of human epithelial breast cancer cell lines (MDA-MB-231, MDA-MB-436, and MDA-MB-468), which belong to the most aggressive subtypes (triple-negative breast cancer). These results are in line with previous data showing that high NORAD expression levels in basal-like tumors were associated with poor prognosis. Here, we demonstrate that NORAD downregulation sensitizes triple-negative breast cancer cells to chemotherapy, through a potential accumulation of genomic aberrations and an impaired capacity to signal DNA damage. These results show that NORAD may represent an unexploited neoadjuvant therapeutic target for chemotherapy-unresponsive breast cancer.

Tendência da mortalidade por Paracoccidioidomicose no Brasil ­ 1996 a 2020 / Mortality trends due to Paracoccidioidomycosis in Brazil ­ 1996 to 2020

Objetivo: Analisar a tendência da mortalidade por paracoccidioidomicose (PCM) e caracterizar o perfil sociodemográfico no Brasil e suas regiões geográficas numa série temporal de 25 anos. Métodos: Trata-se de estudo ecológico de séries temporais. Considerou-se como participantes do estudo a população brasileira dividida em faixas etárias, que tiveram como causa básica do óbito a PCM. Para calcular a variação percentual anual (VPA) dos coeficientes, na análise de tendência, foi utilizada a regressão de Prais-Winsten. Os coeficientes de mortalidade foram calculados a nível nacional, segundo as regiões geográficas, sexo e faixa etária e proporcional para as demais variáveis. Resultados: De acordo com os resultados deste estudo, ocorreram 2.101 óbitos por PCM no Brasil. A tendência ao longo dos 25 anos evidenciou um comportamento estável nas regiões Norte e Nordeste. Já no Sul, Sudeste e Centro-Oeste houve uma tendêndia de queda. A mortalidade média no Brasil foi de 84,04/100 mil hab., VPA -3,29 (IC 95% -2,43; -4,14). Levando em consideração a análise dos aspectos sociodemográficos, houve um predomínio de escolaridade ignorada (764; 36%), raça/ cor da pele branca (1.109; 53%), estado civil misto: casado (942; 45%) e solteiro (640; 30%), local de ocorrência do óbito predominantemente no âmbito hospitalar (1.852; 88%). Conclusão: Tanto no Brasil como nas regiões geográficas Sudeste, Sul e Centro-Oeste a mortalidade por PCM apresentou-se com tendência temporal decrescente. Já nas regiões Nordeste e Norte a tendência foi estacionária. O perfil sociodemográfico dos pacientes que foram a óbito apontou para sexo masculino, adultos, de baixa escolaridade, brancos e casados.

Objective: To analyze the trend in mortality from paracoccidioidomycosis (PCM) and characterize the sociodemographic profile in Brazil and its geographic regions in a 25-year time series. Methods: This is an ecological time series study. The study participants were the Brazilian population divided into age groups whose underlying cause of death was PCM. To calculate the annual percentage change (VPA) of the coefficients in the trend analysis, the Prais-Winsten regression was used. National mortality coefficients were calculated according to geographic regions, sex and age group and proportional to the other variables. Results: According to this study, there were 2,101 deaths from PCM in Brazil. The trend over the 25 years showed stable behavior in the North and Northeast regions. In the South, Southeast, and Midwest, there was a downward trend. The average mortality in Brazil was 84.04/100,000 inhab., VPA -3.29 (95% CI -2.43; -4.14). According to the analysis of sociodemographic aspects, there was a predominance of ignored schooling (764 deaths; 36%), white race/skin color (1,109; 53%), mixed marital status: married (942; 45%) and single (640; 30%), and place of death predominantly in the hospital environment (1,852; 88%). Conclusion: In Brazil and in the Southeast, South, andMidwest geographic regions, mortality from PCM showed a decreasing temporal trend. In the Northeast and North regions, the trend was stationary. The sociodemographic profile of the dying patients indicated males, adults, with low education, white, and married.

In vitro evaluation of antioxidant, cytotoxic, trypanocidal and antimicrobial activities of lignin obtained from Caesalpinia ferrea leaves and its use as an excipient in the release of oxacillin and fluconazole.

In this context, the objective of this work was to isolate an alkaline lignin from the leaves of C. ferrea, in addition to investigating different biological activities and its use in the production of releasing tablets in vitro. Initially, the analysis of the composition of the leaves was performed, the contents were: cellulose (33.09 ± 0.3 %), hemicellulose (25.13 ± 0.1 %), lignin (18.29 ± 0.1 %), extractives (17.28 ± 1.0 %) and ash (6.20 ± 0.1 %). The leaves were fractionated to obtain alkaline lignin. The yield of obtaining lignin was 80.12 ± 0.1 %. The obtained lignin was characterized by the techniques: elemental analysis, FTIR, UV/Vis, 2D-NMR, GPC, TGA/DTG, DSC and PY-GC/MS. The results showed that the lignin obtained is of the GSH type, of low molecular weight and thermally stable. The in vitro antioxidant activity was evaluated by different assays promoting results only for DPPH (559.9 ± 0.8 µg/mL) and ABTS (484.1 ± 0.1 µg/mL) being able to promote low antioxidant activity. In addition, it showed low cytotoxicity in normal mammalian cells and promising antitumor and trypanocidal activity. Regarding antimicrobial activity, it was able to inhibit the growth of a strain of Staphylococcus aureus resistant to methicillin, presenting MIC values equal to the standard antibiotic oxacillin. It was also able to inhibit a strain of Candida albicans HAM13 sensitive to fluconazole. In addition, lignin promoted a synergistic effect by promoting a decrease in MIC against these two strains evaluated. Finally, lignin proved to be an excipient with potential for controlled release of antimicrobials.

A Relação Materno-Infantil e suas Implicações na Queixa Psicossomática / The Maternal-Infant Relationship and its Implications in Psychosomatic Complaint / La Relación Materno-Infantil y sus Implicaciones en la Queja Psicosomática

A somatização é uma manifestação corporal carente de simbolização. Relaciona-se com aspectos psicológicos tendendo a surgir no bebê, que se vê como uma extensão da mãe. O objetivo foi analisar aspectos psicológicos da relação materno-filial e suas implicações nas manifestações psicossomáticas. Trata-se de uma pesquisa documental, considerando os prontuários de crianças entre fevereiro/2015 e dezembro/2019, de uma clínica-escola do Grande ABC-SP. A busca realizada a partir de um software específico para arquivamento dos prontuários, utilizou como filtros os termos: infantil, queixas somatoformes, distúrbios alimentares e distúrbios do sono. Os dados foram categorizados em: a) identificação; b) evolução clínica; e c) aspectos da personalidade e o relacionamento materno. A análise qualitativa, de base psicanalítica, apontou que a dificuldade das mães em lidar com seus próprios conflitos influenciou no surgimento dos sintomas nos filhos. Observou-se relação entre os conflitos maternos e o tipo de queixa apresentada. Os resultados sustentam a importância da relação entre mães e filhos na queixa psicossomática. Fatores orgânicos no desenvolvimento infantil precisam ser considerados para além da natureza biológica, mas da dinâmica psíquica, ampliando a compreensão diagnóstica.

Somatization is a bodily manifestation lacking symbolization. It relates to psychological aspects tending to appear in the baby, who sees himself as an extension of the mother. The objective was to analyze the psychological aspects of the mother-child relationship and its implications for psychosomatic manifestations. This is documentary research, considering the clinical reports of children between February/2015 and December/2019, from a clinical school in Grande ABC-SP. The search performed using clinical reports record file software, used terms as filters: infant, somatoform complaints, eating disorders and sleep disorders. Data were categorized into a) identification; b) clinical evolution; and c) aspects of personality and maternal relationship. The qualitative analysis, based on psychoanalysis, showed that mothers' difficulty dealing with their own conflicts influenced the appearance of symptoms in their children. There was a relationship between maternal conflicts and the type of complaint presented. The results support the importance of the relationship between mothers and children in psychosomatic complaints. Organic factors in child development need to be considered beyond the biological nature, but the psychic dynamics, expanding the diagnostic understanding.

La somatización es una manifestación en el cuerpo del no simbolizado. Se relaciona con aspectos psicológicos que tienden a aparecer en el bebé, quien se ven a sí mismos como una extensión de la madre. El objetivo fue analizar aspectos psicológicos de la relación madre-hijo y sus implicaciones en las manifestaciones psicosomáticas. Es una investigación documental, que toma en cuenta las historias clínicas de niños en los períodos de febrero/2015 y diciembre/2019, de una clínica escuela del Grande ABC-SP. La búsqueda fue hecha con auxilio de un software específico de archivo de las historias clínicas, se utilizó como filtros los términos: infantil, quejas somatomorfas, desórdenes alimentarios y desórdenes del sueño. Los datos se clasificaron en: a) identificación; b) evolución clínica; y c) aspectos de personalidad y relación materna. El análisis cualitativo de base psicoanalítica señalo que la dificultad de las madres para lidiar con sus propios conflictos influyó en la aparición de los síntomas en sus hijos. Hubo relación entre los conflictos maternos y el tipo de queja presentada. Los resultados respaldan la importancia de la relación entre madres y hijos en quejas psicosomáticas. Factores orgánicos del desarrollo infantil necesitan ser considerados más allá de la naturaleza biológica, más de la dinámica psíquica, para ampliar la comprensión del diagnóstico.

Cuidados prestados ao portador de úlcera venosa que auxiliam a cicatrização da ferida / Care provided to patients with venous ulcers to help the wound heal

Objetivo: Identificar na literatura quais são as mais recentes práticas assistenciais prestadas ao paciente portador de úlcera visando a cicatrização da ferida. Método: trata-se de uma revisão integrativa da literatura realizada no período de novembro e dezembro de 2022 indexados nos portais LILACS e MEDLINE, os descritores usados na busca foram "Úlcera varicosa" OR "Insuficiência venosa'' AND "cicatrização" AND "Assistência ao paciente". Resultados: foram incluídos 8 artigos, como principais resultados observou-se que a enfermagem realiza várias intervenções para cicatrização das lesões sendo a mais utilizada é o tratamento com terapia compressiva, seguido do tratamento com hidrocoloide e tratamento com gel de plaquetas homólogo. No que tange a avaliação de lesões, prevalece o uso do instrumento PUSH. Considerações finais: faz-se necessário a avaliação adequada, orientação do paciente e cuidador, cuidado multidisciplinar e associação de novas tecnologias para o tratamento de úlceras venosas. A padronização da utilização de escalas como a PUSH na avaliação dos cuidados prestados é essencial para nortear o atendimento.(AU)

Objective: To identify in the literature which are the most recent care practices provided to patients with ulcers, aiming at wound healing. Method: this is an integrative literature review carried out in the period of November and December 2022 indexed in the LILACS and MEDLINE portals, the descriptors used in the search were "Varicose ulcer" OR "Venous insufficiency'' AND "healing" AND "Assistance to the patient". Results: 8 articles were included. With regard to the assessment of injuries, the use of the PUSH instrument prevails. Final considerations: proper assessment, patient and caregiver guidance, multidisciplinary care and association of new technologies for the treatment of venous ulcers are necessary. The standardization of the use of scales such as the PUSH in the assessment of the care provided is essential to guide care.(AU)

Objetivo: Identificar en la literatura cuáles son las prácticas más recientes de cuidados prestados a pacientes con úlceras visando la cicatrización de las heridas. Método: se trata de una revisión bibliográfica integradora realizada en el período de noviembre y diciembre de 2022 indexada en los portales LILACS y MEDLINE, los descriptores utilizados en la búsqueda fueron "Úlcera varicosa" O "Insuficiencia venosa" Y "cicatrización" Y "Cuidados del paciente". Resultados: Se incluyeron 8 artículos, como principales resultados se observó que enfermería realiza diversas intervenciones para la cicatrización de las lesiones, siendo la más utilizada el tratamiento con terapia compresiva, seguida del tratamiento con hidrocoloide y el tratamiento con gel de plaquetas homólogas. En cuanto a la valoración de las lesiones, prevalece el uso del instrumento PUSH. Consideraciones finales: son necesarias una evaluación adecuada, la orientación al paciente y al cuidador, la atención multidisciplinar y la asociación de nuevas tecnologías para el tratamiento de las úlceras venosas. La estandarización del uso de escalas como el PUSH en la evaluación de los cuidados prestados es esencial para orientar la asistencia.(AU)

Infecciones fúngicas invasoras en niños con cáncer y portadores de aplasia medular severa en nueve hospitales de la red PINDA, Chile. 2016-2020

Introducción: La infección fúngica invasora (IFI) es una causa importante de morbilidad y mortalidad en pacientes oncológicos pediátricos y portadores de aplasia medular (AM) severa. Objetivo: Describir la epidemiología de la IFI desde el año 2016 al 2020 en niños con cáncer y AM para evaluar la necesidad de profilaxis antifúngica. Métodos: Estudio retrospectivo, multicéntrico, en pacientes pediátricos con cáncer y AM severa. Se incluyeron IFI probables y probadas. Resultados: Se diagnosticaron 57 casos de IFI, mediana de edad 9 años, 70% probadas y 30% probables. Hubo 42% de infecciones por levaduras y 56% por hongos filamentosos. Los sitios de infección más frecuentes fueron pulmón 38%, sangre 36% y rinosinusal 21%. La frecuencia global fue 5,4%; de ellas 21% en AM severa, 10% en leucemia mieloide aguda (LMA), 6,9% en recaída de LMA, 5,4% en recaída de leucemia linfática aguda (LLA), 3,8% en LLA. Las infecciones por hongos filamentosos predominaron en LMA, recaída de LMA. y AM severa. La mortalidad en pacientes con IFI fue de 11%. Conclusión: La frecuencia de IFI concuerda con la literatura médica. Recomendamos profilaxis antifúngica contra hongos filamentosos en pacientes con AM severa, LMA y recaída de LMA. Considerar en recaída de LLA de alto riesgo en etapa de inducción.

Background: Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in pediatric oncology patients and severe aplastic anemia (SAA). Aim: To describe the epidemiology of IFI from 2016 to 2020 in children with cancer and SAA to assess the indication of antifungal prophylaxis. Methods: Multicenter, retrospective study of IFIs in pediatric oncology patients and SAA. Probable and proven IFIs were included. Results: Over the 5-year period, 57 IFIs were found, median age 9 years, 70% were proven and 30% were probable. Yeast infections were 42% and mold infections 56%. The most frequent infection sites were lung 38%, blood 36% and rhinosinusal 21%. The total IFI frequency was 5.4%, 21% in SAA, 10% in acute myeloid leukemia (AML), 6.9% in relapsed AML, 5.4% in relapsed acute lymphoblastic leukemia (ALL), 3.8% in ALL. Mold infections were predominant in AML, relapsed AML, and SAA. IFIs mortality was 11%. Conclusion: Frequency of IFI was consistent with the literature. We strongly recommend antifungal prophylaxis against mold infections in patients with SAA, AML, and relapsed AML. Would consider in high risk ALL relapse in induction chemotherapy.

Lateral septum adenosine A2A receptors control stress-induced depressive-like behaviors via signaling to the hypothalamus and habenula.

Major depressive disorder ranks as a major burden of disease worldwide, yet the current antidepressant medications are limited by frequent non-responsiveness and significant side effects. The lateral septum (LS) is thought to control of depression, however, the cellular and circuit substrates are largely unknown. Here, we identified a subpopulation of LS GABAergic adenosine A2A receptors (A2AR)-positive neurons mediating depressive symptoms via direct projects to the lateral habenula (LHb) and the dorsomedial hypothalamus (DMH). Activation of A2AR in the LS augmented the spiking frequency of A2AR-positive neurons leading to a decreased activation of surrounding neurons and the bi-directional manipulation of LS-A2AR activity demonstrated that LS-A2ARs are necessary and sufficient to trigger depressive phenotypes. Thus, the optogenetic modulation (stimulation or inhibition) of LS-A2AR-positive neuronal activity or LS-A2AR-positive neurons projection terminals to the LHb or DMH, phenocopied depressive behaviors. Moreover, A2AR are upregulated in the LS in two male mouse models of repeated stress-induced depression. This identification that aberrantly increased A2AR signaling in the LS is a critical upstream regulator of repeated stress-induced depressive-like behaviors provides a neurophysiological and circuit-based justification of the antidepressant potential of A2AR antagonists, prompting their clinical translation.

Phytochemical Composition and Bioactive Potential of Melissa officinalis L., Salvia officinalis L. and Mentha spicata L. Extracts.

Plants are rich in bioactive phytochemicals that often display medicinal properties. These can play an important role in the production of health-promoting food additives and the replacement of artificial ones. In this sense, this study aimed to characterise the polyphenolic profile and bioactive properties of the decoctions, infusions and hydroethanolic extracts of three plants: lemon balm (Melissa officinalis L.), sage (Salvia officinalis L.) and spearmint (Mentha spicata L.). Total phenolic content ranged from 38.79 mg/g extract to 84.51 mg/g extract, depending on the extract. The main phenolic compound detected in all cases was rosmarinic acid. The results highlighted that some of these extracts may have the ability to prevent food spoilage (due to antibacterial and antifungal effects) and promote health benefits (due to anti-inflammatory and antioxidant capacities) while not displaying toxicity against healthy cells. Furthermore, although no anti-inflammatory capacity was observed from sage extracts, these stood out for often displaying the best outcomes in terms of other bioactivities. Overall, the results of our research provide insight into the potential of plant extracts as a source of active phytochemicals and as natural food additives. They also support the current trends in the food industry of replacing synthetic additives and developing foods with added beneficial health effects beyond basic nutrition.

O papel do psicólogo frente a situações de desastres / The psychologist's role in disaster situations / El papel del psicólogo en situaciones de desastre

INTRODUÇÃO: Os desastres são considerados eventos vitimadores que provocam danos psíquicos e sofrimento às pessoas atingidas e esses casos exigem que os psicólogos estejam cada vez mais preparados para atuar nessas circunstâncias. OBJETIVO: investigar a atuação do psicólogo frente a situações de desastres. A pesquisa se configurou como qualitativa com delineamento de pesquisa de campo. METODOLOGIA: Foram participantes cinco psicólogas com especializações na área de desastres e emergências. O instrumento utilizado para atingir os objetivos da pesquisa foi um roteiro de entrevista semiestruturado composto por sete perguntas semiabertas. As entrevistas foram gravadas em áudio, transcritas na íntegra e analisadas por meio da análise de conteúdo. RESULTADOS: De acordo com os temas abordados pelas participantes, a atuação do psicólogo em desastres é dividida em: pré-desastre, durante o desastre e pós-desastre, o que dependerá do tipo de evento e condições apresentadas; as vítimas devem receber apoio integral, buscando minimizar os danos gerados pela tragédia. Ressalta-se que não é necessária uma atuação apenas depois que o desastre já ocorreu, mas há, além disso, toda uma preparação no prédesastre em locais que possuem maior propensão ao acontecimento destes eventos. CONCLUSÃO: O trabalho do profissional da Psicologia no campo dos desastres é de extrema importância para as vítimas, os parentes das vítimas, a comunidade como um todo e até para os profissionais envolvidos, podendo reduzir o estresse agudo, que é gerado a partir da experiência traumática, priorizando que o sujeito recupere sua capacidade cognitiva de agir e sentir a situação.

INTRODUCTION: Disasters are considered victimizing events that cause psychic damage and suffering to the people affected and these cases require psychologists to be increasingly prepared to act in these circumstances. OBJECTIVE: to investigate the role of the psychologist in the face of disaster situations. The research was configured as qualitative with a field research design. METHODOLOGY: Five psychologists with specializations in the area of disasters and emergencies participated. The instrument used to achieve the research objectives was a semi-structured interview guide composed of seven semi-open questions. The interviews were audio recorded, fully transcribed and analyzed using content analysis. RESULTS: According to the topics addressed by the participants, the psychologist's role in disasters is divided into: pre-disaster, during the disaster and post-disaster, which will depend on the type of event and conditions presented; victims must receive full support, seeking to minimize the damage generated by the tragedy. It is noteworthy that it is not necessary to act only after the disaster has already occurred, but there is, in addition, a whole pre-disaster preparation in places that are more prone to the occurrence of these events. CONCLUSION: The work of the Psychology professional in the field of disasters is extremely important for the victims, the victims' relatives, the community as a whole and even for the professionals involved, and can reduce the acute stress, which is generated from the experience trauma, prioritizing the subject to recover his cognitive ability to act and feel the situation.

INTRODUCCIÓN: Los desastres son considerados hechos victimizantes que provocan daño psíquico y sufrimiento a las personas afectadas, y estos casos exigen que los psicólogos estén cada vez más preparados para actuar en estas circunstancias. OBJETIVO: investigar el papel del psicólogo frente a situaciones de desastre. La investigación se configuró como cualitativa con diseño de investigación de campo. METODOLOGÍA: Participaron cinco psicólogos con especializaciones en el área de desastres y emergencias. El instrumento utilizado para lograr los objetivos de la investigación fue un guión de entrevista semiestructurado compuesto por siete preguntas semiabiertas. Las entrevistas fueron grabadas en audio, transcritas en su totalidad y analizadas mediante análisis de contenido. RESULTADOS: De acuerdo a los temas abordados por los participantes, el rol del psicólogo en desastres se divide en: predesastre, durante el desastre y postdesastre, lo que dependerá del tipo de evento y condiciones que se presenten; las víctimas deben recibir todo el apoyo, buscando minimizar los daños causados por la tragedia. Cabe señalar que no es necesario actuar solo después de que ya haya ocurrido el desastre, sino que existe, además, toda una preparación previa al desastre en los lugares más propensos a la ocurrencia de estos eventos. CONCLUSIÓN: La labor del profesional de la Psicología en el campo de los desastres es sumamente importante para las víctimas, los familiares de las víctimas, la comunidad en su conjunto e incluso para los profesionales involucrados, pudiendo disminuir el estrés agudo, que se genera a partir de la experiencia traumática, priorizando que el sujeto recupere su capacidad cognitiva para actuar y sentir la situación.