Systemic effects of oral tolerance in bone healing.

Bone fractures cause acute inflammation that, despite being important for initial repair, may delay the healing of the damaged bone. Parenteral injection of dietary protein has been shown to decrease inflammation and accelerate the repair of skin wounds and other inflammatory pathologies. Thus, our aim was to evaluate whether the intraperitoneal (i.p.) immunization with zein, an abundant protein in rodent chow, would favor bone healing. Wistar rats received i.p. immunization: saline (SG), adjuvant (AG) and zein associated with adjuvant (ZG). Then, a 2 mm of defect bone was performed on the right tibia, and on days 7, 14, 28 and 45 thereafter, analyses were performed. The results showed that the injection of zein reduced inflammation without impairing bone mineralization. Moreover, biomechanical tests demonstrated higher levels of maximum force (N) in ZG, indicating better mechanical resistance in relation to the others. The computerized tomography also indicated lower levels of medullary content in the ZG than in the SG, suggesting the absence of trabeculae in the medullary region in the ZG. These findings suggest that the injection of zein in previously tolerated animals may improve bone repair, leading to mechanically functional bone formation.

Psychotropic medication use among women seeking assisted reproductive technology (ART) therapy: A cross-sectional study.

Background Infertility is associated with increased anxiety, depressive symptoms and mood disorders. Unfortunately, mental health is not often addressed in infertility treatment and infertile patients could be at higher risk of self-administration of not prescribed drugs or/and be exposed to alternative emotional treatments. Therefore, the aim of the present study is to investigate the use of psychotropic medication and to evaluate the frequency of psychiatric diagnosis among infertile women seeking assisted reproductive technology (ART) therapy. Methods All infertile women starting treatment at an ART clinic who agreed to participate in the study were included. Patients were submitted to a structured psychiatric interview, the Mini International Neuropsychiatric Interview (M.I.N.I.). Current and lifetime use of psychotropic medication were assessed. Results Ninety patients who agreed to participate completed the research protocol.  A total of 12/90  were on current use of psychotropic medication.Thirty-six out of ninety patients  had at least one psychiatric disorder. Mood disorders were detected in 19 of the 90. Anxiety disorders were highly frequent, reaching 27/90 of the patients, as agoraphobia the most common diagnosis (12/90). Limitations The study has several limitations, such as the absence of a control group of fertile patients and strict inclusion criteria, in which only subjects that spontaneously agreed to participate were enrolled. Conclusion Women suffering from infertility seeking ART treatment are at high risk for depression and anxiety disorders and a considerable number of them are in use of medication. Its implications on infertility treatments and offspring are uncertain.

Contribuição da musicoterapia no transtorno do espectro autista: revisão integrativa da literatura / Contribución de la musicoterapia al trastorno del espectro autista: una revisión integradora de la literatura / Contribution of music therapy to autism spectrum disorder: an integrative literature review

Objetivo: verificar as evidências científicas sobre a contribuição da musicoterapia como intervenção no tratamento da criança com Transtorno Espectro Autista. Métodos: Trata-se de uma revisão integrativa da literatura, realizada na base de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde e na Medical Literature Analysis and Retrieval System Online. A busca dos artigos foi realizada de janeiro a março de 2019, utilizando os seguintes descritores controlados: Musicoterapia, Terapêutica e Transtorno autístico que que atenderam aos critérios de inclusão e exclusão do estudo. Resultados: Doze artigos evidenciaram o valor da música e o seu papel como recurso terapêutico em crianças. Conclusão: Analisou doze estudos que enfatizam o uso da musicoterapia como ferramenta de tratamento no TEA, tendo em vista que onze estudos descrevem a forma significativa na melhora do quadro clínico e/psicológico de crianças com Transtorno do Espectro Autista, ao proporcionar melhora na comunicação e na socialização.(AU)

Objective: To analyze the scientific evidence on the contribution of music therapy as an intervention in the treatment of children with autism apectrum disorder. Methods: integrative literature review, carried out in the database: Latin American and Caribbean Literature in Health Sciences and in the Medical Literature Analysis and Retrieval System Online. The search for the articles was carried out from January to March 2019, using the following controlled descriptors: Music Therapy, Treatment, Child, Disorder, Autistic Spectrum that met the inclusion and exclusion criteria of the study. Results: twelve articles showed the value of music and its role as a therapeutic resource in children. Conclusion: Analyzed twelve studies that emphasize the use of music therapy as a treatment tool in autism apectrum disorder, considering that eleven studies describe the significant way in improving the clinical and / psychological condition of children with Autism Spectrum Disorder, by providing improved communication and in socialization.(AU)

Objetivo: analizar la evidencia científica sobre la contribución de la musicoterapia como intervención en el tratamiento de niños con trastorno del espectro autista. Métodos: revisión integradora de la literatura, realizada en la base de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud y en el Sistema de Análisis y Recuperación de Literatura Médica en Línea. La búsqueda de los artículos se realizó de enero a marzo de 2019, utilizando los siguientes descriptores controlados: Musicoterapia, Tratamiento, Niño, Trastorno, Espectro autista que cumplieron con los criterios de inclusión y exclusión del estudio. Resultados: doce artículos mostraron el valor de la música y su papel como recurso terapéutico en los niños. Conclusión: se analizaron doce estudios que enfatizan el uso de la musicoterapia como herramienta de tratamiento en el trastorno del espectro autista, considerando que once estudios describen la forma significativa en la mejora de la condición clínica y / psicológica de los niños con Trastorno del Espectro Autista, al proporcionar una mejor comunicación y socialización.(AU)

Dietary Fiber Intake (Supplemental or Dietary Pattern Rich in Fiber) and Diabetic Kidney Disease: A Systematic Review of Clinical Trials.

Fiber intake is associated with better glycemic control being an important nonpharmacologicaltreatment for diabetes (DM). We hypothesize that a dietary fiber intake can bringbenefits to diabetic kidney disease (DKD), improving renal outcomes. This systematic review aimedto evaluate the effect of dietary fiber (supplemental or dietary pattern rich in fiber) on DKD. Wesearched six databases to identify clinical trials that reported fiber intake and renal outcomes(albuminuria, proteinuria, estimated glomerular filtration rate (eGFR) dialysis) in patients with DM.From 1814 studies, 48 papers were fully evaluated. In the end, seven trials (161 patients, aged 58.3years, 49% females) were included. The studies were organized into three categories (vegetarian,Dietary Approaches to Stop Hypertension (DASH) diet, and fiber supplement), two evaluatedsupplements and five dietary patterns. Vegetarian diet reduced albuminuria in three trials, two inpatients with type 1 DM and one in patients with type 2 DM; and one study demonstrated a change inthe eGFR in type 1 DM. The individual quality of the studies was low/uncertain. A vegetarian dietarypattern may have a beneficial effect on these renal outcomes. However, the individual effect of theintake of fiber on DKD not was possible to be evaluated.

Heterozygous Truncating Variants in POMP Escape Nonsense-Mediated Decay and Cause a Unique Immune Dysregulatory Syndrome.

The proteasome processes proteins to facilitate immune recognition and host defense. When inherently defective, it can lead to aberrant immunity resulting in a dysregulated response that can cause autoimmunity and/or autoinflammation. Biallelic or digenic loss-of-function variants in some of the proteasome subunits have been described as causing a primary immunodeficiency disease that manifests as a severe dysregulatory syndrome: chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE). Proteasome maturation protein (POMP) is a chaperone for proteasome assembly and is critical for the incorporation of catalytic subunits into the proteasome. Here, we characterize and describe POMP-related autoinflammation and immune dysregulation disease (PRAID) discovered in two unrelated individuals with a unique constellation of early-onset combined immunodeficiency, inflammatory neutrophilic dermatosis, and autoimmunity. We also begin to delineate a complex genetic mechanism whereby de novo heterozygous frameshift variants in the penultimate exon of POMP escape nonsense-mediated mRNA decay (NMD) and result in a truncated protein that perturbs proteasome assembly by a dominant-negative mechanism. To our knowledge, this mechanism has not been reported in any primary immunodeficiencies, autoinflammatory syndromes, or autoimmune diseases. Here, we define a unique hypo- and hyper-immune phenotype and report an immune dysregulation syndrome caused by frameshift mutations that escape NMD.

Vitamin D supplementation effects on FoxP3 expression in T cells and FoxP3+/IL-17A ratio and clinical course in systemic lupus erythematosus patients: a study in a Portuguese cohort.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multi-organ inflammation, linked to loss of immune tolerance to self-antigens and the production of a diversity of autoantibodies, with a negative impact on the patients' quality of life. Regulatory T cells have been reported as deficient in number and function in SLE patients. However, some authors also described an enrichment of this cell type. The hypothesis that certain forms of autoimmunity may result from a conversion of Treg cells into a Th17 cell phenotype has been suggested by some studies. In fact, in SLE patients' sera, the IL-17 levels were observed as abnormally high when compared with healthy individuals. Environmental factors, such as vitamin D, that is considered a potential anti-inflammatory agent, combined with genetic and hormonal characteristics have been associated with SLE phenotype and with disease progression. The aim of this study was to evaluate the effect of vitamin D supplementation on FoxP3 expression and IL-17A-producing T cells, through FoxP3+/IL-17A ratio. Additionally, disease evolution, serum vitamin D levels, serum autoantibodies levels and calcium metabolism (to assure safety) were also studied. We assessed 24 phenotypically well-characterized SLE patients. All patients were screened before vitamin D supplementation and 3 and 6 months after the beginning of this treatment. Peripheral blood lymphocyte's subsets were analysed by flow cytometry. Serum 25(OH)D levels significantly increased under vitamin D supplementation (p = 0.001). The FoxP3+/IL-17A ratio in SLE patients after 6 months of vitamin D supplementation was higher than that in the baseline (p < 0.001). In conclusion, this study demonstrated that vitamin D supplementation provided favourable, immunological and clinical impact on SLE.

Open-label placebo treatment in chronic low back pain: a randomized controlled trial.

This randomized controlled trial was performed to investigate whether placebo effects in chronic low back pain could be harnessed ethically by adding open-label placebo (OLP) treatment to treatment as usual (TAU) for 3 weeks. Pain severity was assessed on three 0- to 10-point Numeric Rating Scales, scoring maximum pain, minimum pain, and usual pain, and a composite, primary outcome, total pain score. Our other primary outcome was back-related dysfunction, assessed on the Roland-Morris Disability Questionnaire. In an exploratory follow-up, participants on TAU received placebo pills for 3 additional weeks. We randomized 97 adults reporting persistent low back pain for more than 3 months' duration and diagnosed by a board-certified pain specialist. Eighty-three adults completed the trial. Compared to TAU, OLP elicited greater pain reduction on each of the three 0- to 10-point Numeric Rating Scales and on the 0- to 10-point composite pain scale (P < 0.001), with moderate to large effect sizes. Pain reduction on the composite Numeric Rating Scales was 1.5 (95% confidence interval: 1.0-2.0) in the OLP group and 0.2 (-0.3 to 0.8) in the TAU group. Open-label placebo treatment also reduced disability compared to TAU (P < 0.001), with a large effect size. Improvement in disability scores was 2.9 (1.7-4.0) in the OLP group and 0.0 (-1.1 to 1.2) in the TAU group. After being switched to OLP, the TAU group showed significant reductions in both pain (1.5, 0.8-2.3) and disability (3.4, 2.2-4.5). Our findings suggest that OLP pills presented in a positive context may be helpful in chronic low back pain.

Identification of Polynesian mtDNA haplogroups in remains of Botocudo Amerindians from Brazil.

There is a consensus that modern humans arrived in the Americas 15,000-20,000 y ago during the Late Pleistocene, most probably from northeast Asia through Beringia. However, there is still debate about the time of entry and number of migratory waves, including apparent inconsistencies between genetic and morphological data on Paleoamericans. Here we report the identification of mitochondrial sequences belonging to haplogroups characteristic of Polynesians in DNA extracted from ancient skulls of the now extinct Botocudo Indians from Brazil. The identification of these two Polynesian haplogroups was confirmed in independent replications in Brazil and Denmark, ensuring reliability of the data. Parallel analysis of 12 other Botocudo individuals yielded only the well-known Amerindian mtDNA haplogroup C1. Potential scenarios to try to help understand these results are presented and discussed. The findings of this study may be relevant for the understanding of the pre-Columbian and/or post-Columbian peopling of the Americas.

Portuguese norms for the harvard group scale of hypnotic susceptibility, form a.

The Portuguese version of the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) was administered to 313 Portuguese college students. Score distribution, item pass rates, item analysis, and reliability of the HGSHS:A are presented and compared to earlier published reference samples. No differences were found between males and females. Reliability of the HGSHS:A Portuguese version was lower than that reported by most of the studies but within the range of the non-English versions. In general, Portuguese data are congruent with the reference samples and the Portuguese translation of the HGSHS:A. It appears to be a viable instrument for primary screening of hypnotic suggestibility in a Portuguese context.

Suggested visual hallucinations in and out of hypnosis.

We administered suggestions to see a gray-scale pattern as colored and a colored pattern in shades of gray to 30 high suggestible and eight low suggestible students. The suggestions were administered twice, once following the induction of hypnosis and once without an induction. Besides rating the degree of color they saw in the stimuli differently, participants also rated their states of consciousness as normal, relaxed, hypnotized, or deeply hypnotized. Reports of being hypnotized were limited to highly suggestible participants and only after the hypnotic induction had been administered. Reports of altered color perception were also limited to high suggestibles, but were roughly comparable regardless of whether hypnosis had been induced. These data indicate that suggestible individuals do not slip into a hypnotic state when given imaginative suggestions without the induction of hypnosis, but nevertheless report experiencing difficult suggestions for profound perceptual alterations that are pheonomenologically similar to what they report in hypnosis.

Portuguese norms for the Waterloo-Stanford Group C (WSGC) scale of hypnotic susceptibility.

Portuguese norms for the Waterloo-Stanford Group C (WSGC) scale of hypnotic susceptibility are presented. A Portuguese translation of this scale was given to 625 Portuguese college students. Score distribution, item analysis, and reliability of the WSGC are presented and compared to three North American samples. The findings show that normative data from the Portuguese sample are congruent with the reference samples. The only significant difference obtained was a lower proportion of participants scoring within the high range of hypnotic suggestibility on the WSGC.

The effect of posthypnotic suggestion, hypnotic suggestibility, and goal intentions on adherence to medical instructions.

The effects of implementation intentions and posthypnotic suggestion were investigated in 2 studies. In Experiment 1, participants with high levels of hypnotic suggestibility were instructed to take placebo pills as part of an investigation of how to best enhance compliance with medical instruction. In Experiment 2, participants with high, medium, and low levels of hypnotic suggestibility were asked to run in place, take their pulse rate before, and send an e-mail report to the experimenter each day. Experiment 1 revealed enhanced adherence as a function of both implementation intentions and posthypnotic suggestion. Experiment 2 failed to find any significant main effects but found a significant interaction between suggestibility and the effects of posthypnotic suggestion. Posthypnotic suggestion enhanced adherence among high suggestible participants but lowered it among low suggestibles.