Rapid and long-lasting antidepressant-like effects of ketamine and their relationship with the expression of brain enzymes, BDNF, and astrocytes

Ketamine (KET) is an N-methyl-D-aspartate (NMDA) antagonist with rapid and long-lasting antidepressant effects, but how the drug shows its sustained effects is still a matter of controversy. The objectives were to evaluate the mechanisms for KET rapid (30 min) and long-lasting (15 and 30 days after) antidepressant effects in mice. A single dose of KET (2, 5, or 10 mg/kg, po) was administered to male Swiss mice and the forced swim test (FST) was performed 30 min, 15, or 30 days later. Imipramine (IMI, 30 mg/kg, ip), a tricyclic antidepressant drug, was used as reference. The mice were euthanized, separated into two time-point groups (D1, first day after KET injection; D30, 30 days later), and brain sections were processed for glycogen synthase kinase-3 (GSK-3), histone deacetylase (HDAC), brain-derived neurotrophic factor (BDNF), and glial fibrillary acidic protein (GFAP) immunohistochemical assays. KET (5 and 10 mg/kg) presented rapid and long-lasting antidepressant-like effects. As expected, the immunoreactivities for brain GSK-3 and HDAC decreased compared to control groups in all areas (striatum, DG, CA1, CA3, and mainly pre-frontal cortex, PFC) after KET injection. Increases in BDNF immunostaining were demonstrated in the PFC, DG, CA1, and CA3 areas at D1 and D30 time-points. GFAP immunoreactivity was also increased in the PFC and striatum at both time-points. In conclusion, KET changed brain BDNF and GFAP expressions 30 days after a single administration. Although neuroplasticity could be involved in the observed effects of KET, more studies are needed to explain the mechanisms for the drug's sustained antidepressant-like effects.

Rapid and long-lasting antidepressant-like effects of ketamine and their relationship with the expression of brain enzymes, BDNF, and astrocytes.

Ketamine (KET) is an N-methyl-D-aspartate (NMDA) antagonist with rapid and long-lasting antidepressant effects, but how the drug shows its sustained effects is still a matter of controversy. The objectives were to evaluate the mechanisms for KET rapid (30 min) and long-lasting (15 and 30 days after) antidepressant effects in mice. A single dose of KET (2, 5, or 10 mg/kg, po) was administered to male Swiss mice and the forced swim test (FST) was performed 30 min, 15, or 30 days later. Imipramine (IMI, 30 mg/kg, ip), a tricyclic antidepressant drug, was used as reference. The mice were euthanized, separated into two time-point groups (D1, first day after KET injection; D30, 30 days later), and brain sections were processed for glycogen synthase kinase-3 (GSK-3), histone deacetylase (HDAC), brain-derived neurotrophic factor (BDNF), and glial fibrillary acidic protein (GFAP) immunohistochemical assays. KET (5 and 10 mg/kg) presented rapid and long-lasting antidepressant-like effects. As expected, the immunoreactivities for brain GSK-3 and HDAC decreased compared to control groups in all areas (striatum, DG, CA1, CA3, and mainly pre-frontal cortex, PFC) after KET injection. Increases in BDNF immunostaining were demonstrated in the PFC, DG, CA1, and CA3 areas at D1 and D30 time-points. GFAP immunoreactivity was also increased in the PFC and striatum at both time-points. In conclusion, KET changed brain BDNF and GFAP expressions 30 days after a single administration. Although neuroplasticity could be involved in the observed effects of KET, more studies are needed to explain the mechanisms for the drug's sustained antidepressant-like effects.

Overweight parents are twice as likely to underestimate the weight of their teenage children, regardless of their sociodemographic characteristics.

AIM: It is unclear whether parents' weight affects their ability to recognise whether their teenage children are overweight. This study analysed whether overweight parents assessed their child's weight as well as normal weight parents. METHODS: This cross-sectional study was carried out in Londrina, Brazil, in 2011 and included teenagers between 14 and 17 years of age and their parents or guardians. We recorded the weight and height of the teenagers and asked the parents or guardians to fill in a questionnaire that included how they perceived their child's weight and demographic information. RESULTS: We studied 1231 teenagers - 58.2% girls - and 19.4% were overweight or obese. In 842 (68.4%) of cases both parents replied to the questionnaire. We found that 8.7% of the 1202 mothers and 10.0% of the 871 fathers underestimated how overweight their child was. The adjusted analyses confirmed they were twice as likely to underestimate their child's weight if they were overweight themselves, with an odds ratio of 1.96 for the mothers and 2.04 for the fathers. Sociodemographic characteristics did not affect the results. CONCLUSION: Overweight parents were twice as likely to underestimate the weight of their teenage children, regardless of the sociodemographic characteristics.

Prevalence and epidemiology of chronic hepatitis C among prisoners of Mato Grosso do Sul State, Brazil

In Mato Grosso do Sul state, Brazil, the number of prisoners has increased in the recent years and the control of hepatitis C virus (HCV) has become more complex. The aim of the present study was to estimate the prevalence and identify the genotypes of HCV in prisoners as well as the factors associated with this infectious disease. Thereby, 443 men and 243 women from prisons were interviewed and subjected to blood collection. Anti-HCV reactive samples were analyzed by RT-PCR and genotyped. The overall seroprevalence of HCV infection was 4.8 percent (95 percentCI: 3.4 to 6.8 percent). Furthermore, the prevalence was higher in: men, injecting drug users, tattooed persons, those who were more than 50 years old, individuals who have been arrested multiple times, people with previous history of sexually transmitted disease (STD), persons who received blood transfusions or those with HIV/AIDS. The prevalence of RNA HCV by PCR was 3.0 percent (95 percentCI: 1.7 to 4.2 percent). Moreover, the coinfection of HIV and HCV was 33.3 percent. In addition, genotype 1 was the most frequent (85 percent) followed by genotype 3 (15 percent). The screening strategy for HCV and other infectious diseases in inmates is important as it establishes an early diagnosis, opportunity for treatment and allows the breaking of the transmission chain.

Prevalence and epidemiology of chronic hepatitis C among prisoners of Mato Grosso do Sul State, Brazil

In Mato Grosso do Sul state, Brazil, the number of prisoners has increased in the recent years and the control of hepatitis C virus (HCV) has become more complex. The aim of the present study was to estimate the prevalence and identify the genotypes of HCV in prisoners as well as the factors associated with this infectious disease. Thereby, 443 men and 243 women from prisons were interviewed and subjected to blood collection. Anti-HCV reactive samples were analyzed by RT-PCR and genotyped. The overall seroprevalence of HCV infection was 4.8 percent (95 percentCI: 3.4 to 6.8 percent). Furthermore, the prevalence was higher in: men, injecting drug users, tattooed persons, those who were more than 50 years old, individuals who have been arrested multiple times, people with previous history of sexually transmitted disease (STD), persons who received blood transfusions or those with HIV/AIDS. The prevalence of RNA HCV by PCR was 3.0 percent (95 percentCI: 1.7 to 4.2 percent). Moreover, the coinfection of HIV and HCV was 33.3 percent. In addition, genotype 1 was the most frequent (85 percent) followed by genotype 3 (15 percent). The screening strategy for HCV and other infectious diseases in inmates is important as it establishes an early diagnosis, opportunity for treatment and allows the breaking of the transmission chain.(AU)

Parasite fauna monitoring of matrinxã Brycon amazonicus (Spix & Agassiz, 1829) raised in an intensive husbandry system in a stream channel in the state of Amazonas, Brazil

The matrinxã, Brycon amazonicus, is one of the main species being used for aquaculture and fishery activities in the Amazonian region, yet little is known about the parasites that cause its diseases. The present study monitored parasite fauna infesting an intensive husbandry system in a stream channel. The collections were carried out monthly from September, 1997 to January, 1998. Water quality parameters, fish removal procedures, as well as biometry and anaesthetic data were observed in order to monitor the management conditions. Of the 80 sampled fish, 71 (89 percent) were infested with four Monogenoidea species (Anacanthorus spiralocirrus, Jainus amazonensis, Tereancistrum kerri and Trinibaculum brazilensis), 12 (15 percent) one of Nematoda Spirocamallanus inopinatus, and three (3.75 percent) with the Copepoda Ergasilus bryconis. Monogenoidea presented the highest prevalence and intensity of infestation. The Kruskall-Wallis non-parametric variance analysis showed a significant difference (P < 0.05) in the monthly parasite indexes of A. spiralocirrus, J. amazonensis and T. brazilensis, however no significant difference (P > 0.05) was detected for T. kerri. Evaluation of the management conditions pointed out that monthly capture anaesthesia and hauling procedures may have been responsible for some of the clinical signals such as loss of scales, erosion and no pigments on the caudal fin and cornea opacity, which were the most frequently found injuries in husbandry.

O matrinxã Brycon amazonicus, é uma espécie amplamente cultivada na região Amazônica, entretanto, as doenças parasitárias são praticamente desconhecidas. Este estudo teve como objetivo monitorar mensalmente a fauna parasitológica e as condições de manejo em sistema de cultivo intensivo em canal de igarapé. As coletas foram realizadas mensalmente, durante os meses de setembro de 1997 a janeiro de 1998. O monitoramento das condições de manejo foi realizado observando-se os parâmetros de qualidade de água, procedimentos de despesca, biometrias e anestesia. Oitenta (80) peixes foram amostrados, dos quais, 71 (89 por cento) encontravam-se parasitados com quatro espécies de monogenóideos (Anacanthorus spiralocirrus, Jainus amazonensis, Tereancistrum kerri e Trinibaculum brazilensis), 12 (15 por cento) com o nematóide Spirocamallanus inopinatus e três (3,75 por cento) com o ergasilídeo Ergasilus bryconis. Os monogenóideos apresentaram os maiores valores de prevalências e intensidades de infestação. A análise de variância não paramétrica de Kruskall-Wallis revelou uma diferença significativa (P < 0,05) nos índices parasitários mensais de A. spiralocirrus, J. amazonensis e T. brazilensis, porém para T. kerri não foi detectado diferença significativa (P > 0,05). A avaliação das condições de manejo indicaram que os procedimentos mensais de captura, anestesia e transporte podem ter sido responsáveis por alguns dos sinais clínicos observados durante o cultivo. Os mais freqüentes foram: perda de escamas, erosão e despigmentação da nadadeira caudal e opacidade de córnea.

Parasite fauna monitoring of matrinxã Brycon amazonicus (Spix and Agassiz, 1829) raised in aN intensive husbandry system in a stream channel in the state of Amazonas, Brazil.

The matrinxã, Brycon amazonicus, is one of the main species being used for aquaculture and fishery activities in the Amazonian region, yet little is known about the parasites that cause its diseases. The present study monitored parasite fauna infesting an intensive husbandry system in a stream channel. The collections were carried out monthly from September, 1997 to January, 1998. Water quality parameters, fish removal procedures, as well as biometry and anaesthetic data were observed in order to monitor the management conditions. Of the 80 sampled fish, 71 (89%) were infested with four Monogenoidea species (Anacanthorus spiralocirrus, Jainus amazonensis, Tereancistrum kerri and Trinibaculum brazilensis), 12 (15%) one of Nematoda Spirocamallanus inopinatus, and three (3.75%) with the Copepoda Ergasilus bryconis. Monogenoidea presented the highest prevalence and intensity of infestation. The Kruskall-Wallis non-parametric variance analysis showed a significant difference (P < 0.05) in the monthly parasite indexes of A. spiralocirrus, J. amazonensis and T. brazilensis, however no significant difference (P > or = 0.05) was detected for T. kerri. Evaluation of the management conditions pointed out that monthly capture anaesthesia and hauling procedures may have been responsible for some of the clinical signals such as loss of scales, erosion and no pigments on the caudal fin and cornea opacity, which were the most frequently found injuries in husbandry.

The new Brazilian traffic code and some characteristics of victims in southern Brazil.

OBJECTIVE: The aim was to study characteristics of traffic accident victims before and after the implementation of the new Brazilian traffic code, in January 1998. SUBJECTS AND METHODS: The study population was car and motorcycle occupants seen in a pre-hospital care service in Londrina, Parana State (Brazil) before the introduction of the new Brazilian traffic code, from 22 January to 21 July 1997, and after its implementation during the same period in 1998. Victims were analyzed over the time periods according to helmet and seat belt use, gender, underage driving, and alcohol on the breath. RESULTS: Use of seat belts increased from 45% to 62.6% and of helmets from 31.2% to 66.2% after the introduction of the new Brazilian code. The proportion driving under age 18 and with perceptible alcoholic breath declined significantly only among motorcycle riders. There was a 20% decline in car occupant injuries along with a 9% reduction in motorcycle related injuries after the change of the law. CONCLUSION: Results favor the hypothesis that rigorous legislation increases safer practices in traffic, at least during the first months of its implementation.

[Traffic accidents in a city in Southern Brazil: an evaluation of coverage and quality of data]. / Acidentes de transporte terrestre em cidade da Região Sul do Brasil: avaliação da cobertura e qualidade dos dados.

The aim of this study was to analyze police coverage and the validity of data on emergency and hospitalization records as well as on death certificates for traffic casualties in Londrina, Paraná State, Brazil. Victims (3,643) of road accidents during the first semester of 1996 were investigated and followed up after 180 days to confirm whether death was due to the accident. Police data recorded only 32.5% of the casualties, the coverage being higher for car occupants (71.6%) and lower for cyclists (8.1%) and pedestrians (24.8%). Agreement was low between original information and that derived from investigation of death certificates (Kappa coefficient 0.10; 95% CI: 0.02-0.17), fair for hospitalization records (Kappa coefficient 0.33; 95% CI: 0.27-0.40), and substantial for emergency records (Kappa coefficient 0.63; 95% CI: 0.61-0.65). Results suggest that police data underestimate the number of traffic casualties and that it is necessary to improve the validity of medical records.

[Road accidents in a city in southern Brazil]. / Acidentes de transporte terrestre em município da Região Sul do Brasil.

The study was conducted in the municipality of Londrina, a medium-sized city of southern Brazil. Analysis was performed in the characteristics of road accidents that had occurred during the first semester of 1996, resulting in 3,643 victims. Car or small truck collisions were the most common type of accident. The rate of motorcycle-related injuries (per 1,000 registered vehicles) was seven times higher than that resulting from cars or small trucks. Fatality rates were higher for motorcyclists who collided with stationary objects (29.4%) and pedestrians who were injured by lorries or buses (22.2%), in comparison with a mean fatality rate of 1.8%. This information may provide a basis for the implementation of public policies aiming at reducing accidents.

[Haemophilus influenzae type b meningitis in the state of Paraná, Brazil] / Meningite por Haemophilus influenzae tipo b em cidades do estado do Paraná, Brasil.

OBJECTIVE: During the second half of 1996, the municipalities of Londrina and Curitiba (State of Paraná, Brazil) included Haemophilus influenzae type b (Hib) vaccine into their routine vaccination regimen, approximately 30 months before its introduction into the National Immunization Program. The present study aimed at verifying the incidence of meningitis caused by Hib among children in Londrina, Curitiba, and in the remaining municipalities of the State, before and after the introduction of this vaccine into the immunization program. METHODS: An observational and retrospective study was carried out. The study included all cases of Haemophilus influenzae type b meningitis recorded by the epidemiological surveillance system in Londrina and by the State of Paraná Health Secretariat between 1992 and 1999 among children aged less than 5 years. The incidence rates of Hib meningitis were calculated per 100,000 children aged less than five years. RESULTS: After the introduction of Hib vaccine, an important reduction in the incidence rate of Haemophilus influenzae type b meningitis was observed in Londrina (from 23.91 in 1996 to 2.79 in 1999). A Similar decrease was observed in Curitiba. In the remaining localities of the state, which had not introduced the vaccine till mid-1999, the incidence rate remained almost unchanged. CONCLUSION: Regular vaccination against Hib was effective in reducing the incidence rate of meningitis amongst children younger than five years in Londrina and Curitiba. In order to maintain this low incidence rate, adequate vaccination coverage and strict epidemiological surveillance should be guaranteed.

[Characteristics of the victims of traffic accidents in a city of the southern region of Brazil]. / Características das vítimas por acidentes de transporte terrestre em município da Região Sul do Brasil.

OBJECTIVE: To evaluate the magnitude of morbidity and mortality and describe some of the characteristics of road accident victims. METHODS: The study population was composed of 3,643 victims of road accidents which occurred in Londrina, PR (Brazil), during the first semester of 1996. There were included victims from accidents registered by the Military Police, those who died at the accident scenario or on their way to the hospital, those who received emergency care or were hospitalized through the Unified Care System. It was observed a period of 180 days for death verification. RESULTS: The mean incidence and mortality rates were 1,582.2 and 29. 0 per 100,000 inhabitants, respectively. These rates, however, have demonstrated great variability in relation to several characteristics (place of residence, gender, age and the victim's mode of transport). The majority of victims were motorcyclists, followed by cyclists and pedestrians who, altogether, accounted for 76.9% of the total, and 81.5% of those who died. CONCLUSIONS: These results suggest that road accidents constitute a major cause of morbidity and mortality and that specific preventive measures should be considered in order to reduce such accidents, especially those that involve the most vulnerable road passers.

[Analysis of registries of live births in an urban area of Southern Brazil]. / Análise dos registros de nascimentos vivos em localidade urbana no Sul do Brasil.

Live births which occurred in the period from April to September of 1994 were analysed, using the two copies of the Birth Declaration-BD-(the white copy coming from the hospital where the child was born and the yellow copy sent by the Legal Registry Office where the birth was registered) received by the Londrina Municipal Health Service. After the "cross matching" of both copies (for each child), household interviews were performed in cases without matched pairs (only a white or only a yellow copy indicating possible unregistered or home deliveries). Results showed that the proportion of births not legally registered was of from 5.3 to 6.6% of the hospital births. Cost, negligence and legitimacy were the main reasons given for not registering births legally. The average time taken to make the registration was 26.5 days (standard deviation of 52 days) and 88.7% of the families did it by the 60th day from the date of the birth. A statistical association was detected between the act of registration and the period within which registration is required (within 60 days from birth) and type of delivery, maternal age and education. The official proportion of home deliveries was 0.5%; however, after the research the value was found to be somewhere between 0.13 and 0.3% of all the registered births--only 36.8% were really born at home. Reasons for home deliveries were: option, "there wasn't a means of transport to take the pregnant woman to hospital" and "there wasn't enough time to get to a hospital".

[Enteral feeding at home]. / Nutrição enteral domiciliar.

Enteral nutrition was used for the purpose of providing an adequate alimentary support to patients who had been discharged from the hospital. Ten of them received the enteral diet in their own homes by means of a Dobbhoff tube. Six patients, however, had been receiving it during their hospitalization period, and four had started the treatment in their own houses, thus avoiding need for hospitalization. Enteral feeding was the only nutritional support used in the case of six patients. For the others, an oral diet was free to be used, even though the enteral diet provided all the required calories and proteins. All patients did very well and improvement of their nutritional condition was observed, without any intercurrence due to the enteral nutrition. Development of this procedure allows provision of adequate nutritional support to patients in their own homes, even in more complex situations. The low-cost enteral diet is easy to prepare and administer, thus enabling low-income patients to receive it in their own homes. Furthermore, it shortens the hospitalization period, and avoids the risk of discontinuing adequate nourishment of ill persons after their discharge from the hospital.

Suporte nutricional em pacientes hospitalizados: experiencia de um ano. / Nutritional support in hospitalized patients: experience of 1 year

A equipe de nutricao clinica da Escola Paulista de Medicina (EPM) atende aos pedidos de interconsulta das diversas enfermarias do Hospital Sao Paulo que estao sob a responsabilidade de diferentes disciplinas da EPM. De outubro de 1982 a outubro de 1983, a equipe avaliou o estado nutricional e indicou a conduta de suporte nutricional em 89 doentes. Quando a alimentacao enteral foi a indicada, a dieta formulada foi adaptada a cada caso,segundo as necessidades energeticas e, quando necessario, com restricoes de nutrientes, tais como proteina, sodio e agua. A prevalencia de desnutricao proteico-calorica foi de 68%. A nutricao enteral foi indicada em 80 pacientes, sendo instalada em 57 dos quais 24 receberam-na, durante a hospitalizacao, por tempo medio de 32 dias e 4 receberam-na no hospital e, depois da alta, em seus domicilios, por tempo medio de 46 dias.Esses pacientes mostraram melhora do estado nutricional e nao apresentaram complicacoes decorrentes da terapeutica nutricional aplicada