Relevance of Oxocyclam from Palladium(II) Coordination to Radiopharmaceutical Development.

We provide a comprehensive study of the coordination of oxocyclam with palladium(II), including presentation of a novel bifunctional analogue, p-H2N-Bn-oxocyclam, bearing an aniline pendant. The complexation of palladium(II) with oxocyclam was examined by various techniques, including NMR analysis and potentiometric titrations which revealed that the Pd(II) complex can adopt different configurations such as trans-I and trans-III. In addition, oxocyclam forms a thermodynamically stable palladium(II) complex, the stabilization being attributed to the deprotonation of the amide function. The crystal structures of [Pd(H-1oxocyclam)]+ and [Pd(oxocyclam)]2+ were obtained, revealing the structural details previously anticipated, including, in the second case, the presence of the proton on the carbonyl oxygen atom. Additionally, the study explored the redox behavior of the Pd(II)-oxocyclam complex through reduction and oxidation voltammograms at different pH values. Successful 109Pd-labeling of oxocyclam and p-H2N-Bn-oxocyclam at pH 3.5 demonstrated high labeling efficiencies, whatever the species formed. The stability of the radiocomplexes was assessed and moderate transchelation toward EDTA was observed. Overall, oxocyclam displayed favorable properties for Pd(II) coordination and radiolabeling, suggesting its potential as a chelating agent for this metal in palladium-based applications.

ABCB1 C1236T, G2677TA and C3435T Genetic Polymorphisms and Antidepressant Response Phenotypes: Results from a Portuguese Major Depressive Disorder Cohort.

P-glycoprotein (P-GP) is a transporter molecule expressed on the apical surface of capillary endothelial cells of the Blood-Brain Barrier (BBB), whose activity heavily influences drug distribution, including antidepressants. This transporter is encoded by ABCB1 gene, and genetic variations within ABCB1 gene have been proposed to affect drug efflux and have been previously associated with depression. In this context, we aimed to evaluate the role of C1236T, G2677TA and C3435T ABCB1 genetic polymorphisms in antidepressant treatment phenotypes from a cohort of patients harboring Major Depressive Disorder. Patients enrolled in the study consisted of 80 individuals with Major Depressive Disorder, who took part in a 27-month follow-up study at HML, Portugal. To investigate the correlation between ABCB1 polymorphisms and antidepressant response phenotypes, DNA was extracted from peripheral blood, and C1236T, C3435T and G2677TA polymorphisms were genotyped with TaqMan® SNP Genotyping Assays. Despite the fact that the evaluated polymorphisms (C1236T, C3435T and G2677TA) were not associated with treatment resistant depression, or relapse, we observed that patients carrying TT genotype of the C3435T polymorphism remit earlier than the ones carrying CC or CT genotypes (10.2 weeks vs. 14.9 and 21.3, respectively, p = 0.028, Log-rank test). Since we found an association with C3435T and time to remission, and not to the absence of remission, we suggest that this polymorphism could have an impact on antidepressant drug distribution, and thus influence on the time to remission will occur, without influencing the risk of remission itself.

Spatially resolved distribution of pancreatic hormones proteoforms by MALDI-imaging mass spectrometry.

Zinc plays a crucial role both in the immune system and endocrine processes. Zinc restriction in the diet has been shown to lead to degeneration of the endocrine pancreas, resulting in hormonal imbalance within the ß-cells. Proteostasismay vary depending on the stage of a pathophysiological process, which underscores the need for tools aimed at directly analyzing biological status. Among proteomics methods, MALDI-ToF-MS can serve as a rapid peptidomics tool for analyzing extracts or by histological imaging. Here we report the optimization of MALDI imaging mass spectrometry analysis of histological thin sections from mouse pancreas. This optimization enables the identification of the major islet peptide hormones as well as the major accumulated precursors and/or proteolytic products of peptide hormones. Cross-validation of the identified peptide hormones was performed by LC-ESI-MS from pancreatic islet extracts. Mice subjected to a zinc-restricted diet exhibited a relatively lower amount of peptide intermediates compared to the control group. These findings provide evidence for a complex modulation of proteostasis by micronutrients imbalance, a phenomenon directly accessed by MALDI-MSI.

Stool Glycoproteomics Signatures of Pre-Cancerous Lesions and Colorectal Cancer.

Colorectal cancer (CRC) screening relies primarily on stool analysis to identify occult blood. However, its sensitivity for detecting precancerous lesions is limited, requiring the development of new tools to improve CRC screening. Carcinogenesis involves significant alterations in mucosal epithelium glycocalyx that decisively contribute to disease progression. Building on this knowledge, we examined patient series comprehending premalignant lesions, colorectal tumors, and healthy controls for the T-antigen-a short-chain O-glycosylation of proteins considered a surrogate marker of malignancy in multiple solid cancers. We found the T-antigen in the secretions of dysplastic lesions as well as in cancer. In CRC, T-antigen expression was associated with the presence of distant metastases. In parallel, we analyzed a broad number of stools from individuals who underwent colonoscopy, which showed high T expressions in high-grade dysplasia and carcinomas. Employing mass spectrometry-based lectin-affinity enrichment, we identified a total of 262 proteins, 67% of which potentially exhibited altered glycosylation patterns associated with cancer and advanced pre-cancerous lesions. Also, we found that the stool (glyco)proteome of pre-cancerous lesions is enriched for protein species involved in key biological processes linked to humoral and innate immune responses. This study offers a thorough analysis of the stool glycoproteome, laying the groundwork for harnessing glycosylation alterations to improve non-invasive cancer detection.

Bigger Calves from Doing Higher Resistance Training Volume?

We compared the effects of different weekly calf training sets on muscle size changes. Sixty-one untrained young women performed a calf training program for 6 weeks, 3 d·wk-1, with differences in resistance training volume. The participants were randomly assigned to one of the three groups: 6-SET, 9-SET, and 12-SET weekly calf training sets. The calf raise exercise was performed in sets of 15-20 repetitions maximum. The muscle thickness measurements of medial gastrocnemius (MG), lateral gastrocnemius (LG), and soleus (SOL) were taken via B-mode ultrasound. We used the sum of the three-muscle thickness as a proxy for the triceps surae (TSSUM). The 12-SET group elicited greater increases than the 6-SET in LG (6-SET=+ 8.1% vs. 12-SET=+ 14.3%; P=0.017), SOL (6-SET=+ 6.7% vs. 12-SET=+ 12.7%; P=0.024), and TSSUM (6-SET=+ 6.9% vs. 12-SET=+ 12.0%; P=0.005), but there was no significant difference in MG changes (6-SET=+ 6.6% vs. 12-SET=+ 9.9%; P=0.067). There were no significant differences when comparing 9-SET vs. 6-SET and 12-SET (P≥0.099). Although all groups experienced calf muscle hypertrophy, our results suggest that the higher dose range may optimize triceps surae muscle size gains.

Aberrantly Glycosylated GLUT1 as a Poor Prognosis Marker in Aggressive Bladder Cancer.

Muscle-invasive bladder cancer (MIBC) remains a pressing health concern due to conventional treatment failure and significant molecular heterogeneity, hampering the development of novel targeted therapeutics. In our quest for novel targetable markers, recent glycoproteomics and bioinformatics data have pinpointed (glucose transporter 1) GLUT1 as a potential biomarker due to its increased expression in tumours compared to healthy tissues. This study explores this hypothesis in more detail, with emphasis on GLUT1 glycosylation patterns and cancer specificity. Immunohistochemistry analysis across a diverse set of human bladder tumours representing all disease stages revealed increasing GLUT1 expression with lesion severity, extending to metastasis, while remaining undetectable in healthy urothelium. In line with this, GLUT1 emerged as a marker of reduced overall survival. Revisiting nanoLC-EThcD-MS/MS data targeting immature O-glycosylation on muscle-invasive tumours identified GLUT1 as a carrier of short glycosylation associated with invasive disease. Precise glycosite mapping uncovered significant heterogeneity between patient samples, but also common glycopatterns that could provide the molecular basis for targeted solutions. Immature O-glycosylation conferred cancer specificity to GLUT1, laying the molecular groundwork for enhanced targeted therapeutics in bladder cancer. Future studies should focus on a comprehensive mapping of GLUT1 glycosites for highly specific cancer-targeted therapy development for bladder cancer.

Applications of Mass Spectrometry in the Characterization, Screening, Diagnosis, and Prognosis of COVID-19.

Mass spectrometry (MS) is a powerful analytical technique that plays a central role in modern protein analysis and the study of proteostasis. In the field of advanced molecular technologies, MS-based proteomics has become a cornerstone that is making a significant impact in the post-genomic era and as precision medicine moves from the research laboratory to clinical practice. The global dissemination of COVID-19 has spurred collective efforts to develop effective diagnostics, vaccines, and therapeutic interventions. This chapter highlights how MS seamlessly integrates with established methods such as RT-PCR and ELISA to improve viral identification and disease progression assessment. In particular, matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) takes the center stage, unraveling intricate details of SARS-CoV-2 proteins, revealing modifications such as glycosylation, and providing insights critical to formulating therapies and assessing prognosis. However, high-throughput analysis of MALDI data presents challenges in manual interpretation, which has driven the development of programmatic pipelines and specialized packages such as MALDIquant. As we move forward, it becomes clear that integrating proteomic data with various omic findings is an effective strategy to gain a comprehensive understanding of the intricate biology of COVID-19 and ultimately develop targeted therapeutic paradigms.

Minimizing false positives for CTC identification.

BACKGROUND: Cancer is a leading cause of death worldwide, with metastasis playing a significant role. Circulating Tumour Cells (CTCs) can provide important real-time insights into tumour heterogeneity and clonal evolution, making them an important tool for early diagnosis and patient monitoring. Isolated CTCs are typically identified by immunocytochemistry using positive biomarkers (cytokeratin) and exclusion biomarkers (CD45). However, some white blood cell (WBC) populations can express low levels of CD45 and stain non-specifically for cytokeratin, increasing their risk of misclassification as CTCs. There is a clear need to improve CTC detection and enumeration criteria to unequivocally eliminate interfering WBC populations. RESULTS: This study showed that, indeed, some granulocyte subpopulations expressed low levels of CD45 and stained non-specifically for cytokeratin, misidentifying them as CTCs. These same cells, however, strongly expressed CD15, allowing them to be identified as WBCs and excluded from CTC classification. Flow cytometry confirmed the specificity of the CD15 antibody for the granulocyte subpopulation. False positives were considerably reduced from 25 % to 0.2 % by double exclusion, combining a CD15 antibody with a highly specific CD45 antibody. Furthermore, complete elimination of potential false positives was achieved using double exclusion in combination with improved selection of cytokeratin antibody. The study emphasises the importance of a robust exclusion criteria and high antibody specificity in CTC immuno-assays for accurate identification of CTC candidates and thorough exclusion of interfering WBC subpopulations. SIGNIFICANCE: This study demonstrated how misidentifying a granulocyte subpopulation can lead to inaccurate CTC evaluation. However, sensitivity and specificity of CTC identification may be improved by using high-performing antibodies and by including a second exclusion biomarker, in turn, allowing for a more comprehensive clinical application of CTCs.

Assessing the efficacy of gutiferone E in photodynamic therapy for oral candidiasis.

The rise in antifungal resistance and side effects of conventional treatments drive the search for innovative therapies like Photodynamic Therapy (PDT). This study explored the efficacy of PDT mediated by gutiferone, an isolated compound from red propolis, for candidiasis treatment. Multiple evaluation methods were employed, including determining the minimum inhibitory concentration (MIC) via broth microdilution, quantifying biomass using crystal violet detachment, and cell counting through total plate count. PDT mediated by gutiferone was also assessed in five groups of mice, followed by histopathological examination and agar plating of lingual tissue samples. Among the seven Candida species tested, gutiferone displayed efficacy against C. albicans, C. glabrata, and C. tropicalis, with MIC values of 1000 µg/mL. In C. tropicalis biofilms, exposure to gutiferone led to a reduction of 1.61 Log10 CFU/mL. PDT mediated by gutiferone achieved an average reduction of 3.68 Log10 CFU/mL in C. tropicalis biofilm cells, underscoring its potent fungicidal activity. Histopathological analysis revealed fungal structures, such as pseudohyphae and hyphae, in infected groups (G2) and irradiated mice. In contrast, groups treated with gutiferone or subjected to gutiferone-assisted PDT (G5) exhibited only few blastoconidia. Furthermore, CFU/mL assessments in lingual tissue post-treatment demonstrated a significantly lower count (0.30 Log10 CFU/mL) in the G5 group compared to G2 (2.43 Log10 CFU/mL). These findings highlight the potential of PDT mediated by gutiferone as a promising alternative for managing denture stomatitis. Future research and clinical investigations offer the promise of validating its clinical applicability and improving outcomes in the treatment of oral candidiasis.

Medicalização da assistência ao parto normal: Perfil de gestantes atendidas em uma maternidade de risco habitual / Medicalización de la asistencia del parto natural: Perfil de las mujeres embarazadas atendidas en una maternidad de bajo riesgo / Medicalization of natural childbirth assistance: Profile of pregnancies women in a low-risk maternity hospital

Introdução: O nascimento tem experimentado mudanças na compreensão do parto como processo natural, tornando-o passível de intervenções, como as relacionadas a abreviação do parto através do uso de medicamentos. Objetivo: Descrever o perfil da assistência às gestantes, verificando a prevalência do uso de medicamentos, instrumentos e protocolos, durante o trabalho de parto e parto, em maternidade pública de saúde, destinada à assistência a gestantes de risco habitual. Método: Estudo transversal, descritivo, exploratório e quantitativo, com população por conveniência (n=26 profissionais de saúde). Foram investigadas as características sociodemográficas dos enfermeiros e médicos que prestavam assistência direta ao parto, além daquelas relativas ao uso de medicamentos, instrumentos e protocolos. Os dados foram tabulados no Epiinfo 7.2.2.2, sendo realizada análise estatística descritiva. Resultados: Observou-se que 53,8% são enfermeiros obstetras e 46,2% médicos obstetras. Dentre os entrevistados: 65,4% asseguraram preencher sempre ou quase sempre o partograma, 61,6% aplicam sempre ou quase sempre o índice de Bishop, 57,7% fazem uso de medicamentos para induzir o parto. A prevalência de profissionais que afirmaram não existir protocolos assistenciais ao parto na instituição somou 80,8%. Conclusão: O presente estudo foi relevante para demonstrar que a maioria dos profissionais não usavam medicamentos aceleradores do trabalho de parto; consideravam a integridade das membranas antes da indução medicamentosa, com maior prevalência de uso da ocitocina em relação ao misoprostol nos casos de necessidade de indução com iguais condições do colo uterino. A maior parte dos profissionais afirmou ainda fazer uso de protocolos de assistência ao parto, embora não fossem os institucionais.

Introducción: El nacimiento ha experimentado cambios en la comprensión del parto como un proceso natural, haciéndolo susceptible de intervenciones, como las relacionadas con la abreviación del parto mediante el uso de medicamentos. Objetivo: Describir el perfil de atención de la gestante, para verificar la prevalencia del uso de medicamentos, instrumentos y protocolos durante el trabajo de parto y parto en una maternidad de la red pública de salud, destinada a la asistencia de gestantes de riesgo habitual. Método: Estudio transversal, descriptivo, exploratorio y cuantitativo con población (n=26 profesionales de la salud). Se investigaron las características sociodemográficas de profesionales de enfermería y profesionales médicos que ofrecían asistencia directa durante el parto, además de las relacionadas con el uso de medicamentos, instrumentos y protocolos. Los datos se tabularon en el programa Epiinfo 7.2.2.2 y se realizó el análisis estadístico descriptivo. Resultados: Se observó que el 53.8 % son personal de enfermería obstetricia y el 46.2 % son obstetras. Entre las entrevistadas, el 65.4 % aseguró que siempre o casi siempre completaba el partograma, el 61.6 % siempre o casi siempre aplicaba el índice de Bishop, el 57.7 % utilizaba medicación para inducir el parto. La prevalencia de profesionales que afirmaron que no existían protocolos de atención del parto en la institución fue de 80.8 %. Conclusión: El presente estudio fue relevante para demostrar que la mayoría de los profesionales no utilizaban fármacos para acelerar el trabajo de parto, consideraron la integridad de las membranas antes de la inducción medicamentosa, con mayor prevalencia de uso de oxitocina, en relación al misoprostol en casos de necesidad de inducción con las mismas condiciones del cuello uterino. La mayoría de los profesionales dijeron que todavía hacen uso de los protocolos de atención al parto, aunque no sean institucionales.

Introduction: Birth has experienced changes in the understanding of childbirth as a natural process, making it amenable to interventions, such as those related to shorten the labor time by medication. Objective: To describe the prevalence of the use of drugs, instruments, and protocols in the labor and delivery profile of assistance in a public maternity hospital that nurses low risk pregnancies. Method: This is a cross-sectional, descriptive, exploratory, and quantitative study with population (n=26 health professionals). The sociodemographic characteristics of nurses and doctors who provide direct assistance during childbirth were analyzed in addition to those related to the use of medications, instruments, and protocols. Data were tabulated in the Epiinfo 7.2.2.2 program; then, a descriptive statistical analysis was performed. Results: It was observed that 53.8% are obstetric nurses and 46.2% are obstetricians. Among the interviewees: 65.4% assured that they always or almost always completed the partograph, 61.6% always or almost always applied the Bishop index, 57.7% used medication to induce labor. The prevalence of professionals who stated that there were no childbirth care protocols in the institution totaled 80.8%. Conclusion: The present study was relevant to demonstrate that most professionals did not use drugs for labor induction; they considered the integrity of the membranes before these drugs; and, when induction was needed, there was a higher prevalence of the use of oxytocin in relation to misoprostol in cases with the same conditions of the uterine cervix. Most professionals said that they still use childbirth care protocols although they are not institutional.

Criação percutânea de fenestrações via trans hepática no conduto extra cardíaco no PO tardio de Fontan / Percutaneous creation of transhepatic fenestrations in the extracardiac conduit in the late postoperative period of Fontan

INTRODUÇÃO: Pacientes submetidos a cirurgia de Fontan podem apresentar complicações tardias devido a congestão venosa crônica. A criação de fenestrações nos condutos sem fenestrações pode, teoricamente, atenuar a congestão venosa e melhorar as condições clínicas já que leva a aumento do débito cardíaco sistêmico a despeito de leve dessaturação. A literatura é controversa sobre a eficácia deste tipo de procedimento. OBJETIVO: Relatar nossa experiência com a criação percutânea de fenestrações usando uma nova técnica por via trans hepática. MÉTODOS: Estudo observacional de pacientes com complicações tardias de Fontan extra cardíaco não fenestrado (hepatopatia, enteropatia perdedora de proteína, ICC direita). A via transhepática foi obtida por punção percutânea usando fluoroscopia e contraste. Por dentro de uma bainha longa 8Fr uma agulha de punção transeptal foi avançada para perfuração mecânica do conduto. Stents revestidos de 5-7 mm foram usados para criação da fenestração. O ecocardiograma transesofágico (ETE) foi empregado na monitoração. O trajeto hepático foi ocluído com plugs. Anticoagulação vs antiplaquetários ficou a critério clínico. Parâmetros clínicos e laboratoriais foram aplicados no seguimento para avaliar os desfechos. RESULTADOS: Seis pacientes (mediana idade 10 anos) foram submetidos ao procedimento com sucesso e sem complicações. Três deles apresentavam sinais e sintomas de enteropatia perdedora de proteínas (EPP) e os outros ICC direita. Não foram observadas altas pressões no conduto. Um ótimo ângulo de ataque para perfuração na porção inferior do conduto foi obtido em todos os casos. Ao ETE todas as fenestrações apresentavam fluxo adequado D-E pelo stent após implante. A saturação caiu de 92 +/- 3 para 85 +/- 2%. Não houve sangramentos ou hematomas no fígado. Houve melhora clínica inicial em todos os pacientes com redução da congestão venosa. Apesar disto, não houve remissão da EPP nos 3 pacientes (apesar de melhoria laboratorial). Em um destes houve oclusão tardia do stent não sendo possível sua recanalização. CONCLUSÕES: A via trans hepática proporcionou um ótimo ângulo de ataque para criação percutânea de fenestrações com stents em condutos não fenestrados no Fontan. Esta técnica foi segura em nossas mãos, mas sua eficácia foi errática. Estudos adicionais de longo prazo são necessários para avaliar o impacto clínico da criação destas fenestrações nestes difíceis pacientes.

Enfermedades asintomáticas o diagnósticos incipientes / Asymptomatic diseases or early diagnoses

RESUMEN Introducción: Constituye hecho relevante en el ejercicio de la medicina, individual o poblacional, conocer precozmente la instauración de las enfermedades, y por ello se tratan de realizar los diagnósticos clínicos precozmente. Sin embargo, un grupo de enfermedades, infecciosas o no infecciosas, agudas o crónicas, se caracterizan por escasas manifestaciones clínicas, por lo que el conocimiento de su existencia es de vital importancia, por ejemplo, la hipertensión arterial o la diabetes mellitus, cuyas expresiones sintomáticas pueden aparecer tardíamente. En igual medida, la actual pandemia por SARS-CoV-2, ha proliferado rápidamente debido al gran número de personas infectadas que no expresan síntomas. Objetivo: Caracterizar aspectos clínicos relevantes sobre las enfermedades asintomáticas y la importancia de los diagnósticos clínicos o biotecnológicos incipientes, individuales y poblacionales. Métodos: Se realizaron búsquedas bibliográficas de los últimos cinco años en libros clásicos de Medicina Interna, se analizaron artículos publicados en revistas nacionales e internacionales, específicamente en revistas de alto impacto como Lancet y The New England Journal of Medicine. Se consideraron bases de datos de la Organización Mundial de la Salud, así como lo expuesto en Infomed; además se utilizó Google Académico, con los descriptores de interés al respecto. Conclusiones: Por el momento siempre serán parciales, pues se enfatiza en las recomendaciones de la Organización Mundial de la Salud sobre la actual pandemia, para la identificación y control del SARS-CoV-2; se acentúa en la importancia de los métodos clínicos y epidemiológicos, así como en el desarrollo de la biotecnología para el conocimiento de las enfermedades.

ABSTRACT Introduction: early detection of the onset of diseases constitutes a relevant fact in the practice of individual or population medicine that is why early clinical diagnoses are tried to be made. However, a group of infectious or non-infectious, acute or chronic clinical diseases are characterized by few clinical manifestations, for which knowledge of their existence is of vital importance, for example, arterial hypertension or diabetes mellitus, whose symptomatic expressions may appear late. To the same extent, the current SARS-CoV-2 pandemic has proliferated rapidly due to the large number of infected people who do not express symptoms. Objective: to characterize relevant clinical aspects of asymptomatic diseases and the importance of incipient, individual and population clinical or biotechnological diagnoses. Methods: bibliographic searches of the last five years were carried out in classic books on Internal Medicine, articles published in national and international journals were analyzed, specifically in high-impact journals such as the Lancet and The New England Journal of Medicine. Databases of the World Health Organization were considered, as well as what was exposed in Infomed; in addition, Google Scholar was used, with the descriptors of interest in this regard. Conclusions: conclusions will always be partial for the moment, since the recommendations of the World Health Organization for the identification and control of SARS-CoV-2 are emphasized; the importance of clinical and epidemiological methods is highlighted, as well as the development of biotechnology for the knowledge of diseases.

Neuroprogression in post-traumatic stress disorder: a systematic review

Abstract Introduction Neuroprogression has been proposed as the pathological rewiring of the brain that takes place in parallel with clinical and neurocognitive deterioration in the course of psychiatric disorders. This study aims to review the biological underpinnings and clinical outcomes related to neuroprogression in post-traumatic stress disorder (PTSD). Methods We performed a systematic review by searching PubMed, Embase, and Web of Science for articles published between January 1, 1960, and January 6, 2020. Inclusion criteria were met when articles assessed brain changes, neurocognition, functioning, inflammation, oxidative stress, and neurotrophins in patients with PTSD. Narrative review articles, case reports, and preclinical studies were excluded. Results A total of 965 abstracts were identified and 15 articles were included in our systematic review. It seems that for a subset of patients whose symptoms worsen or are maintained at a high intensity there is a progressive change in the frontal lobe, especially the prefrontal cortex, and worsening of both neurocognition (verbal memory and facial recognition) and functioning (physical, psychological, social and environmental). Conclusion Although current findings associate progressive reduction in frontal lobe size with neurocognitive impairment, further research is needed to characterize PTSD as a neuroprogressive disorder.

Relationship between childhood trauma, parental bonding, and defensive styles and psychiatric symptoms in adult life

Abstract Introduction A relationship between different types of childhood trauma, parental care, and defensive styles and development of psychiatric symptoms in adulthood is proposed in this study. Understanding the nature of this association is essential to assist psychotherapists who treat patients with a history of past trauma. This study aims to examine the associations between childhood trauma, parental bonding, and defensive styles and current symptoms in adult patients who sought care at an analytical psychotherapy clinic. Methods The sample comprised 197 patients from an analytically oriented psychotherapy clinic. Participants responded to four self-report instruments that assessed, respectively, presence and frequency of several types of early trauma, type of parental attachment, styles of defenses, and current symptoms encompassing a wide variety of psychopathological syndromes. Results Only 5% of patients reported not having experienced any traumatic experience in childhood. Several traumas such as emotional and physical abuse, emotional neglect, and physical neglect showed positive and significant associations with several dimensions of current symptoms, and also with parental bonding and defensive styles. When analyzed together with the other variables, defensive styles explained the level of psychological suffering caused by the symptoms. Conclusions This study offers additional support for understanding the associations between childhood trauma, parental bonding styles, and defense styles and the psychiatric symptoms of patients in analytically oriented psychotherapy.

Use of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density

ABSTRACT Objective: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). Subjects and methods: Thirty-four postmenopausal women with BC, without bone metastasis, renal function impairment and who were not receiving bone-active drugs were selected from a population of 523 outpatients treated for BC. According to the presence of hormonal receptors, HER2 and Ki67, seventeen had positive hormonal receptors and received anastrozole (AI group), and seventeen were triple-negative receptors (non-AI group), previously treated with chemotherapy. Areal bone mineral density (aBMD) and vertebral fracture assessment (VFA) analyses were performed by DXA; vBMD and bone microarchitecture were evaluated by HR-pQCT. Fracture risk was estimated using the FRAX tool. Results: No patient referred previous low-impact fracture, and VFA detected one moderate vertebral fracture in a non-AI patient. AI patients showed lower aBMD and BMD T-scores at the hip and 33% radius and a higher proportion of osteoporosis diagnosis on DXA (47%) vs non-AI (17.6%). AI group had significantly lower values for vBMD at the entire, cortical and trabecular bone compartments, cortical and trabecular thickness and BV/TV. They also had a higher risk for major fractures and for hip fractures estimated by FRAX. Several HR-pQCT parameters evaluated at distal radius and distal tibia were significantly associated with fracture risk. Conclusion: AI is associated with alterations in bone density and microarchitecture of both the cortical and trabecular compartments. These findings explain the overall increase in fracture risk in this specific population.

COVID-19 pandemic and social distancing: economic, psychological, family, and technological effects

Abstract Introduction The concept of social isolation is currently understood as a measure of epidemiological containment that aims to reduce the speed of spread of the disease, enabling health services to prepare their resources to cope with the likely increase in demand, while also seeking to provide additional protection to groups considered to be at higher risk. Objective The present narrative review aims to compile and synthesize the literature related to social isolation produced during the COVID-19 pandemic in 2020. Method This study is a narrative review of the literature on social isolation in the context of the COVID-19 pandemic. Results 73 publications were included for full-text reading and were classified into the following categories: levels of social isolation, economic effects, family relationships, health system, mental health of the population, and use of technology. Conclusions It is necessary to plan an escalation of responses to the consequences of the pandemic, especially in view of the increased demand on the health sector and social services. The negative effects of social isolation can be prevented by public policies that offer a response to the economic recession, maintenance of social work, encouragement of quality care in mental health services, and community support for vulnerable families.

Trauma infantil e manifestações histéricas na atualidade: uma revisão da literatura / Child trauma and hysterical manifestations today: a literature review

As reações corporais e emocionais sentidas pelos pacientes com manifestações histéricas podem atingir tamanha intensidade, a ponto de prejudicar sua vida social, familiar e laboral. O trabalho parte dos seguintes questionamentos: como são as manifestações histéricas na atualidade? Qual a compreensão sobre a histeria na literatura da área ao longo do tempo? O objetivo é descrever aspectos teóricos sobre a histeria e o trauma infantil, articulando-os com a clínica atual. Foi desenvolvida uma revisão da literatura por meio do método narrativo. Os resultados encontrados foram 106 estudos nos últimos 6 anos (Bireme e Dialnet), sendo que, de 2017 em diante, houve um decréscimo nas publicações científicas sobre o tema. Apesar de a categoria psicopatológica da histeria ter desaparecido dos manuais de transtornos mentais, na clínica atual as manifestações histéricas são facilmente confundidas com outros transtornos (depressivos, dissociativos e distúrbio borderline). As manifestações somáticas aparecem no corpo para comunicar eventos traumáticos não contidos pelo aparelho psíquico. Conclui-se que as manifestações histéricas seguem presentes nos dias de hoje, e o corpo tende a ser uma via de expressão somática. No contexto da relação entre sintomas histéricos e traumas vivenciados na infância, a psicoterapia ocupa lugar de destaque, promovendo ressignificações para tais eventos traumáticos.(AU)

The bodily and emotional reactions felt by patients with hysterical manifestations can reach such intensity as to harm their social, family and work life, causing several losses for the individual. The study starts from the following questions: how are the hysterical manifestations today? What about understanding hysteria in the literature of the area over time? The objective is to describe theoretical aspects of hysteria and childhood trauma, in conjunction with the current clinic. A literature review using the narrative method was developed. The results found were 106 studies in the last 6 years (Bireme and Dialnet), and as of 2017 there is a decrease in scientific publications on the topic. Although the psychopathological category of hysteria has disappeared from the manuals of mental disorders, nowadays in the clinic the hysterical manifestations are easily confused with other disorders (depressive, dissociative and borderline). Somatic manifestations appear in the body to communicate traumatic events not contained by the psychic apparatus. It is concluded that the hysterical manifestations are still present today, and the body tends to be an important way of expressing symptoms through the somatic path. In the context of the relationship between hysterical symptoms and childhood trauma, psychotherapy occupies a prominent place, promoting reframing for such traumatic events.(AU)

Las reacciones corporales y emocionales que sienten los pacientes con manifestaciones histéricas pueden alcanzar tal intensidad como para dañar su vida social, familiar y laboral, causando varias pérdidas para el individuo. El estudio parte de las siguientes preguntas: ¿Cómo son hoy las manifestaciones histéricas? ¿Cuál es la comprensión de la histeria en la literatura de la zona a lo largo del tiempo? El objetivo es describir aspectos teóricos de la histeria y el trauma infantil, en conjunto con la clínica actual. Se ha elaborado una revisión de la literatura utilizando el método narrativo. Los resultados encontrados fueron 106 estudios en los últimos 6 años (Bireme y Dialnet), y a partir de 2017 hubo una disminución en las publicaciones científicas sobre el tema. Aunque la categoría psicopatológica de histeria ha desaparecido de los manuales de trastornos mentales, hoy en día en la clínica las manifestaciones histéricas se confunden fácilmente con otros trastornos (depresivo, disociativo y borderline). Las manifestaciones somáticas aparecen en el cuerpo para comunicar eventos traumáticos no contenidos por el aparato psíquico. Se concluye que las manifestaciones histéricas todavía están presentes hoy en día, y el cuerpo tiende a ser una forma importante de expresar los síntomas a través de las vías somáticas. En el contexto de la relación entre los síntomas histéricos y el trauma vivido en la infancia, la psicoterapia ocupa un lugar destacado, promoviendo replanteamiento para tales eventos traumáticos.(AU)