Effects of coenzyme Q10 and N-acetylcysteine on experimental poisoning by paracetamol in Wistar rats.

Paracetamol (PAR) is a drug widely used in human and veterinary medicine as an analgesic and antipyretic, often involved in cases of intoxication. The most common clinical signs result from damage to red blood cells and hepatocytes, and this intoxication is considered a model for the induction of acute liver failure. In the present study, the hepatoprotective effects of coenzyme Q10 (CoQ10) and N-acetylcysteine (NAC) against experimental paracetamol (PAR) poisoning were analysed. Thirty-five adult Wistar rats (Rattus novergicus albinus) were randomly assigned to five groups, and thirty-one of these survived the treatments. Negative control group (CON-) received 1mL of 0.9% NaCl orally (PO). Other groups received 1.2g/kg of PAR (PO). Positive control group (CON+) received only PAR. NAC group received 800 mg/kg intraperitoneally (IP) of NAC 1h after the administration of PAR and at 12 h received 1mL of 0.9% NaCl, IP. The fourth group (CoQ10) received 1h and 12 h after intoxication, CoQ10 (10mg/kg IP). And the fifth group (NAC+CoQ10) received NAC (800mg/kg, IP) and CoQ10 (10mg/kg, IP). After 12 hours, the rats were euthanized and necropsied to collect liver and kidney tissues for histopathological evaluation and electronic microscopy. A single dose of PAR caused severe acute hepatitis. NAC couldn't reverse the liver and kidney damages. The group that received CoQ10 and NAC had moderate liver damage, while the group that received only CoQ10 had lower values of liver enzymes and mild liver and kidney damage. Animals that received treatment with CoQ10 or NAC+CoQ10 presented normal hepatocyte mitochondria and nuclei. Although CoQ10 couldn't reverse PAR organ damage, results indicate promising hepatoprotection in Wistar rats.

E-Health technologies for treatment of depression, anxiety and emotional distress in person with diabetes mellitus: A systematic review and meta-analysis.

OBJECTIVE: This systematic review of randomized clinical trials (RCT) summarized the available evidence regarding the use of e-Health technologies for the treatment of depression, anxiety, and emotional distress in person with diabetes mellitus. METHODS: The Cochrane CENTRAL, MEDLINE, EMBASE, Web of Science and LILACS databases searched were up to January 11th, 2023. The primary outcomes were improvement of depression, anxiety, diabetes-related emotional distress and quality of life. Reviewers, in pairs and independently, selected the studies and extracted their data. RESULTS: A total of 10 RCT involving 2,209 participants were analyzed. The methodological quality of the studies reviewed was high. Results showed improvements in depression with the use of Internet-Guided Self-Help (SMD = -0.74, 95%CI = -1.04 to -0.43) or Telephone-Delivered Cognitive Behavioral Therapy (CBT) (SMD = -0.42, 95%CI = -0.65 to -0.19); in anxiety with Internet-Guided Self-Help (SMD = -0.72, 95%CI = -1.02 to -0.42) or Diabetes-specific-CBT (SMD = -0.60, 95%CI = -1.18 to -0.02); and in emotional distress with Internet-Guided Self-Help (SMD = -0.72, 95%CI = -1.02 to -0.41) or Healthy Outcomes through Patient Empowerment (SMD = -0.26, 95%CI = -0.53 to 0.01) compared to usual care. CONCLUSION: Due to heterogeneity in interventions, populations, follow-up time and outcomes, future RCT should be conducted to confirm these findings.

ABCDE and ABCDEF care bundles: A systematic review of the implementation process in intensive care units.

BACKGROUND: The ABCDE (Awakening and Breathing Coordination of daily sedation and ventilator removal trials, Delirium monitoring and management, and Early mobility and exercise) and ABCDEF (Assessment, prevent and manage pain, Both spontaneous awakening and spontaneous breathing trials, Choice of analgesia and sedation, assess, prevent and manage Delirium, Early mobility and exercise, Family engagement) care bundles consist of small sets of evidence-based interventions and are part of the science behind Intensive Care Unit (ICU) liberation. This review sought to analyse the process of implementation of ABCDE and ABCDEF care bundles in ICUs, identifying barriers, facilitators and changes in perception and attitudes of healthcare professionals; and to estimate care bundle effectiveness and safety. METHODS: We selected qualitative and quantitative studies addressing the implementation of ABCDE and ABCDEF bundles in the ICU, identified on MEDLINE, Embase, CINAHL, The Cochrane Library, Web of Science, Epistemonikos, PsycINFO, Virtual Health Library and Open Grey, without restriction on language or date of publication, up to June 2018. The outcomes measured were ICU and hospital length of stay; mechanical ventilation time; incidence and prevalence of delirium or coma; level of agitation and sedation; early mobilization; mortality in ICU and hospital; change in perception, attitude or behaviour of the stakeholders; and change in knowledge of health professionals. Two reviewers independently selected the studies, performed data extraction, and assessed risk of bias and methodological quality. A meta-analysis of random effects was performed. RESULTS: Twenty studies were included, 13 of which had a predominantly qualitative and 7 a quantitative design (31,604 participants). The implementation strategies were categorized according to the taxonomy developed by the Cochrane Effective Practice and Organization of Care Group and eighty strategies were identified. The meta-analysis results showed that implementation of the bundles may reduce length of ICU stay, mechanical ventilation time, delirium, ICU and hospital mortality, and promoted early mobilization in critically-ill patients. CONCLUSIONS: : This study can contribute to the planning and execution of the implementation process of ABCDE and ABCDEF care bundles in ICUs. However, the effectiveness and safety of these bundles need to be corroborated by further studies with greater methodological rigor. PROTOCOL REGISTRATION: PROSPERO CRD42019121307.

Dynamic development of AT-rich heterochromatin has followed diversification and genome expansion of psammophilous Mycetophylax (Formicidae: Attini: Attina).

Heterochromatin is an important genome constituent comprised by a high density of repetitive DNA sequences that mediate chromosome structure and function. The species Mycetophylax morschi currently harbours three cytotypes: 2n = 26, 2n = 28 and 2n = 30 chromosomes. However, Mycetophylax conformis and Mycetophylax simplex harbour 2n = 30 and 2n = 36 chromosomes, respectively. None of the cytotypes of M. morschi showed any AT-positive blocks, whereas the karyotypes of M. conformis and M. simplex revealed AT-rich blocks around the pericentromeric region and on the short arm of several chromosomes. This AT-rich pattern is coincident with the known heterochromatin distribution of psammophilous Mycetophylax, confirming that heterochromatin is AT-rich, in line with the genome size and AT%. Our results demonstrated that genome size among psammophilous Mycetophylax is correlated with the proportion of base pairs, biased to adenine and thymine. Thus, genome size and the proportion of adenine and thymine in the species studied here suggest that the genome changes in psammophilous Mycetophylax are related to the expansion of repetitive DNA in AT-rich heterochromatin. Considering the phylogenetic relationship of psammophilous Mycetophylax, the dynamic development of AT-rich heterochromatin and karyotype repatterning encompasses the diversification of such ants.

Uremic toxins levels from the gut microbiota seem not to be altered by physical exercise in hemodialysis patients.

PURPOSE: Regular physical exercise may result in many benefits to patients with chronic kidney disease (CKD) on hemodialysis (HD), including gut microbiota modulation and solute removal. The study aimed to evaluate the effects of two programs of intradialytic exercises on uremic toxins plasma levels in HD patients. METHODS: In experiment 1, twenty HD patients [12 men, 44.1 ± 8.9 years, BMI of 23.4 ± 2.4 kg/m2] were randomized into two groups: Aerobic exercise group (AEG, n = 11) that performed aerobic exercise on an adapted exercise bike three times a week for three months (36 sessions) and Control group (CG, n = 9). In experiment 2, twenty-six HD patients [19 men, 47.6 ± 11.0 years, BMI of 25.9 ± 3.6 kg/m2] were randomized into Resistance exercise group (REG, n = 14) that performed a resistance exercise program (using elastic bands and ankle cuffs with both lower limbs) monitored three times a week, during six months (72 sessions) and CG (n = 12). P-cresyl sulfate (p-CS), indoxyl sulfate (IS), and indol-3-acetic acid (IAA) plasma levels were determined by high-performance liquid chromatography (HPLC) with fluorescent detection. RESULTS: The uremic toxins plasma levels did not reduce in both exercise programs, aerobic exercise (IS: 32.7 ± 14.0 vs 33.0 ± 15.4 mg/L, p = 0.86; p-CS: 59.9 ± 39.3 vs 60.0 ± 41.2 mg/L, p = 0.99; IAA: 2233 [1488-2848] vs 2227 [1275-2824] µg/L, p = 0.72) and resistance exercise (IS: 28.3 ± 11.3 vs 29.1 ± 9.7 mg/L, p = 0.77; p-CS: 31.4 ± 21.3 vs 34.2 ± 19.8 mg/L, p = 0.63; IAA: 1628 [1330-3530] vs 2000 [971-3085] µg/L, p = 0.35) in HD patients. CONCLUSION: According to our findings, physical exercise does not appear to alter the levels of uremic toxins produced by the gut microbiota in HD patients.

Sigilo médico na era digital: análise da relação médico-paciente / Medical confidentiality in the digital era: an analysis of physician-patient relations / Confidencialidad médica en la era digital: análisis de la relación médico-paciente

Resumo O estudo analisa o sigilo na relação médico-paciente, abordando a influência de novas tecnologias, como as mídias sociais, no exercício da profissão, e aferindo o conhecimento de profissionais sobre situações em que o sigilo pode ser quebrado sem consequências legais. Trata-se de pesquisa de natureza exploratória, de abordagem quantitativa e corte transversal realizada entre outubro e novembro de 2019, com 116 médicos, por meio de questionário estruturado com 19 questões, entre as quais cinco avaliaram o conhecimento sobre sigilo profissional de acordo com o Código de Ética Médica e o ordenamento jurídico brasileiro. Considerou-se que os médicos que responderam três ou mais questões corretamente apresentaram conhecimento satisfatório sobre o uso de mídias sociais e o sigilo médico (apenas 55,2% dos entrevistados). O resultado revela a importância da educação médica continuada, principalmente quanto ao sigilo médico.

Abstract The study analyzes confidentiality in the physician-patient relations, addressing how new technologies, such as social media, influence professional practice, and assessing the professionals' knowledge regarding situations in which confidentiality can be broken without legal consequences. This cross-sectional, quantitative and exploratory research took place between October and November 2019, involving 116 physicians who answered a structured questionnaire with 19 questions, among which five assessed knowledge on professional secrecy according to the Code of Medical Ethics and the Brazilian legal system. Physicians who answered three or more questions correctly were considered to have satisfactory knowledge on social media use and medical confidentiality (only 55.2% of respondents). Results reveal the importance of continuing medical education, especially regarding medical confidentiality.

Resumen El estudio analiza la confidencialidad en la relación médico-paciente, abordando la influencia de las nuevas tecnologías, como las redes sociales, en el ejercicio de la profesión, y midiendo el conocimiento de los profesionales sobre situaciones en las que la confidencialidad puede romperse sin consecuencias legales. Se trata de una investigación exploratoria, con enfoque cuantitativo y transversal, realizada entre octubre y noviembre de 2019, con 116 médicos, mediante un cuestionario estructurado con 19 preguntas, entre las que cinco evaluaron conocimientos sobre la confidencialidad profesional según el Código de Ética Médica. y el sistema legal brasileño. Se consideró que los médicos que respondieron correctamente a tres o más preguntas tenían un conocimiento satisfactorio sobre el uso de las redes sociales y la confidencialidad médica (solo el 55,2% de los encuestados). El resultado revela la importancia de la educación médica continua, especialmente en lo que respecta a la confidencialidad médica.

"Unscrupulous and Morally Ill-Prepared" Laymen or Professionals? Controlling Pharmacists during the Brazilian Military Dictatorship.

This article traces the transformation of the system of control and repression of Brazilian pharmaceutical activities between the 1930s and the 1970s, through a Foucauldian framework of "differential management of illegalisms." The period between 1930 and 1960 can be understood as a process of negotiation between pharmacists and state agencies that achieved a compromise on the differential management of illegalisms in relation to drugs, with a clear distinction between "laymen" and "professionals." This compromise came into question during the dictatorship, due to institutional transformations that reinforced the autonomy of institutions of repression and a military struggle against subversion and corruption. Pharmacists and laymen alike were considered potential suspects. This suspicion even extended to the civilian agencies that were at the core of the regulation of the licit drug market. These developments profoundly changed the way illegalisms committed by professionals and state officials were treated, blurring the boundaries that had been established between laymen, professionals, inspectors, and industrialists. The final section of the article focuses on the various ways in which institutions of repression focused on pharmacists and state regulatory control agencies as potential places of subversive activity or corruption.

Evaluation of wood degradation rates by Teredinidae (Mollusca: Bivalvia) in two ecologically distinct areas, and temperature and salinity influences on the cellulolytic activity of associated bacteria.

Teredinidae (shipworms) is a family of marine wood-boring bivalves that has an important role in the degradation of wood through its symbiotic relationship with cellulolytic bacteria. To evaluate the rate of degradation of wood by teredinids in two sites with different oceanographic conditions in Rio de Janeiro State, Brazil, artificial structures composed of pine wood sheets were immersed in the ocean for three months at Arraial do Cabo in an area under the influence of upwelling, and at Ilha Grande Bay under tropical and oligotrophic influences. After the immersion period, teredinids were removed from the collectors, identified, and counted. Wood consumption by the teredinids was quantified by comparing the dry weights of the collectors before and after immersion. Associated bacteria were isolated and their cellulolytic activities evaluated at different temperatures and salinities. Two Teredinidae species were recorded: Bankia gouldi and Lyrodus floridanus. The highest wood degradation rate and enzymatic activities of the isolated bacterial strains were recorded at Arraial do Cabo, suggesting that upwelling influenced the activities of those species.

Intraspecific variation in the karyotype length and genome size of fungus-farming ants (genus Mycetophylax), with remarks on procedures for the estimation of genome size in the Formicidae by flow cytometry.

Ants (Formicidae) present considerable diversity in chromosome numbers, which vary from n = 1 to n = 60, although this variation is not proportional to that in genome size, for which estimates range from 0.18 pg to 0.77 pg. Intraspecific variation in the chromosome number and karyotype structure has been reported among species, although the variation among populations of the same species has received much less attention, and there are few data on genome size. Here, we studied the karyotype length and genome size of different populations of the fungus-farming ants Mycetophylax conformis (Mayr, 1884) and Mycetophylax morschi (Emery, 1888). We also provide remarks on procedure for the estimation of ant genome size by Flow Cytometry (FCM) analysis. Chromosome number and morphology did not vary among the populations of M. conformis or the cytotypes of M. morschi, but karyotype length and genome size were significantly distinct among the populations of these ants. Our results on the variation in karyotype length and genome size among M. morschi and M. conformis populations reveal considerable diversity that would be largely overlooked by more traditional descriptions of karyotypes, which were also supported by the estimates of genome size obtained using flow cytometry. Changes in the amount of DNA reflect variation in the fine structure of the chromosomes, which may represent the first steps of karyotype evolution and may occur previously to any changes in the chromosome number.

Rational Design, Synthesis and Evaluation of Indole Nitrogen Hybrids as Photosystem II Inhibitors.

We report the synthesis of twelve indole derivatives bearing nitro or amide groups via Fischer indole methodology followed by reduction/acetylation and amidation reactions. After thorough characterization, these indoles were subjected to a number of studies in order to evaluate their bioactive potential as photosynthesis and plant growth inhibitors. Firstly, these molecular hybrids were evaluated as photosystem II (PSII) inhibitors through chlorophyll a (Chl a) fluorescence measurement. In this study, 6-chloro-8-nitro-2,3,4,9-tetrahydro-1H-carbazole (15a) and 5-chloro-2,3-dimethyl-7-nitro-1H-indole (15b) showed the best results by reducing the phenomenological parameters of reaction centers ABS/RC, TR0 /RC and ET0 /RC of PSII. Electron chain blockage by these compounds may lead to diminished ATP synthesis and CO2 fixation which interrupt the plant development. The compounds 15a and 15b both act as postemergent herbicides, reducing the dry biomass of Ipomoea grandifolia and Senna alata weeds by an average of 40% and 37%, respectively, corroborating the fluorescence results. Additionally, the molecular docking study revealed that the presence of strong electron-withdrawing groups at the indole phenyl ring is important for the ligand's interaction with the binding pocket of protein D1 on PSII. The optimization of these molecular features is the goal of our research group in further understanding and development of new potent herbicides.

Use of IMMPACT domains in clinical trials of acupuncture for chronic pain: A methodological survey.

Acupuncture is one of the therapeutic resources used for the management of chronic pain. Variability in outcome measurements in randomized clinical trials of non-oncologic chronic pain (RCT-NOCP) generates inconsistencies in determining effects of treatments. The objective of this survey was to assess the adherence to the recommendations made by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) in the measurement of RCT-NOCP of acupuncture. This methodological research made a systematic search for eligible studies from different sources of information. Eligible studies included those with number of patients ≥100, who randomized and allocated patients with chronic non-oncologic pain to be treated with acupuncture or with "sham" acupuncture, or non-acupuncture. This research included the recommendations for IMMPACT in the measurement of RCT-NOCP: presence of outcomes pain, physical function, emotional state and improvement perception of patient, the source of the outcome information pain and the tools used to measure such domains. From a total of 1,386 studies, 24 were included in this survey. Eleven studies presented low risk of bias. Pain outcome was measured in 23 studies, physical function in 22 studies, emotional state in 14 studies and improvement perception of patient in one study. As for the pain outcome, the patient was the information source in 50% of the studies. The measurement tools recommended for IMMPACT were included in eight studies (35%) that evaluated pain, one study that evaluated the emotional state (7%), and one study that evaluated the improvement perception and satisfaction of patient. It was observed that studies which did not adhere to the recommendations had more favorable results for acupuncture in the outcome pain. This study concludes that randomized clinical trials that used acupuncture to manage chronic pain failed to adhere to IMMPACT recommendations. Clinical societies and IMMPACT do not share the same recommendations. This fact reflects in the diversity of outcomes and instruments adopted in the studies, making it difficult to compare the results.

Antimicrobial activity of Lactobacillus fermentum TcUESC01 against Streptococcus mutans UA159.

Dental caries is a multifactorial chronic-infection disease, which starts with a bacterial biofilm formation caused mainly by Streptococcus mutans. The use of probiotics has shown numerous health benefits, including in the fight against oral diseases. Strains of Lactobacillus fermentum have already shown probiotic potential against S. mutans, but there are still few studies. Thus, the aim of our study was to evaluate the antimicrobial activity of the inoculum and metabolites produced by L. fermentum TcUESC01 against S. mutans UA159. For this, a growth curve of L. fermentum was performed and both the inoculum and the metabolites formed in the fermentation were tested against the growth of S. mutans UA159 in agar diffusion tests, and only its metabolites were tested to determine the minimum inhibitory concentration, minimal bactericidal concentration and inhibition of cell adhesion. Inhibition of biofilm formation, pH drop and proton permeability were also tested with the metabolites. The zone of inhibition began to be formed at 14 h and continued until 16 h. The inoculum containing L. fermentum also showed zone of inhibition. The MIC for the metabolites was 1280 mg/mL and the MBC was obtained with a concentration higher than the MIC equal to 5120 mg/mL. Half of the MIC concentration (640 mg/mL) was required to inhibit S. mutans adhesion to the surface of the microplates. In the biofilm analyzes, the treatment with the metabolites in the tested concentration was not able to reduce biomass, insoluble glucans and alkali soluble compared to the control biofilm (p > 0.05). The metabolites also did not affect acid production and acid tolerance of S. mutans cells in biofilms compared to saline group (p > 0.05). Lactic acid (50.38%) was the most abundant organic acid produced by L. fermentum. This is the first report showing that the metabolites produced by the Lactobacillus fermentum TcUESC01 have a potential to be used as an antimicrobial agent against S. mutans, showing anti-adherence and bactericidal activity against planktonic cells of S. mutans. Thus, further studies should be carried out in order to better understand the antimicrobial activity of metabolites of L. fermentum TCUESC01.

Endophytic fungal extracts: evaluation as photosynthesis and weed growth inhibitors.

A central pillar of modern weed control is the discovery of new herbicides which are nontoxic to humans and the environment and which have low application dosage. The natural products found in plants and microorganisms are well suited in this context because they are generally nontoxic and have a wide variety of biological activities. In this work, Diaporthe phaseolorum (Dp), Penicillium simplicissimum (Ps) and Trichoderma spirale (Ts) (methanolic extracts) were evaluated as photosynthesis and plant growth inhibitors in Senna occidentalis and Ipomoea grandifolia. The most significant results were observed for Ts and Dp in S. occidentalis and I. grandifolia, respectively. Ts reduced PI(abs), ET0/CS0, PHI(E0) and PSI0 parameters by 64, 28, 40 and 38%, respectively, indicating a reduction on electron transport efficiency. Additionally, Ts decreased shoot length by 9%, affecting the plant growth. Dp reduced PI(abs), ET0/CS0 and PHI(E0) parameters by 50, 20, 26 and 22%, respectively, revealing the inhibition competency on PSII acceptor site. Furthermore, Dp decreased by 50% the shoot length on germination assay. Thus, the phytotoxic behaviors based on endophytic fungal extracts may serve as a valuable tool in the further development of a bioherbicide since natural products represent an interesting alternative to replace commercial herbicides.

ABCDE and ABCDEF care bundles: A systematic review protocol of the implementation process in intensive care units.

BACKGROUND: The awakening and breathing coordination of daily sedation and ventilator removal trials, delirium monitoring and management, and early mobility and exercise (ABCDE) and assessment, prevent and manage pain, both spontaneous awakening and spontaneous breathing trials, choice of analgesia and sedation, assess, prevent and manage delirium, early mobility and exercise, family engagement (ABCDEF) bundles are part of the science of the liberation of the intensive care unit (ICU). There are not enough studies that have evaluated the effectiveness and safety of the implementation of these bundles. This study will analyze the implementation process, estimate their effectiveness and safety, and identify barriers, facilitators and attitudes that have influenced the implementation process. METHODS: Qualitative and quantitative studies will be eligible for our systematic review with adult patients who have been exposed to the implementation of the ABCDE or ABCDEF bundles compared to the usual care in the ICU. In order to search the implementation interventions of the bundles, we will search electronically: MEDLINE (PubMed); Excerpta Medica Database (Ovid); Cumulative Index to Nursing and Allied Health Literature (EBSCO); The Cochrane Library (Wiley); Web of Science; Virtual Health Library; and OpenGrey. We will not impose any language restrictions or publication status. Outcomes of interest include ICU and hospital length of stay; mechanical ventilation time; incidence and prevalence of delirium or coma; level of agitation and sedation; early mobilization; mortality in ICU and hospital; change in perception, attitude or behavior of the stakeholders; and change in knowledge of health professionals. The team of reviewers will independently screen search results, extract data from eligible studies, and assess risk of bias. Disagreements between the reviewers will be solved through consensus or arbitration by a third-party investigator. To assess the quality and risk of bias in randomized and quasi-randomized trials we will use the domain-based evaluation recommended by The Cochrane Handbook. Studies with other methodological designs will be evaluated using the Critical Appraisal Tools developed by The Joanna Briggs Institute. Other instruments may be used, if necessary. RESULTS: The evidence derived from this study will increase the knowledge of effectiveness and safety of the implementation process of ABCDE and ABCDEF bundles. CONCLUSION: The results could guide patients and healthcare practitioners by helping to facilitate evidence-based shared care decision making. PROTOCOL REGISTRATION: PROSPERO CRD42019121307.

A Produção Científica Nacional na Área de Educação Especial e a Creche / National Scientific Production in the Special Education Area and Daycare

RESUMO: Este artigo tem por objetivo descrever a produção científica na área de Educação Especial sobre o atendimento educacional à faixa etária de zero a três anos, fase inicial da Educação Infantil, nos últimos 25 anos. Utiliza-se como fonte de busca as bases de dados Scientific Electronic Library Online (SciELO), Periódicos Eletrônicos em Psicologia (Pepsic), Portal de Periódicos Capes/MEC; Biblioteca Digital Brasileira de Teses e Dissertações (BDTD); Red de Revistas Científicas da América Latina Y el Caribe, España y Portugal (Redalyc) e, como descritores, os termos "educação especial", "educação inclusiva", "inclusão" e "creche", no período de 1993 a 2017. Foram encontrados 25 trabalhos, dentre eles 17 teses e dissertações e oito artigos. Após leitura minuciosa dos objetivos, métodos e resultados, verificou-se que os temas políticas públicas de Educação Infantil e Educação Especial; creches inclusivas: relatos de casos; formação de profissionais e concepções sobre inclusão contemplam as discussões na área. A inclusão na creche ainda é incipiente, tanto nos documentos oficiais como na prática. No entanto, a formação dos profissionais para essa realidade influencia fortemente na percepção e nas concepções que eles têm das crianças e das atividades nos contextos educacionais. Desse modo, são importantes novos olhares sobre esses contextos, de forma a produzir materiais que possibilitem identificar fragilidades, experiências de sucesso, discussões relevantes que auxiliem na melhora da qualidade dos serviços oferecidos a essa faixa etária.

ABSTRACT: This paper aims to describe the scientific production in the Special Education area upon educational care offered to children aged from zero to three, initial stage of Early Childhood Education for the past 25 years. The database used as a search source were the Scientific Electronic Library Online (SciELO), Periódicos Eletrônicos em Psicologia (PEPSIC), Portal de Periódicos Capes/MEC; Biblioteca Digital Brasileira de Teses e Dissertações (BDTD) and Red de Revistas Científicas da América Latina Y el Caribe, España y Portugal (REDALYC), and, as descriptors, the terms "educação especial" (special education), "educação inclusiva" (inclusive education),"inclusão" (inclusion) and "creche" (daycare facility ), from 1993 to 2017. Twenty five papers, among them seventeen doctoral dissertations and master's theses and eight papers. After a thorough reading of the objectives, methods and results, it was verified that the public policy themes of Early Childhood Education and Special Education; inclusive daycare facilities: case reports; education of professionals and conceptions about inclusion contemplate the discussions in the area. Inclusion in daycare is still incipient, both in official documents and in practice. However, the education of professionals for this reality strongly influences the perception and conceptions they have of children and activities in educational contexts. Therefore, new perspectives on these contexts are important, in order to produce materials that allow us to identify fragilities, successful experiences and relevant discussions that help to improve the quality of the services offered to that age group.

Use of steroid and nonsteroidal anti-inflammatories in the treatment of rheumatoid arthritis: Systematic review protocol.

BACKGROUND: Rheumatoid arthritis affects 1% of the world's population and its current treatment options are costly. There are not enough studies that evaluated the efficacy and safety of anti-inflammatory drugs medications used to reduce rheumatoid arthritis's symptoms. This study will evaluate the effectiveness and the safety of steroid and nonsteroidal anti-inflammatory drugs for the treatment of patients with rheumatoid arthritis. METHODS: Randomized clinical trials eligible for our systematic review will enroll adults with rheumatoid arthritis treated with anti-inflammatory drugs compared with a control group (placebo or active control) at any dose, duration, and route of administration and double blind studies. In order to include all forms of rheumatoid arthritis and anti-inflammatory drugs, we will search the following electronic databases: Cochrane Central Register of Controlled Trials, MEDLINE (via Ovid); ExcerptaMedica Database (via Ovid); Cumulative Index to Nursing and Allied Health Literature (via Ovid); Web of Science; ClinicalTrial.gov; and WHO International Clinical Trials Registry Platform. We will not impose any language restrictions or publication status. Outcomes of interest include are pain, physical function, swelling, stiffness, grip force, radiological image of the joint, quality of life, adverse events, discontinuation due to adverse events, satisfaction with the treatment, and rescue medication for pain. A team of reviewers will independently screen search results, extract data from eligible trials, and assess risk of bias. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to rate overall certainty of the evidence by outcome. Dichotomous data will be summarized as risk ratios; continuous data will be given as standard average differences with 95% confidence intervals. RESULTS: The evidence derived by this study will increase awareness of the effectiveness and safety of steroid and nonsteroidal anti-inflammatory drugs for the treatment of rheumatoid arthritis. CONCLUSION: The results could guide patients and healthcare practitioners and help facilitate evidence-based shared care decision making.

Chromosomal variation among populations of a fungus-farming ant: implications for karyotype evolution and potential restriction to gene flow.

BACKGROUND: Intraspecific variation in chromosome structure may cause genetic incompatibilities and thus provides the first step in the formation of species. In ants, chromosome number varies tremendously from 2n = 2 to 2n = 120, and several studies have revealed considerable variation in karyotype within species. However, most previous studies were limited to the description of chromosome number and morphology, and more detailed karyomorphometric analyses may reveal additional, substantial variation. Here, we studied karyotype length, genome size, and phylogeography of five populations of the fungus-farming ant Trachymyrmex holmgreni in order to detect potential barriers to gene flow. RESULTS: Chromosome number and morphology did not vary among the five populations, but karyotype length and genome size were significantly higher in the southernmost populations than in the northern populations of this ant. Individuals or colonies with different karyotype lengths were not observed. Karyotype length variation appears to result from variation in centromere length. CONCLUSION: T. holmgreni shows considerable variation in karyotype length and might provide a second example of centromere drive in ants, similar to what has previously been observed in Solenopsis fire ants. Whether this variation leads to genetic incompatibilities between the different populations remains to be studied.

Corpus callosum volumes in the 5 years following the first-episode of schizophrenia: Effects of antipsychotics, chronicity and maturation.

Background: White matter (WM) structural changes, particularly affecting the corpus callosum (CC), seem to be critically implicated in psychosis. Whether such abnormalities are progressive or static is still a matter of debate in schizophrenia research. Aberrant maturation processes might also influence the longitudinal trajectory of age-related CC changes in schizophrenia patients. We investigated whether patients with first-episode schizophrenia-related psychoses (FESZ) would present longitudinal CC and whole WM volume changes over the 5 years after disease onset. Method: Thirty-two FESZ patients and 34 controls recruited using a population-based design completed a 5-year assessment protocol, including structural MRI scanning at baseline and follow-up. The linear effects of disease duration, clinical outcome and antipsychotic (AP) use over time on WM and CC volumes were studied using both voxelwise and volume-based morphometry analyses. We also examined maturation/aging abnormalities through cross-sectional analyses of age-related trajectories of total WM and CC volume changes. Results: No interaction between diagnosis and time was observed, and clinical outcome did not influence CC volumes in patients. On the other hand, FESZ patients continuously exposed to AP medication showed volume increase over time in posterior CC. Curve-estimation analyses revealed a different aging pattern in FESZ patients versus controls: while patients displayed a linear decline of total WM and anterior CC volumes with age, a non-linear trajectory of total WM and relative preservation of CC volumes were observed in controls. Conclusions: Continuous AP exposure can influence CC morphology during the first years after schizophrenia onset. Schizophrenia is associated with an abnormal pattern of total WM and anterior CC aging during non-elderly adulthood, and this adds complexity to the discussion on the static or progressive nature of structural abnormalities in psychosis.

Extraversion/introversion and age-related differences in speed-accuracy tradeoff / Diferenças de extroversão/introversão e idade na troca velocidade-precisão / Diferencias de extroversión/introversión y edad en el cambio velocidad-precisión

ABSTRACT Introduction: Extraversion/introversion and age differences might influence speed-accuracy tradeoff. Objective: The speed-accuracy tradeoff was investigated in extroverted and introverted female children, young adults and older adults. Method: Participants carried out an alternative version of Fitts' task, which involved making alternate clicks with the mouse held in the dominant hand, moving as fast as possible, on two rectangular targets on a computer screen in order to make twelve attempts at six random levels of difficulty (twelve combinations of target widths and distances between targets). Each of the three groups was composed of 16 introverted and 16 extroverted subjects, based upon Brazilian versions of Eysenck's questionnaire. Results: Elderly introverts fell short of the target more often and committed more overall errors than the elderly extroverts. Additionally, compared to their younger adult counterparts, the elderly subjects fell short of the target more often and committed more overall errors, besides taking longer to complete the task with higher levels of difficulty. Conclusion: The findings were interpreted in light of theories designed to explain the main processes underlying extroversion/introversion and age-related differences. Level of Evidence II; Lesser quality prospective study.

RESUMO Introdução: Diferenças de extroversão/introversão e idade podem influenciar na troca velocidade-precisão. Objetivo: A troca velocidade-precisão foi investigada em garotas, jovens adultas e idosas extrovertidas e introvertidas. Método: As participantes realizaram uma versão alternativa da tarefa de Fitts, a qual consistia em clicar alternadamente com a mão dominante no mouse, o mais rápido possível, em dois alvos retangulares na tela do computador, a fim de fazer doze tentativas em seis níveis aleatórios de dificuldade (doze combinações de larguras e distâncias entre os alvos). Cada um dos três grupos era composto por 16 introvertidas e 16 extrovertidas, com base nas versões brasileiras do questionário de Eysenck. Resultados: As idosas introvertidas acertaram menos o alvo com mais frequência e cometeram mais erros gerais em comparação às idosas extrovertidas. Ainda, as idosas acertaram menos o alvo com mais frequência e cometeram mais erros gerais, além de demorarem mais tempo para concluírem as tarefas com níveis maiores de dificuldade quando comparadas com as jovens adultas. Conclusão: Os achados foram interpretados com base nas teorias criadas para explicarem os principais processos sobre as diferenças relacionadas à extroversão/introversão e à idade. Nível de Evidência II; Estudo prospectivo de menor qualidade.

RESUMEN Introducción: Las diferencias de extroversión/introversión y edad pueden influir en el cambio velocidad-precisión. Objetivo: El cambio velocidad-precisión fue investigado en mujeres jóvenes adultas y de la tercera edad introvertidas y extrovertidas. Método: Las participantes realizaron una versión alternativa de la tarea de Fitts, que consistía en hacer clic alternadamente con el ratón, usando la mano dominante, lo más rápidamente posible, en dos objetos rectangulares en la pantalla de la computadora, a fin de realizar doce tentativas con seis niveles aleatorios de dificultad (doce combinaciones de anchos y distancias entre los objetos). Cada uno de los tres grupos fue compuesto por 16 introvertidas y 16 extrovertidas, con base en las versiones brasileñas del cuestionario de Eysenck. Resultados: Las mujeres de tercera edad introvertidas acertaron menos el objeto con más frecuencia y cometieron más errores generales en comparación a las mujeres de tercera edad extrovertidas. Además, las mujeres de tercera edad acertaron menos el objeto con más frecuencia y cometieron más errores generales, además de demorar más tiempo para concluir las tareas con niveles mayores de dificultad cuando comparadas con las mujeres jóvenes adultas. Conclusión: Los hallazgos fueron interpretados con base en las teorías creadas para explicar los principales procesos sobre las diferencias relacionadas a la extroversión/la introversión y a la edad. Nivel de Evidencia II; Estudio prospectivo de menor calidad.

Oral herbal medicines marketed in Brazil for the treatment of osteoarthritis: A systematic review and meta-analysis.

Herbal medications are commonly used to manage symptoms associated with osteoarthritis (OA). This systematic review evaluated the effectiveness and safety of oral medications used in Brazil for the treatment of OA. Randomized clinical trials involving adults with OA treated by a herbal medicine or a control group were eligible. The primary outcomes measured were pain, physical function, swelling, stiffness and quality of life; and the secondary outcomes were adverse events, activity limitations and treatment satisfaction. Sixteen studies were included (n = 1,741 patients) in the systematic review and nine studies in the meta-analysis, representing 6 of the 13 herbal medicines studied: Boswellia serrata (n = 2), Curcuma longa (n = 3), Harpagophytum procumbens (n = 1), Salix daphnoides (n = 3), Uncaria guianensis (n = 2) and Zingiber officinale (n = 5). B. serrata was more effective than both placebo and valdecoxib for improvement of pain and physical function. No difference was observed for H. procumbens, C. longa and U. guianensis compared with control. Z. officinale showed improvement of pain over placebo. The evidence was insufficient to support the effective and safe use of these herbal medicines, because the quality of evidence of studies was low. This study guides managers of the Brazilian public health system and prescribers in decision-making regarding the use of these herbal medicines for OA. Copyright © 2017 John Wiley & Sons, Ltd.