Effects of yoga on impulsivity in patients with and without mental disorders: a systematic review.

BACKGROUND: Yoga can be used as a complementary intervention to conventional treatments, whether pharmacological or non-pharmacological. Sustained practice of yoga can generate a series of benefits for individuals' quality of life and improve their physical fitness. OBJECTIVE: To investigate the potential effects of yoga as an adjunct intervention in conditions involving impulse control issues, such as attention deficit hyperactivity disorder (ADHD), borderline personality disorder, bipolar affective disorder, and substance use disorders. METHODS: We performed a systematic review of placebo-controlled, randomized trials of yoga in patients with impulsivity. PubMed, Web of Science, and Science Direct databases were searched for trials published up to January, 2023. Data were extracted from published reports and quality assessment was performed per Cochrane recommendations. RESULTS: Out of 277 database results, 6 RCT were included in this systematic review. To assess the level of attention and impulsiveness, the following scales were analyzed: Barratt Impulsiveness, UPPS-P Impulsive Behavior scale, Conners' Continuous Performance Test IIª and Conners' Parent Rating Scale-Revised: Long. CONCLUSIONS: Yoga didn't have a significant improvement in impulsivity when compared to placebo. There are many tools to assess impulsivity, but they mean different concepts and domains consisting in a weakness on comparison of yoga effects. PROSPERO REGISTRATION: CRD42023389088.

A simple, quick and non-destructive approach for sampling drugs of abuse in tablets and blotter for qualitative analysis by paper spray mass spectrometry.

This study presents the development of a simple, fast, and inexpensive approach for the direct analysis of new psychoactive substances (NPS) in seized tablets and blotter paper, with improved sample preservation and increased analytical frequency. Paper triangles were gently rubbed against the surface of the samples containing synthetic drugs and then subjected to analysis by paper spray ionization mass spectrometry (PS-MS). Seized samples containing lysergic acid diethylamide (LSD) and several other substances from the classes of amphetamines, N-benzyl-substituted phenethylamines, synthetic cathinones, and synthetic cannabinoids, were analysed. Three types of paper were tested (filter paper, blotter paper, and synthetic paper) and several combinations of spray solvents were studied for the optimization. All samples were weighed and photographed before and after sequences of analysis in order to attest to the sample preservation. The results revealed that the approach is excellent for sample preservation, with less than 5% of mass loss even after 27 consecutive analyses. Moreover, no significant signal decreases were observed in mass spectrometry (MS) even after the experiments. It was possible to unequivocally identify illicit substances from seized samples (pills and blotter paper). By overcoming the solubilization and wet extraction process used for sample preparation, the waste was restricted to a volume of only 10 µL of solvent for the PS-MS analysis. The main advantage of our approach over existing methods is the sample preparation, which is simple and quick since the samples are just rubbed against the PS paper. This brings enormous benefits in terms of analytical frequency, economy of time and low consumption of solvents. Another important point is that the sample can remain intact for further analysis, which is crucial in forensic analysis.

Psychometric properties of the Brazilian Portuguese version of the UPPS-P impulsive behavior scale for children and adolescents.

OBJECTIVE: To translate and validate the version for children and adolescents of the UPPS-P scale into Brazilian Portuguese. METHOD: After a five-step translation process, the final draft was submitted to a panel of 12 different specialties experts. Subsequently, the application of the scale was applied concomitantly with the "Swanson, Nolan, and Pelham Scale - Version IV" (SNAP-IV) and the "Child and Adolescent Behavior Inventory" (CABI) scale to analyze the correlation between them. Content Validity Index (CVI) and reliability were estimated by calculating internal consistency and analyzing its test-retest stability. RESULTS: The items whose CVI was lower than 80% underwent a detailed analysis to verify the reason for the bad evaluation. Five items (3, 7, 11, 22 and 35) scored below 80% and were reassessed. There was high internal consistency in all parameters: Lack of premeditation (McDonald's omega = 0.806; Cronbach's alpha = 0.801), Negative Urgency (McDonald's omega = 0.838; Cronbach's alpha = 0.836), Sensation seeking (McDonald's omega = 0.826; Cronbach's alpha = 0.810), Lack of Perseverance (McDonald's omega = 0.800; Cronbach's alpha = 0.799) and Positive Urgency (McDonald's omega = 0.936; Cronbach's alpha = 0.934). A strong correlation was observed between UPPS-P features and impulsivity in behavioral assessments. CONCLUSIONS: The Brazilian Portuguese version of the UPPS-P scale is a good instrument to assess impulsivity in children and adolescents.

Anaphylactic reaction to praziquantel following schistosomiasis treatment.

Praziquantel (PZQ) is a medication used to treat several parasitic infections, including human schistosomiasis. Although this drug commonly causes transient adverse effects, severe hypersensitivity is rare, and only eight cases have been reported worldwide. Herein we report a case of a 13-year-old Brazilian female who developed anaphylaxis, a severe hypersensitive reaction, after taking praziquantel to treat Schistosoma mansoni infection. During a mass drug administration event in a socially vulnerable endemic area of Bahia (Brazil), after taking 60 mg/kg of praziquantel the patient developed rash and generalized edema an hour later, evolving to somnolence and hypotension. Following the anaphylactic episode, she received adequate treatment and recovered approximately 1 day later. Although praziquantel is considered safe, health professionals should be aware of potential life-threatening adverse events.

Overview of the seized and examined pharmaceutical in the state of Minas Gerais-Brazil by the Civil Police from 2017 to 2022: A fundamental analysis of the recent impact over the drugs market.

This work presents a data survey regarding the qualitative chemical analysis of drugs seized by the Police in the state of Minas Gerais between July 2017 and June 2022, including an evaluation of labeling of 265 samples of anabolic androgenic steroids (AAS) seized in 2020. The Active Pharmaceutical Ingredients (API) present in the samples were identified through chemical analysis and classified by system Anatomical Therapeutic Chemical (ATC) methods. Analysis of the labeling information for 265 samples of AAS followed the guidance of legislation RDC 71 (2009) from ANVISA. For this study 6355 seized pharmaceuticals underwent qualitative chemical analysis that corresponded to 7739 APIs successfully identified and classified. Among the components studied AAS, psychostimulants, anesthetics, and analgesics were the most commonly examined. AAS seized and tested increased by over 100% and for the majority of the samples analyzed were found to not match the labeling on the packaging. In the meantime, anti-obesity drugs presented a prominent increase of 400% from 2020/1 to 2021/2, during covid-19 quarantine. Seized pharmaceuticals and tests can support information in the planning of public health and safety policies.

Os impactos de técnicas não farmacológicas na impulsividade / The impacts of non-pharmacological techniques on impulsivity

A impulsividade é um fenômeno multifacetado e é caracterizada por diferentes padrões cognitivos e comportamentais que podem levar a consequências disfuncionais imediatas e em médio/longo prazo. O tratamento da impulsividade tem sido um grande desafio na área da saúde mental, pois não há muitas ferramentas bem descritas e cientificamente validadas que sejam eficazes para a melhora do bem-estar geral desses indivíduos. Dentre as abordagens gerais que podem ser utilizadas para isso, destacam-se as intervenções farmacológicas, atividades físicas e abordagens psicoterápicas como a terapia cognitivo-comportamental (TCC), o treinamento de habilidades sociais e emocionais e a terapia de controle de impulsos. Neste estudo, iremos analisar outras três técnicas não farmacológicas promissoras para serem utilizadas no controle de impulso que são as técnicas de Yoga, Mindfulness e Neuromodulação não invasiva. Para isso, fizemos três revisões sistemáticas conduzidas em acordo com os critérios do PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Os protocolos de revisão foram registrados no Registro Prospectivo Internacional de Revisões Sistemáticas (PROSPERO). Para escolha dos descritores que seriam utilizados na busca foi utilizado o Medical Subject Headings (MeSH). A pesquisa pelos artigos foi feita nas bases de dados da PubMed, Scopus, Science Direct e Embase. Só foram incluídos artigos em inglês e não houve delimitação de período de publicação dos artigos incluídos. Os artigos incluídos nesta revisão sistemática foram selecionados de forma independente por dois revisores distintos. Eles realizaram a seleção em duas etapas, sendo a primeira baseada na leitura dos títulos e resumos e a segunda com a leitura completa do texto e caso houvesse divergência na seleção dos artigos, um terceiro revisor foi acionado. A qualidade dos estudos incluídos nestas revisões sistemáticas foi avaliada utilizando a ferramenta Cochrane Risk of Bias tool. Ao final da seleção dos artigos, 6 artigos foram analisados no estudo sobre yoga, 18 no de Mindfulness e 18 no de Neuromodulação não invasiva (9 artigos sobre Estimulação Transcraniana por Corrente Contínua (ETCC) e 9 sobre Estimulação Magnética Transcraniana (EMT)) e foi realizada metanálise de seus dados. Com base nos resultados obtidos, as técnicas de Yoga e Mindfulness surgem como promissoras no tratamento da impulsividade, demonstrando efetividade em diversos testes psicométricos e escalas. Essas abordagens terapêuticas são de fácil implantação, escaláveis e apresentam baixo custo, o que as torna viáveis tanto para o contexto clínico quanto para a saúde pública. Por outro lado, os estudos sobre ETCC e EMT ainda carecem de evidências suficientes para embasar sua implementação no tratamento da impulsividade. A falta de padronização nos estímulos utilizados e a diversidade nos desenhos de estudo dificultam a definição de protocolos efetivos. Portanto, futuras pesquisas serão necessárias para estabelecer parâmetros mais específicos e padrões de intervenção claros para essas técnicas de neuromodulação não invasiva no contexto da impulsividade.

Impulsivity is a multifaceted phenomenon characterized by different cognitive and behavioral patterns that can lead to immediate and medium-to-long-term dysfunctional consequences. The treatment of impulsivity has been a major challenge in the field of mental health, as there are not many well-described and scientifically validated tools that are effective in improving the overall well-being of these individuals. Among the general approaches that can be used for this purpose, pharmacological interventions, physical activities, and psychotherapeutic approaches such as cognitive-behavioral therapy (CBT), social and emotional skills training, and impulse control therapy stand out. In this study, we will analyze three other promising non-pharmacological techniques for impulse control, namely Yoga, Mindfulness, and non-invasive neuromodulation. To do so, we conducted three systematic reviews in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. The review protocols were registered in the International Prospective Register of Systematic Reviews (PROSPERO). The Medical Subject Headings (MeSH) were used to select the descriptors for the search. The article search was conducted in the PubMed, Scopus, Science Direct, and Embase databases. Only articles in English were included, and there was no restriction on the publication period of the included articles. The articles included in this systematic review were independently selected by two different reviewers. They performed the selection in two stages, the first based on the reading of titles and abstracts, and the second with the full-text reading. In case of divergence in the article selection, a third reviewer was consulted. The quality of the studies included in these systematic reviews was assessed using the Cochrane Risk of Bias tool. At the end of the article selection process, 6 articles were analyzed in the Yoga study, 18 in the Mindfulness study, and 18 in the non-invasive neuromodulation study (9 articles on Transcranial Direct Current Stimulation (tDCS) and 9 on Transcranial Magnetic Stimulation (TMS)), and a meta-analysis of their data was performed. Based on the results obtained, Yoga and Mindfulness techniques emerge as promising in the treatment of impulsivity, demonstrating effectiveness in various psychometric tests and scales. These therapeutic approaches are easy to implement, scalable, and cost-effective, making them viable for both clinical and public health contexts. On the other hand, studies on tDCS and TMS still lack sufficient evidence to support their implementation in the treatment of impulsivity. The lack of standardization in the stimuli used and the diversity in study designs hinder the definition of effective protocols. Therefore, future research will be necessary to establish more specific parameters and clear intervention standards for these non-invasive neuromodulation techniques in the context of impulsivity

Psychometric properties of the Brazilian Portuguese version of the UPPS-P impulsive behavior scale for children and adolescents

Abstract Objective: To translate and validate the version for children and adolescents of the UPPS-P scale into Brazilian Portuguese. Method: After a five-step translation process, the final draft was submitted to a panel of 12 different specialties experts. Subsequently, the application of the scale was applied concomitantly with the "Swanson, Nolan, and Pelham Scale - Version IV" (SNAP-IV) and the "Child and Adolescent Behavior Inventory" (CABI) scale to analyze the correlation between them. Content Validity Index (CVI) and reliability were estimated by calculating internal consistency and analyzing its test-retest stability. Results: The items whose CVI was lower than 80% underwent a detailed analysis to verify the reason for the bad evaluation. Five items (3, 7, 11, 22 and 35) scored below 80% and were reassessed. There was high internal consistency in all parameters: Lack of premeditation (McDonald's omega = 0.806; Cronbach's alpha = 0.801), Negative Urgency (McDonald's omega = 0.838; Cronbach's alpha = 0.836), Sensation seeking (McDonald's omega = 0.826; Cronbach's alpha = 0.810), Lack of Perseverance (McDonald's omega = 0.800; Cronbach's alpha = 0.799) and Positive Urgency (McDonald's omega = 0.936; Cronbach's alpha = 0.934). A strong correlation was observed between UPPS-P features and impulsivity in behavioral assessments. Conclusions: The Brazilian Portuguese version of the UPPS-P scale is a good instrument to assess impulsivity in children and adolescents.

Cardiac abnormalities in patients with nonalcoholic fatty liver disease.

OBJECTIVE: This study aimed to evaluate the correlation between Nonalcoholic fatty liver disease and cardiac abnormalities. METHODS: Patients with Nonalcoholic fatty liver disease who attended an outpatient clinic in Southern Brazil were prospectively evaluated. Patients should be older than 18 years and have steatosis. RESULTS: A total of 174 patients were evaluated. The mean age was 63±12 years, 65% were women, 71% white, 82.2% hypertensive, 52.3% diabetic, 56.3% obese, and 30% dyslipidemic. There was no association between Nonalcoholic fatty liver disease and cardiac abnormalities, even after adjusting for age, sex, and metabolic syndrome. CONCLUSIONS: The present study did not show a direct correlation between Nonalcoholic fatty liver disease and cardiac abnormalities, regardless of metabolic syndrome.

Cardiac abnormalities in patients with nonalcoholic fatty liver disease

SUMMARY OBJECTIVE: This study aimed to evaluate the correlation between Nonalcoholic fatty liver disease and cardiac abnormalities. METHODS: Patients with Nonalcoholic fatty liver disease who attended an outpatient clinic in Southern Brazil were prospectively evaluated. Patients should be older than 18 years and have steatosis. RESULTS: A total of 174 patients were evaluated. The mean age was 63±12 years, 65% were women, 71% white, 82.2% hypertensive, 52.3% diabetic, 56.3% obese, and 30% dyslipidemic. There was no association between Nonalcoholic fatty liver disease and cardiac abnormalities, even after adjusting for age, sex, and metabolic syndrome. CONCLUSIONS: The present study did not show a direct correlation between Nonalcoholic fatty liver disease and cardiac abnormalities, regardless of metabolic syndrome.

Análise comparativa: direitos humanos e as leis orgânicas da saúde / Comparative analysis: human rights and the organic laws of health / Análisis comparativo: los derechos humanos y las leyes orgánicas de la salud

Resumo Este artigo realiza uma análise comparativa entre os direitos humanos descritos na Declaração Universal de Direitos Humanos e as Leis Orgânicas 8.080/1990 e 8.142/1990, que regulamentam o Sistema Único de Saúde. O método se baseou na associação e comparação dos três documentos, sendo o primeiro de nível internacional e os demais de cunho nacional, a fim de identificar valores humanísticos e éticos nas bases legais da saúde pública brasileira. Discussões acerca dessa temática são fundamentais para que profissionais da saúde identifiquem lacunas entre teoria e prática hospitalar e, dessa forma, garantam os direitos dos pacientes.

Abstract This article presents a comparative analysis between the human rights described in the Universal Declaration of Human Rights and Organic Laws 8,080/1990 and 8,142/1990, which regulate the Brazilian Unified Health System. The three documents were related and compared, the first, an international one and the other two of national character, to identify humanistic and ethical values in the legal framework of Brazilian public health. Discussions on this topic are fundamental so health professionals can identify the gaps between theory and hospital practice, thus ensuring the rights of patients.

Resumen Este artículo realiza un análisis comparativo entre los derechos humanos descritos en la Declaración Universal de los Derechos Humanos y las Leyes Orgánicas 8.080/1990 y 8.142/1990, que regulan el Sistema Único de Salud en Brasil. El método se basó en la asociación y comparación de los tres documentos, con el primero de ámbito internacional y los otros de carácter nacional, con el fin de identificar valores humanísticos y éticos en las bases jurídicas de la salud pública brasileña. Las discusiones sobre este tema son esenciales para que los profesionales de la salud puedan identificar lagunas entre teoría y práctica en el hospital y, de esa manera, garantizar los derechos de los pacientes.

Antileishmanial activity of fullerol and its liposomal formulation in experimental models of visceral leishmaniasis.

Visceral leishmaniasis (VL) is a systemic parasitic disease that leads to high rates of morbidity and mortality in humans worldwide. There is a great need to develop new drugs and novel strategies to make chemotherapy for this disease more efficacious and well tolerated. Recent reports on the immunomodulatory effects and the low toxicity of the spherical carbon nanostructure fullerol led us to investigate in vitro and in vivo antileishmanial activity in free and encapsulated forms in liposomes. When assayed against intramacrophagic Leishmania amastigotes, fullerol showed a dose-dependent reduction of the infection index with IC50 of 0.042 mg/mL. When given daily by i.p. route for 20 days (0.05 mg/kg/d) in a murine model of acute VL, fullerol promoted significant reduction in the liver parasite load. To improve the delivery of fullerol to the infection sites, liposomal formulations were prepared by the dehydration-rehydration method. When evaluated in the acute VL model, liposomal fullerol (Lip-Ful) formulations given i.p. at 0.05 and 0.2 mg/kg with 4-days intervals were more effective than the free form, with significant parasite reductions in both liver and spleen. Lip-Ful at 0.2 mg/kg promoted complete parasite elimination in the liver. The antileishmanial activity of Lip-Ful was further confirmed in a chronic model of VL. Lip-Ful was also found to induce secretion of pro-inflammatory TNF-α, IFN-γ and IL-1ß cytokines. In conclusion, this work reports for the first time the antileishmanial activity of fullerol and introduces an innovative approach for treatment of VL based on the association of this nanostructure with liposomes.

Genuine sildenafil tablets sold in Brazil disguised as MDMA.

MDMA and sildenafil are two examples among many substances consumed in "raves", as well as in other types of "recreative" social events nowadays. During the first six months of 2017, five cases of supposedly MDMA tablets seized by local law enforcement forces in the state of Minas Gerais, Brazil, and brought to our forensic laboratory for examination, attracted our attention among dozens of others, as the tablets apprehended in these cases were, in fact, colorfully painted versions of genuine, pentagon-shaped, sildenafil tablets, freely available for sale in local pharmacies and drugstores. Physical profiling, together with ATR-FTIR spectral matching, multi-component/deconvolution analysis and correlation were employed to prove that these tablets were genuine sildenafil tablets from a specific manufacturer, painted in a colorful way so that they could be marketed as MDMA tablets to unsuspecting buyers.

25I-NBOH: a new potent serotonin 5-HT2A receptor agonist identified in blotter paper seizures in Brazil.

A new potent serotonin 5-HT2A receptor agonist was identified in blotter papers by several state level forensic laboratories in Brazil. The 25I-NBOH is a labile molecule, which fragments into 2C-I when analyzed by routine seized material screening gas chromatography (GC) methods. GC-mass spectrometry (MS), liquid chromatography-quadrupole time-of-flight-MS, and Fourier transform infrared and nuclear magnetic resonance analyses were performed to complete molecular characterization. Individual doses range from 300 to 1000 µg. Despite its being a potent 5-HT2A receptor agonist, 25I-NBOH is neither registered in the United Nations Office on Drugs and Crime (UNODC) nor classified as a scheduled substance in most countries. Sweden and Brazil seem to be the only countries to control 25I-NBOH. To our knowledge, this is the first scientific report dealing with identification of 25I-NBOH in actual seizures.

Brephedrone: A new psychoactive substance seized in Brazil.

At the beginning of 2015, sixty-two capsules containing red-brown crystals seized in a historical city in Brazil were sent to this forensic laboratory for drug testing analysis. The material was identified as being Brephedrone, a new psychoactive substance and a bromine synthetic cathinone that is related to serotonin transportation. This substance was analyzed by ATR-FTIR, GC-MS, LC-MS, 1H, 13C and 2D NMR. Brephedrone apprehensions have been previously reported in Finland, France and Spain. It was the first detection of this substance in the State of Minas Gerais. No reports or information regarding any other apprehension nor identification of Brephedrone in Brazil were known prior to the present case.

Screening for bipolar disorder in the primary care: a Brazilian survey.

BACKGROUND: Two recent studies conducted in the US and in France found an unexpectedly high prevalence of a positive screen for bipolar disorder (BD) in primary care (PC). There are few studies of the prevalence of BD in PC and no information exists on the epidemiology of BD in Brazilian PC services. This study investigated the prevalence and correlates of a positive screen for BD among patients attending three Brazilian PC centers. METHODS: This cross-sectional survey recruited a systematic sample of 720 patients between 18 and 70 years of age who were seeking primary care treatment. Study measures included the Mood Disorder Questionnaire, the Center for Epidemiologic Studies Depression Scale, the World Health Organization Quality of Life instrument-Abbreviated version, the Functional Comorbidity Index, the Functioning Assessment Short Test, data on past mental health care, service utilization and a review of medical records for coded diagnosis. RESULTS: The prevalence of receiving positive screen for BD was 7.6% (n=55; 95% CI: 5.6-9.5%), but only 2 (3.6%) were recognized by general practitioners. A positive screen for BD was associated with significant depressive symptoms (CES-D score ≥16; 70.9%) and more general medical conditions, along with higher primary care utilization. Patients who screened positive for BD reported worse health-related quality of life as well as impaired functioning, compared to those who screened negative. LIMITATIONS: Co-morbid mental disorders were not assessed. The cross-sectional design prevents firm cause-effect inferences. CONCLUSIONS: The prevalence of a positive screening for BD is high, clinically significant and under-recognized in Brazilian PC settings.