Synthesis and anxiolytic effect of europium metallic complex containing lapachol [Eu(DBM)3. LAP] in adult zebrafish through serotonergic neurotransmission: in vivo and in silico approach.

Anxiety-related mental health problems are estimated at 3.6% globally, benzodiazepines (BZDs) are the class of drugs indicated for the treatment of anxiety, including lorazepam and diazepam. However, concerns have been raised about the short- and long-term risks associated with BZDs. Therefore, despite anxiolytic and antidepressant drugs, there is a need to develop more effective pharmacotherapies with fewer side effects than existing drugs. The present work reported the synthesis, anxiolytic activity, mechanism of action in Adult Zebrafish (Danio rerio) and in silico study of a europium metallic complex with Lapachol, [Eu(DBM)3. LAP]. Each animal (n = 6/group) was treated intraperitoneally (i.p.; 20 µL) with the synthesized complex (4, 20 and 40 mg/Kg) and with the vehicle (DMSO 3%; 20 µL), being submitted to the tests of locomotor activity and 96h acute toxicity. The light/dark test was also performed, and the serotonergic mechanism (5-HT) was evaluated through the antagonists of the 5-HTR1, 5-HTR2A/2C and 5-HTR3A/3B receptors. The complex was characterized using spectrometric techniques, and the anxiolytic effect of complex may be involved the neuromodulation of receptors 5-HT3A/3B, since the pre-treatment with pizotifen and cyproheptadine did not block the anxiolytic effect of [Eu(DBM)3. LAP], unlike fluoxetine had its anxiolytic effect reversed. In addition, molecular docking showed interaction between the [Eu(DBM)3. LAP] and 5HT3A receptor with binding energy -7.8 kcal/mol and the ADMET study showed that complex has low toxic risk. It is expected that the beginning of this study will allow the application of the new anxiolytic drugs, given the pharmacological potential of the lapachol complex.Communicated by Ramaswamy H. Sarma.

Long-term monitoring of COVID-19 prevalence in raw and treated wastewater in Salvador, the largest capital of the Brazilian Northeast.

Wastewater-based epidemiology (WBE) becomes an interesting epidemiological approach to monitoring the prevalence of SARS-CoV-2 broadly and non-invasively. Herein, we employ for the first time WBE, associated or not with the PEG 8000 precipitation method, for the detection of SARS-CoV-2 in samples of raw or treated wastewater from 22 municipal wastewater treatment stations (WWTPs) located in Salvador, the fourth most populous city in Brazil. Our results demonstrate the success of the application of WBE for detecting SARS-CoV-2 in both types of evaluated samples, regardless of the usage of PEG 8000 concentration procedure. Further, an increase in SARS-CoV-2 positivity rate was observed in samples collected in months that presented the highest number of confirmed COVID-19 cases (May/2021, June/2021 and January/2022). While PEG 8000 concentration step was found to significantly increase the positivity rate in treated wastewater samples (p < 0.005), a strong positive correlation (r: 0.84; p < 0.002) between non-concentrated raw wastewater samples with the number of new cases of COVID-19 (April/2021-February/2022) was observed. In general, the present results reinforce the efficiency of WBE approach to monitoring the presence of SARS-CoV-2 in either low- or high-capacity WWTPs. The successful usage of WBE even in raw wastewater samples makes it an interesting low-cost tool for epidemiological surveillance.

Identification of Cyanobacteria and Its Potential Toxins in the Joanes I Reservoir, Bahia, Brazil.

The Joanes I Reservoir is responsible for 40% of the drinking water supply of the Metropolitan Region of Salvador, Bahia, Brazil. For water sources such as this, there is concern regarding the proliferation of potentially toxin-producing cyanobacteria, which can cause environmental and public health impacts. To evaluate the presence of cyanobacteria and their cyanotoxins in the water of this reservoir, the cyanobacteria were identified by microscopy; the presence of the genes of the cyanotoxin-producing cyanobacteria was detected by molecular methods (polymerase chain reaction (PCR)/sequencing); and the presence of toxins was determined by liquid chromatography with tandem mass spectrometry (LC-MS/MS). The water samples were collected at four sampling points in the Joanes I Reservoir in a monitoring campaign conducted during the occurrence of phytoplankton blooms, and the water quality parameters were also analysed. Ten cyanobacteria species/genera were identified at the monitoring sites, including five potentially cyanotoxin-producing species, such as Cylindrospermopsis raciborskii, Cylindrospermopsis cf. acuminato-crispa, Aphanocapsa sp., Phormidium sp., and Pseudanabaena sp. A positive result for the presence of the cylindrospermopsin toxin was confirmed at two sampling points by LC-MS/MS, which indicated that the populations are actively producing toxins. The analysis of the PCR products using the HEPF/HEPR primer pair for the detection of the microcystin biosynthesis gene mcyE was positive for the analysed samples. The results of this study point to the worrisome condition of this reservoir, from which water is collected for public supply, and indicate the importance of the joint use of different methods for the analysis of cyanobacteria and their toxins in reservoir monitoring.

Evaluation of SARS-CoV-2 concentrations in wastewater and river water samples.

There are only a few established methods to determine the concentration of encapsulated viruses, such as SARS-CoV-2, in water matrices, limiting the application of wastewater-based epidemiology (WBE)-an important tool for public health research. The present study compared four methods that are commonly used to concentrate non-encapsulated enteric viruses for determining SARS-CoV-2 concentration in wastewater and wastewater-enriched river water samples. The four methods tested were electronegative membrane with Mg+2 addition, aluminum hydroxide-based precipitation, polyethylene glycol (PEG) 8000 precipitation, and ultrafiltration (with porosity of 10 and 50 kDa). Prior to the concentration step, filtration or centrifugation was performed to remove suspended particles from the samples (pretreatment). To evaluate the recovery efficiency (%), samples of SARS-CoV-2 from nasopharyngeal swabs obtained from RT-qPCR-positive patients were used as spiked samples. The second part of the analysis involved the quantification of the SARS-CoV-2 copy number in analytes without SARS-CoV-2-spiked samples. Among the tested methods, pretreatment via centrifugation followed by ultrafiltration with a 50-kDa cut-off was found the most efficient method for wastewater samples with spiked samples (54.3 or 113.01% efficiency). For the wastewater-enriched river samples with spiked samples, pretreatment via centrifugation followed by filtration using an electronegative membrane was the most efficient method (110.8% and 95.9% for N1 and N2 markers, respectively). However, ultrafiltration of the raw river water samples using 10 or 50 kDa cut-off filters and PEG 8000 precipitation showed the best concentration efficiency based on copy number, regardless of the pretreatment approach or sample type (values ranging from 3 × 105 to 6.7 × 103). The effectiveness of the concentration method can vary depending on the type of sample and concentration method. We consider that this study will contribute to more widespread use of WBE for the environmental surveillance of SARS-CoV-2.

Spirituality and practice of the euphemism in the workplace: perceptions of a nursing team.

OBJECTIVES: to understand the spirituality and the practice of euphemism experienced by nursing professionals in the hospital scenario. METHODS: a descriptive, exploratory research with a qualitative approach, carried out with 18 nursing professionals from a hospital in southern Brazil. Data collection took place from September to October 2018, through recorded audio interviews. The reports were submitted to thematic content analysis and the discussion was based on the theory of transpersonal care. RESULTS: four categories emerged from the speeches: Motivational reflection of spirituality in the work environment; Adherence to the practice of euphemism by nursing professionals; Satisfaction and frustration in the practice of euphemism by nursing professionals and; Spirituality as an increase in human faith. FINAL CONSIDERATIONS: professionals understand spirituality and the practice of euphemism as a tool that helps in motivating the team to face difficulties at work and increase the faith of hospitalized patients.

Spirituality and practice of the euphemism in the workplace: perceptions of a nursing team / Espiritualidad y práctica de la eufemia en el lugar de trabajo: percepciones de un equipo de enfermería / Espiritualidade e prática da eufemia no ambiente de trabalho: percepções de uma equipe de enfermagem

ABSTRACT Objectives: to understand the spirituality and the practice of euphemism experienced by nursing professionals in the hospital scenario. Methods: a descriptive, exploratory research with a qualitative approach, carried out with 18 nursing professionals from a hospital in southern Brazil. Data collection took place from September to October 2018, through recorded audio interviews. The reports were submitted to thematic content analysis and the discussion was based on the theory of transpersonal care. Results: four categories emerged from the speeches: Motivational reflection of spirituality in the work environment; Adherence to the practice of euphemism by nursing professionals; Satisfaction and frustration in the practice of euphemism by nursing professionals and; Spirituality as an increase in human faith. Final Considerations: professionals understand spirituality and the practice of euphemism as a tool that helps in motivating the team to face difficulties at work and increase the faith of hospitalized patients.

RESUMEN Objetivos: comprender la espiritualidad y la práctica de la eufemia que experimentan los profesionales de enfermería en el contexto hospitalario. Métodos: investigación exploratoria, descriptiva, cualitativa, desarrollada con 18 profesionales de enfermería de un hospital en el sur de Brasil. Los datos se recopilaron entre septiembre y octubre de 2018, a través de entrevistas de audio grabadas. Los informes fueron sometidos a análisis de contenido temático y la discusión se basó en la teoría del cuidado transpersonal. Resultados: de las declaraciones surgieron cuatro categorías: Reflexión motivacional de la espiritualidad en el ambiente de trabajo; Adhesión a la práctica de la eufemia por profesionales de enfermería; Satisfacción y frustración en la práctica de la eufemia por profesionales de enfermería; y La espiritualidad como un aumento en la fe humana. Consideraciones Finales: los profesionales perciben la espiritualidad y la práctica de la eufemia como una herramienta que ayuda a motivar al equipo, hacer frente a las dificultades en el trabajo y aumentar la fe de los pacientes hospitalizados.

RESUMO Objetivos: compreender a espiritualidade e a prática da eufemia vivenciada por profissionais de enfermagem no contexto hospitalar. Métodos: pesquisa descritiva, exploratória, de abordagem qualitativa, desenvolvida com 18 profissionais de enfermagem de uma instituição hospitalar no Sul do Brasil. Os dados foram coletados no período de setembro a outubro de 2018, por meio de entrevistas áudio gravadas. Os relatos foram submetidos à análise de conteúdo temática e a discussão se fundamentou na teoria do cuidado transpessoal. Resultados: das falas emergiram quatro categorias: Reflexo motivacional da espiritualidade no ambiente de trabalho; Adesão à prática da eufemia por profissionais de enfermagem; Satisfação e frustração na prática da eufemia por profissionais de enfermagem e; Espiritualidade como incremento da fé humana. Considerações Finais: os profissionais percebem a espiritualidade e a prática da eufemia como ferramenta que auxilia a motivação da equipe para o enfrentamento das dificuldades no trabalho e no incremento da fé de pacientes hospitalizados.

Impact of long-stay beds on the performance of a tertiary hospital in emergencies.

OBJECTIVE: To assess the impact of implementing long-stay beds for patients of low complexity and high dependency in small hospitals on the performance of an emergency referral tertiary hospital. METHODS: For this longitudinal study, we identified hospitals in three municipalities of a regional department of health covered by tertiary care that supplied 10 long-stay beds each. Patients were transferred to hospitals in those municipalities based on a specific protocol. The outcome of transferred patients was obtained by daily monitoring. Confounding factors were adjusted by Cox logistic and semiparametric regression. RESULTS: Between September 1, 2013 and September 30, 2014, 97 patients were transferred, 72.1% male, with a mean age of 60.5 years (SD = 1.9), for which 108 transfers were performed. Of these patients, 41.7% died, 33.3% were discharged, 15.7% returned to tertiary care, and only 9.3% tertiary remained hospitalized until the end of the analysis period. We estimated the Charlson comorbidity index - 0 (n = 28 [25.9%]), 1 (n = 31 [56.5%]) and ≥ 2 (n = 19 [17.5%]) - the only variable that increased the chance of death or return to the tertiary hospital (Odds Ratio = 2.4; 95%CI 1.3;4.4). The length of stay in long-stay beds was 4,253 patient days, which would represent 607 patients at the tertiary hospital, considering the average hospital stay of seven days. The tertiary hospital increased the number of patients treated in 50.0% for Intensive Care, 66.0% for Neurology and 9.3% in total. Patients stayed in long-stay beds mainly in the first 30 (50.0%) and 60 (75.0%) days. CONCLUSIONS: Implementing long-stay beds increased the number of patients treated in tertiary care, both in general and in system bottleneck areas such as Neurology and Intensive Care. The Charlson index of comorbidity is associated with the chance of patient death or return to tertiary care, even when adjusted for possible confounding factors.

Impact of long-stay beds on the performance of a tertiary hospital in emergencies / Impacto de leitos de longa permanência no desempenho de hospital terciário em emergências

ABSTRACT OBJECTIVE To assess the impact of implementing long-stay beds for patients of low complexity and high dependency in small hospitals on the performance of an emergency referral tertiary hospital. METHODS For this longitudinal study, we identified hospitals in three municipalities of a regional department of health covered by tertiary care that supplied 10 long-stay beds each. Patients were transferred to hospitals in those municipalities based on a specific protocol. The outcome of transferred patients was obtained by daily monitoring. Confounding factors were adjusted by Cox logistic and semiparametric regression. RESULTS Between September 1, 2013 and September 30, 2014, 97 patients were transferred, 72.1% male, with a mean age of 60.5 years (SD = 1.9), for which 108 transfers were performed. Of these patients, 41.7% died, 33.3% were discharged, 15.7% returned to tertiary care, and only 9.3% tertiary remained hospitalized until the end of the analysis period. We estimated the Charlson comorbidity index - 0 (n = 28 [25.9%]), 1 (n = 31 [56.5%]) and ≥ 2 (n = 19 [17.5%]) - the only variable that increased the chance of death or return to the tertiary hospital (Odds Ratio = 2.4; 95%CI 1.3;4.4). The length of stay in long-stay beds was 4,253 patient days, which would represent 607 patients at the tertiary hospital, considering the average hospital stay of seven days. The tertiary hospital increased the number of patients treated in 50.0% for Intensive Care, 66.0% for Neurology and 9.3% in total. Patients stayed in long-stay beds mainly in the first 30 (50.0%) and 60 (75.0%) days. CONCLUSIONS Implementing long-stay beds increased the number of patients treated in tertiary care, both in general and in system bottleneck areas such as Neurology and Intensive Care. The Charlson index of comorbidity is associated with the chance of patient death or return to tertiary care, even when adjusted for possible confounding factors.

RESUMO OBJETIVO Avaliar o impacto da implantação de leitos de longa permanência para pacientes de baixa complexidade e alta dependência em hospitais de pequeno porte sobre o desempenho de hospital terciário de referência em emergência. MÉTODOS Para este estudo longitudinal, foram identificados hospitais em três municípios no departamento regional de saúde coberto pela instância terciária e que forneciam 10 leitos de longa permanência cada. Os pacientes foram transferidos para os hospitais desses municípios com base em protocolo específico. Obteve-se o desfecho dos pacientes transferidos por acompanhamento diário. Fatores de confusão foram ajustados por regressão logística e semiparamétrica de Cox. RESULTADOS Entre 1 de setembro de 2013 e 30 de setembro de 2014, foram transferidos 97 pacientes, sendo 72,1% homens, com idade média de 60,5 anos (DP = 1,9), para os quais foram realizadas 108 transferências. Desses pacientes, 41,7% evoluíram ao óbito, 33,3% receberam alta, 15,7% retornaram à instância terciária, e apenas 9,3% permaneceram internados até o final do período analisado. Foi calculado o índice de comorbidade de Charlson - 0 (n = 28 [25,9%]), 1 (n = 31 [56,5%]) e ≥ 2 (n = 19 [17,5%]) - a única variável que aumentou a chance de óbito ou retorno ao hospital terciário (Razão de Chances = 2,4; IC95% 1,3;4,4). O tempo de permanência nos leitos de longa permanência foi de 4.253 pacientes-dia, que representariam 607 vagas no hospital terciário, considerando-se a média de internação de sete dias. O hospital terciário aumentou o número de vagas em 50,0% para terapia intensiva, 66,0% para neurologia e 9,3% para as vagas totais. A permanência dos pacientes nos leitos de longa permanência limitou-se em grande parte aos primeiros 30 (50,0%) e 60 (75,0%) dias. CONCLUSÕES A implantação de leitos de longa permanência teve impacto no aumento de vagas novas oferecidas pela instância terciária tanto gerais como para áreas de estrangulamento do sistema, como a Neurologia e Terapia Intensiva. O índice de comorbidade de Charlson está associado à chance de o paciente evoluir ao óbito ou retornar para a instância terciária, mesmo quando ajustado por possíveis fatores de confusão.

Integrated assessment of mangrove sediments in the Camamu Bay (Bahia, Brazil).

Camamu Bay, an Environmentally Protected Area, may be affected by the pressures of tourism and oil exploration in the adjacent continental platform. The current quality of the mangrove sediments was evaluated by porewater bioassays using embryos of Crassostrea rhizophorae and by an analysis of benthic macrofauna and its relationships with organic compounds, trace metals and bioavailability. Porewater toxicity varied from low to moderate in the majority of the samples, and polychaetes dominated the benthos. The Grande Island sampling station (Station 1) presented more sandy sediments, differentiated macrobenthic assemblages and the highest metal concentrations in relation to other stations and guideline values, and it was the only station that indicated a possible bioavailability of metals. The origin of the metals (mainly barium) is most likely associated with the barite ore deposits located in the Grande and Pequena islands. These results may be useful for future assessment of the impact of oil exploration in the coastal region.

Acute resistance exercise reduces blood pressure and vascular reactivity, and increases endothelium-dependent relaxation in spontaneously hypertensive rats.

The aim of the present study was to assess the effects of acute dynamic resistance exercise on resting blood pressure (BP) and on endothelial function of vascular bed of spontaneously hypertensive rats. Hemodynamic measurements were performed before and after acute dynamic resistance exercise in conscious animals. After exercise, the tail artery was cannulated for mean perfusion pressure with constant flow measurement and for performing concentration-response curves to acetylcholine (ACh) and sodium nitroprusside (SNP) and dose-response curves to phenylephrine (PHE). PHE protocol was also repeated with damaged endothelium and after L-NAME and indomethacin perfusion on the tail. The maximal response (E(max)) and sensitivity (pD(2)) were evaluated to these drugs. Exercise reduced resting systolic and diastolic BP (Delta -79 +/- 1.8; -23 +/- 2.3 mmHg, respectively; P < 0.05). ACh-induced relaxation increased in the exercise group (pD(2) = 9.8 +/- 0.06, P < 0.05) when compared with control rats (pD(2) = 8.7 +/- 0.1). The E(max) to PHE with intact endothelium decreased following exercise condition (439 +/- 18 mmHg, P < 0.05) when compared with control rats (276 +/- 22 mmHg). This response was abolished after L-NAME and indomethacin administration. After damage of the endothelium, PHE responses were not significantly different between the groups; however, E(max) and pD(2) increased when compared with responses obtained with intact endothelium. The results demonstrated that acute dynamic resistance exercise decreased resting BP and reactivity to PHE and increased endothelium-dependent relaxation. Nitric oxide and vasodilators prostanoids appear to be involved in post-exercise endothelial and pressor responses.

Combined system of activated sludge and ozonation for the treatment of kraft E1 effluent.

The treatment of paper mill effluent for COD, TOC, total phenols and color removal was investigated using combined activated sludge-ozonation processes and single processes. The combined activated sludge-O3/pH 10 treatment was able to remove around 80% of COD, TOC and color from Kraft E(1) effluent. For the total phenols, the efficiency removal was around 70%. The ozonation post treatment carried out at pH 8.3 also showed better results than the single process. The COD, TOC, color and total phenols removal efficiency obtained were 75.5, 59.1, 77 and 52.3%, respectively. The difference in the concentrations of free radical produced by activated sludge-O3/pH 10 and activated sludge-O3/pH 8.3 affected mainly the TOC and total phenol removal values.

Do psychiatric comorbidities predict postoperative seizure outcome in temporal lobe epilepsy surgery?

Clinical and demographic presurgical variables may be associated with unfavorable postsurgical neurological outcome in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). However, few reports include preoperative psychiatric disorders as a factor predictive of long-term postsurgical MTLE-HS neurological outcome. We used Engel's criteria to follow 186 postsurgical patients with MTLE-HS for an average of 6 years. DSM-IV criteria and psychiatric comorbidity criteria specific to epilepsy (interictal dysphoric disorder, postictal and interictal psychosis) were used to assess presurgical psychiatric disorders. Kaplan-Meier event-free survival and adjusted hazard ratios were estimated with unconditional logistic regression. Seventy-seven (41.4%) patients had a preoperative Axis I psychiatric diagnosis. Thirty-six patients had depression, 11 interictal dysphoric disorder, 14 interictal psychosis, 6 postictal psychosis, and 10 anxiety disorders. Twenty-three (12.4%) patients had Axis II personality disorders. Regarding seizure outcome, preoperative anxiety disorders (P=0.009) and personality disorders (P=0.003) were positively correlated with Engel class 1B (remaining auras) or higher. These findings emphasize the importance of presurgical psychiatric evaluation, counseling, and postsurgical follow-up of patients with epilepsy and psychiatric disorders.

Olanzapine for recurrent aggression in a patient with temporal lobe epilepsy who had temporal lobectomy.

We report the case of a patient with epilepsy who had interictal severe affective aggression, and whose epilepsy significantly improved (but not aggression) after successful temporal lobectomy. Olanzapine significantly improved these aggressive episodes refractory to neurosurgery and previous pharmacological treatments including antipsychotics, anticonvulsants/mood stabilizers and benzodiazepines.

Mortalidade materna na Clínica Obstétrica do Hospital Baräo de Lucena: análise de 70 casos / Maternal mortality at the Clínica Obstétrica do Hospital Baräo de Lucena: analysis of 70 cases

De 1980 a 1984 houve 70 óbitos maternos na Clínica Obstétrica do Hospital Baräo de Lucena, Recife, entre 13.723 nascidos vivos propiciando um coeficiente global de 5.100%. Tal cifra näo sofreu oscilaçöes significativas nos diferentes anos considerados. O obituário materno foi mais freqüente quando a via do parto foi a abdominal e a infecçäo surgiu como a principal causa dos decessos. Em 73% das oportunidades os óbitos ocorreram em pacientes procedentes de outras instituiçöes hospitalares