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OBJECTIVE: There is early evidence about Valproic acid (VPA) antiviral effect. Our aim was to investigate the incidence and severity of SARS-CoV-2 infection in VPA users as compared with the general population. MATERIAL AND METHODS: A case-control study nested within a cohort, carried out between March 1 and December 17, 2020. Retrospectively, we identified confirmed SARS-CoV-2 infection patients exposed to VPA in our health department (defined as case). We ascertained VPA regimen (all the time (AT) (292 days) or at least 20% of the study period (notAT) (≥58 days) and if VPA levels were in therapeutic range (ATR) (50-100mcg/mL) in the last 24 months. We calculated the cumulative incidence of SARS-CoV-2 infection and hospital admission in the cases, comparing it with the general unexposed VPA population (controls). RESULTS: During the study period, 6183 PCR+ were detected among 281,035 inhabitants, of these, 746 were hospitalized. 691 patients were on VPA notAT and 628 (90.1%) AT. The indication for VPA use was epilepsy in 54.9%. The incidence of PCR+ was 1.736% (OR 0.785 (95%CI 0.443-1.390) and 1.910% (OR 0.865 (95%CI 0.488-1.533), on VPA notAT and VPA AT patients, respectively vs. 2.201% in people without VPA regimen. Those patients with VPA ATR had a lower risk of PCR + (OR 0.233 (95%CI 0.057-0.951) notAT; OR 0.218 (95%CI 0.053-0.890) AT). Hospital admission incidence was lower in patient on VPA (OR was 0.543 (95% CI 0.076-3.871). CONCLUSION: Patients with VPA within the therapeutic range had a reduction of SARS-Cov-2 infection incidence greater than 75%. There is a downward trend in the risk of COVID-19 admission by SARS-CoV-2 in patients on VPA therapy. These findings warrant further investigation.
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COVID-19 , Epilepsia , Ácido Valproico , Humanos , Ácido Valproico/uso terapêutico , Estudos de Casos e Controles , Masculino , Feminino , Pessoa de Meia-Idade , COVID-19/epidemiologia , Estudos Retrospectivos , Adulto , Idoso , Epilepsia/tratamento farmacológico , Tratamento Farmacológico da COVID-19 , Incidência , Antivirais/uso terapêutico , Anticonvulsivantes/uso terapêutico , Hospitalização/estatística & dados numéricos , SARS-CoV-2RESUMO
OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the countries of Latin America and the Caribbean. This study aims to summarise key findings from the Global Burden of Disease (GBD) 2021 in the region. We also explore disparities in burden rates and the relationship with the Socio-demographic Index (SDI). STUDY DESIGN: A cross-sectional analysis of GBD 2021 results was conducted. METHODS: We obtained the disability-adjusted life years (DALYs) due to COVID-19 for 20 countries, analysing number- and age-adjusted rates. Spearman's correlation (rho) and 95% confidence intervals (CIs) assessed the SDI-DALY rates relationship. RESULTS: COVID-19 was the leading cause disease burden in the region, with 20,437,321 DALYs in 2020 and 31,525,824 in 2021. Premature mortality (years of life lost) accounted for over 95%. Disparities existed across sexes, age groups, and countries, with Bolivia and Peru having the highest rates. A significant 2021 correlation was found (rho = -0.55, 95% CI: -0.90 to 0.19; P = 0.013) but not in 2020 (rho = -0.40, 95% CI: -0.75 to 0.05; P = 0.078). CONCLUSIONS: COVID-19 posed a significant burden in Latin America and the Caribbean, emphasising the need for targeted interventions, especially in socioeconomically disadvantaged regions.
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The objective of this study was to evaluate the prevalence of human papillomavirus (HPV) genotypes and their relationship with different grades of cytological lesions in female students of the Faculty of Health Sciences of the National University of Chimborazo. Material and Methods: The research had a quantitative and descriptive approach, with a comparative analysis of HPV genotypes and cytological lesions in students of the Faculty of Health Sciences. It is an experimental and field study, cross-sectional and retrospective, conducted from November 2023 to March 2024. Thirty students were selected by quota sampling, analyzing conventional cytology and data using SPSS 26. The results showed that 75.8% of the samples had Bethesda Negative results, whereas 24.2% had some degree of cytological lesion (ASC-US 13.7%, L-SIL 8.1%, H-SIL 1.6%, and ASC-H 0.8%). Genotyping showed the high prevalence of HPV, with HPV 18 and 33 being the most common high-risk genotypes. The most common low-risk indicators were HPV 43 and 42. Conclusions: The study confirmed the high prevalence of HPV among female university students and established a significant correlation between high-risk genotypes and the presence of more severe cytological lesions. These findings underscore the need for interventions aimed at prevention and early treatment of HPV, especially in high-risk populations.
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Genótipo , Papillomaviridae , Infecções por Papillomavirus , Estudantes , Humanos , Feminino , Infecções por Papillomavirus/virologia , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/patologia , Estudantes/estatística & dados numéricos , Universidades , Estudos Transversais , Adulto Jovem , Papillomaviridae/genética , Papillomaviridae/isolamento & purificação , Adulto , Estudos Retrospectivos , Neoplasias do Colo do Útero/virologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia , Prevalência , Adolescente , Esfregaço Vaginal , Displasia do Colo do Útero/virologia , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/patologiaRESUMO
This study aimed to evaluate the influence of culture media, irradiance, and sealing system on the in vitro and ex vitro growth of Cattleya walkeriana Gardner. We used MS medium as culture medium, supplemented with 30 g L-1 of sucrose and solidified with 7.0 g L-1 of bacteriological agar. This medium served as a control, while for the other treatments we supplemented the media as follows: 2) MS with 150 g L-1 of banana pulp = P150; 3) MS with 300 g L-1 of banana pulp = P300; 4) MS with 150 g L-1 of banana peel = PE150; and 5) MS with 300 g L-1 of banana peel = PE300. The irradiances were provided by 3000K LED lamps: 86 µmol m-2 s-1 (Irradiance-1) and 128 µmol m-2 s-1 (Irradiance-2) and the conventional sealing (CSS) and sealing systems that allow gas exchange (GESS). After 120 (in vitro) and 180 days (ex vitro) of cultivation, we evaluated them for pseudobulb (PN), leaf (LN) and root number (RN), plant height (PH), pseudobulb diameter (PD), longest leaf (LL) and root length (RL), fresh mass (TFM) and survival (%SURV). There was a significant interaction for all the variables analyzed. The CM x SS double interaction was significant for PH, LL, and RL. The CM x I x SS interaction was significant for PN, LN, RN, PD, TFM, and %SURV traits of C. walkeriana grown in vitro. There was a significant interaction between CM x I x SS for all C. walkeriana traits evaluated in ex vitro culture. Using the medium with up to 150 g L-1 of banana pulp combined with Irradiance-2 and CSS provided the highest values for in vitro plant growth. However, prior cultivation in MS medium, Irradiance-1, and CSS provided the greatest survival and establishment of this species plants in ex vitro culture.
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Meios de Cultura , Orchidaceae , Orchidaceae/crescimento & desenvolvimento , Luz , Fatores de Tempo , Musa/crescimento & desenvolvimentoRESUMO
Understanding the impact of plastic and its additives on wild species is crucial as their presence in the environment increases. Polybrominated diphenyl ethers (PBDEs), once used as flame retardants, were restricted due to known toxic effects, but are still detected in the environment. Naturally occurring methoxylated PBDEs (MeO-BDEs) can result from PBDE transformation and may cause similar hazardous effects. Yellow-legged gulls (Larus michahellis, YLG) and Audouin's gulls (Ichthyaetus audouinii, AG) are highly susceptible to plastic additives, due to their distribution, trophic position, and behaviour. In this study, we assessed PBDEs and MeO-BDEs uptake in different tissues and their effects on physiological and reproductive parameters. Findings indicate that, apart from annual differences, adult AG accumulated more MeO-BDEs than YLG in a natural breeding habitat (Deserta), while the latter had lower PBDE levels than YLG breeding in the city of Porto. In relation to chicks, only YLG from Deserta showed higher PBDE concentrations than AG chicks. Individual analysis of each physiological parameter revealed impacts only for adult YLG from Deserta, with neurofunction and immune system inhibition at higher MeO-BDE concentrations. For chicks, AG showed impaired neurofunction, while YLG chicks from Porto exhibited potential genotoxicity effects triggered by higher MeO-BDE levels. Overall health analysis showed activation of antioxidant defences and compromised immune system in YLG adults from Porto due to high values of PBDEs, while chicks from Deserta exhibited inflammation and oxidative stress with high concentrations of MeO-BDEs in the same species. Fertility parameters showed significant differences for sperm counts though suggesting individuals may be able to compensate any exposure effects. This study confirms the widespread presence of plastic-associated compounds and their harmful effects on gulls, particularly on neurofunction, immune system, oxidative balance and fertility, especially due to the presence of MeO-BDEs.
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Charadriiformes , Fertilidade , Retardadores de Chama , Éteres Difenil Halogenados , Animais , Charadriiformes/fisiologia , Éteres Difenil Halogenados/toxicidade , Fertilidade/efeitos dos fármacos , Retardadores de Chama/toxicidade , Plásticos/toxicidade , Poluentes Ambientais/toxicidade , Masculino , Reprodução/efeitos dos fármacos , Feminino , Monitoramento AmbientalRESUMO
The presence of plastic debris and organo-brominated compounds in the marine environment poses a concern to wildlife. Plastic can absorb and release chemical compounds, making their ingestion potentially harmful, while chemical compounds have become omnipresent, with a tendency to bioaccumulate in the food web. Seabirds are often used as indicators of marine plastic pollution, yet studies on the exposure of tropical communities to plastic contamination are still scarce. In this study we monitored the amounts of plastics in faeces and organo-brominated compounds ingested/assimilated in feathers by adults and chicks of Cape Verde shearwaters and Bulwer's petrels from Cabo Verde. Anthropogenic pollutants, polybrominated diphenyl ethers (PBDEs), and naturally generated methoxylated-PBDEs (MeO-PBDEs) were among the probed compounds. The frequency of plastic debris ingestion was similar in both species' adults and chicks, although, the characteristics of the ingested plastic differed. Frequency and number of microplastics increased throughout the nestling season for chicks from both species. All species and age groups showed the presence of PBDEs and MeO-PBDEs. Among PBDEs, Bulwer's petrels exhibited higher concentrations than Cape Verde shearwaters, and chicks had higher concentration profiles than adults. Specifically, Bulwer's petrel chicks showed higher concentrations than Cape Verde shearwater chicks. On the contrary, Cape Verde shearwater adults exhibited higher occurrence and concentrations of MeO-PBDEs when compared to Cape Verde shearwater chicks. We found no effect of plastic loadings or loadings of organohalogen contaminants on body condition or size, although harmful effects may be hidden or reveal themselves in a medium- to long-term. Feather samples from both adults and chicks were shown to be useful for comparing intraspecific contamination levels and appear suitable for the long-term assessment of organohalogen contaminants in seabirds. Species-specific foraging and feeding strategies are likely the drivers of the observed variation in organochlorine contamination burdens among seabird species.
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Monitoramento Ambiental , Éteres Difenil Halogenados , Plásticos , Poluentes Químicos da Água , Animais , Plásticos/análise , Éteres Difenil Halogenados/análise , Poluentes Químicos da Água/análise , Aves/metabolismo , Plumas/química , Masculino , Exposição Ambiental/estatística & dados numéricosRESUMO
Introduction: In competitive sports, teams are increasingly relying on advanced systems for improved performance and results. This study reviews the literature on the role of artificial intelligence (AI) in managing these complexities and encouraging a system thinking shift. It found various AI applications, including performance enhancement, healthcare, technical and tactical support, talent identification, game prediction, business growth, and AI testing innovations. The main goal of the study was to assess research supporting performance and healthcare. Methods: Systematic searches were conducted on databases such as Pubmed, Web of Sciences, and Scopus to find articles using AI to understand or improve sports team performance. Thirty-two studies were selected for review. Results: The analysis shows that, of the thirty-two articles reviewed, fifteen focused on performance and seventeen on healthcare. Football (Soccer) was the most researched sport, making up 67% of studies. The revised studies comprised 2,823 professional athletes, with a gender split of 65.36% male and 34.64% female. Identified AI and non-AI methods mainly included Tree-based techniques (36%), Ada/XGBoost (19%), Neural Networks (9%), K-Nearest Neighbours (9%), Classical Regression Techniques (9%), and Support Vector Machines (6%). Conclusions: This study highlights the increasing use of AI in managing sports-related healthcare and performance complexities. These findings aim to assist researchers, practitioners, and policymakers in developing practical applications and exploring future complex systems dynamics.
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In this study, neural networks and support vector regression (SVR) were employed to predict the degradation over three pharmaceutically active compounds (PhACs): Ibuprofen (IBP), diclofenac (DCF), and caffeine (CAF) within a stirred reactor featuring a flotation cell with two non-concentric ultraviolet lamps. A total of 438 datapoints were collected from published works and distributed into 70% training and 30% test datasets while cross-validation was utilized to assess the training reliability. The models incorporated 15 input variables concerning reaction kinetics, molecular properties, hydrodynamic information, presence of radiation, and catalytic properties. It was observed that the Support Vector Regression (SVR) presented a poor performance as the ε hyperparameter ignored large error over low concentration levels. Meanwhile, the Artificial Neural Networks (ANN) model was able to provide rough estimations on the expected degradation of the pollutants without requiring information regarding reaction rate constants. The multi-objective optimization analysis suggested a leading role due to ozone kinetic for a rapid degradation of the contaminants and most of the results required intensification with hydrogen peroxide and Fenton process. Although both models were affected by accuracy limitations, this work provided a lightweight model to evaluate different Advanced Oxidation Processes (AOPs) by providing general information regarding the process operational conditions as well as know molecular and catalytic properties.
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Diclofenaco , Peróxido de Hidrogênio , Ibuprofeno , Aprendizado de Máquina , Redes Neurais de Computação , Diclofenaco/química , Peróxido de Hidrogênio/química , Ibuprofeno/química , Cinética , Poluentes Químicos da Água/química , Poluentes Químicos da Água/análise , Cafeína/química , Oxirredução , Preparações Farmacêuticas/química , Preparações Farmacêuticas/análise , Ozônio/química , Máquina de Vetores de Suporte , Análise Custo-Benefício , Raios Ultravioleta , Catálise , FotóliseRESUMO
The presented paper discusses the production of radioactive ion beams of francium, radium, and actinium from thick uranium carbide (UC x ) targets at ISOLDE, CERN. This study focuses on the release curves and extractable yields of francium, radium and actinium isotopes. The ion source temperature was varied in order to study the relative contributions of surface and laser ionization to the production of the actinium ion beams. The experimental results are presented in the form of release parameters. Representative extractable yields per µ C are presented for 222 - 231 Ac, several Ra and Fr isotopes in the mass ranges 214 ≤ A ≤ 233 and 205 ≤ A ≤ 231 respectively. The release efficiency for several isotopes of each of the studied elements was calculated by comparing their yields to the estimated in-target production rates modeled by CERN-FLUKA. The maximal extraction efficiency of actinium was calculated to be 2.1(6)% for a combination of surface ionization using a Ta ion source and resonant laser ionization using the two-step 438.58 nm, and 424.69 nm scheme.
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Chronic pain and functional limitations caused by coxarthrosis are important factors in the onset of depression, as there are higher rates of depression in this group of patients than in the general population. Total hip arthroplasty (THA) has been shown to decrease pain and improve function in these patients, which may positively influence the patient's depressive symptoms. The objectives of the study are to evaluate the differences between patients with depression and patients without depression in the immediate postoperative period (pain and hospitalization time) and to evaluate functional outcomes one year after surgery. Therefore, we conducted a prospective cohort study in which all patients with indications for primary total hip arthroplasty during 2018 were included. Preoperatively, patients completed the PHQ-9 questionnaire, and were classified into patients with depression (if preoperative PHQ-9 > or = to 10) and patients without depression (pre PHQ-9 < to 10). During the hospital stay, postoperative pain was assessed by VAS, and the need for analgesic rescue with major opioids. One year after surgery, the PHQ-9 test was retaken, and functional outcomes were assessed. The results showed that both groups were comparable in terms of sex, age, BMI, and ASA. No differences were found in postoperative pain or hospitalization time. There were also no differences between the two groups of patients in functional outcomes one year after surgery. Therefore, we can conclude that patients with a diagnosis of depression do not present worse postoperative pain after THA. In addition, they show a significant improvement in their depressive symptoms one year after surgery.
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Artroplastia de Quadril , Depressão , Dor Pós-Operatória , Humanos , Artroplastia de Quadril/efeitos adversos , Feminino , Masculino , Estudos Prospectivos , Depressão/etiologia , Dor Pós-Operatória/psicologia , Dor Pós-Operatória/etiologia , Idoso , Pessoa de Meia-Idade , Medição da Dor , Osteoartrite do Quadril/cirurgia , Tempo de Internação , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Oral Pathology (OP) and Oral Medicine (OM) are specialties in dentistry whose main objective is the diagnosis and treatment of oral and maxillofacial diseases, and aspects related to the academic training of professionals and fields of practice are distinct and heterogeneous around the world. This study aimed to evaluate professional training and areas of activity in OP and OM in Latin American countries. MATERIAL AND METHODS: A questionnaire was sent to 11 countries, with a professional in each country responsible for answering it. The questionnaire had 21 questions related to the process of professional training, areas of practice, the existence of scientific events in each country, and also collected demographic and population information. RESULTS: OP and OM are practiced in all the countries studied, but the specialty is not recognized in all of them. Brazil was the first to recognize both as a specialty. Postgraduate programs designed to train specialists are available in various countries. Two countries offer residency programs, 6 countries provide specialization courses, 6 offer master's programs, and 3 have doctoral programs. Brazil boasts the highest number of undergraduate courses (n=412), while Uruguay has the lowest (n=2). Professional societies representing the specialty exist in ten countries. Brazil has the highest number of OP and OM specialists (n=422 and 1,072), while Paraguay has the smallest number (n=1 and 3). CONCLUSIONS: Although both specialties are widely practiced around the globe, professional training, the number of dentists trained and the fields of professional practice are very different between the countries studied.
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Medicina Bucal , Patologia Bucal , América Latina , Medicina Bucal/educação , Patologia Bucal/educação , Humanos , AutorrelatoRESUMO
Introducción El síndrome de pseudotumor cerebri (SPTC) en pacientes prepuberales presenta características que lo diferencian respecto a su presentación en la etapa pospuberal. Nuestro objetivo es describir las características de los pacientes diagnosticados de SPTC pediátrico en nuestro centro y compararlas en función de su estado puberal. Pacientes y métodos Se incluyeron a los pacientes diagnosticados de SPTC en un hospital de tercer nivel entre los años 2006 y 2019 con edades comprendidas entre uno y 18 años que cumplieran los criterios diagnósticos actualizados del SPTC. Se clasificaron en función de su estado puberal y peso corporal. Posteriormente, se analizaron los datos de las punciones lumbares, estudios de neuroimagen, valoraciones oftalmológicas, así como el régimen terapéutico recibido a lo largo de su seguimiento. Resultados Se recogieron 28 pacientes, 22 prepuberales y seis pospuberales, con edad media de 9,04 ± 2,86 años. El 83,3% de los pacientes pospuberales eran varones presentando sobrepeso/obesidad en el 66,7%. Eran varones el 27% de los pacientes prepuberales, de ellos asociaban sobrepeso el 31,8%. La sintomatología más frecuente fue cefalea (89,9%) y visión borrosa (42,9%). Todos los pacientes presentaron papiledema; un 21,4% de los casos presentaron parálisis del VI par. Se identificó un posible desencadenante en un 28,6%. El 19% presentaron recurrencia clínica, siendo todos ellos prepuberales. La resolución clínica completa se produjo en el 55,6% de los pacientes. Conclusión Pacientes con SPTC presentan menor prevalencia de obesidad en la etapa prepuberal, junto con un mayor porcentaje de etiologías secundarias y tasa de recurrencia que los pacientes pospuberales. (AU)
Introduction Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. Patients and methods We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. Results We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. Conclusion Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients. (AU)
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Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Pseudotumor Cerebral , Obesidade , Puberdade , Estudos Longitudinais , Estudos RetrospectivosRESUMO
Background: Football player's health is important, and preventing sudden cardiac arrest may be a critical issue. Professional football players have different ECG signals than the average population, yet there are considerable gaps in study whereas the general population has been extensively studied. Objectives: (a) Generate a reference and innovative resting 12-lead ECG database from 54 UEFA PRO level male football players from La Liga. This is a novel approach to cope the ECG and possible arrythmias in athletes. (b) Manage each XML athlete ECG data and develop a free-use program to visualize, denoise and filter the signal with the capacity to automate the labelling of the waves and save the reports. (c) Study the ECG wave shape and generate models through ML to analyse its utility to automate basic diagnosis. Methods: The dataset collection is based on a prospective observational cohort and includes 10 s, 12-lead ECGs and rhythm and condition labels for each athlete. Physiological sport arrhythmias, T-Wave shape and other findings were studied and labelled. ECG Visualizer was developed and used for 3 machine learning (ML) methods to automate sinus bradycardia arrhythmia diagnosis. Results: A dataset with 163 ECGs in XML format was collected comprising the Pro Football 12-lead Resting Electrocardiogram Database (PF12RED). "ECG Visualizer" software was developed, and ML was shown to be useful in detecting sinus bradycardia. Conclusions: The study demonstrates that AI and machine learning can detect simple arrhythmias with accuracy, also it provides a valuable dataset and a free software application.
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OBJECTIVE: Antimicrobial stewardship programs (ASP) have become a key tool in the adaptation of these drugs to the health system. The information available on the application and indicators used in these programs in emergency departments is scarce. The objective of this study is to know the extent of ASP implementation in the emergency departments, as well as the use of antimicrobials in these units. METHODS: Multicenter retrospective study. An invitation was sent to all participants of the REDFASTER-SEFH emergency pharmacist working group. A questionnaire was used consisting of 21 items, answered by a team made up of a pharmacist, emergency room specialist, infectious disease specialist and microbiologist. RESULTS: Eighteen hospitals completed the survey. Fourteen (77.8%) had an ASP manager. The DDD value per 1000 admissions ranged between 36.5 and 400.5 (median: 100.4 [IQR:57.2-157.3]). Both carbapenem and macrolide group presented wide variability in use. Six (33.3%) hospitals had an annual report on the specific resistance profile for urine and blood cultures. The percentage of multi-drug resistant strains in urine cultures was 12.5% and in blood cultures 12.2%. The percentage of adequacy in the bacteremia treatment was 81.0% (IQR:74.6-85.0%), while in urinary tract infections was 78.0% (IQR:71.5-88.0). CONCLUSIONS: Despite the existence of ASP members in emergency services, as well as the training activity and local guidelines is common. knowledge of the use of antimicrobials and resistances is limited. Future activities must be aimed at improving information about the ASP results in these units.
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Anti-Infecciosos , Gestão de Antimicrobianos , Humanos , Estudos Retrospectivos , Anti-Infecciosos/uso terapêutico , Antibacterianos/uso terapêutico , HospitaisRESUMO
BACKGROUND: Childhood trauma is intimately related with suicidal behaviour. Patients who have suffered childhood trauma develop impaired Reflective Functioning (RF), which refers to the capacity to understand ourselves and others in terms of intentional mental states. An improvement in RF has been associated with a reduction in suicidal attempts, but the mediating role of RF between childhood trauma and suicidal behaviour has not been addressed so far. OBJECTIVE: We aim to examine the potential mediating effect of RF among childhood trauma and suicide attempts. METHOD: We included 748 patients who had attempted suicide at least once. They were asked to complete the Reflective Functioning Questionnaire (RFQ-8), the Columbia-Suicide Severity Rating scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We conducted linear regressions by simple mediating model to examine the role of RF in the indirect association between childhood trauma and the number of suicide attempts. RESULTS: Our results show significant indirect effects through hypo and hypermentalizing between Emotional Abuse (EA) and Sexual Abuse (SA) in childhood and the number of suicide attempts in lifetime. These results indicate that ineffective RF significantly mediates the association between childhood trauma and suicidality. CONCLUSION: This is the first study supporting the mediational role of RF in the relationship between EA and SA, and the number of suicide attempt in lifetime. These findings have important implications for reducing suicide rates and preventing future re-attempts. Further studies analysing this mediating role and focusing efforts on increasing RF-based interventions are required.
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Experiências Adversas da Infância , Testes Psicológicos , Tentativa de Suicídio , Humanos , Autorrelato , Ideação Suicida , Fatores de RiscoRESUMO
INTRODUCTION: Pseudotumor cerebri (PC) in prepubertal patients displays certain characteristics that differentiate it from its presentation at the postpubertal stage. The aim of this study is to describe the characteristics of paediatric patients diagnosed with PC at our centre and to compare them according to their pubertal status. PATIENTS AND METHODS: We included patients aged between 1 and 18 years who were diagnosed with PC in a tertiary-level hospital between 2006 and 2019 and who met the updated diagnostic criteria for PC. They were classified according to body weight and pubertal status. Subsequently, we analysed results from lumbar punctures, neuroimaging studies, ophthalmological assessments, and treatments received during follow-up. RESULTS: We included 28 patients, of whom 22 were of prepubertal age and 6 were of postpubertal age. The mean age (standard deviation) was 9.04 (2.86) years. Among the postpubertal patients, 83.3% were boys, 66.7% of whom presented overweight/obesity. In the group of prepubertal patients, 27% were boys, 31.8% of whom were overweight. The most frequent symptoms were headache (89.9%) and blurred vision (42.9%). All patients presented papilloedema, and 21.4% manifested sixth nerve palsy. Possible triggers were identified in 28.6% of cases. Nineteen percent of patients presented clinical recurrence, all of whom were prepubertal patients. Complete clinical resolution was achieved in 55.6% of patients. CONCLUSION: Prepubertal patients with PC show lower prevalence of obesity, higher prevalence of secondary aetiologies, and higher recurrence rates than postpubertal patients.
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Pseudotumor Cerebral , Masculino , Humanos , Criança , Lactente , Pré-Escolar , Adolescente , Feminino , Pseudotumor Cerebral/diagnóstico , Pseudotumor Cerebral/epidemiologia , Sobrepeso/complicações , Estudos Retrospectivos , Prognóstico , Obesidade/complicaçõesRESUMO
In this study we found that endocrine disrupting chemicals (EDCs) were omnipresent in a tropical seabird community comprising diverse ecological guilds and distinct foraging and trophic preferences. Because EDCs tend to bioaccumulate within the food web and microplastics can absorb and release harmful chemical compounds, our findings draw attention to the potential threats to wildlife. Thus, the goal of this study was to investigate the role of plastic ingestion, trophic and foraging patterns (δ15N and δ13C) of five tropical seabird species breeding in sympatry, on the exposure to EDCs, namely Polybrominated diphenyl ethers (PBDEs), methoxylated polybrominated diphenyl ethers (MeO-PBDEs) and personal care products (PCPs, e.g., musk fragrances and UV-filters). Results indicated that microplastics occurrence and EDCs detection frequency varied among species. Microplastics occurrence was higher in species with dual and coastal foraging strategies. Preen oil had higher levels of MeO-PBDEs and PCPs, while serum had higher levels of PBDEs. In brown boobies, the correlation between microplastics and ∑PBDEs levels was significant, suggesting that microplastics ingestion is a key PBDEs route. Trophic position (δ15N) plays a key role in PBDEs accumulation, particularly in Bulwer's petrel, which occupies a high trophic position and had more specialized feeding ecology than the other species. MeO-PBDEs were linked to foraging habitat (δ13C), although the link to foraging locations deserves further investigation. Overall, our findings not only fill key gaps in our understanding of seabirds' exposure to microplastics and EDCs, but also provide an essential baseline for future research and monitoring efforts. These findings have broader implications for the marine wildlife conservation and pollution management in sensitive environments, such as the tropical regions off West Africa.
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Disruptores Endócrinos , Monitoramento Ambiental , Animais , Éteres Difenil Halogenados/análise , Microplásticos , Plásticos , Animais Selvagens , Aves , Ingestão de AlimentosRESUMO
BACKGROUND: Mozambique has high rates of cervical cancer and cancer-related deaths among women. A high rate of refusal and low acceptance of treatment is observed among cervical cancer patients. The extent of their knowledge of the disease is unknown. OBJECTIVES: To assess knowledge about this disease (prevention, risk factors, and the possibilities of early diagnosis) in women with cervical cancer attended in gynecological services in Gaza province, Mozambique. MATERIALS AND METHODS: This cross-sectional study took place in the city of Xai-Xai at the Provincial Hospital of Xai-Xai (HPXX) in the southern province of Gaza (Mozambique). Non-probability convenience sampling was used. Eligible patients (women) aged 35-50 years, diagnosed with cervical cancer and followed at the HPXX in the second quarter of 2021 (n = 60), took part in the survey during their scheduled consultations. Descriptive statistics were calculated using SPSS statistical software (version 16). RESULTS: The study included 60 women, 39 (65%) HIV positive. More than half (55.0%) believed that having a single sexual partner was an effective form of prevention; 50.0% reported that excessive alcohol consumption and having many sexual partners could cause the disease, and 46.7% affirmed that having many children increased the risk. Thirty-eight (63.3%) women reported that early diagnosis of cervical cancer was important for receiving prompt treatment, and 54 (90.0%) said regular visits to the gynecologist were important for an early diagnosis. Thirty-five (58.3%) mentioned acetic acid screening as a diagnostic test. CONCLUSIONS: There are significant gaps in awareness of cervical cancer among high-risk groups.
Assuntos
Ginecologia , Neoplasias do Colo do Útero , Criança , Humanos , Feminino , Masculino , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Detecção Precoce de Câncer , Moçambique/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
We investigate the thermodynamic uncertainty relations (TURs) in mesoscopic devices for all universal symmetry classes of Wigner-Dyson and Dirac (chiral). The observables of interest include the TUR (MS), which is defined in terms of the ratio between the mean noise and mean conductance, as well as a new TUR (R) proposed in this article, which is based on the ensemble mean of the noise-to-conductance ratio. A detailed study is made on the quantum interference corrections associated with the TURs. We also analyze the influence of orbital and sublattice/chiral degrees of freedom for the validity of the observables in these chaotic mesoscopic billiards. Our investigation is based on the concatenation between the Landauer-Büttiker theory, the Mahaux-Wendeinmüller theory, and the TURs. We simulate the universal mesoscopic chaotic quantum dots using the random-matrix theory and compare our numerical results with the pertinent experimental data. The results were obtained for a different number of channels and tunneling rates that vary from the opaque to the ideal regime and, in all cases, demonstrate a clear phenomenological distinction between the TURs. In particular, the opaque regime engenders remarkable differences between the observables, even in the semiclassical regime, which characterizes a clear violation of the central limit theorem. Furthermore, we show that the phenomenology of the quantum interference corrections is strikingly robust, surprisingly exhibiting an order of magnitude greater than the supposedly leading semiclassical term for the TUR (R).