Potential use of other starch sources in the treatment of glycogen storage disease type Ia - an in vitro study.

BACKGROUND: Glycogen storage disease type Ia (GSD-Ia) is one of the most common hepatic GSD. Its treatment mainly consists of a diet including a high intake of slow-digestion carbohydrates such as raw cornstarch and the restriction of simple sugars. This enables the maintenance of euglycemia and prevents secondary metabolic disorders. Starch is a glucose polymer formed by amylose and amylopectin, which can be obtained from distinct sources. Although uncooked cornstarch has been successfully used in the treatment of GSD-Ia, it can lead to hyperglycemia and weight gain. in vitro andin vivo tests indicated that sweet manioc starch can be potentially used in the treatment of GSD-Ia. RESULTS: The moisture analysis revealed a variation from 10.3 to 12.8% in the sweet manioc starch samples, whereas the moisture content of uncooked cornstarch ranged from 7.3 to 11.1%. Quantifiable sugar was detected in 3/5 samples of sweet manioc starch and 1/3 samples of uncooked cornstarch. Notably, this uncooked cornstarch brand is widely employed in GSD-Ia treatment in Brazil. Products B and E had higher values of amylopectin and undetectable levels of sugars. A clinical trial is warranted to compare samples F and G and determine the impact of sugar trace in the same dietary source of starch. CONCLUSIONS: Collectively, the results demonstrated possible therapeutic alternatives for GSD-Ia in addition to traditional uncooked cornstarch.

Fasting glucose: a cardiometabolic indicator for subclinical atherosclerosis on excess weight adolescents

Abstract Objective: To build a model based on cardiometabolic indicators that allow the identification of overweight adolescents at higher risk of subclinical atherosclerotic disease (SAD). Methods: Cross-sectional study involving 161 adolescents with a body mass index ≥ + 1 z-Score, aged 10 to 19 years. Carotid intima-media complex thickness (IMT) was evaluated using ultrasound to assess subclinical atherosclerotic disease. Cardiometabolic indicators evaluated included nutritional status, central adiposity, blood pressure, lipidic profile, glycemic profile, as well as age and sex. Data was presented using measures of central tendency and dispersion, as well as absolute and relative frequency. The relationship between IMT measurement (outcome variable) and other variables (independent variables) was assessed using Pearson or Spearman correlation, followed by multiple regression modeling with Gamma distribution to analyze predictors of IMT. Statistical analysis was performed using SPSS and R software, considering a significance level of 5 %. Results: It was observed that 23.7 % had Carotid thickening, and the prevalence of abnormal fasting glucose was the lowest. Age and fasting glucose were identified as predictors of IMT increase, with IMT decreasing with age by approximately 1 % per year and increasing with glucose by around 0.24 % per mg/dL. Conclusion: The adolescent at higher risk is younger with higher fasting glycemia levels.

Stimulation of mouse hematopoietic stem cells by angiogenin and DNA preparations

Immature hematopoietic progenitors are a constant source for renewal of hemocyte populations and the basic component of the tissue and cell repair apparatus. A unique property of these cells of internalizing extracellular double-stranded DNA has been previously shown. The leukostimulatory effect demonstrated in our pioneering studies was considered to be due to the feature of this cell. In the present research, we have analyzed the effects of DNA genome reconstructor preparation (DNAgr), DNAmix, and human recombinant angiogenin on both hematopoietic stem cells and multipotent progenitors. Treatment with bone marrow cells of experimental mice with these preparations stimulates colony formation by hematopoietic stem cells and proliferation of multipotent descendants. The main lineage responsible for this is the granulocyte-macrophage hematopoietic lineage. Using fluorescent microscopy as well as FACS assay, co-localization of primitive c-Kit- and Sca-1-positive progenitors and the TAMRA-labeled double-stranded DNA has been shown. Human recombinant angiogenin was used as a reference agent. Cells with specific markers were quantified in intact bone marrow and colonies grown in the presence of inducers. Quantitative analysis revealed that a total of 14,000 fragment copies of 500 bp, which is 0.2% of the haploid genome, can be delivered into early progenitors. Extracellular double-stranded DNA fragments stimulated the colony formation in early hematopoietic progenitors from the bone marrow, which assumed their effect on cells in G0. The observed number of Sca1+/c-Kit+ cells in colonies testifies to the possibility of both symmetrical and asymmetrical division of the initial hematopoietic stem cell and its progeny.

Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study.

BACKGROUND: Incidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP. METHODS: We used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately. RESULTS: Schizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia. CONCLUSIONS: Schizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.

Is near-infrared spectroscopy a promising predictor for early intracranial hemorrhage diagnosis in the Emergency Department?

Intracranial hemorrhage (ICH) is a serious medical condition that can lead to significant morbidity and mortality if not diagnosed and treated promptly. Early detection and treatment are essential for improving the outcome in patients with ICH. Near-infrared spectroscopy (NIRS) is a non-invasive imaging technique that has been used to detect changes in brain tissue oxygenation and blood flow in various conditions. The aim of this study was to investigate the predictive potential of NIRS for early diagnosis of ICH in patients presenting to the Emergency Department (ED) triage with headache. A total of 378 patients were included in the study. According to the final diagnosis of the patients, 4 groups were formed: migraine, tension-cluster headache, intracranial hemorrhage and intracranial mass, and control group. Cerebral NIRS values "rSO2" were measured at the first professional medical contact with the patient. The right and left rSO2 (RrSO2, LrSO2) were significantly lower and the rSO2 difference was significantly higher in the intracranial hemorrhage group compared to all other patient groups (P<0.001). The cut-off values determined in the receiver operating characteristics (ROC) analysis were RrSO2 ≤67, LrSO2 ≤67, and ΔrSO2 ≥9. This study found that a difference of more than 9 in cerebral right-left NIRS values can be a non-invasive, easy-to-administer, rapid, and reliable diagnostic test for early detection of intracranial bleeding. NIRS holds promise as an objective method in ED triage for patients with intracranial hemorrhage. However, further research is needed to fully understand the potential benefits and limitations of this method.

Cell death induced by NLRP3-palmitate axis impairs pulmonary damage tolerance and aggravates immunopathology during obesity-tuberculosis comorbidity.

A low-grade and persistent inflammation, which is the hallmark of obesity, requires the participation of NLRP3 and cell death. During Mycobacterium tuberculosis infection, NLRP3 signaling is important for bacterial killing by macrophages in vitro but was shown to be dispensable for host protection in vivo. We hypothesized that during obesity-tuberculosis (TB) comorbidity, NLRP3 signaling might play a detrimental role by inducing excessive inflammation. We employed a model of high-fat-diet-induced obesity, followed by M. tuberculosis infection in C57BL/6 mice. Obese mice presented increased susceptibility to infection and pulmonary immunopathology compared to lean mice. Using treatment with NLRP3 antagonist and Nlrp3-/- mice, we showed that NLRP3 signaling promoted cell death, with no effect in bacterial loads. The levels of palmitate were higher in the lungs of obese infected mice compared to lean counterparts, and we observed that this lipid increased M. tuberculosis-induced macrophage death in vitro, which was dependent on NLRP3 and caspase-1. At the chronic phase, although lungs of obese Nlrp3-/- mice showed an indication of granuloma formation compared to obese wild-type mice, there was no difference in the bacterial load. Our findings indicate that NLRP3 may be a potential target for host-directed therapy to reduce initial and severe inflammation-mediated disease and to treat comorbidity-associated TB. © 2022 The Pathological Society of Great Britain and Ireland.

Movement Disorders and Mortality in Severely Mentally Ill Patients: The Curacao Extrapyramidal Syndromes Study XIV.

BACKGROUND AND HYPOTHESIS: There is a substantial gap in life expectancy between patients with severe mental illness (SMI) and the general population and it is important to understand which factors contribute to this difference. Research suggests an association between tardive dyskinesia (TD) and mortality; however, results are inconclusive. In addition, studies investigating associations between parkinsonism or akathisia and mortality are rare. We hypothesized that TD would be a risk factor for mortality in patients with SMI. STUDY DESIGN: We studied a cohort of 157 patients diagnosed predominantly with schizophrenia on the former Netherlands Antilles. TD, parkinsonism, and akathisia were assessed with rating scales on eight occasions over a period of 18 years. Twenty-four years after baseline, survival status and if applicable date of death were determined. Associations between movement disorders and survival were analyzed using Cox regression. Sex, age, antipsychotics, antidepressants and benzodiazepines at each measurement occasion were tested as covariates. STUDY RESULTS: Parkinsonism was a significant risk factor with an HR of 1.02 per point on the motor subscale of the Unified Parkinson's Disease Rating Scale (range 0-56). TD and akathisia were not significantly associated with mortality. CONCLUSIONS: Parkinsonism may be an important risk factor for mortality in SMI patients. This finding calls for more follow-up and intervention studies to confirm this finding and to explore whether treatment or prevention of parkinsonism can reduce excess mortality.

PSA nadir predicts biochemical recurrence after external beam radiation therapy combined to high dose rate brachytherapy in the treatment of prostate cancer.

INTRODUCTION: Prostate cancer (PCa) is the second most prevalent neoplasm among men in the world. Its treatment has a wide spectrum of alternatives and variables, ranging from active surveillance through radio and/or brachytherapy, to surgery. OBJECTIVE: The present work aimed to identify the predictive factors for biochemical recurrence and to evaluate the toxicity of the treatment using the association of external beam radiation therapy (EBRT) with high dose rate brachytherapy (HDR-BT) applied in the treatment of patients with prostate cancer. METHODS: Longitudinal retrospective study, using a prospectively collected database between 2005 and 2014 of 186 consecutive patients records with a diagnosis of low, intermediate, or high-risk prostate cancer treated with EBRT combined with HDR-BT, in a single medical institution located in the city of Campinas, SP, Brazil (Radium Institute). PSA increase over 2 ng/ml above the nadir PSA was considered as biochemical recurrence, following the definition of the Phoenix Consensus. Continuous and clinically relevant categorical variables (age, initial PSA, delivered dose in EBRT, number of implants, number of positive cores in transrectal biopsy, use of hormone blockade, Gleason score, TNM staging, post treatment PSA and PSA Nadir) were evaluated with absolute (n) and percentage (%) values using multiple logistic regression and validated our previously described optimal PSA nadir as predictor of biochemical recurrence. RESULTS: Post treatment PSA was the only independent predictor of biochemical recurrence, P<0.0001. The lower the PSA nadir the lower the biochemical recurrence risk (P=0.0009). PSA nadir >1 was the best cutoff (P=0.018) determinant of biochemical recurrence. The incidence of grade 3 late toxicity to the genitourinary tract was 0.6%, and there were no cases of severe complications to the gastrointestinal tract. CONCLUSION: External Beam Radiation Therapy conjugated to Brachytherapy in the treatment of Prostate Cancer has demonstrated low biochemical recurrence rates, mainly when PSA nadir <1, with low toxicity into both GU and GI tracts.

Duration of Untreated Psychosis in First-Episode Psychosis is not Associated With Common Genetic Variants for Major Psychiatric Conditions: Results From the Multi-Center EU-GEI Study.

Duration of untreated psychosis (DUP) is associated with clinical outcomes in people with a diagnosis of first-episode psychosis (FEP), but factors associated with length of DUP are still poorly understood. Aiming to obtain insights into the possible biological impact on DUP, we report genetic analyses of a large multi-center phenotypically well-defined sample encompassing individuals with a diagnosis of FEP recruited from 6 countries spanning 17 research sites, as part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. Genetic propensity was measured using polygenic scores for schizophrenia (SZ-PGS), bipolar disorder (BD-PGS), major depressive disorder (MDD-PGS), and intelligence (IQ-PGS), which were calculated based on the results from the most recent genome-wide association meta-analyses. Following imputation for missing data and log transformation of DUP to handle skewedness, the association between DUP and polygenic scores (PGS), adjusting for important confounders, was investigated with multivariable linear regression models. The sample comprised 619 individuals with a diagnosis of FEP disorders with a median age at first contact of 29.0 years (interquartile range [IQR] = 22.0-38.0). The median length of DUP in the sample was 10.1 weeks (IQR = 3.8-30.8). One SD increases in SZ-PGS, BD-PGS, MDD-PGS or IQ-PGS were not significantly associated with the length of DUP. Our results suggest that genetic variation does not contribute to the DUP in patients with a diagnosis of FEP disorders.

Resultados del tratamiento quirúrgico de pacientes con cáncer pulmonar

Fundamento:la incidencia de cáncer de pulmón en la provincia Sancti Spíritus es alta y su diagnóstico por lo general, se realiza en etapas avanzadas por lo cual el tratamiento quirúrgico no siempre es posible.Objetivo:analizar las principales características y resultados de los pacientes operados por cáncer de pulmón.Métodos:se realizó un estudio observacional descriptivo de corte transversal en el servicio de Cirugía General del Hospital Universitario General Camilo Cienfuegos en la provincia Sancti Spiritus en el período comprendido entre enero de 1996 y diciembre de 2019. El universo consistió en 83 pacientes operados con cáncer de pulmón que se sometieron a resección acompañados de muestreo de ganglios linfáticos mediastinales. Resultados: el sexo masculino predominó en el grupo estudiado. Los grupos de edades más frecuentes para ambos sexos fueron los de 51 a 60 años y los mayores de 60 años. El hábito de fumar estuvo presente en la mayoría de los pacientes. La localización tumoral más predominó fue en los lóbulos superiores y la lobectomía fue la técnica más realizada. Las etapas patológicas que predominaron fueron la lB y llB, seguidas de la lllA. El carcinoma de células escamosas fue el tipo histológico más frecuente. Las atelectasias y las infecciones respiratorias fueron las complicaciones más frecuentes. Los fallecidos fueron pocos.Conclusiones:las características demográficas de los pacientes estudiados se corresponden a otras series de pacientes con cáncer del pulmón. La localización tumoral en los lóbulos superiores, el carcinoma epidermoide, así como las etapas tempranas, predominaron en la serie estudiada. La lobectomía fue la técnica quirúrgica que se utilizó con mayor frecuencia y dentro de las complicaciones, las respiratorias fueron las más frecuentes.[AU]

Evidence for an interrelated cluster of Hallucinatory experiences in the general population: an incidence study.

BACKGROUND: Although hallucinations have been studied in terms of prevalence and its associations with psychopathology and functional impairment, very little is known about sensory modalities other than auditory (i.e. haptic, visual and olfactory), as well the incidence of hallucinations, factors predicting incidence and subsequent course. METHODS: We examined the incidence, course and risk factors of hallucinatory experiences across different modalities in two unique prospective general population cohorts in the same country using similar methodology and with three interview waves, one over the period 1996-1999 (NEMESIS) and one over the period 2007-2015 (NEMESIS-2). RESULTS: In NEMESIS-2, the yearly incidence of self-reported visual hallucinations was highest (0.33%), followed by haptic hallucinations (0.31%), auditory hallucinations (0.26%) and olfactory hallucinations (0.23%). Rates in NEMESIS-1 were similar (respectively: 0.35%, 0.26%, 0.23%, 0.22%). The incidence of clinician-confirmed hallucinations was approximately 60% of the self-reported rate. The persistence rate of incident hallucinations was around 20-30%, increasing to 40-50% for prevalent hallucinations. Incident hallucinations in one modality were very strongly associated with occurrence in another modality (median OR = 59) and all modalities were strongly associated with delusional ideation (median OR = 21). Modalities were approximately equally strongly associated with the presence of any mental disorder (median OR = 4), functioning, indicators of help-seeking and established environmental risk factors for psychotic disorder. CONCLUSIONS: Hallucinations across different modalities are a clinically relevant feature of non-psychotic disorders and need to be studied in relation to each other and in relation to delusional ideation, as all appear to have a common underlying mechanism.

Profiling Village Chickens Predators, Parasites and Medicinal Plants Used to Control the Parasites

ABSTRACT Rural communities rely heavily on chickens to meet their socio-economic needs. However, predators, diseases, and parasites deprive them of nutrients required for sustained growth and development. A cross-sectional survey and key informant interviews were conducted in selected villages of Limpopo Province, South Africa to find out the parasites and predators prevalent in indigenous chickens. Medicinal plants commonly used to control parasites as well as the household heads views on the preservation of indigenous chickens for sustained rural food security were investigated. Qualitative data gathered through interviews was analysed thematically using Atlas Ti version 8.1.4 while the IBM Statistical Package for the Social Sciences version 25.0 was used to compute descriptive statistics and carry out cross-tabulations of quantitative data. Approximately, 72 % of the respondents reported that predation affected chicks with hens at (67 %) and cocks (63 %) following in that respective order. Snakes such as the king cobra (phakhu phakhu), birds such as the martial eagle (Goni), and wild animals, especially the genet cat (tsimba) were the predominant predators. Among the commonest parasites, fleas [Dermanyssus gallinae (thatha)] and mites [Siphonaptera (magomani)] were predominant. Sorghum (Sorghum bicolour) and aloe (Aloe vera) were the most common medicinal plants that were used to control the parasites. It is, therefore, recommended that farmers and extension officers alike, consider the profile of major predators, parasites, medical plants, and preservation of indigenous knowledge for the sustainability of indigenous chickens and enhanced rural food security.

Pathology of Free-Ranging and Captive Brazilian Anteaters.

There is little information on the anatomical pathology of Brazilian anteaters. Considering the relevance of knowledge of diseases of these species for their conservation, the aim of this study was to describe pathological changes in 99 captive and free-ranging anteaters from the Brazilian states of São Paulo, Minas Gerais, Bahia, Mato Grosso do Sul and Amazonas. Forty-two animals were killed on roads and 10 died from burns injuries. Other significant conditions included the metabolic diseases of iron storage disease, tissue mineralization and taurine deficiency, protozoan and metazoan infections, candidiasis, sporotrichosis, clostridiosis and proliferative disorders including squamous cell carcinoma.

Validation of the Portuguese version of the Community Assessment of Psychic Experiences and characterization of psychotic experiences in a Brazilian sample

Objective: We investigated: i) the reliability and validity of a Brazilian version of the Community Assessment of Psychic Experiences (CAPE), developed to detect and characterize psychotic experiences in the general population; and ii) the association between psychotic experiences, childhood adversity, and cannabis use in a population-based sample. Methods: We performed factorial analyses and generalized linear models with CAPE scores as the dependent variable in a sample composed of 217 first-episode psychosis patients, 104 unaffected biological siblings, and 319 non-psychotic population-based participants. Results: After removing seven items from its positive dimension and two items from its negative dimension, a 33-item Brazilian version of the CAPE showed acceptable adjustment indices (confirmatory fit index = 0.895; goodness of fit index = 0.822; parsimony goodness of fit index = 0.761; root mean square error of approximation [RMSEA] = 0.055, p [RMSEA ≤ 0.05] = 0.04) and internal consistency in all its dimensions (> 0.70). Childhood adversity was associated with higher scores in all three dimensions, as well as with total score. Lifetime cannabis use was associated with higher scores only in the positive dimension. Conclusion: The proposed Brazilian version of the CAPE corroborates the tridimensional approach for assessing psychosis-proneness, and the frequency and severity of psychotic manifestations are distributed as a spectrum in the general population.

Validation of the Portuguese version of the Community Assessment of Psychic Experiences and characterization of psychotic experiences in a Brazilian sample.

OBJECTIVE: We investigated: i) the reliability and validity of a Brazilian version of the Community Assessment of Psychic Experiences (CAPE), developed to detect and characterize psychotic experiences in the general population; and ii) the association between psychotic experiences, childhood adversity, and cannabis use in a population-based sample. METHODS: We performed factorial analyses and generalized linear models with CAPE scores as the dependent variable in a sample composed of 217 first-episode psychosis patients, 104 unaffected biological siblings, and 319 non-psychotic population-based participants. RESULTS: After removing seven items from its positive dimension and two items from its negative dimension, a 33-item Brazilian version of the CAPE showed acceptable adjustment indices (confirmatory fit index = 0.895; goodness of fit index = 0.822; parsimony goodness of fit index = 0.761; root mean square error of approximation [RMSEA] = 0.055, p [RMSEA ≤ 0.05] = 0.04) and internal consistency in all its dimensions (> 0.70). Childhood adversity was associated with higher scores in all three dimensions, as well as with total score. Lifetime cannabis use was associated with higher scores only in the positive dimension. CONCLUSION: The proposed Brazilian version of the CAPE corroborates the tridimensional approach for assessing psychosis-proneness, and the frequency and severity of psychotic manifestations are distributed as a spectrum in the general population.

Bundle Adherence of Intravenous Antibiotic Fluid Resuscitation and Vasopressor in Children with Severe Sepsis or Septic Shock.

OBJECTIVE: The aim of this study was to measure the effects of a bundle of interventions in children admitted with severe sepsis or septic shock in the first hour after diagnosis on mortality. MATERIALS AND METHODS: A retrospective study was conducted at a pediatric intensive care unit (PICU) between January 2014 and January 2016. Three interventions (intravenous [IV] antibiotic, fluid boluses, and vasopressor administration) applied in the first hour of severe sepsis or septic shock diagnosis were analyzed according to their adherence rates. The main outcome was mortality. Odds ratios were calculated. RESULTS: Of a total of 530 PICU admissions, 105 patients met the criteria for sepsis, 53 (50.5%) with severe sepsis and 52 (49.5%) with septic shock. Seventy-two (68.6%) patients received IV antibiotic within the first hour, 65 (61.9%) received IV fluid bolus, and 55 (53.3%) received a vasopressor drug. Fifty-two (49.5%) patients received concomitant IV antibiotics and fluid bolus. Blood cultures were collected before IV antibiotic administration in 87 (82.9%) out of 105 patients. Thirteen (12.4%) patients died, 1 with severe sepsis and 12 with septic shock. In a univariate analysis, the odds ratios for death and IV antibiotic were 6.39 (p value = 0.081, 95% CI = 0.795-51.465), 4.77 for fluid bolus between 21 and 40 mL/kg (p value = 0.013, 95% CI = 1.395-16.336), and 3.23 for vasopressor administration (p value < 0.0001, 95% CI = 1.734-6.018). In a multivariate analysis, the odds ratio of fluid bolus between 21 and 40 mL/kg was 42.66 (p value = 0.005, 95% CI = 3.117-583.841) and noradrenaline use was 23.93 (p value = 0.010, 95% CI = 2.124-269.750). CONCLUSION: Adherence was observed for more than half of the single interventions as IV antibiotic, fluid resuscitation, and vasopressor administration in the first hour. The antibiotic administration alone was not associated with high mortality. Vasopressor administration was related to higher mortality but moderate fluid bolus was a protective factor associated with lower mortality. HOW TO CITE THIS ARTICLE: Barboza CL, Valete COS, da Silva ARA. Bundle Adherence of Intravenous Antibiotic Fluid Resuscitation and Vasopressor in Children with Severe Sepsis or Septic Shock. Indian J Crit Care Med 2020;24(2):128-132.

The EUropean Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI): Incidence and First-Episode Case-Control Programme.

PURPOSE: The EUropean Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study contains an unparalleled wealth of comprehensive data that allows for testing hypotheses about (1) variations in incidence within and between countries, including by urbanicity and minority ethnic groups; and (2) the role of multiple environmental and genetic risk factors, and their interactions, in the development of psychotic disorders. METHODS: Between 2010 and 2015, we identified 2774 incident cases of psychotic disorders during 12.9 million person-years at risk, across 17 sites in 6 countries (UK, The Netherlands, France, Spain, Italy, and Brazil). Of the 2774 incident cases, 1130 cases were assessed in detail and form the case sample for case-control analyses. Across all sites, 1497 controls were recruited and assessed. We collected data on an extensive range of exposures and outcomes, including demographic, clinical (e.g. premorbid adjustment), social (e.g. childhood and adult adversity, cannabis use, migration, discrimination), cognitive (e.g. IQ, facial affect processing, attributional biases), and biological (DNA via blood sample/cheek swab). We describe the methodology of the study and some descriptive results, including representativeness of the cohort. CONCLUSIONS: This resource constitutes the largest and most extensive incidence and case-control study of psychosis ever conducted.

Eliminación de huevos de los pequeños estróngilos en la materia fecal de los equinos y su importancia práctica en la posibilidad de tratamientos selectivos / Fecal shedding of equine small strongyle eggs and its practical importance for selective treatment

Resumen Los pequeños estróngilos son los parásitos de mayor prevalencia e importancia en los equinos de todo el mundo, y el desarrollo generalizado de la resistencia de estos nematodos a los antihelmínticos está impulsando la aplicación de tratamientos selectivos (TS) para disminuir o demorar el desarrollo de estos fenómenos. Esta estrategia se basa en conteos de huevos de nematodos en la materia fecal de todos los integrantes del grupo animal para tratar solamente aquellos que sobrepasan un determinado umbral o cut off. Este principio de TS se ve favorecido por la consistencia de los conteos de huevos por gramo de heces (hpg) en los equinos y está siendo empleada en algunos países del hemisferio norte, especialmente en los animales adultos. En la Argentina, existe una ausencia de información básica en relación a las condiciones climáticas, de pastoreo y manejo que podrían resultar en cargas parasitarias y transmisión de nematodos diferentes a las observadas en el hemisferio norte. En este contexto, el objetivo de este estudio fue caracterizar la eliminación de huevos de pequeños estróngilos en 436 equinos de diferentes edades pertenecientes a 19 establecimientos del área central de la Argentina. El 90% de los equinos mostró huevos de estróngilos en las heces y los valores de hpg fueron menores a 200 y mayores a 1.000 en el 32% y 22% de los equinos respectivamente. La distribución de los huevos de estróngilos entre individuos de todas las edades fue sobre-dispersa o agregada, con una media aritmética general de 671,59 ± 789,76 y un valor de k o parámetro de agregación inversa de 0,72 (distribución de la binomial negativa). La edad de los animales (potrillos vs adultos) y los biotipos (deportivo vs trabajo) en la categoría adultos influenciaron la magnitud de los valores del hpg (p<0,001). En esta última categoría el 35% de los animales fue responsable de la excreción de aproximadamente el 80% de los huevos eliminados en las pasturas. Si bien existen algunas diferencias con lo observado en países del hemisferio norte con poblaciones parasitarias más agregadas o sobre-dispersas, los TS para el control de los pequeños estróngilos en equinos adultos podrían también ser una estrategia válida bajo nuestras condiciones para disminuir la presión de selección sobre el genoma parasitario y permitir el desarrollo de poblaciones en refugio.

Abstract Small strongyles are the most prevalent and important parasites in grazing horses throughout the world and the widespread development of antihelminthic resistance has prompted in some countries of the northern hemisphere the application of selective treatments (ST) to reduce or delay the development of these phenomena. This strategy is based on determining strongyle fecal egg counts of all herd members and treating only those exceeding a certain threshold or cut off. However, there is an absence of basic information on horses maintained under climatic, grazing or management conditions different from those observed in the northern hemisphere. In this context, the aim of this study was to characterize the elimination of eggs of small strongyles in horses of different ages from 19 farms in the central area of Argentina. Out of a total of 436 horses, 90% showed positive strongyles egg counts and in these animals the count of eggs per gram of feces (epg) was under 200 and over 1,000 in 32% and 22% of the horses respectively. The distribution of strongyle eggs among individuals of all categories was over-dispersed or aggregated with a general epg arithmetic mean of 671.59 ± 789.76 and a value of the inverse aggregation parameter of 0.72 (negative binomial distribution). The age of the animals (foals vs. adults) and the biotypes in the adult category (sports vs. work) influenced the magnitude of the epg values (P <0.001). In the latter category, approximately 35% of the animals were responsible for the excretion of approximately 80% of the eggs in the pastures. Although some differences on magnitude and distribution of strongyle fecal egg counts were observed in countries of the northern hemisphere, ST of small strongyles in adult equines could also be a valid strategy under Argentinian conditions to reduce the selection pressure on the parasitic genome and allow the development of refugia populations.

Bioaccumulation of Organochlorine Pesticides, Procamallanus sp. (Baylis, 1923) infections, and Microbial Colonization in African Snakehead fish Sampled from Lekki Lagoon, Lagos, Nigeria

Abstract The exponential rise in the Nigerian population has necessitated the use of agrochemicals for enhanced agricultural yields to meet the ever-rising demand for food. However, agrochemicals such as organochlorine pesticides (OCPs) have caused several devastating health and ecological challenges. The study was therefore aimed at assessing the bioaccumulation of OCPs and the associated parasitological and microbial susceptibility in P. obscura to determine the possible ecological impacts of the chemical. A total of 106 specimens of Parachanna obscura fish species were sampled between July and November 2019 from Lekki Lagoon in Lagos, Nigeria. Four culture media, namely nutrient agar (NA), MacConkay agar (MCA), eosin methylene blue (EMB), and sabouraud dextrose agar (SDA) were employed in microbial culture. These microbes were subjected to ceftazidime, ceftriaxone, cefuroxime, gentamicin, ofloxacin, augmentin, nitrofurantoin, ciprofloxacin, and erythromycin to test for resistance, susceptibility and intermediate statuses before and after curing. OCPs were tested in the water, sediment, and tissues of P. obscura using gas chromatography flame ionization detector (GC-FID). P. obscura sampled in the lagoon had poor growth exponent which was characterized by negative allometry (slenderness) in the sampled fish. Although the incidence of parasitic infection in the fish was not alarming, the situation might be aggravated if the prevalent anthropogenic activities persist, resulting in immunosuppression. Regulation of anthropogenic activities in the catchment area is recommended to forestall the prognosis of health and environmental hazards associated with the agricultural, industrial, pharmaceutical, and municipal activities around the lagoon. Bacteria that conferred the most resistance to the majority of the antibiotics were Staphylococcus sp., Micrococcus sp. Escherichia coli and Klebsiella sp., testing positive to plasmid profile. They conferred high resistance to the antibiotics before plasmid curing but became highly susceptible post- plasmid curing. This implies that the gene for resistance in the bacteria isolates was plasmid-mediated, that is, they were obtained from the environment. In the event of an outbreak of waterborne diseases such as cholera, typhoid, dysentery, and diarrhea, there may be non-response to treatment among the infected inhabitants. The incidence of antibiotic resistance in bacteria colonies recorded in this study is of great public health concern, given the possibility of the antibiotic-resistant bacteria strains being passed to humans through fish consumption, resulting in increased multi-drug resistance in humans. Regulation of anthropogenic activities around the lagoon is recommended to forestall prognosis of health and environmental hazards associated with OCPs from agricultural, industrial, pharmaceutical, and municipal sources.

Resumo O aumento exponencial da população nigeriana exigiu o uso de agroquímicos para aumentar a produção agrícola e, assim, atender à crescente demanda por alimentos. No entanto, agroquímicos como pesticidas organoclorados (OCPs) causaram vários problemas de saúde e ecológicos. Portanto, o estudo teve como objetivo avaliar a bioacumulação de OCPs e a suscetibilidade parasitológica e microbiana associada em Parachanna obscura, a fim de determinar os possíveis impactos ecológicos desse produto químico. Foi amostrado um total de 106 espécimes de P. obscura entre julho e novembro de 2019 da lagoa Lekki, em Lagos, Nigéria. Quatro meios de cultura, como o ágar nutritivo (NA), o ágar MacConkay (MCA), o ágar eosina azul de metileno (EMB) e o ágar sabouraud dextrose (SDA), foram empregados na cultura microbiana. Esses micróbios foram submetidos a ceftazidima, ceftriaxona, cefuroxima, gentamicina, ofloxacina, augmentin, nitrofurantoína, ciprofloxacina e eritromicina para testar resistência, suscetibilidade e status intermediário antes e depois da cura. Os OCPs foram testados na água, sedimentos e tecidos de P. obscura usando um detector de ionização de chama por cromatografia em fase gasosa (GC-FID). Os peixes amostrados de P. obscura da lagoa apresentaram um expoente de crescimento ruim, caracterizado por alometria negativa (esbelteza). Embora a incidência de infecção parasitária nos peixes não tenha sido alarmante, a situação pode ser agravada se as atividades antropogênicas prevalecentes persistirem, resultando em imunossupressão. Recomenda-se a regulamentação de atividades antropogênicas na área de captação para prevenir o prognóstico de riscos à saúde e ecológicos associados a atividades agrícolas, industriais, farmacêuticas e municipais ao redor da lagoa. As bactérias que conferiram maior resistência à maioria dos antibióticos foram Staphylococcus sp., Micrococcus sp., Escherichia coli e Klebsiella sp., com teste positivo para o perfil plasmidial. Elas conferiram alta resistência aos antibióticos antes da cura do plasmídeo, mas se tornaram altamente suscetíveis após a cura dele. Isso implica que o gene de resistência nos isolados de bactérias foi mediado por plasmídeo, ou seja, foi obtido do ambiente. No caso de surtos de doenças transmitidas pela água, como cólera, febre tifoide, disenteria e diarreia, pode haver não resposta ao tratamento entre os habitantes infectados. A incidência de resistência a antibióticos nas colônias de bactérias registradas neste estudo é de grande preocupação para a saúde pública, dada a possibilidade de que as cepas de bactérias resistentes a antibióticos sejam transmitidas aos seres humanos por meio do consumo de peixes, resultando em maior resistência a múltiplas drogas em seres humanos. Recomenda-se a regulamentação de atividades antropogênicas ao redor da lagoa para impedir o prognóstico de riscos à saúde e ecológicos associados aos OCPs de fontes agrícolas, industriais, farmacêuticas e municipais.

Meanings of alcohol, other drugs and corporal practices in dependents of psychoactive substances / Significados do álcool e outras drogas e das práticas corporais em dependentes de substâncias psicoativas

ABSTRACT The objective of the study was to analyze the significance of alcohol, illicit drugs and corporal practices for users of psychoactive substances who are in the process of rehabilitation at CAPS ad. 76 users who were in rehabilitation at CAPS ad Recife/PE were interviewed. Multiplicity was found in the meaning of alcohol and drugs, with negative factors predominating, even considering that alcohol is initially recognized as an element of social integration. Corporal practices presented positive meanings related mainly to body movement and mind occupation. Translated with www.DeepL.com/Translator (free version)

RESUMO O objetivo do estudo foi analisar o significado do álcool, das drogas ilícitas e das práticas corporais para os usuários de substâncias psicoativas que estão em processo de reabilitação nos CAPS ad. 76 usuários que estiveram em reabilitação nos CAPS ad do Recife/PE foram entrevistados. Foi encontrada multiplicidade no significado do álcool e das drogas, predominando fatores negativos, mesmo considerando que o álcool inicialmente é reconhecido como elemento de integração social. As práticas corporais apresentaram significados positivos relacionados, principalmente, ao movimento corporal e ocupação da mente.