Violência e Saúde Mental: desafios contemporâneos / Violence and Mental Health: contemporary challenges

Este texto explora as problemáticas emergentes no contexto brasileiro do século XXI relacionadas às intersecções entre violências e saúde mental. Se há pelo menos três séculos a humanidade experimentou o transcurso da era viral e bacteriológica, o que acomete com grande intensidade na contemporaneidade são os sofrimentos psicológicos, doenças mentais, distúrbios emocionais e os variados tipos de agressões que atingem cotidianamente pessoas de diferentes lugares, idades, classes, etnias, raça, cor da pele, orientação sexual e gênero (Whitaker, 2017). Problemas que além de afetarem as vítimas diretas, adentram no tecido social, entrelaçam processos de produção de subjetividades, estabelecem rearranjos organizacionais do convívio nas cidades e introduzem outras formas de viver em sociedade. A violência atrelada ao conjunto de determinantes sociais pode constituir e desenvolver sofrimentos, adoecimentos e transtornos mentais, impactando de forma insidiosa a saúde e a vida das vítimas e das pessoas que convivem no contexto violento. Ainda, aquelas que apresentam algum tipo de problema mental são mais vulneráveis à violência interpessoal, além de potencialmente sofrerem com a violência estrutural, conforme a classificação de Minayo (2006). Portanto, trata-se de uma intersecção que se retroalimenta: a violência afeta a saúde mental e os adoecimentos mentais vulnerabilizam à violência. Ositinerários percorridos pelas vítimas na busca por proteção contra violências e cuidado em saúde mental são marcados por fragilidades, negligências e dificuldades de acesso - tanto no que tange às redes institucionais, como serviços de saúde, quanto sociais, como familiares e amigos. Trata-se, portanto, de problemas de difícil resolução e que são permeados por rotas críticas e ineficientes, principalmente quando envolvem grupos sociais vulnerabilizados - como mulheres, negras e pobre em uma sociedade marcada por um regime racista, patriarcal e capitalista. A produção científica sobre essas duas questões no campo da Saúde Coletiva, embora tenha aumentado nos últimos anos, ainda carece de evidências que deem conta de compreender ambos os fenômenos na sua totalidade, principalmente quando interseccionados, tendo em vista a rápida transformação social na contemporaneidade. Assim, este texto visa contribuir com o debate a partir da apresentação de um mapa conceitual e epidemiológico, além dos desafios que emergem na sociedade.

Atividades práticas na formação médica durante o ensino remoto no contexto da pandemia

Com o advento da pandemia de COVID-19, a formação médica foi impactada por desafios, como a paralisação das atividades presenciais, necessitando adaptações ao processo de ensinoaprendizagem com uso de ambientes virtuais de ensino. Objetivo: Analisar os efeitos da ausência de atividades práticas na formação médica durante o ensino remoto emergencial no curso de medicina da Universidade Federal de Santa Catarina - campus Araranguá. Método: Trata-se de um estudo qualitativo do tipo exploratório. Participaram 46 estudantes de medicina vinculados à instituição. A seleção foi por conveniência, considerou a disponibilidade das pessoas, sendo estes solicitados por meio de um procedimento de amostragem em cadeia denominado Snowball Sampling. A coleta de dados ocorreu entre os meses de junho e julho de 2021 com a realização de sete grupos focais on-line compostos entre seis ou sete pessoas. As informações foram analisadas pelo método de Análise de Conteúdo do tipo temática. Resultados: Foram destacadas três categorias: educação à distância e aprendizagem em casa; defasagens no aprendizado e ausência de práticas; e prejuízos na construção do conhecimento. Evidenciou-se dificuldades enfrentadas pelos estudantes na modalidade remota de ensino e os impactos na formação médica. Conclusão: O advento do ensino remoto ocasionou preocupações aos estudantes de medicina, diante da excessiva carga horária de conteúdo teórico. Em um contexto similar ao transcorrido na pandemia, alguns problemas no ensino remoto podem ser dirimidos, com formas de simulação de práticas e situações problemas com o aprendizado no domicílio, com o uso de estudos e discussões de casos com auxílio de vídeo gravação como instrumento docente para ensino de comunicação clínica.

A cross-sectional study on the association between social media addiction, body image, and social comparison among young adult Filipino women aged 18-25 years old in Metro Manila / The Health Sciences Journal

INTRODUCTION@#The Philippines tops globally for time spent on social media. This study aimed to explore the association between social media addiction, body image, and social comparison among young adult Filipino women aged 18-25 years old in Metro Manila.@*METHODS@#The Social Media Addiction Scale (SMAS), Body Image Questionnaire (BIQ), and Iowa-Netherlands Comparison Orientation Measure (INCOM) were used to assess social media addiction, body image, and social comparison, respectively. PRR (CI 95%) assessed the association between SMA and BI, and SMA and SC.@*RESULTS@#Majority of participants had social media addiction (91.11%), while most reported a neutral body image (87.64%). Additionally, more than half of the participants exhibited a high tendency towards social comparison (53.15%). The study found a positive association between social media addiction and negative body image, as well as a significant positive association between social media addiction and social comparison. Obesity showed a significant positive association with negative body image perception, while being overweight was significantly associated with a lower likelihood of having a positive body image. Spending at least 4 hours per day on social media was significantly associated with a higher tendency towards social comparison.@*CONCLUSION@#These findings suggest the presence of social media addiction among young adult Filipino women and its association with body image and social comparison. Awareness of these associations can contribute to the development of targeted interventions and educational programs to promote healthier social media use and positive body image among young adults.

Hippo Signaling Pathway Activation during SARS-CoV-2 Infection Contributes to Host Antiviral Response

SARS-CoV-2, responsible for the COVID-19 pandemic, causes respiratory failure and damage to multiple organ systems. The emergence of viral variants poses a risk of vaccine failures and prolongation of the pandemic. However, our understanding of the molecular basis of SARS-CoV-2 infection and subsequent COVID-19 pathophysiology is limited. In this study, we have uncovered a critical role for the evolutionarily conserved Hippo signaling pathway in COVID-19 pathogenesis. Given the complexity of COVID-19 associated cell injury and immunopathogenesis processes, we investigated Hippo pathway dynamics in SARS-CoV-2 infection by utilizing COVID-19 lung samples, and human cell models based on pluripotent stem cell-derived cardiomyocytes (PSC-CMs) and human primary lung air-liquid interface (ALI) cultures. SARS-CoV-2 infection caused activation of the Hippo signaling pathway in COVID-19 lung and in vitro cultures. Both parental and Delta variant of concern (VOC) strains induced Hippo pathway. The chemical inhibition and gene knockdown of upstream kinases MST1/2 and LATS1 resulted in significantly enhanced SARS-CoV-2 replication, indicating antiviral roles. Verteporfin a pharmacological inhibitor of the Hippo pathway downstream transactivator, YAP, significantly reduced virus replication. These results delineate a direct antiviral role for Hippo signaling in SARS-CoV-2 infection and the potential for this pathway to be pharmacologically targeted to treat COVID-19.

Mitoquinone mesylate targets SARS-CoV-2 and associated lung inflammation through host pathways

To date, there is no effective oral antiviral against SARS-CoV-2 that is also anti-inflammatory. Herein, we show that the mitochondrial antioxidant mitoquinone/mitoquinol mesylate (Mito-MES), a dietary supplement, has potent antiviral activity against SARS-CoV-2 and its variants of concern in vitro and in vivo. Mito-MES had nanomolar in vitro antiviral potency against the Beta and Delta SARS-CoV-2 variants as well as the murine hepatitis virus (MHV-A59). Mito-MES given in SARS-CoV-2 infected K18-hACE2 mice through oral gavage reduced viral titer by nearly 4 log units relative to the vehicle group. We found in vitro that the antiviral effect of Mito-MES is attributable to its hydrophobic dTPP+ moiety and its combined effects scavenging reactive oxygen species (ROS), activating Nrf2 and increasing the host defense proteins TOM70 and MX1. Mito-MES was efficacious reducing increase in cleaved caspase-3 and inflammation induced by SARS-CoV2 infection both in lung epithelial cells and a transgenic mouse model of COVID-19. Mito-MES reduced production of IL-6 by SARS-CoV-2 infected epithelial cells through its antioxidant properties (Nrf2 agonist, coenzyme Q10 moiety) and the dTPP moiety. Given established safety of Mito-MES in humans, our results suggest that Mito-MES may represent a rapidly applicable therapeutic strategy that can be added in the therapeutic arsenal against COVID-19. Its potential long-term use by humans as diet supplement could help control the SARS-CoV-2 pandemic, especially in the setting of rapidly emerging SARS-CoV-2 variants that may compromise vaccine efficacy. One-Sentence SummaryMitoquinone/mitoquinol mesylate has potent antiviral and anti-inflammatory activity in preclinical models of SARS-CoV-2 infection.

Association of comprehensive knowledge on HIV/AIDS and discriminatory attitudes towards people living with HIV/AIDS (PLWHA) among Filipino women

Background@#The Philippines is among the countries with the fastest growth rate of HIV cases in the Asia-Pacific Region. HIV/AIDS stigma and discrimination are recognized as major barriers, directly and indirectly inflicting harm to people living with HIV/AIDS (PLWHA). Despite this, there is a lack of studies regarding HIV/AIDS discrimination in the Philippines. This study aimed to assess the association between comprehensive knowledge on HIV/AIDS and discriminatory attitudes towards PLWHA among women in the Philippines. @*Methodology@#Secondary data analysis was done using the Philippine National Demographic Health Survey (2017). Twenty two thousand eight hundred thirteen (22,813) Filipino women aged 15-49 years old were included in this study. Multiple logistic regression was performed to determine the association between comprehensive knowledge and discriminatory attitudes. The final model was built using the change in estimate criterion and sampling weights were applied. @*Results@#More than 3 out of 4 (76.87%) had discriminatory attitudes towards PLWHA, whereas only 1 out of 4 (26.24%) had comprehensive knowledge on HIV/AIDS. Results of multiple logistic regression reveal that women without comprehensive knowledge are 2.53 times more likely to have discriminatory attitudes towards PLWHA (OR= 2.53, 95% CI =2.26-2.84). @*Conclusion@#Given that women without comprehensive knowledge are more likely to have discriminatory attitudes, HIV/AIDS campaigns may be strengthened by integrating necessary concepts in comprehensive sexual education and conducting more active nationwide information and education campaign efforts. Moreover, there is a need to formally evaluate the overall effectiveness of existing interventions.

O ensino remoto na formação médica durante a pandemia da Covid-19 / Remote teaching in medical education during the Covid-19 pandemic

Resumo: Introdução: A educação médica no contexto da pandemia da Covid-19 enfrentou dificuldades e mudanças no processo de ensino-aprendizado. Objetivo: Este estudo teve como objetivo compreender os desafios do ensino remoto na formação médica durante a pandemia da Covid-19 em uma universidade federal do Sul do país. Método: Trata-se de um estudo com abordagem qualitativa, em que os participantes foram 46 estudantes de dois cursos de Medicina da Universidade Federal de Santa Catarina, dos campi de Florianópolis e Araranguá, durante o ano de 2021. A técnica utilizada para a coleta de dados foi o grupo focal on-line, totalizando sete encontros. Investigaram-se os dados coletados por meio da análise de conteúdo temática. Resultado: Observou-se prejuízo nas relações entre estudantes de Medicina e comunidade, principalmente em razão da restrita inserção de conhecimentos sobre a pandemia nos currículos formais dos cursos, da diminuição do convívio com pacientes, da dissolução do elemento teórico-prático no ensino remoto pela ausência de atividades práticas e do engessamento do currículo formal. Durante a formação acadêmica, houve sofrimento psicológico dos estudantes decorrente do distanciamento social e da exaustiva carga horária teórica. Conclusão: A construção do conhecimento médico e a oferta de cuidados coerentes às necessidades da população foram afetadas pela Covid-19. Tornam-se indispensáveis o reconhecimento de tal descompasso e a necessidade da constituição de estratégias para solucionar as problemáticas relacionadas às dificuldades encontradas pelos estudantes, com base em seus aprendizados, na resposta aos anseios da população e na necessidade de adaptações na educação médica diante da pandemia da Covid-19 para o processo de formação médica.

Abstract: Introduction: In the context of the COVID-19 pandemic, medical education has faced changes in the teaching-learning process. Objective: To understand the challenges of remote teaching in medical training during the COVID-19 pandemic at a Federal University in the south of Brazil. Method: This is a study with a qualitative approach, whose subjects comprised students from two medical courses at the Federal University of Santa Catarina, Florianópolis campus and Araranguá campus, during 2021. The technique used for data collection was the online focus group, totaling seven meetings. Forty-six students participated. The collected data were investigated through Thematic Content Analysis. Results: Deterioration in the relationship between medical students and the community was observed, mainly due to the restricted inclusion of knowledge about the pandemic in the formal curricula of the courses, reduced contact with patients, dissolution of the theoretical-practical element in remote teaching due to the absence of practical activities and the inflexible nature of the formal curriculum. During academic training, there was psychological overload on students due to social distancing and exhaustive theoretical workload. Conclusions: The construction of medical knowledge and the provision of care consistent with the population's needs was affected by COVID-19. It is essential to recognize such a mismatch and the need to establish strategies to solve the problems related to the difficulties encountered by students, based on their learning, in response to the population's aspirations and the need for adaptations in medical education in the face of the COVID-19 pandemic for the medical education process.

Diálogos em quarentena / Dialogues in quarantine

Em tempos em que o isolamento e a solidão se constituíram como princípios éticos para sobreviver e fazer viver a vida do outro, nada mais revolucionário do que apostar no diálogo como ferramenta, quase que artesanal, para produzir afetos, encontrar saídas e construir um pilar para segurar o céu que está caindo. São tempos de pandemia. Ora, se não há encontros de corpos, há de haver encontros reais-virtuais, mediados pela tela, mas transbordados de intensidades. Não podemos ficar parados. Somos movimentos. É como colocar a existência em rizoma: é pensar nas coisas e entre as coisas, e não criar raiz, traçar a linha e não o ponto. Criamos, com o "Diálogos em quarentena", não apenas um acúmulo de conhecimentos verbalizados e transcritos, mas experimentações, linguagens e aproximações. É como Gilles Deleuze e Claire Parnet tratam a questão no livro Diálogos: não se trata de falar dos infelizes, de falar em nome das vítimas, dos suplicados e dos oprimidos, mas de traçar uma linha viva, uma linha quebrada. "Diálogos em quarentena" foi um ciclo de debates de cunho reflexivo cujo objetivo era discutir a importância da Saúde Coletiva e da educação para resistir à pandemia da COVID-19 durante o ano de 2020. Fomentou debates que abordaram temas relacionados ao contexto epidemiológico, sociológico, filosófico e psicológico vinculados às medidas de prevenção, sobretudo a quarentena e o isolamento social. Foram sendo fabricados, a cada encontro, diálogos tratando de temas distintos com a interlocução entre debatedores de diferentes lugares. Foram realizados por intelectuais e professores do campo da Saúde Coletiva e serviram de aprimoramento para a análise crítica diante dos efeitos sociais da pandemia. O material foi cuidadosamente transcrito e polido, lido e relido, no sentido de transpor a linguagem falada para a escrita, respeitando a fluidez, a estética e a liberdade da boa conversa. Eis que surgiu este livro. Podemos dizer que os diálogos em quarentena fizeram emergir um fato inconteste: vivemos pandemias, no plural, todas elas relacionadas entre si e vivenciadas de múltiplas maneiras pelos diferentes atores sociais. Ao afirmar isso, também refletimos sobre a globalização de um vírus que desata nos variados contextos sociais, culturais e políticos uma série de graves crises. Portanto, dialogamos com nossos pares sobre os efeitos da COVID-19 para além da crise sanitária. Nessa interlocução foi fundamental o caráter interdisciplinar do campo da Saúde Coletiva.

Structure-based design of antisense oligonucleotides that inhibit SARS-CoV-2 replication

Antisense oligonucleotides (ASOs) are an emerging class of drugs that target RNAs. Current ASO designs strictly follow the rule of Watson-Crick base pairing along target sequences. However, RNAs often fold into structures that interfere with ASO hybridization. Here we developed a structure-based ASO design method and applied it to target severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our method makes sure that ASO binding is compatible with target structures in three-dimensional (3D) space by employing structural design templates. These 3D-ASOs recognize the shapes and hydrogen bonding patterns of targets via tertiary interactions, achieving enhanced affinity and specificity. We designed 3D-ASOs that bind to the frameshift stimulation element and transcription regulatory sequence of SARS-CoV-2 and identified lead ASOs that strongly inhibit viral replication in human cells. We further optimized the lead sequences and characterized structure-activity relationship. The 3D-ASO technology helps fight coronavirus disease-2019 and is broadly applicable to ASO drug development.

ORAI1 establishes resistance to SARS-CoV-2 infection by regulating tonic type I interferon signaling

ORAI1 and STIM1 are the critical mediators of store-operated Ca2+ entry by acting as the pore subunit and an endoplasmic reticulum-resident signaling molecule, respectively. In addition to Ca2+ signaling, STIM1 is also involved in regulation of a cytosolic nucleic acid sensing pathway. Using ORAI1 and STIM1 knockout cells, we examined their contribution to the host response to SARS-CoV-2 infection. STIM1 knockout cells showed strong resistance to SARS-CoV-2 infection due to enhanced type I interferon response. On the contrary, ORAI1 knockout cells showed high susceptibility to SARS-CoV-2 infection as judged by increased expression of viral proteins and a high viral load. Mechanistically, ORAI1 knockout cells showed reduced homeostatic cytoplasmic Ca2+ concentration and severe impairment in tonic interferon signaling. Transcriptome analysis showed downregulation of multiple cellular defense mechanisms, including antiviral signaling pathways in ORAI1 knockout cells, which are likely due to reduced expression of the Ca2+-dependent transcription factors of the activator protein 1 (AP-1) family and MEF2C. Our results identify a novel role of ORAI1-mediated Ca2+ signaling in regulating the baseline type I interferon level, which is a determinant of host resistance to SARS-CoV-2 infection.

Factors associated with hypertension and diabetes among risk-assessed patients in a Pasig City health center

Background@#Non-communicable diseases (NCDs) are among the growing public health problems globally which cause premature and preventable deaths. They remain as leading causes of mortality in the Philippines, specifically hypertension and Type 2 Diabetes Mellitus (T2DM). @*Objective@#This study aimed to determine the factors associated with high risk for hypertension and T2DM among patients who were risk-assessed in the Center for Dialysis, Healthy Lifestyle, Ambulatory Surgery, Maternity Clinic and Newborn Care of Pasig City (CHAMP) Health Center from January to December 2020. @*Methodology@#An analytical cross-sectional study design was utilized to determine the factors associated with hypertension and T2DM among risk-assessed patients. Secondary data from the NCD registry of the City Health Department of Pasig was obtained through a one-time collection. @*Results@#Among the 77 patients included in the study, 19.48% were classified as high-risk for hypertension and T2DM. Through a simple logistic regression, no variable was statistically significant at a 5% level of significance which means there is no sufficient basis to conclude that there is an association between the factors with high risk for hypertension and T2DM. Looking at the characteristics of the participants, 74% were obese and more than half had no regular exercise; they may still be at risk for NCDs because being at non-high-risk does not eliminate risk completely.@*Conclusion@#Policies or strategies regarding access to health centers for risk assessment should not be neglected even during a communicable disease pandemic because this may lead to a misreporting of high-risk individuals.

Financial assistance for the treatment of schizophrenia in select institutions in the Philippines

@#<p style="text-align: justify;"><strong>Objective:</strong> This paper aims to characterize existing financial assistance available to patients with schizophrenia. Specifically, we described (1) the funding mechanisms for the treatment of patients with schizophrenia; (2) the process for accessing financial assistance; and (3) the experiences of consumers of services of these support mechanisms.</p><p style="text-align: justify;"><strong>Methods:</strong> We employed qualitative techniques using key informant interviews (KII) and focus group discussion (FGD). Key informants were officials from institutions providing or offering financial assistance for patients with any health-related concerns, including schizophrenia. Focus group participants were support group members or caregivers of patients with schizophrenia. Purposive sampling was used to select participants for both providers and consumers of financial assistance or scheme. Topic guides for KII and FGD were used for data collection. Thematic analysis was performed on the qualitative data gathered from the informants and focus group participants.</p><p style="text-align: justify;"><strong>Results:</strong> Securing financial assistance for schizophrenia followed a generally similar process, whether the source is from government offices or civil society organizations, and can be grouped into three main stages: (a) pre-application, (b) application, and (c) post-application. While the process of seeking financial assistance appears to be straightforward, issues were encountered in all of the stages by both providers and recipients alike, namely: (a) Financial assistance as an augmentation to patient resources; (b) Mismatch between demand and service capability; (c) Measures of organizational effectiveness; (d) Health professionals and support groups as "bridges" / "facilitators" to financial assistance providers; (e) Financial and non-financial costs incurred by caregivers in applying for financial assistance; and (f) Recipient-provider relationship as a barrier to the feedback process.</p><p style="text-align: justify;"><strong>Conclusion:</strong> This study provides a glimpse of available financial and other relevant assistance to clients, including clients suffering from schizophrenia. More extensive research covering more organizations, support groups, and caregivers from different parts of the country is recommended.</p>

The effect of a two-day training and refresher program on the basic emergency obstetric and newborn care knowledge and skills of health workers in Legazpi City, Albay

@#<p style="text-align: justify;"><strong>Objectives:</strong> The availability of emergency obstetric and newborn care (EmONC) services is one of the key strategies in improving maternal health and achieving Sustainable Development Goal 3. Health staff knowledge and competency on these interventions are crucial to ensure the effective handling and management of obstetric and newborn emergencies. Health workers, despite having undergone formal training, require regular refresher courses to keep up with new, evidence-based information on EmONC intervention; and to ensure compliance with national and local referral guidelines. A two-day workshop was implemented to assess the knowledge and skills of health workers in Legazpi, Albay, regarding obstetric emergency cases and referral guidelines.</p><p style="text-align: justify;"><strong>Methods:</strong> A pretest was conducted on the first day to assess the knowledge of the participants. A series of lectures were given before administering a posttest at the end of these lectures. An Objective Structured Clinical Examination (OSCE) was conducted on the second day, which aimed to assess the skills of the participants.</p><p style="text-align: justify;"><strong>Results:</strong> The pretest findings indicated that the participants are generally knowledgeable about areas such as handwashing and prenatal care. Results of the posttest show that participants had difficulty with the category of referrals. Moreover, comparing the pretest and posttest scores, there is strong evidence that there is a difference in the median values of the pretest scores as compared to the posttest scores. The results of the OSCE also indicate the need for further training on partograph use and adherence to an EINC protocol. More than half of the participants passed all five parts of the OSCE.</p><p style="text-align: justify;"><strong>Conclusion:</strong> The workshop contributed to an improvement in the knowledge of health care workers in obstetric emergency cases. Skills-wise, more frequent training may need to be conducted to improve other competencies such as partograph utilization and the practice of EINC interventions.</p><p style="text-align: justify;"><strong>Key Words:</strong> emergency obstetric care, training, skilled birth attendants, knowledge, skills</p>

A monoclonal antibody against staphylococcal enterotoxin B superantigen inhibits SARS-CoV-2 entry in vitro

We recently discovered a superantigen-like motif, similar to Staphylococcal enterotoxin B (SEB), near the S1/S2 cleavage site of SARS-CoV-2 Spike protein, which might explain the multisystem-inflammatory syndrome (MIS-C) observed in children and cytokine storm in severe COVID-19 patients. We show here that an anti-SEB monoclonal antibody (mAb), 6D3, can bind this viral motif, and in particular its PRRA insert, to inhibit infection by blocking the access of host cell proteases, TMPRSS2 or furin, to the cleavage site. The high affinity of 6D3 for the furin-cleavage site originates from a poly-acidic segment at its heavy chain CDR2, a feature shared with SARS-CoV-2-neutralizing mAb 4A8. The affinity of 6D3 and 4A8 for this site points to their potential utility as therapeutics for treating COVID-19, MIS-C, or common cold caused by human coronaviruses (HCoVs) that possess a furin-like cleavage site.

Impact of the home confinement related to COVID-19 on the device-assessed physical activity and sedentary patterns of Spanish older adults

ObjectivesThe main objective of this study was to device-assess the levels of physical activity and sedentary behaviour patterns of older adults during the situation prior to COVID-19 pandemic, home-quarantine and the ending of isolation. We also aimed analysing the effectiveness of an unsupervised home-based exercise routine to counteract the potential increase in sedentary behaviour during the periods within the pandemic. Methods18 non-institutionalized elderly (78.4{+/-}6.0 y.), members of the Spanish cohort of EXERNET-Elder 3.0 project participated in the study. They were recommended to perform an exercise prescription based on resistance, balance and aerobic exercises during the pandemic. Wrist triaxial accelerometers (ActiGraph GT9X) were used to assess the percentage of sedentary time, physical activity and sedentary bouts and breaks of sedentary time. An ANOVA for repeated measures was performed to analyse the differences between the three different periods. ResultsDuring home-quarantine, older adults spent more time in sedentary behaviours (71.6{+/-}5.3%) in comparison with either the situation prior to the pandemic (65.5{+/-}6.7%) or the ending of isolation (67.7{+/-}7.1%) (all p<0.05). Moreover, participants performed less bouts of physical activity and with a shorter duration during home quarantine (both p<0.05). Additionally, no differences in the physical activity behaviours were found between the situation prior to the pandemic and the ending of isolation. ConclusionsAccording with our results, the home-quarantine could negatively affect health due to increased sedentary lifestyle and the reduction of physical activity. Therefore, our unsupervised exercise program does not seem to be a completely effective strategy at least in this period. What is already known on this topicO_LIAlthough the available information is scarce and includes subjective methodology (questionnaires), it seems that the COVID-19 pandemic has negatively affected physical activity patterns. C_LIO_LIIt is known that physical activity interventions are effective in improving health and reducing sedentary lifestyle in older adults. Nevertheless, little is known about whether an unsupervised home-based exercise routine is an effective alternative to counteract the potential increase in sedentary behaviour in this specific population during the pandemic lockdown. C_LI What are the findings? / What this study addsO_LIDespite unsupervised training, during home-quarantine, older adults spent more sedentary time than in the situation prior to COVID-19 and the ending of isolation (phase 0). C_LIO_LIThere were no differences in break of sedentary time patterns between the situation prior to COVID-19 and the periods within the pandemic. C_LIO_LIDuring home-quarantine older adults performed fewer and shorter physical activity bouts than in the situation prior to COVID-19 despite unsupervised training. C_LIO_LIOur unsupervised home-exercise routine was not a completely effective alternative to avoid the increase of sedentary behaviour during home-quarantine. C_LI How might it impact on clinical practice in the future?O_LIOur findings can be used as a starting point to manage isolation restrictions more effectively and to develop strategies to promote physical activity and reduce sedentary behaviour among older adults during situations of forced lockdowns, as in the present COVID-19 pandemic. C_LI

Cold plasma for SARS-CoV-2 Inactivation

SARS-CoV-2 infectious virions are viable on various surfaces (e.g., plastic, metals, cardboard) for several hours. This presents a transmission cycle for the human infection that can be broken by developing new inactivation approaches. We employed an efficient cold atmospheric plasma (CAP) with argon feed gas to inactivate SARS-CoV-2 on various surfaces including plastic, metal, cardboard, basketball composite leather, football leather, and baseball leather. These results demonstrate the great potential of CAP as a safe and effective means to prevent virus transmission and infections.

Impacto de la tecnología híbrida PET/RM con 18F-colina en la estrategia terapéutica de los pacientes con cáncer de próstata tratados con prostatectomía que presentan elevación del antígeno prostático específico inferior a 1 ng/ml / Value of 18F-Choline PET/MRI hybrid technique on the therapeutic approach for patients with prostate cancer treated with prostatectomy and rising prostate specific antigen levels below 1 ng/ml

OBJETIVO: Evaluar la tasa de detección de la PET/RM con 18F-colina y los cambios en el manejo terapéutico de los pacientes con cáncer de próstata tratados con prostatectomía que presentan elevación del PSA <1 ng/ml. MÉTODO: Estudio prospectivo de los 36 primeros pacientes con cáncer de próstata tratados con prostatectomía, con elevación de PSA<1 ng/ml, a los que hemos realizado una PET/RM con 18F-colina. Tras la administración de 185±10% MBq de 18F-colina se ha adquirido un estudio en dos fases: 1) precoz prostática (inmediatamente tras la administración del trazador): emisión PET/RM multiparamétrica. 2) Estudio una hora postinyección de cuerpo completo: emisión PET/RM: T1, T2, STIR, difusión. El comité oncológico ha decidido la estrategia terapéutica de los pacientes según los hallazgos de la PET/RM con 18F-colina. RESULTADOS: De los 36 pacientes, 20 (55,6%) han mostrado positividad del estudio PET/RM con 18F-colina: en 8 (22,2%) lecho de prostatectomía, en 7 (19,4%) adenopatías infradiafragmáticas, en 4 (11,1%) recidiva local y adenopatías infradiafragmáticas, en 1 (2,8%) una metástasis ósea. De los 36 pacientes, en 16 (44,4%) el estudio PET/RM con 18F-colina ha sido negativo. Los hallazgos de la PET/RM con 18F-colina han condicionado la estrategia terapéutica: en 15 pacientes (41,6%) enfermedad oligometastásica tratada con radioterapia guiada por la imagen, en 5 (13,9%) enfermedad multimetastásica tratada con privación androgénica, en 16 (44,4%) negativo en vigilancia activa. CONCLUSIÓN: La técnica híbrida PET/RM con 18F-colina ha demostrado una elevada tasa de detección de la recidiva en los pacientes tratados con prostatectomía que presentan PSA <1 ng/ml, permitiendo una estrategia terapéutica personalizada según los hallazgos de la exploración

OBJECTIVE: To assess the detection rate of 18F-Choline PET/MRI and subsequent changes in therapy approach for patients with prostate cancer treated by prostatectomy and with rising levels of PSA <1 ng/ml. METHODS: Prospective study with our first 36 patients with prostatectomy for prostate cancer and rising levels of PSA, who were referred for an 18F-Choline PET/MRI study. A dual-phase study was acquired after intravenous administration of 185±10% MBq of 18F-Choline: 1) early imaging (immediately after tracer administration) of prostate area (emission PET/Multiparametric MRI). 2) whole-body imaging 1 h after tracer injection (emission PET/MRI: T1, T2, STIR, diffusion). The therapy approach for patients was decided upon the Oncology Committee consensus based on 18F-Choline PET/MRI findings. RESULTS: Twenty out of 36 patients (55.6%) were positive for the 18F-Choline PET/MRI study: 8 (22.2%) within the prostatectomy bed, 7 (19.4%) with infradiaphragmatic lymph nodes, 4 (11.1%) with local recurrence and infradiaphragmatic lymph nodes, and 1 (2.8%) with bone metastasis. Sixteen out of the 36 patients (44.4%) were negative for the 18F-Choline PET/MRI study. 18F-Choline PET/MRI findings had an impact on the therapy approach to follow: 15 patients (41.6%) showed oligometastatic disease which was treated by imaging-guided radiotherapy, 5 (13.9%) with multiple metastatic disease were treated by androgen deprivation therapy, 16 (44.4%) negative were under active surveillance. CONCLUSION: Hybrid 18F-Choline PET/MRI procedure showed a high detection rate for recurrence in prostate cancer patients treated with prostatectomy and rising PSA levels <1 ng/ml, and 18F-Choline PET/MRI findings resulted in a better tailored therapy approach delivered to our patients

Estandarización de los protocolos de adquisición mediante PET/TC con 18F-Colina en el cáncer de próstata / Standardization of acquisition protocols using PET/CT with 18F-Choline in prostate cancer

INTRODUCCIÓN: Estandarizar los protocolos de adquisición de 18F-Colina PET/TC, que permitan evitar la interferencia urinaria, evaluar el mejor tiempo del estudio de cuerpo completo y valorar si la «doble fase» permite la diferenciación entre lesiones benignas frente a malignas. MÉTODO: Estudio prospectivo que incluye 100 pacientes con cáncer de próstata: 31 estadificación y 69 recidiva bioquímica (32 posprostatectomía y 37 posradioterapia). Adquisición pélvica inmediatamente tras inyección de 18F-Colina y estudio de cuerpo completo, 1 y 2h p.i. Cálculo de media SUVmáx por territorios en todos los estudios secuenciales. Análisis de medias (χ2) y porcentaje de cambio del SUV (2/1h; 1h/0min). Patrón de dinámica metabólica: acumulativo frente a aclaramiento. Seguimiento tras tratamiento en todos los pacientes y de forma dirigida, cuando éticamente es posible. RESULTADOS: Cincuenta y tres focos prostáticos, en ninguna de las imágenes precoces actividad urinaria: Patrón acumulativo en 42, porcentaje de aumento: 0min/1h: +16,7% (X20,94); 1/2h: +10,0% (X20,83). Patrón aclaramiento en 11, porcentaje de reducción: 0min/1h: 21,4% (X20,91); 1/2h: −7,7% (X20,85), correspondiendo en 7 a estadificación y 4 a posradioterapia. Todos los focos infradiafragmáticos (n: 24) mostraron dinámica acumulativa, porcentaje de aumento: +9,1% (χ20,97), todas ellas visibles en el primer estudio. De los 12 focos supradiafragmáticos, 8 mostraron aclaramiento, porcentaje de reducción: −13,0% (χ2 0,95). Los otros 4 dinámica acumulativa, porcentaje de aumento: +13,0% (χ2 0,96), siendo valorados invasivamente. Todos los focos óseos (n: 18) mostraron dinámica acumulativa, porcentaje de aumento: +17,1% (χ20,95), todas ellas visibles en el estudio 1h. CONCLUSIONES: En la valoración prostática la mejor técnica doble fase es 0min/1h. En la diferenciación de adenopatías supradiafragmáticas es aconsejable la técnica de doble fase: 1/2h. Para la infiltración infradiafragmática y ósea, ante hallazgos dudosos, las imágenes 2h aumentan la confianza diagnóstica

AIM: To standardize acquisition protocols for 18F-Choline PET/CT to prevent from urine interference, to determine the best time point for the whole-body study, and to assess whether "dual point" acquisition allows for differentiating malignant vs. benign lesions. METHODS: One hundred consecutive patients with prostate cancer were prospectively studied. Immediately after 18F-Choline injection, a pelvis study was acquired, and a whole-body was subsequently obtained 1 and 2 hours p.i. Mean SUVmax was obtained in regions and for every sequential imaging. Mean analysis (χ2) and SUV percentage change (2/1 hours; 1 hours/0 min) were obtained. Metabolic pattern dynamics were assessed: accumulative vs. clearance. Patient follow-up after therapy and directed classification whenever ethically possible were performed. RESULTS: Fifty-three prostate foci, without disturbing urinary activity was ever found on early images. Accumulative pattern in 42, with percentage increase was: 0 min/1 hour: +16.7% (χ20.94); 1/2 hours: +10,0% (χ2 0.83). Clearance pattern in 11, with percentage decrease: 0 min/1 hour: −21.4% (χ20.91): −7.7% (χ20.85), corresponding in 7 to initial staging and in 4 post-radiotherapy biochemical recurrence. Every infradiaphragmatic uptake (n: 24) showed accumulative pattern, with percentage increase of +9.1% (χ20.97), all of them depicted on early imaging. As for 12 supradiaphragmantic uptake, 8 of them showed clearance pattern with percentage decrease: −13.0% (χ20.95). Accumulative pattern showed in 4 of them with percentage increase +13.0% (χ2 0.96), thus being assessed as invasive/malignant. Every bone uptake (n: 18) showed accumulative pattern, with percentage increase: +17.1% (χ20.95), all of them depicted on 1 hour imaging. CONCLUSIONS: As for prostate assessment is concerned, dual point at 0 min/1 hour proved to be the best procedure. As for supradiaphragmatic lymph-nodes detection, dual point with 1/2 hours performed best. As for infradiaphragmatic and bone involvement, as well as for inconclusive findings, the 2 hour imaging increased our diagnostic confidence

Utilidad de la PET con 68Ga-DOTATOC en la búsqueda del tumor primario en pacientes con metástasis hepáticas de origen neuroendocrino. A propósito de un caso / Diagnostic value of 68Ga-DOTATOC PET in the localization of primary tumor in patients with liver metastases of neuroendocrine origin but unknown primary. About a case

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