Multidisciplinary barriers to addressing tobacco cessation during an inpatient psychiatric hospitalization.

Tobacco use and resultant health complications disproportionately impact individuals with psychiatric disorders. Inpatient psychiatric hospitalizations provide an opportunity to initiate tobacco treatment. In this study, electronic medical record review identified demographic and clinical information, smoking status, and tobacco cessation treatment offered for adults hospitalized on two acute, non-smoking psychiatric units in Massachusetts from January 2016 to March 2018. We additionally conducted semi-structured interviews with 15 inpatient nursing, psychiatry, psychology and social work providers regarding their tobacco cessation treatment practices and perceived facilitators and barriers to addressing tobacco use on psychiatric inpatient units. Chart review identified 1099 of 3140 (35%) people admitted reporting daily tobacco smoking. On discharge, 5 (0.005%) of inpatient smokers received a prescription for varenicline, 43 (0.04%) for dual-nicotine replacement therapy, 211 (19.2%) for nicotine patch, and 5 (0.005%) for bupropion. Barriers to inpatient smoking cessation treatment initiation identified in qualitative interviews included: 1) smoking cessation as low priority, 2) smoking cessation as the responsibility of outpatient providers, 3) lack of education about tobacco treatment, and 4) treatment discussions framed as preventing withdrawal. Given the potential to impact a large percentage of psychiatric tobacco users, future interventions should investigate provision of tobacco cessation counseling and pharmacotherapy in inpatient settings, with interventions that take into account the barriers and opportunities presented in this study.

Insights on the epigenetic mechanisms underlying pulmonary arterial hypertension.

Pulmonary arterial hypertension (PAH), characterized by localized increased arterial blood pressure in the lungs, is a slow developing long-term disease that can be fatal. PAH is characterized by inflammation, vascular tone imbalance, pathological pulmonary vascular remodeling, and right-sided heart failure. Current treatments for PAH are palliative and development of new therapies is necessary. Recent and relevant studies have demonstrated that epigenetic processes may exert key influences on the pathogenesis of PAH and may be promising therapeutic targets in the prevention and/or cure of this condition. The aim of the present mini-review is to summarize the occurrence of epigenetic-based mechanisms in the context of PAH physiopathology, focusing on the roles of DNA methylation, histone post-translational modifications and non-coding RNAs. We also discuss the potential of epigenetic-based therapies for PAH.

Insights on the epigenetic mechanisms underlying pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH), characterized by localized increased arterial blood pressure in the lungs, is a slow developing long-term disease that can be fatal. PAH is characterized by inflammation, vascular tone imbalance, pathological pulmonary vascular remodeling, and right-sided heart failure. Current treatments for PAH are palliative and development of new therapies is necessary. Recent and relevant studies have demonstrated that epigenetic processes may exert key influences on the pathogenesis of PAH and may be promising therapeutic targets in the prevention and/or cure of this condition. The aim of the present mini-review is to summarize the occurrence of epigenetic-based mechanisms in the context of PAH physiopathology, focusing on the roles of DNA methylation, histone post-translational modifications and non-coding RNAs. We also discuss the potential of epigenetic-based therapies for PAH.

Patients' Families' Perceptions of Lupus in Sub-Saharan Africa.

Lupus is an autoimmune disease affecting the connective tissue. Its clinical and biological polymorphism is often misunderstood by patients and families and can lead to treatment interruption and a decision to turn to alternative medicine. We used a questionnaire to assess the degree of knowledge of this disease of family members living with lupus patients. Of the 56 lupus patients receiving regular follow-up at our hospital, 123 members of 30 of their families (53.5%) participated. Overall, among these families, 81.5% of the participants perceived the disease as predominantly non-mystical, 72.3% as hereditary, 87.9% as non-contagious, and 60.9% as curable ; 90.2% considered it compatible with pregnancy, another 90.2% with work, and 73.9% with sports activity. The principal clinical signs mentioned involved joint (22.7%), skin (13%), and finger-related (11.3%) disorders, with renal disease (9.7%), heart disease (8.1%), and general signs (8.1%) mentioned most frequently as the main complications. The best-known medications for disease control were corticosteroids (20.3%) and hydroxychloroquine (17%). Family members considered non-adherence (53.6%) the most frequent factor in disease flares. More than half were unaware of the life expectancy associated with this disease, but 30.1 % thought it was lower than that of the national population of Gabon - 70 years. Only 64 (52%) of the respondents had seen documentation about lupus, mostly through the Internet (65.6%). Lupus is not a disease that families know and understand well.

The association between the HLA-G 14-bp insertion/deletion polymorphism and type 1 diabetes.

Type 1 diabetes (T1D) is a multifactorial disease that has a strong genetic component. The HLA-G is a nonclassical HLA class I locus that is associated with immunomodulatory functions, including downregulation of innate and adaptive immune responses and induction of immune tolerance. However, there is currently limited information about the involvement of HLA-G in T1D susceptibility. This case-control study aims to investigate the T1D susceptibility association of alleles and genotypes of a widely investigated 14-bp insertion/deletion polymorphism in the HLA-G and to provide further evidence of the frequency distribution of class II HLA-DR-DQ-risk genotypes in T1D children and adolescents in the Brazilian population. The deletion allele and the homozygous deletion genotype are associated with susceptibility to T1D and the insertion allele and the heterozygous deletion/insertion genotype are associated with protection from T1D. We also confirm that genetic susceptibility to T1D is associated with the DRB1*03:01-DQA1*05:01-DQB1*02:01 and DRB1*04-DQA1*03:01-DQB1*03:02 haplotypes in Brazilian northeast region. The DR3-DQ2/DR4-DQ8 genotype conferred the highest detected risk for T1D. Our results identify a novel association of the 14-bp deletion allele and the homozygous deletion genotype with T1D development and provide additional evidence of the importance of HLA class II heterozygous DR3-DQ2/DR4-DQ8 genotype in T1D susceptibility.

[Copper deficiency and peripheral neuropathy as an outcome of gastrectomy]. / Déficit en cuivre et neuropathie périphérique compliquant une gastrectomie.

INTRODUCTION: Bariatric surgery may be indicated in patients with morbid obesity. Peripheral and central neurological complications can occur after bariatric surgery. OBSERVATION: We report a 47-year-old woman who presented with a tetraparesis related to copper deficiency after sleeve gastrectomy for morbid obesity. CONCLUSION: Neurological complications related to copper deficiency can occur after bariatric surgery.

Substratos, concentrações de ácido indolbutírico e tipos de miniestacas no enraizamento de melaleuca (Melaleuca alternifolia Cheel) / Substrates, indolebutyric acid levels and types of minicuttings on the rooting of tea tree (Melaleuca alternifolia Cheel)

Melaleuca alternifolia tem como produto principal o óleo essencial extraído das folhas devido às propriedades antifúngicas e antibacterianas. Pouco se tem relatado sobre a propagação desta espécie, sendo a miniestaquia uma alternativa para a propagação vegetativa de clones superiores visando à implantação de campo de produção. Este trabalho teve como objetivo avaliar o efeito de diferentes substratos, concentrações de AIB, e tipo de miniestaca, no enraizamento de Melaleuca alternifolia. No primeiro experimento foram testados os substratos, areia de granulometria média, Plantmax HT®, Golden-Mix® e vermiculita. No segundo experimento foram avaliadas diferentes concentrações de AIB (0, 500, 1000 e 2000 mg L-1), em dois tipos de miniestacas (apical e mediana). As miniestacas foram confeccionadas com 5 cm de comprimento, mantidas em casa de vegetação com nebulização intermitente, e, após 45 dias do plantio, foram avaliadas as porcentagens de miniestacas enraizadas, com calos e não responsivas, o número de raízes formadas por miniestaca e o comprimento das três maiores raízes (cm). O substrato Golden-Mix® e as miniestacas coletadas da porção apical do ramo submetidas ao tratamento com 500 mg L-1 de AIB apresentaram maior porcentagem de enraizamento e melhor qualidade do sistema radicial.

Melaleuca alternifolia has as major product the essential oil extracted from its leaves due to its antifungal and antibacterial properties. There are scarce reports about the propagation of this species, and minicutting is an alternative for vegetative propagation of superior clones in order to establish a production field. This study aimed to evaluate the effect of different substrates, IBA levels and types of minicuttings on the rooting of Melaleuca alternifolia. In the first experiment, the following substrates were tested: medium sand, Plantmax HT®, Golden-Mix® and vermiculite. In the second experiment, different IBA levels (0, 500, 1000 and 2000 mg L-1) were tested for two minicutting types (apical and medium). Minicuttings were prepared with 5 cm length and were kept in a greenhouse with intermittent mist; then, at 45 days after planting, we evaluated: the percentages of rooted minicuttings, with callus and non-responsive, the number of roots per minicutting and the length of the three longest roots. The substrate Golden-Mix® and the minicuttings collected from the apical part of the branch and treated with 500 mg L-1 IBA presented the largest rooting percentage and the best root system quality.

Efeito dos ácidos naftaleno acético e indolilbutírico no enraizamento de estacas de jambolão [Syzygium cumini (L. ) Skeels] / Effect of naphthaleneacetic acid and indolebutyric acid on rooting of jambul [Syzygium cumini (L. ) Skeels] cuttings

O jambolão propaga-se normalmente por sementes o que acarreta variabilidade nas plantas descendentes e um problema quando o objetivo é a formação de pomar comercial. O desenvolvimento de protocolo de propagação vegetativa por meio da estaquia possibilitaria a reprodução de todas as características da planta matriz, uniformidade nas populações e facilidade de propagação. O presente trabalho teve por objetivo avaliar o efeito dos ácidos naftaleno acético (ANA) e indolilbutírico (AIB) no enraizamento de estacas de jambolão. Estacas da região mediana dos ramos foram confeccionadas com 12 cm de comprimento, cortadas em bisel na base e reto acima da última gema axilar, mantendo-se um par de folhas reduzidas à metade. As bases das estacas foram imersas por 10 segundos em soluções aquosas contendo ANA ou AIB nas concentrações de 0, 500, 1.000 e 1.500 mg L-1. Para o plantio foram utilizadas bandejas plásticas contendo areia de granulometria média. As estacas foram mantidas em casa-de-vegetação com nebulização intermitente e após 120 dias do plantio, foram avaliadas as variáveis: porcentagem de estacas enraizadas, com calos, vivas (não enraizadas e sem calos) e mortas, comprimento das três maiores raízes (cm) e número de raízes formadas por estaca. Os melhores resultados de enraizamento foram verificados com 1.000 mg L-1 para ambos os fitorreguladores testados. A porcentagem de enraizamento foi ligeiramente superior com a utilização de ANA quando comparada ao AIB.

Jambul usually propagates by seeds, which causes variability in the descendant plants and represents a problem in the formation of commercial orchards. The development of a protocol for vegetative propagation by cuttings would enable the reproduction of all features of the Mother plant, uniformity in populations and easy propagation. The aim of this work was to evaluate the effect of naphthaleneacetic acid (NAA) and indolebutyric acid (IBA) on rooting of jambul cuttings. Twelve-cm-long cuttings from the median region of branches were prepared through bevel cut in the base and right cut above the last axillary bud, keeping one pair of halved leaves. Cutting bases were immersed for 10s in aqueous solutions containing NAA or IBA at 0, 500, 1000 and 1500 mg L-1 concentrations. Plastic trays containing medium sand were used in the planting. The cuttings were kept in a greenhouse under intermittent nebulization and, at 120 days after planting, the following variables were evaluated: percentage of rooted, with calluses, alive (not-rooted and without calluses) and dead cuttings; length of the three largest roots (cm); and number of roots per cutting. The best rooting was observed by using 1000 mg L-1 of both tested plant growth regulators. Rooting percentage was slightly higher under NAA relative to IBA.

Neurovascular compression in painful tic convulsif.

This article describes the case of a 67-year-old woman who presented with a typical left hemifacial spasm of 8-month duration. After 2 months, she experienced lacinating and sharp shock-like pain in the left side of her face affecting the V1 and V2 territories and a discrete attenuation of nauseous reflex on the left side. CT angiography and MRI revealed significant compression of left cranial nerves V, VII, VIII, IX and X by a giant and tortuous vertebro-basilar arterial complex. This case illustrates the nonlinearity of the relationship between the presence of the stressor factor and the actual manifestation of the disease.

Pesquisa do Progama Nacional de Incentivo ao Aleitamento Materno. 2a.Parte: entrevistas com profissionais de saude e centros de saude. / Research the National Program for Breast Feeding Promotion. 2a. Part: interviews with health personnal and health centers

Pretende-se conhecer as condicoes do sistema de saude e dos profissionais de saude que influenciam o comportamento das mulheres quanto a amamentacao. Foram entrevistados 105 servicos de saude materno-infantil e 200 profissionais. Entre os resultados fica claro o desinteresse generalizado dos profissionais sobre a atualizacao cientifica quanto a amamentacao.No pre-natal tem-se omitido completamente o assunto amamentacao e a postura antialojamento conjunto e grande entre os administradores das maternidades. Nos servicos de puericultura o pessoal auxiliar desconhece conceitos de prevencao e nao sabe orientar sobre as intercorrencias comuns da lactacao. A presenca da industria de alimentos substitutos do leite materno e clara sobre os servicios infantis e o pediatra

Pesquisa do programa nacional de incentivo ao aleitamento materno. 1a.parte: Entrevistas com maes. / Research of the incentive national program of breast feeding. 1st Part: Interviews with mothers

Os resultados deste estudo serao publicados em tres documentos. O primeiro, resumido, e este, que corresponde as entrevistas com maes. Etapa I - Foi analisada a situacao do aleitamento materno em Sao Paulo e Recife metropolitanos. Entrevistaram-se 1.000 mulheres e os resultados mostram um desmame muito precoce, a maioria antes de um mes de idade, sendo introduzida cedo a mamadeira. As maes nao recebem informacoes sobre aleitamento materno. Analisou-se a opiniao das maes para parar ou continuar amamentando e os fatores que influenciam uma amamentacao mais prolongada. Entre eles destacam-se: introducao tardia da mamadeira, mamadas noturnas, informacoes sobre aleitamento materno recebidas pelas maes e outras

[The retro-articular process or the retro-mandibular process of the human skull]. / Le processus rétro-articulaire ou tubercule rétro-mandibulaire du squelette crânien chez l'homme.

The frequency, morphology, symmetry and asymmetry of the retro-articular process of the human temporal bone are studied in 811 adult skulls, being 386 from whites (301 men and 85 women), 245 from Negroes (137 men and 108 women), 138 from mulattoes (94 men and 44 women) and 42 from Japanese (31 men and 11 women). In 1,591 out of the 1,622 observations there was an evident retro-articular process. It was classified according to its shape as mammillary, pyramidal, tubercular, crest-like or molar. Furthermore, in each one of these above referred types the process showed to be large, middle or small in size. The author states that in 98.4% of the skulls studied an evident retro-articular process could be observed; it was symmetrical in 790 cases, asymmetrical in 713 cases. These results are against the literature on the subject because it has been stated that in the present-day man the retro-articular process is very rare and, when present, usually very small.