Patients and physician's self-assessment regarding clinical stability in severe mental disorders: a cross-sectional study / Autoavaliação de pacientes e médicos em relação à estabilidade clínica em transtornos mentais graves: um estudo transversal

OBJECTIVE: This study explores the relationship between patients' self-assessment and physicians' evaluation regarding clinical stability. METHODS: This cross-sectional study was carried out at the general outpatient clinic of the Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB-UFRJ) in a large sample (1,447) of outpatients, of which 67.9% were patients with severe mental disorders (SMD). We collected information using a structured questionnaire developed for this purpose, filled in by the patient's physician. Clinical stability was assessed by means of five psychiatric instability criteria and by the physician's global clinical impression over the six previous months. The patients' self-assessment was based on a question about how they evaluated their health status: stable/better, worse, does not know. For the analyses, patients' self-evaluation was considered as our standard. RESULTS: The sample was composed of 824 (57%) women with an average age of 49 years. The most prevalent diagnoses within the SMD category corresponded to 937 patients, of whom 846 (90.3%) assessed themselves as stable/better. The physicians' evaluations agreed more with patients with bipolar disorders and less with schizophrenics regarding stability. As for patients with depressive disorder, physicians agreed more with them regarding instability. CONCLUSION: The data analysis confirms our hypothesis that the self- -assessment made by patients with SMD was accurate regarding their health condition, and that the self- -assessment made by patients who considered themselves stable agree with the physicians' evaluation.

OBJETIVO: Este estudo explora a relação entre a autoavaliação dos pacientes e a avaliação dos médicos quanto à estabilidade clínica. MÉTODOS: Trata-se de um estudo transversal realizado no ambulatório do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB-UFRJ) em uma ampla amostra de pacientes (1.447), dos quais 67,9% eram portadores de transtornos mentais graves (TMG). Coletamos informações por meio de um questionário estruturado desenvolvido para esse fim, preenchido pelo médico assistente. A estabilidade clínica foi avaliada por meio de cinco critérios de instabilidade psiquiátrica e pela impressão clínica global do médico, nos seis meses anteriores. A autoavaliação dos pacientes baseou-se em uma pergunta sobre como eles avaliavam seu estado de saúde: estável/melhor, pior, não sabe. Para as análises, a autoavaliação dos pacientes foi considerada como nosso padrão. RESULTADOS: A amostra foi composta por 824 (57%) mulheres, com idade média de 49 anos. Os diagnósticos mais prevalentes na categoria TMG corresponderam a 937 pacientes, dos quais 846 (90,3%) se avaliaram como estáveis/melhores. As avaliações dos médicos concordaram mais com pacientes portadores de transtorno bipolar e menos com esquizofrênicos em relação à estabilidade. Quanto aos pacientes com transtorno depressivo, os médicos concordaram mais com eles em relação à instabilidade. CONCLUSÃO: A análise dos dados confirma nossa hipótese de que a autoavaliação feita por pacientes com TMG foi precisa quanto à sua condição de saúde e que a autoavaliação feita por pacientes que se consideravam estáveis concorda com a avaliação dos médicos.

The pro-proliferative effect of insulin in human breast epithelial DMBA-transformed and non-transformed cell lines is PI3K-, mTOR- and GLUT1-dependent.

Type 2 diabetes mellitus (T2DM) is linked to an increased risk of breast cancer. We aimed to investigate how T2DM-associated characteristics (high levels of glucose, insulin, leptin, inflammatory mediators and oxidative stress) influence breast cancer carcinogenesis, in DMBA-treated (MCF-12ADMBA ) and non-treated breast epithelial (MCF-12A) cell lines. Insulin (50 nM) promotes cell proliferation, 3 H-DG uptake and lactic acid production in both cell lines. The stimulatory effects of insulin upon cell proliferation and 3 H-DG uptake were hampered by rapamycin, LY294001 and BAY-876, in both cell lines. In conclusion, hyperinsulinemia, one important characteristic of T2DM, contributes to the initiation of breast cancer by a PI3K- and mTOR-dependent mechanism involving increased GLUT1-mediated glucose uptake. SIGNIFICANCE: The pro-proliferative effect of insulin in human breast epithelial DMBA-transformed and non-transformed cell lines is PI3K-, mTOR- and GLUT1-dependent.

Biological age, testosterone, and estradiol as discriminating factors of muscle strength levels in young athletes.

BACKGROUND: Neuromuscular fitness can be influenced at puberty by a steroid hormones, such as testosterone (TRT) and estradiol (EST). However, more information is needed to assess the reliability between the discriminatory power of biological age (BA) markers with the discriminatory power of TRT and EST in relation to muscle strength in young athletes who are at puberty. The aim of this paper was to analyze BA, TRT and EST as discriminating factors of upper limb (ULS) and lower (LLS) strength levels in young athletes. METHODS: The sample of 81 young athletes (54.4% female and 45.6% male; age: 11.4±1.08). Hormones were analyzed by chemiluminescence, BA markers by anthropometric variables and body composition by tetrapolar bioimpedance. ULS was verified by the medicineball launch test and LLS by the countermovement jump test on a force platform. RESULTS: EST was reliable for discriminating ULS (P<0.05) and LLS (P<0.05) in females. TRT showed reliability in discriminating ULS (P<0.05) and LLS (P<0.05) in males. BA was significant in discriminating ULS (P<0.0001) in females and ULS (P=0.002) and LLS (P<0.0001) in males. BA showed significant reliability with hormonal analyzes (P<0.05). CONCLUSIONS: That hormonal concentrations are reliable in discriminating ULS and LLS of young athletes of both sexes. BA was shown to be effective in discriminating ULS (in both sexes) and LLS (in males). BA showed significant reliability with hormonal analyzes (ULS and LLS in male sex; LLS for female sex).

Factors related to lower limb performance in children and adolescents aged 7 to 17 years: A systematic review with meta-analysis.

BACKGROUND: The literature identifies several factors that are associated with lower limb performance (LLP). However, there is little consensus on which factors have the major associations with LLP. OBJECTIVE: Examine, analyze and summarize the scientific evidence on the factors associated with the performance of LLP in children and adolescents of both sexes aged between 7 and 17 years. DESIGN: This systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and was registered in PROSPERO. DATA SOURCES: A systematic literature search of five electronic databases (i.e., SPORTDiscus, PubMed, CINAHL, Google Scholar, and SCOPUS) with date restrictions was conducted (2010 to 2021). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Eligibility criteria included (i) a study published between 2010 and 2021; (ii) a research study with observational design; (iii) a study analyzing LLP; and (iv) a sample composed of young people between 7 and 17 years old (regardless of sex). ANALYSES: Literature analysis was carried out in English and Portuguese between 2018 and 2021, "blindly" by two researchers. For data sorting, Rayyan® was used. Data extraction and evidence analysis were performed "blindly", using the Loney scale. The minimum items for observational studies were analyzed by the STROBE checklist. Meta-analyses were conducted based on age group (Childhood [7 to 11 Yrs] and Adolescence [12 to 17 Yrs]) and puberty stages (i.e., Prepupertal and Pubertal). The heterogeneity between the samples of the studies was assessed using the "Cochran's Q" and "I^2" statistics. Meta-regression analyses were performed to check the factors related to heterogeneity of the studies and to check the associations between chronological age and LLP. RESULTS: The literature search resulted in 1,109,650 observational studies of which 39 were included in this review. Through Meta-analysis and Meta-regressions, it was possible to indicate that advancing chronological age related to increased LLP (p<0.01), and that in relation to puberty stages pubertal subjects had higher LLP than their pre-pubertal peers (p<0.01). DISCUSSION: The main findings of the present systematic review suggest that as chronological age advances (childhood to adolescence), neuromuscular systems mature and this may be due to advancing puberty, which is also associated with an increase in LLP. CONCLUSION: The factors associated with lower limbs performance are still inconsistent in the literature. However, advancing chronological age and stage of puberty are both associated with increased lower limbs performance. TRIAL REGISTRATION: ID-PROSPERO-CRD42020137925.

Relationship of Biological Maturation with Muscle Power in Young Female Athletes.

There is still no consensus on how biological maturation (BM) affects the muscle power of upper and lower limbs in young people. The objective was to verify associations between BM and muscle power, as well as to compare the muscle power of upper (ULP) and lower limbs (LLP) among young athletes in different stages of BM. The sample consisted of 79 female athletes (10.9 ± 1.11 years old). Regarding BM, the sample was divided into three groups: delayed BM, synchronized BM, and accelerated BM. BM was identified by subtracting chronological age from bone age (BA). BA was measured by a mathematical model based on anthropometry. The muscular power of the upper limbs was analyzed by the medicine ball launch test, and that of the lower limbs was analyzed by the countermovement jump on a force platform. BM and BA correlated with ULP (BA: r =0.74; BM: r =0.65) and LLP (BA: r = 0.50; BM: r =0.41). In the comparisons of the tests of ULP and LLP, the groups with synchronized and accelerated BM were superior to the group with delayed BM. The advance of BM is associated with the ULP and LLP, as well as the advance of the BM affects muscle power in young female athletes. This occurs due to the increase in body mass resulting from the advancement of BM, which may favor the predominance of lean body mass, assisting in the production of muscle strength.

Forecasting COVID-19 Severity by Intelligent Optical Fingerprinting of Blood Samples.

Forecasting COVID-19 disease severity is key to supporting clinical decision making and assisting resource allocation, particularly in intensive care units (ICUs). Here, we investigated the utility of time- and frequency-related features of the backscattered signal of serum patient samples to predict COVID-19 disease severity immediately after diagnosis. ICU admission was the primary outcome used to define disease severity. We developed a stacking ensemble machine learning model including the backscattered signal features (optical fingerprint), patient comorbidities, and age (AUROC = 0.80), which significantly outperformed the predictive value of clinical and laboratory variables available at hospital admission (AUROC = 0.71). The information derived from patient optical fingerprints was not strongly correlated with any clinical/laboratory variable, suggesting that optical fingerprinting brings unique information for COVID-19 severity risk assessment. Optical fingerprinting is a label-free, real-time, and low-cost technology that can be easily integrated as a front-line tool to facilitate the triage and clinical management of COVID-19 patients.

Isolation Method and Characterization of Outer Membranes Vesicles of Helicobacter pylori Grown in a Chemically Defined Medium.

Outer membrane vesicles (OMVs) are small vesicles constitutively shed by all Gram-negative bacterium, which have been proposed to play a role in Helicobacter pylori persistence and pathogenesis. The methods currently available for the isolation of H. pylori OMVs are diverse and time-consuming, raising the need for a protocol standardization, which was the main aim of this study. Here, we showed that the chemically defined F12 medium, supplemented with cholesterol, nutritionally supports bacterial growth and maintains H. pylori viability for at least 72 h. Additionally, we developed an abridged protocol for isolation of OMVs from these bacterial cultures, which comprises a low-speed centrifugation, supernatant filtration through a 0.45 µm pore, and two ultracentrifugations for OMVs' recovery and washing. Using this approach, a good yield of highly pure bona fide OMVs was recovered from cultures of different H. pylori strains and in different periods of bacterial growth, as assessed by nanoparticle tracking analysis, transmission electron microscopy (TEM), and proteomic analyses, confirming the reliability of the protocol. Analysis of the proteome of OMVs isolated from H. pylori F12-cholesterol cultures at different time points of bacterial growth revealed differentially expressed proteins, including the vacuolating cytotoxin VacA. In conclusion, this work proposes a time- and cost-efficient protocol for the isolation of H. pylori OMVs from a chemically defined culture medium that is suitable for implementation in research and in the biopharmaceutical field.

Occurrence of IGG antibodies anti-TOXOPLASMA GONDII and NEOSPORA CANINUM in cattle raised in family agricultural properties in Realeza, Parana, Brazil

This cross-sectional study evaluates the presence of antibodies against Neospora caninum and Toxoplasma gondii in cattle raised in Realeza, PR. There was a seroprevalence of N. caninum and T. gondii of 87.5% and 67.9%, respectively in the properties assessed. The frequencies of T. gondii and N. caninum in the animals were 41.1% and 55.1%, respectively. The studied coccidia are widely distributed in dairy cows reared on family farms in the municipality of Realeza, PR. Sanitary control for reproductive diseases must be adopted to prevent miscarriages and the economic damage caused by the disease. Future studies should be performed to investigate how widespread these pathogens are in cattle herds in southwestern Parana.

Can the Neuromuscular Performance of Young Athletes Be Influenced by Hormone Levels and Different Stages of Puberty?

BACKGROUND: Endocrine mechanisms can be a determining factor in the neuromuscular performance of young athletes. OBJECTIVE: The objective of the present study was to relate maturational and hormonal markers to neuromuscular performance, as well as to verify whether young athletes with different testosterone levels show differences in muscle strength. METHODS: The sample consisted of 37 young male Brazilian athletes (11.3 ± 0.94 years) who were members of a sports initiation project. Hormonal markers were analyzed biochemically by blood samples, and maturation markers by mathematical models based on anthropometry. Body composition was verified by tetrapolar bioimpedance. The performance of upper and lower limb strength and body speed were analyzed. RESULTS: Hormonal and maturational markers were related to neuromuscular performance (p < 0.05). Young people with higher testosterone levels showed higher muscle strength (p < 0.05). Artificial neural networks showed that testosterone predicted the performance of upper limbs by 49%, and maturation by 60%. Maturation foreshadowed the performance of lower limbs by 30.3%. CONCLUSION: Biological maturation and hormonal levels can be related to neuromuscular performance, and young people with higher testosterone levels show superior muscle strength in relation to the others.

Biological Maturation and Hormonal Markers, Relationship to Neuromotor Performance in Female Children.

Background: Mechanisms that influence muscle strength can interfere with neuromotor performance and overall health, thus hormone markers and maturation can interact in this process. Objective: The present study aimed to verify the relationship of hormonal markers and biological maturation on neuromotor abilities in young people. Methods: This is a cross-sectional study with 44 female participants (11.5 ± 1.5 years). Hormones were analyzed biochemically. Skeletal and somatic maturation were analyzed using anthropometry. The muscular power of the upper and lower limbs, body speed with change of direction, and speed of the upper limbs were verified. Results: Bone age was correlated with hormonal markers (estradiol: r = 0.58; p = 0.0007), (testosterone: r = 0.51; p = 0.005). Peak growth velocity correlated with estradiol (r = 0.51; p = 0.004). The power of the lower limbs (estradiol: r = 0.52; p = 0.006; testosterone: r = 0.42; p = 0.03) and of the upper limbs (estradiol: r = 0.51; p = 0.007; testosterone: r = 0.42; p = 0.02) had a positive correlation with hormone levels and had similar results with maturation. The analysis by artificial neural networks indicated that the maturation can predict the neuromotor performance between 57.4% and 76%, while the hormonal markers showed a potential of more than 95% for the foreshadowing of the neuromotor performance of the upper limbs. Conclusion: It was possible to conclude that the hormones had a relationship with maturational development and bone age in female subjects.

Multiple Myeloma: Available Therapies and Causes of Drug Resistance.

Multiple myeloma (MM) is the second most common blood cancer. Treatments for MM include corticosteroids, alkylating agents, anthracyclines, proteasome inhibitors, immunomodulatory drugs, histone deacetylase inhibitors and monoclonal antibodies. Survival outcomes have improved substantially due to the introduction of many of these drugs allied with their rational use. Nonetheless, MM patients successively relapse after one or more treatment regimens or become refractory, mostly due to drug resistance. This review focuses on the main drugs used in MM treatment and on causes of drug resistance, including cytogenetic, genetic and epigenetic alterations, abnormal drug transport and metabolism, dysregulation of apoptosis, autophagy activation and other intracellular signaling pathways, the presence of cancer stem cells, and the tumor microenvironment. Furthermore, we highlight the areas that need to be further clarified in an attempt to identify novel therapeutic targets to counteract drug resistance in MM patients.

Evaluation of the Use of Formalin-Fixed and Paraffin-Embedded Archive Gastric Tissues for Microbiota Characterization Using Next-Generation Sequencing.

Large numbers of well-characterized clinical samples are fundamental to establish relevant associations between the microbiota and disease. Formalin-fixed and paraffin-embedded (FFPE) tissues are routinely used and are widely available clinical materials. Since current approaches to study the microbiota are based on next-generation sequencing (NGS) targeting the bacterial 16S rRNA gene, our aim was to evaluate the feasibility of FFPE gastric tissues for NGS-based microbiota characterization. Analysis of sequencing data revealed the presence of bacteria in the paraffin control. After the subtraction of the operational taxonomic units (OTUs) present in the paraffin control to the FFPE tissue sample dataset, we evaluated the microbiota profiles between paired FFPE and frozen gastric tissues, and between different times of archiving. Compared with frozen gastric tissues, we detected a lower number of OTUs in the microbiota of paired FFPE tissues, regardless of the time of archiving. No major differences in microbial diversity were identified, but taxonomic variation in the relative abundance of phyla and orders was observed between the two preservation methods. This variation was also evident in each case and throughout the times of FFPE archiving. The use of FFPE tissues for NGS-based microbiota characterization should be considered carefully, as biases can be introduced by the embedding process and the time of tissue archiving.

Level of physical activity and motor coordination of schoolchildren in different maturational stages / Nível de atividade física e coordenação motora de escolares em diferentes estágios maturacionais

INTRODUCTION: Studies and debates in the field of motor development reveal that sport and physical activity develop and improve motor skills. These studies seek to understand the changes that occur with movement, which becomes more complex as it develops through physical activity. OBJECTIVE: To compare the level of physical activity and motor coordination of students in different maturational stages and to relate the level of physical activity with the motor coordination of young people. METHODS: Descriptive research with cross section. The study included 46 male individuals, aged between 10 and 14 years. The Baecke Habitual Physical Activity questionnaire was applied; the maturity stage was verified through the Pubertal Maturation Prediction Equation; body composition was assessed using the Guedes protocol for children and adolescents; Finally, the coordinating performance was rated using the Korperkoordinationstest fur Kinder (KTK) test battery. RESULTS: There were significant differences for the variables Age and Height between all stages: P3, P4 and P5 of maturation. The differences found in body mass occurred only between stages P3 and P5; P4 and P5. It was also observed that no significant differences were found for motor coordination between the maturation stages. The same occurred when the physical activity indices were compared CONCLUSION: There is no difference in the level of physical activity between stages 3, 4 and 5 of sexual maturation, nor does the maturational stage seem to influence the level of motor coordination of young schoolchildren.

INTRODUÇÃO: Estudos e debates na área do desenvolvimento motor revelam que o esporte e a atividade física desenvolvem e melhoram as habilidades motoras. Esses estudos buscam compreender as mudanças que ocorrem com o movimento, o qual se torna mais complexo à medida que se desenvolve através da atividade física. OBJETIVO: Comparar o nível de atividade física e coordenação motora de escolares em diferentes estágios maturacionais e relacionar o nível de atividade física com a coordenação motora de jovens MÉTODO: Pesquisa descritiva com corte transversal. Participaram do estudo 46 indivíduos do sexo masculino, com idades entre 10 e 14 anos. Foi aplicado o questionário de Atividade Física Habitual de Baecke; o estágio de maturidade foi verificado através da Equação de Predição da Maturação Puberal; a composição corporal foi avaliada através do protocolo de Guedes para crianças e adolescentes; por fim, o desempenho coordenativo foi classificado por meio da bateria de testes Korperkoordinationstest fur Kinder (KTK). RESULTADOS: Houve diferenças significativas para as variáveis Idade e Estatura entre todos os estágios: P3, P4 e P5 de maturação. As diferenças encontradas na massa corporal ocorreram apenas entre os estágios P3 e P5; P4 e P5. Observou-se também que não foram encontradas diferenças significativas para a coordenação motora entre os estágios de maturação. O mesmo ocorreu quando os índices de atividade física foram comparados. CONCLUSÃO: Não existe diferença no nível de atividade física entre os estágios 3, 4 e 5 da maturação sexual, assim como o estágio maturacional não parece influenciar o nível de coordenação motora de jovens escolares

Interrelationship Between Contractility, Protein Synthesis and Metabolism in Mantle of Juvenile Cuttlefish (Sepia officinalis).

Young juvenile cuttlefish (Sepia officinalis) can grow at rates as high as 12% body weight per day. How the metabolic demands of such a massive growth rate impacts muscle performance that competes for ATP is unknown. Here, we integrate aspects of contractility, protein synthesis, and energy metabolism in mantle of specimens weighing 1.1 g to lend insight into the processes. Isolated mantle muscle preparations were electrically stimulated and isometric force development monitored. Preparations were forced to contract at 3 Hz for 30 s to simulate a jetting event. We then measured oxygen consumption, glucose uptake and protein synthesis in the hour following the stimulation. Protein synthesis was inhibited with cycloheximide and glycolysis was inhibited with iodoacetic acid in a subset of samples. Inhibition of protein synthesis impaired contractility and decreased oxygen consumption. An intact protein synthesis is required to maintain contractility possibly due to rapidly turning over proteins. At least, 41% of whole animal MO2 is used to support protein synthesis in mantle, while the cost of protein synthesis (50 µmol O2 mg protein-1) in mantle was in the range reported for other aquatic ectotherms. A single jetting challenge stimulated protein synthesis by approximately 25% (2.51-3.12% day-1) over a 1 h post contractile period, a similar response to that which occurs in mammalian skeletal muscle. Aerobic metabolism was not supported by extracellular glucose leading to the contention that at this life stage either glycogen or amino acids are catabolized. Regardless, an intact glycolysis is required to support contractile performance and protein synthesis in resting muscle. It is proposed that glycolysis is needed to maintain intracellular ionic gradients. Intracellular glucose at approximately 3 mmol L-1 was higher than the 1 mmol L-1 glucose in the bathing medium suggesting an active glucose transport mechanism. Octopine did not accumulate during a single physiologically relevant jetting challenge; however, octopine accumulation increased following a stress that is sufficient to lower Arg-P and increase free arginine.

In vitro Characteristics of Heterogeneous Equine Hoof Progenitor Cell Isolates.

Damage to an ectodermal-mesodermal interface like that in the equine hoof and human finger nail bed can permanently alter tissue structure and associated function. The purpose of this study was to establish and validate in vitro culture of primary progenitor cell isolates from the ectodermal-mesodermal tissue junction in equine hooves, the stratum internum, with and without chronic inflammation known to contribute to lifelong tissue defects. The following were evaluated in hoof stratum internum cell isolates up to 5 cell passages (P): expansion capacity by cell doublings and doubling time; plasticity with multi-lineage differentiation and colony-forming unit (CFU) frequency percentage; immunophenotype with immunocytochemistry and flow cytometry; gene expression with RT-PCR; and ultrastructure with transmission electron microscopy. The presence of keratin (K)14, 15 and K19 as well as cluster of differentiation (CD)44 and CD29 was determined in situ with immunohistochemistry. To confirm in vivo extracellular matrix (ECM) formation, cell-scaffold (polyethylene glycol/poly-L-lactic acid and tricalcium phosphate/hydroxyapatite) constructs were evaluated with scanning electron microscopy 9 weeks after implantation in athymic mice. Cultured cells had characteristic progenitor cell morphology, expansion, CFU frequency percentage and adipocytic, osteoblastic, and neurocytic differentiation capacity. CD44, CD29, K14, K15 and K19 proteins were present in native hoof stratum internum. Cultured cells also expressed K15, K19 and desmogleins 1 and 3. Gene expression of CD105, CD44, K14, K15, sex determining region Y-box 2 (SOX2) and octamer-binding transcription factor 4 (OCT4) was confirmed in vitro. Cultured cells had large, eccentric nuclei, elongated mitochondria, and intracellular vacuoles. Scaffold implants with cells contained fibrous ECM 9 weeks after implantation compared to little or none on acellular scaffolds. In vitro expansion and plasticity and in vivo ECM deposition of heterogeneous, immature cell isolates from the ectodermal-mesodermal tissue interface of normal and chronically inflamed hooves are typical of primary cell isolates from other adult tissues, and they appear to have both mesodermal and ectodermal qualities in vitro. These results establish a unique cell culture model to target preventative and restorative therapies for ectodermal-mesodermal tissue junctions.

Clinical stability, diagnosis and catchment area: the patients of a university-based psychiatric outpatient clinic / Estabilidade clínica, diagnóstico e território: os pacientes de um ambulatório psiquiátrico universitário

ABSTRACT Objective This study aimed to characterize the patients assisted at the general outpatient clinic of the Psychiatry Institute of Universidade Federal do Rio de Janeiro (IPUB-UFRJ) and to assess these patients' clinical stability. Methods This cross-sectional study collected information using a structured questionnaire filled in by the patient's physician. The questionnaire, specifically developed for this purpose, included sociodemographic data; the dwelling area; psychiatric diagnosis according to ICD-10; clinical stability assessment by means of five psychiatric instability criteria and the physician's global clinical impression over the six previous months. Clinical stability was defined as a negative answer to all five pre-defined instability criteria. Results Overall, 1,447 questionnaires were filled in. The sample was composed of 824 (57%) women; with an average age of 49 years; 1,104 (76.3%) patients lived in the city of Rio de Janeiro and 343 (23.7%) lived outside the city; 983 (67.9%) patients had a severe mental disorder (SMD) diagnosis and 946 (65.3%) patients were considered stable. Statistically, the clinical stability by dwelling area did not differ. The most frequent clinical instability criterion was "exacerbation or emergence of acute manifestations of the disease". Conclusion The major part of the patients displayed a SMD and was considered clinically stable.

RESUMO Objetivo Este trabalho buscou caracterizar os pacientes atendidos no ambulatório geral do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB-UFRJ) e avaliar sua estabilidade clínica. Métodos Este estudo descritivo, transversal, coletou informações utilizando um questionário estruturado preenchido pelo médico assistente. O questionário, especificamente desenvolvido para esse propósito, continha dados sociodemográficos, área de moradia, diagnóstico psiquiátrico de acordo com a CID-10, avaliação da estabilidade clínica por meio de cinco critérios de instabilidade psiquiátrica e a impressão clínica global do médico, nos últimos seis meses. A estabilidade clínica foi definida como uma resposta negativa a todos os cinco critérios de instabilidade predefinidos. Resultados No total, 1.447 questionários foram preenchidos. A amostra foi composta por 824 (57%) mulheres, com média de idade de 49 anos; 1.104 (76,3%) pacientes residentes na cidade do Rio de Janeiro e 343 (23,7%) residentes fora da cidade; 983 (67,9%) pacientes com diagnóstico de transtorno mental grave (TMG) e 946 (65,3%) pacientes foram considerados estáveis. Estatisticamente, a estabilidade clínica por área de moradia não apresentou diferenças. O critério de instabilidade mais frequente foi "recrudescimento ou o surgimento de manifestações agudas da doença". Conclusão A maioria dos pacientes apresentava um TMG e foi considerada clinicamente estável.

Prediction of pubertal maturation from anthropometric variables: proposal for a non-invasive method.

BACKGROUND: Identifying new perspectives for the development of methods to analyze biological maturation is a very important step for the selection of sports talent. The current study proposed a non-invasive method for evaluating the pubertal status of young males based on anthropometric variables. METHODS: Two hundred six male participants between 8 and 18 years old were evaluated, selected randomly from a school in Natal, Brazil. Seven anthropometric variables were evaluated, as recommended by ISAK, in addition to the pubertal stages being measured through analysis of genital development. The statistics were represented through means and standard deviations of the groups. An Analysis of Variance and multivariate method of discriminative analysis were performed to compare groups and create the predictive equation. RESULTS: The significant differences in the anthropometric variables between the pubertal stages were able to predict the stage of maturity of the participants with an accuracy of 75%. Through a validation sample (N.=52), the level of agreement between the proposed equation and the objective method was excellent, presenting an index of 0.840. CONCLUSIONS: The predicted equation proposed in this study demonstrated a high level of validity, presenting it as a new alternative for the evaluation of pubertal maturity of male youths.

Estágios maturacionais: comparação de indicadores de crescimento e capacidade física em adolescentes / Maturational stages: comparison of growth and physical capacity indicators in adolescents

INTRODUCTION: The identification of physical capacity is an important marker related to healthy behavior during childhood and adolescence, in which some factors appear to contribute to motor performance such as maturation and hormonal levels. OBJECTIVE: To compare growth indicators, physical capacity and hormonal markers according to gender and maturational stage in adolescents. METHODS: Eighty-nine adolescents of both genders aged 10-13 years participated in the study. Sexual maturation was evaluated using the Tanner's self-evaluation method. Physical capacity (explosive strength of upper and lower limbs, upper limb velocity and agility) and hormonal markers (testosterone and estradiol) were evaluated through the chemiluminescence method. RESULTS: In the comparison by gender, girls had higher weight (p = 0.023), height (p = 0.018) and fat percentage values (p = 0.001), while boys presented better motor performance for the explosive strength of upper limbs (p = 0.005) and lower limbs (p = 0.011), agility (0.018) and upper limb velocity (p = 0.014). Regarding maturational stage, boys did not present differences in any variable analyzed; (Stage V versus I), height (stage III, IV and V versus I) and upper limb explosive strength (stage III and IV versus I). CONCLUSION: Growth, weight and height, as well as explosive strength of upper limbs were higher in girls at more advanced maturational stages and appear to be gender dependent.

INTRODUÇÃO: A identificação da capacidade física se apresenta como importante marcador relacionado ao comportamento saudável durante a infância e adolescência, no qual alguns fatores aparentam contribuir para o desempenho motor como a maturação e níveis hormonais. OBJETIVO: Comparar indicadores de crescimento, capacidades físicas e marcadores hormonais de acordo com o sexo e estágio maturacional em adolescentes. MÉTODO: Participaram do estudo 89 adolescentes de ambos os sexos de 10 a 13 anos. Foram avaliados a maturação sexual, obtida através do método de autoavaliação de Tanner, capacidades físicas (força explosiva de membros superiores e inferiores, velocidade de membros superiores e agilidade) e marcadores hormonais (testosterona e estradiol) através do método de quimiluminescência. RESULTADOS: Na comparação pelo sexo, as meninas obtiveram maiores valores para o peso (p=0,023), estatura (p=0,018) e percentual de gordura (p=0,001), enquanto que os meninos apresentaram melhor rendimento motor para a força explosiva de membros superiores (p=0,005) e inferiores (p=0,011), agilidade (0,018) e velocidade de membros superiores (p=0,014). Em relação ao estágio maturacional os meninos não apresentaram diferenças em nenhuma variável analisada; enquanto as meninas em estágio maturacional mais avançado apresentaram maiores valores para o peso (estágio V versus I), estatura (estágio III, IV e V versus I) e força explosiva de membros superiores (estágio III e IV versus I). CONCLUSÃO: Os indicadores de crescimento, peso e estatura, bem como a força explosiva de membros superiores foram mais elevados nas meninas em estágios maturacionais mais avançados e parecem ser dependentes do sexo.

Skeletal age and explosive strength in young volleyball players / Idade óssea e força explosiva de jovens praticantes de voleibol

Abstract Identifying different anthropometric, physiological and motor aspects is essential to obtain success in sports practice. However, these components may be developed in same age subjects differently, in part due biological development. The aim of the study was compare and correlate the explosive strength to biological maturation by sex, obtained by estimation of skeletal age based on anthropometric variables. The sample consisted of 239 subjects of both sexes, aged 10 to 13 years. Maturation was assessed by skeletal age predictive equation and upper and lower limbs explosive strength using medicine ball throw test and vertical jump, respectively. Skeletal age was assessed by skeletal age using a predictive anthropometrical based equation. Upper and lower limbs explosive strength were evaluated by medicine ball throwing test and vertical jump test, respectively. Post hoc analysis showed delayed biological development subjects had worst medicine ball throwing test performance than accelerated boys (p=0.001; d=0.96) and girls (p< 0.01; d= 2.01); regarding to vertical jump test, worst performance was also detected to maturational delayed boys when compared to accelerated ones (p=0.24; d=1.1) and girls (p=0.007; d=0.75). Regression analysis showed skeletal age explained variance of 36% and 19.2% for boys and 45.2% and 16.1% for girls upper and lower limbs explosive strength. Skeletal age is positively related to upper and lower limbs explosive strength and show higher performance for accelerated biological development young players when compared to delayed ones, independently from sex.

Resumo Para se alcançar o sucesso no esporte, a identificação de diferentes aspectos antropométricos, motores e fisiológicos são imprescindíveis. Porém, esses componentes podem se desenvolver diferentemente em indivíduos na mesma faixa etária, em parte pelo desenvolvimento biológico. O objetivo do estudo foi comparar e relacionar a força explosiva com a maturação biológica de acordo com o sexo. A amostra foi composta por 239 sujeitos, com idades entre 10 a 13 anos. A idade óssea foi estimada por uma equação preditora baseada em variáveis antropométricas. A força explosiva de membros superiores e inferiores foram avaliadas através do teste de arremesso de medicine ball e de salto vertical, respectivamente. A análise de post hoc mostrou que os sujeitos com desenvolvimento biológico atrasado obtiveram o pior desempenho no teste de arremesso de medicine ball quando comparados com o grupo acelerado dos meninos (p=0.001; d=0.96) e meninas (p< 0.01; d= 2.01); em relação ao teste de salto vertical, desempenho inferior também foi observado para o estágio atrasado quando comparado com o grupo acelerado dos meninos (p=0.24; d=1.1) e meninas (p= 0.007; d=0.75). Análise de regressão demonstrou que 36% e 19,2% da variância no desempenho da força explosiva de membros superiores e inferiores foi compartilhada pela idade óssea dos meninos, e 45,2% e 16,1%, respectivamente, nas meninas. Conclui-se que a força explosiva de membros superiores e inferiores se relaciona de forma positiva com a idade óssea, sendo o desempenho destes componentes superiores em jovens com desenvolvimento biológico acelerado, quando comparados com o desenvolvimento atrasado, independente do sexo.

Relação da idade óssea e marcadores hormonais com a capacidade física de adolescentes / Relationship between skeletal age, hormonal markers and physical capacity in adolescents

INTRODUCTION: Physical capabilities are an important parameter of the functional development of adolescents, not only by chronological age but also by their maturational state, as individuals with the same chronological age can have different performance to their less mature counterparts. OBJECTIVE: To compare and relate the physical capabilities and hormonal markers according to sex and maturity of adolescents. METHODS: The sample consisted of adolescents of both sexes, aged 10 to 14 years. We evaluated the maturity achieved by a predictive equation of skeletal age, physical capabilities (explosive power of upper and lower limbs, velocity of upper limbs and agility) and hormonal markers (testosterone and oestradiol) via chemiluminescence. RESULTS: Females showed more advanced maturational status, higher weight, body height and oestradiol levels; males performed better in the explosive force of upper and lower limbs, upper limb speed, agility and testosterone levels. In the normal maturational state males showed greater skeletal age, body weight, body height, explosive strength of upper and lower limbs, and testosterone levels; the females in the normal maturational state had higher skeletal age, body weight, body height, explosive upper limb strength and oestradiol levels. In the male correlation analysis, skeletal age was related to the explosive strength of upper and lower limbs and testosterone; while skeletal age in females was related to explosive upper limb strength and oestradiol. CONCLUSION: It is concluded that maturation, testosterone and oestradiol levels play an important role in the physical aspects and performance of motor skills of adolescents, especially in upper limb force which was more related to the maturation obtained by skeletal age of males and females.

INTRODUÇÃO: A capacidade física é um importante parâmetro do desenvolvimento funcional a ser investigado em crianças e adolescentes, não apenas pela idade cronológica e sim pelo seu estado maturacional, já que sujeitos com mesma idade cronológica podem apresentar desempenho diferente ao seu par menos maturado. OBJETIVO: Comparar e relacionar as capacidades físicas e marcadores hormonais de acordo com o sexo e maturação de crianças e adolescentes. MÉTODO: A amostra foi composta por 89 crianças e adolescentes de ambos os sexos de 10 a 13 anos. Foram avaliados a maturação obtida através de uma equação preditora da idade óssea, capacidades físicas (força explosiva de membros superiores e inferiores, velocidade de membros superiores e agilidade) e marcadores hormonais (testosterona e estradiol) através do método de quimioluminescência RESULTADOS: Na comparação entre os sexos as meninas obtiveram estado maturacional mais avançado, maior peso, estatura corporal e níveis de estradiol; já os meninos apresentaram melhor desempenho na força explosiva de membros superior e inferior, velocidade de membro superior, agilidade e níveis de testosterona. Relativo à maturação, os meninos em estado maturacional normal apresentaram maior idade óssea, peso e estatura corporal, força explosiva de membros superior e inferior, e níveis de testosterona; já as meninas no estado maturacional normal obtiveram maior idade óssea, peso, estatura corporal, força explosiva de membro superior e níveis de estradiol. Na análise de correlação dos meninos a idade óssea se relacionou com a força explosiva de membros superior e inferior e testosterona; já a idade óssea das meninas se relacionou com a força explosiva de membro superior e estradiol. CONCLUSÃO: Desta forma, se conclui que maturação e os níveis de testosterona e estradiol exercem um importante papel nos aspectos físicos e no desempenho das habilidades motoras das crianças e dos adolescentes, principalmente na força de membro superior a qual se mostrou mais relacionada com a maturação obtida pela idade óssea de meninos e meninas.