Integral inequalities for closed linear Weingarten submanifolds in the product spaces.

An integral inequality for closed linear Weingarten 𝑚-submanifolds with parallel normalized mean curvature vector field (pnmc lw-submanifolds) in the product spaces 𝑀𝑛(𝑐) × â„, 𝑛 > 𝑚 ≥ 4, where 𝑀𝑛(𝑐) is a space form of constant sectional curvature 𝑐 ∈ {-1, 1}, is proved. As an application is shown that the sharpness in this inequality is attained in the totally umbilical hypersurfaces, and in a certain family of standard product of the form 𝕊1(√1 - 𝑟2) × ð•Šð‘š-1(𝑟) with 0 < 𝑟 < 1 when 𝑐 = 1. In the case where 𝑐 = -1, is obtained an integral inequality whose sharpness is attained only in the totally umbilical hypersurfaces. When 𝑚 = 2 and 𝑚 = 3, an integral inequality is also obtained with equality happening in the totally umbilical hypersurfaces.

Flavoured and nicotine-containing e-liquids impair homeostatic properties of an alveolar-capillary cell model.

Most people consider that electronic cigarettes are safer than tobacco and are marketed as quit-smoking products. The e-liquid, which usually contains propylene glycol (PG) and vegetable glycerin (VG) in different ratios, nicotine and a wide variety of flavours, is heated by a coil and the aerosol droplets are primarily delivered to the alveolar area where nicotine and other molecules cross the alveolar-capillary barrier (ACB). However, e-cigarettes effects on the ACB are not yet established. In our study, a well-characterised in vitro model of the ACB was exposed to PG and VG and to five flavoured e-liquids with and without nicotine. The vehicles, due to their hypertonic properties, modulated the ACB integrity by modifying occludin expression. Below a 10% concentration, the vehicles did not trigger oxidative stress or cell death. Different results were observed between flavoured e-liquids: while red fruits and mint-eucalyptus disrupted ACB integrity, triggered oxidative stress and cell death, blond tobacco had no worse effect compared to the vehicles. However, the addition of nicotine in the latter e-liquid increased oxidative stress and cell death compared to the vehicles. Finally, mint-eucalyptus e-liquid increased some inflammation markers. Our results revealed that e-liquids alter ACB homeostasis, depending on flavour and nicotine presence.

Nischarin Is Not the Functional I1 Imidazoline Receptor Involved in Blood Pressure Regulation.

ABSTRACT: Imidazoline receptor antisera selected/Nischarin was proposed several years ago as the functional entity for the I1 medullary receptors (I1Rs) targeted, together with α2-adrenoceptors, by the centrally acting antihypertensive drugs, such as clonidine. The objective of this study was to test this assumption using a pyrroline analog of clonidine, LNP599, which, unlike clonidine and related compounds, displays high selectivity toward I1Rs. Cardiovascular effects of LNP599 (3 mg/kg intravenous) were evaluated in anesthetized, artificially ventilated nischarin mutant rats expressing a truncated form of nischarin lacking the putative imidazoline binding site. LNP599 induced a rapid and pronounced fall in arterial blood pressure in wild-type animals (-42.7% ± 11.0% after 15 minutes), associated with a ≈30% heart rate reduction. Similar effects were obtained in homozygous and heterozygous nischarin mutant rats. The observation that the hypotensive response to I1R activation is not affected by the absence of the putative imidazoline binding site on nischarin strongly suggests that nischarin cannot be regarded as the functional I1R. Carbohydrate regulation was improved in nischarin mutant rats, further supporting the conclusion that nischarin and I1R are 2 distinct molecular entities.

Anjos da Guarda: ferramenta para o ensino médico / Anjos Da Guarda (Guardian Angels): Medical Teaching Tool

Resumo A verdadeira medicina combina conhecimento biotecnocientífico ao cuidado. No entanto, as escolas médicas têm dado maior ênfase ao conhecimento científico em detrimento da relação médico-paciente. Objetivos: Este relato tem como objetivo descrever a experiência de imersão vivida por quatro estudantes de medicina do sexto período nos meses de fevereiro e março de 2020. Método: Tal imersão deu-se em um projeto de ensino denominado Anjos da Guarda, o qual é usado como ferramenta de educação médica no Hospital Universitário Gaffrée e Guinle da Universidade Federal do Estado do Rio de Janeiro (HUGG-UNIRIO). Resultados: O Projeto Anjos da Guarda desenvolve o profissionalismo médico, a empatia e os fundamentos da medicina centrados na pessoa do paciente como parte do processo de cuidado, sem menosprezar a importância do conhecimento biotecnocientífico e do raciocínio clínico. Conclusão: A experiência possibilitou ganhos em aprendizado para os estudantes, além de contribuir com o sistema de saúde e de beneficiar os pacientes envolvidos.

Abstract Conventional medicine combines biotechnoscientific knowledge with care. However, medical schools have placed greater emphasis on scientific knowledge to the detriment of the doctor-patient relationship. Objectives: This report aims to describe the immersion experience lived by four sixth-term medical students during the months of February and March 2020. Method: Such immersion took place in a teaching project named Anjos da Guarda, which is used as a medical education tool at the Gaffrée e Guinle University Hospital of the Federal University of the State of Rio de Janeiro (HUGG-UNIRIO). Results: The Anjos da Guarda Project develops medical professionalism, empathy and the fundamentals of medicine centered on the patient as part of the care process, without underestimating the importance of biotechnoscientific knowledge and clinical reasoning. Conclusion: The experience enabled gains in learning for students, in addition to contributing to the health system and benefiting the patients involved.

10Boron Is Mobile in Cowpea Plants.

Cowpea [Vigna unguiculata (L.) Walp] is cultivated in tropical and subtropical regions worldwide, but its production is usually limited by boron (B) deficiency, which can be mitigated by applying B via foliar spraying. In plants with nutrient mobility, the residual effect of foliar fertilization increases, which might improve its efficiency. An experiment was carried out to evaluate the concentration and mobility of the B isotopic tracer (10B) in different organs of cowpea plants, after the application of this micronutrient in the growing media and also to leaves. Treatments were designed based on B fertilization as follows: without B in the growth media, with 10B applied via foliar spraying (10B-L), with B in the growth media (substrate) and 10B via foliar spraying (10B-L + B-S), and with 10B in the growth media (substrate) without foliar spraying (10B-S), and a control without fertilization. A redistribution of 10B was observed in new leaves when the element was supplied via foliar spraying, resulting in greater leaf area, dry mass and dry matter production of aerial parts, and also the whole plant. 10Boron was redistributed when applied via foliar spraying in cowpea plants, regardless of the plant's nutritional status, which in turn might increase internal B cycling.

Blood-Brain Barrier Permeability: Is 5-Hydroxytryptamine Receptor Type 4 a Game Changer?

Serotonin affects many functions in the body, both in the central nervous system (CNS) and the periphery. However, its effect on the blood-brain barrier (BBB) in separating these two worlds has been scarcely investigated. The aim of this work was to characterize the serotonin receptor 5-HT4 in the hCMEC/D3 cell line, in the rat and the human BBB. We also examined the effect of prucalopride, a 5-HT4 receptor agonist, on the permeability of the hCMEC/D3 in an in vitro model of BBB. We then confirmed our observations by in vivo experiments. In this work, we show that the 5-HT4 receptor is expressed by hCMEC/D3 cells and in the capillaries of rat and human brains. Prucalopride increases the BBB permeability by downregulating the expression of the tight junction protein, occludin. This effect is prevented by GR113808, a 5-HT4 receptor antagonist, and is mediated by the Src/ERK1/2 signaling pathway. The canonical G-protein-dependent pathway does not appear to be involved in this phenomenon. Finally, the administration of prucalopride increases the diffusion of Evans blue in the rat brain parenchyma, which is synonymous with BBB permeabilization. All these data indicate that the 5-HT4 receptor contributes to the regulation of BBB permeability.

Characterization of the spontaneous degenerative mitral valve disease in FVB mice.

BACKGROUND: The development of new non-surgical treatments dedicated to mitral valve degeneration is limited by the absence of relevant spontaneous and rapidly progressing animal experimental models. ANIMALS: We characterized the spontaneous mitral valve degeneration in two inbred FVB mouse strains compared to C57BL/6J and investigated a contribution of the serotonergic system. METHODS: Males and females FVB/NJ and FVB/NRj were compared to the putative C57BL/6J control at 12, 16, 20 and 24 weeks of age. Body weight, systolic blood pressure, heart rate, urinary 5-hydroxyindoleacetic acid (5-HIAA), whole blood and plasma serotonin, tail bleeding time, blood cell count, plasma TGF-ß1 and plasma natriuretic peptide concentrations were measured. Myocardium and mitral valves were characterized by histology. mRNA mitral expression of 5-HT2A and 5-HT2B receptors was measured in the anterior leaflet. Cardiac anatomy and function were assessed by echocardiography. RESULTS: Compared to C57BL/6J, FVB mice strains did not significantly differ regarding body weight increase, arterial blood pressure and heart rate. A progressive augmentation of plasma pro-ANP was observed in FVB mice. Nevertheless, no cardiac hypertrophy or left-ventricular fibrosis were observed. Accordingly, plasma TGF-ß1 was not different among the three strains. Conversely, FVB mice demonstrated a high prevalence of fibromyxoid highly cellularized and enriched in glycosaminoglycans lesions, inducing major mitral leaflets thickening without increase in length. The increased thickness was correlated with urinary 5-HIAA and blood platelet count. Whole blood serotonin concentration was similar in the two strains but, in FVB, a reduction of plasma serotonin was observed together with an increase of the bleeding time. Finally, echocardiography identified left atrial and left ventricular remodeling associated with thickening of both mitral leaflets and mitral insufficient in 30% of FVB mice but no systolic protrusion of mitral leaflets towards the atrium. CONCLUSION: The FVB mouse strain is highly prone to spontaneous mitral myxomatous degeneration. A contribution of the peripheral serotonergic system is suggested.

Klotho genetic variants mediate the association between obstructive sleep apnea and short telomere length.

The core features of obstructive sleep apnea (OSA) can potentially contribute to the acceleration of telomere shortening mechanisms. Other factor associated with telomeres is Klotho gene as it can negatively regulates telomerase activity. Noteworthy, KLOTHO protein level has recently been associated with OSA. In this sense, it was plausible to hypothesize that OSA would be associated with short telomere length and those with OSA plus risk single nucleotide polymorphisms (SNPs) in Klotho gene would present even shorter telomere length. As part of the EPISONO cohort, 1042 individuals answered questionnaires, underwent polysomnography and had blood collected for DNA extraction. OSA was defined according to AHI≥ 15 events/hour. Leukocyte telomere length (LTL) was measured through real-time polymerase chain reaction (qPCR) and Klotho SNPs were genotyped by array. Mediation analyses considered the presence of SNPs in Klotho gene and how this interaction can affect OSA and its consequence in telomere length. All the analyses were corrected for multiple comparisons. LTL was significantly shorter in OSA compared to controls in a severity-dependent manner (B = 0.055; CI = 0.007-0.102; p = 0.02). Among the 43 Klotho SNPs analyzed, we observed that 4 SNPs (rs525014, rs7982726, rs685417 and rs9563124) significantly mediated the association between OSA and short LTL. Klotho gene opens a new venue in OSA research since it can contribute in the increase of knowledge of the mechanisms involved in the consequences of short telomeres in individuals with OSA.

O processo de construção do TCC em psicologia: uma experiência compartilhada / The process of constructing the TCC in psychology: a shared experience

O presente trabalho apresenta as concepções que guiam as diretrizes e o processo de construção dos trabalhos de conclusão de curso (TCC) do curso de Psicologia da Escola Bahiana de Medicina e Saúde Pública (EBMSP), além de uma análise das principais características que marcam as produções dos últimos 10 anos (2009-2019). O TCC integra a construção curricular em Psicologia, na EBMSP, como uma narrativa autoral e orientada que rubrica a formação com autonomia e reflexão teórico-metodológica de um tema-problema da contemporaneidade. O trabalho trafega em dialogicidade, perspectiva comunicacional horizontal que permite trocas, implicações, negociações entre os entes que compõem a compreensão e a escrita. Por ser artesanal, o processo de construção do TCC surge nesse texto como metáfora do ofício das baianas do acarajé, uma vez que, assim como ocorre com a culinária do acarajé, envolve etapas interdependentes e sequenciais. Para tornar isso possível, o curso oferece cinco disciplinas que oferecem suporte direto ao desenvolvimento dos TCCs, estando distribuídas ao longo de três semestres letivos. O encerramento dessa trajetória é coroado pela solenidade de defesa pública do trabalho. Nos últimos 10 anos, 387 TCCs foram produzidos e defendidos no curso, representando diferentes modalidades de produções científicas, como revisões de literatura, pesquisas empíricas e relatos de experiência. Evidencia-se elevado interesse pelas temáticas relacionadas ao eixo da Psicologia, Sociedade e Cultura e pelas áreas de atuação ligadas à saúde e clínica, o que reflete características ligadas à própria profissão e ao perfil do curso da EBMSP.

The present work presents the conceptions that guide the guidelines and the process of construction of the course conclusion works (TCC) of the Psychology course at the Bahiana School of Medicine and Public Health (EBMSP), in addition to an analysis of the main characteristics that mark the productions from the last 10 years (2009-2019). The TCC integrates the curricular construction in Psychology, in the EBMSP, as an authorial and oriented narrative that initials the training with autonomy and theoretical-methodological reflection of a contemporary theme-problem. The work travels in dialogicity, a horizontal communicational perspective that allows exchanges, implications, negotiations between the entities that make up comprehension and writing. Because it is handmade, the construction process of the TCC appears in this text as a metaphor for the craft of the Bahian women of the acarajé, since, as with the cuisine of the acarajé, it involves interdependent and sequential stages. To make this possible, the course offers five subjects that offer direct support to the development of the TCCs, being distributed over three academic semesters. The end of this trajectory is crowned by the public defense of labor ceremony. In the last 10 years, 387 TCCs were produced and defended in the course, representing different types of scientific production, such as literature reviews, empirical research and experience reports. There is a high interest in the themes related to the Psychology, Society and Culture axis and in the areas of activity linked to health and clinic, which reflects characteristics related to the profession itself and the profile of the EBMSP course.

O fazer dos estágios curriculares na formação em psicologia: uma experiência coletiva / The making of curricular internships in psychology training: a collective experience

O presente trabalho apresenta a concepção e o fazer dos estágios básicos e específicos do curso de Psicologia da Escola Bahiana de Medicina e Saúde Pública (EBMSP), instituição vocacionada para a saúde. Em seguida, descreve o funcionamento das referidas práticas, apresentando o contexto na qual elas estão inseridas e o processo de gestão do processo. Os estágios ocupam um lugar diferenciado na organização curricular do curso de Psicologia da EBMSP, pois oferecem aos discentes possibilidades de articulação entre teoria e prática de maneira crítica e reflexiva, conforme orientação das Diretrizes Curriculares Nacionais para os Cursos de Graduação de Psicologia. Os componentes fazem parte do eixo pré-profissionalizante e possibilitam a experiência em espaços e processos diversos de trabalho, nas duas ênfases do curso, Saúde e Trabalho. As atividades acontecem ao longo do quarto e quinto ano e são mediadas por vários participantes: corpo discente, corpo docente, coordenação e supervisor de campo. É a organização acadêmica e pedagógica dos estágios que permite a oferta de experiências práticas diferenciadas para o desenvolvimento de competências relacionadas ao fazer do Psicólogo. Observa-se que ao longo dos 20 anos do curso de Psicologia da EBMSP, os estágios estão em aprimoramento contínuo com foco na construção da identidade profissional do discente. Evidenciase, a partir da avaliação dos discentes, docentes e dos supervisores de campo que o egresso do curso de Psicologia da EBMSP, apresenta uma formação generalista, com competências práticas adquiridas para atuarem nos campos da saúde e trabalho com elevado nível técnico, integrados de forma crítica à sociedade, à realidade e ao mundo de trabalho.

This work presents the conception and implementation of basic and specific internships in the Psychology course at the Bahiana School of Medicine and Public Health (EBMSP), an institution dedicated to health. Then, it describes the functioning of these practices, presenting the context in which they are inserted and the process management process. The internships occupy a different place in the curricular organization of the Psychology course at EBMSP, as they offer students possibilities of articulation between theory and practice in a critical and reflective way, as guided by the National Curricular Guidelines for Psychology Undergraduate Courses. The components are part of the pre-professional axis and enable the experience in different work spaces and processes, in the two emphases of the course, Health and Work. The activities take place over the fourth and fifth year and are mediated by several participants: student body, faculty, coordination and field supervisor. It is the academic and pedagogical organization of the internships that allows the offering of different practical experiences for the development of skills related to the Psychologist's work. It is observed that throughout the 20 years of the Psychology course at EBMSP, the internships are in continuous improvement with a focus on building the student's professional identity. It is evident from the evaluation of students, teachers and field supervisors that the graduate of the Psychology course at EBMSP, presents a generalist training, with practical skills acquired to work in the fields of health and work with high technical level, integrated critically to society, reality and the world of work.

Stigma perceived by overweight women.

OBJECTIVE: to understand the experience of discrimination perceived by overweight women. METHODS: a qualitative research conducted at an outpatient clinic in Salvador, Bahia, where eleven women were interviewed. The interviews were transcribed and submitted to thematic content analysis. RESULTS: the analysis of the statements expressed three categories: Suffering discrimination in different social contexts: denounced disrespect, hostility, veiled and/or explicit exclusion, prejudice, injustice and insults lived in public transport, at work, in the family environment, in social events and commercial establishments; Experiencing negative feelings about discrimination: revealed inferiority, sadness, shame, fear, anger, frustration, low esteem and discouragement faced by women; Reacting to discrimination: expressed isolation of marital intimacy and social encounters, removal from work, concealment of body and feelings and even illness of women. FINAL CONSIDERATIONS: the discrimination experienced in various settings has caused suffering, embarrassment, negative feelings, shame, isolation and loss in women's lives.

Chronic REM sleep restriction in young rats increases energy expenditure with no change in food intake.

NEW FINDINGS: What is the central question of this study? What are the effects of different periods of REM sleep restriction (7, 14 and 21 days) on metabolic parameters in young rats? What is the main finding and its importance? Animals submitted to each period of REM sleep deprivation showed a negative energy balance, with reduced body weight gain, body energy gain and gross food efficiency, less body fat content, and increased energy expenditure. There was no increase in food intake after any of the REM sleep restriction periods. In young rats, negative energy balance is not compensated by increased dietary intake as observed in adult rats. ABSTRACT: Reduced sleep is associated with metabolic alterations, not only in adults, but also in children and adolescents. Several studies have shown that sleep restricted (SR) adult rats exhibit metabolic changes, followed by increased food intake, but few have evaluated these functions in young animals. The aim of the present study was to establish the metabolic parameters of young rats subjected to different periods of REM sleep restriction and to propose a correction factor for the correct measurement of food intake. Young male Wistar rats were distributed in control and SR groups for 7, 14 or 21 days. Sleep restriction was performed by the single platform method for 18 h. Regardless of the length of sleep restriction, all SR rats had a negative energy balance, evidenced by reduction in body weight gain, body energy gain and gross food efficiency, accompanied by increased energy expenditure. In addition, sleep restriction reduced body fat content throughout the entire period. Discounting food spillage, there was no increase in food intake by SR rats. In conclusion, the present study revealed metabolic changes in SR young rats after different lengths of REM sleep restriction and that weight loss and increased energy expenditure were not compensated by increased dietary intake as occurs in adult rats, indicating that young rats use other mechanisms to cope with the negative energy balance caused by sleep restriction. In addition, we propose a correction factor for food intake, to prevent overestimation of this parameter, due to food spillage in the water containers.

Maternal mortality and social vulnerability in a Northeast State in Brazil: a spatial-temporal approach / Mortalidade materna e vulnerabilidade social no Estado de Alagoas no Nordeste brasileiro: uma abordagem espaço-temporal

Abstract Objectives: to analyze the epidemiological profile and the spatial-temporal dynamics on maternal mortality in Alagoas and its relationship with social vulnerability and income inequality. Methods: a mixed ecological study involving maternal deaths who resided in Alagoas from 1996 to 2016. Sociodemographic variables (age, race/color, education, marital status), clinical (type of obstetric cause, death by category and ICD group) were analyzed, besides the indicators (Maternal Mortality Ratio-MMR, Social Vulnerability Index and Gini Index). For the temporal analysis, we used the inflection point regression model and for the spatial analysis, the local empirical Bayesian model, Moran Global and Local statistics, and the bivariate local spatial autocorrelation analysis. Results: a total of 586 deaths (47.63/100 thousand live births) were registered, with a trend of MMR growth (APC 2.8%), with a heterogeneous distribution between health regions and cities. The profile was characterized by the predominance of young, black / mixed skin color women with low schooling. Eight cities were considered priority. There was spatial correlation with the Social Vulnerability Index and income inequality. Conclusions: identifying priority areas may contribute to planning and targeting interventions.

Resumo Objetivos: analisar o perfil epidemiológico e a dinâmica espaço-temporal da mortalidade materna em Alagoas e sua relação com a vulnerabilidade social e a desigualdade de renda. Métodos: estudo ecológico misto envolvendo os óbitos maternos de residentes em Alagoas de 1996 a 2016. Foram analisadas variáveis sociodemográficas (faixa etária, raça/cor, escolaridade, estado civil), clínicas (tipo de causa obstétrica, óbito por categoria e grupo de CID), além de indicadores (Razão de Mortalidade Materna-RMM, Índice de Vulnerabilidade Social e Índice de Gini). Para a análise temporal utilizou-se o modelo de regressão por pontos de inflexão e para a análise espacial o modelo bayesiano empírico local, a estatística de Moran Global e Local e a análise de autocorrelação espacial local bivariável. Resultados: foram registrados 586 óbitos (47,63/100 mil nascidos vivos), com tendência de crescimento da RMM (APC 2,8%), com distribuição heterogênea entre as regiões de saúde e municípios. O perfil foi caracterizado pelo predomínio de mulheres jovens, pretas/pardas e de baixa escolaridade. Oito municípios foram considerados prioritários. Houve correlação espacial com o Índice de Vulnerabilidade Social e de desigualdade de renda. Conclusões: a identificação de áreas prioritárias pode contribuir para o planejamento e direcionamento de intervenções.

Stigma perceived by overweight women / Estigma percibido por mujeres con sobrepeso / Estigma percebido por mulheres com excesso de peso

ABSTRACT Objective: to understand the experience of discrimination perceived by overweight women. Methods: a qualitative research conducted at an outpatient clinic in Salvador, Bahia, where eleven women were interviewed. The interviews were transcribed and submitted to thematic content analysis. Results: the analysis of the statements expressed three categories: Suffering discrimination in different social contexts: denounced disrespect, hostility, veiled and/or explicit exclusion, prejudice, injustice and insults lived in public transport, at work, in the family environment, in social events and commercial establishments; Experiencing negative feelings about discrimination: revealed inferiority, sadness, shame, fear, anger, frustration, low esteem and discouragement faced by women; Reacting to discrimination: expressed isolation of marital intimacy and social encounters, removal from work, concealment of body and feelings and even illness of women. Final considerations: the discrimination experienced in various settings has caused suffering, embarrassment, negative feelings, shame, isolation and loss in women's lives.

RESUMEN Objetivo: comprender la experiencia de discriminación percibida por las mujeres con sobrepeso. Métodos: investigación cualitativa realizada en una clínica ambulatoria en Salvador, Bahia, donde se entrevistó a once mujeres. Las entrevistas fueron transcritas y sometidas a Análisis de Contenido Temático. Resultados: el análisis de las declaraciones expresó tres categorías: Sufriendo discriminación en diferentes contextos sociales: denunciando falta de respeto, hostilidad, exclusión velada y/o explícita, prejuicios, injusticias e insultos experimentados en el transporte público, en el trabajo, en el entorno familiar, en eventos sociales y establecimientos comerciales; Experimentar sentimientos negativos sobre la discriminación: inferioridad revelada, tristeza, vergüenza, miedo, ira, frustración, baja estima y desánimo que enfrentan las mujeres; Reacción a la discriminación: aislamiento expresado de la intimidad conyugal y encuentros sociales, retiro del trabajo, ocultación del cuerpo y los sentimientos e incluso enfermedades de las mujeres. Consideraciones finales: la discriminación experimentada en diversos entornos ha causado sufrimiento, vergüenza, sentimientos negativos, vergüenza, aislamiento y pérdida en la vida de las mujeres.

RESUMO Objetivo: compreender a vivência da discriminação percebida por mulheres com excesso de peso. Métodos: pesquisa qualitativa desenvolvida em ambulatório, em Salvador, Bahia, onde onze mulheres foram entrevistadas. As entrevistas foram transcritas e submetidas à Análise de Conteúdo Temática. Resultados: a análise dos depoimentos expressou três categorias: Sofrendo discriminação em diferentes contextos sociais: denunciou desrespeito, hostilidade, exclusão velada e/ou explícita, preconceito, injustiça e insultos vividos em transportes coletivos, no trabalho, no ambiente familiar, em eventos sociais e estabelecimentos comerciais; Experienciando sentimentos negativos face à discriminação: revelou inferioridade, tristeza, vergonha, medo, raiva, frustração, baixa da estima e desânimo enfrentados pelas mulheres; Reagindo à discriminação: expressou o isolamento da intimidade conjugal e de encontros sociais, o afastamento do trabalho, a ocultação do corpo e de sentimentos e até mesmo adoecimento de mulheres. Considerações finais: a discriminação vivida em diversos cenários causou sofrimento, constrangimento, sentimentos negativos, vergonha, isolamento e perdas na vida das mulheres.

Stigma perceived by overweight women / Estigma percibido por mujeres con sobrepeso / Estigma percebido por mulheres com excesso de peso

ABSTRACT Objective: to understand the experience of discrimination perceived by overweight women. Methods: a qualitative research conducted at an outpatient clinic in Salvador, Bahia, where eleven women were interviewed. The interviews were transcribed and submitted to thematic content analysis. Results: the analysis of the statements expressed three categories: Suffering discrimination in different social contexts: denounced disrespect, hostility, veiled and/or explicit exclusion, prejudice, injustice and insults lived in public transport, at work, in the family environment, in social events and commercial establishments; Experiencing negative feelings about discrimination: revealed inferiority, sadness, shame, fear, anger, frustration, low esteem and discouragement faced by women; Reacting to discrimination: expressed isolation of marital intimacy and social encounters, removal from work, concealment of body and feelings and even illness of women. Final considerations: the discrimination experienced in various settings has caused suffering, embarrassment, negative feelings, shame, isolation and loss in women's lives.

RESUMEN Objetivo: comprender la experiencia de discriminación percibida por las mujeres con sobrepeso. Métodos: investigación cualitativa realizada en una clínica ambulatoria en Salvador, Bahia, donde se entrevistó a once mujeres. Las entrevistas fueron transcritas y sometidas a Análisis de Contenido Temático. Resultados: el análisis de las declaraciones expresó tres categorías: Sufriendo discriminación en diferentes contextos sociales: denunciando falta de respeto, hostilidad, exclusión velada y/o explícita, prejuicios, injusticias e insultos experimentados en el transporte público, en el trabajo, en el entorno familiar, en eventos sociales y establecimientos comerciales; Experimentar sentimientos negativos sobre la discriminación: inferioridad revelada, tristeza, vergüenza, miedo, ira, frustración, baja estima y desánimo que enfrentan las mujeres; Reacción a la discriminación: aislamiento expresado de la intimidad conyugal y encuentros sociales, retiro del trabajo, ocultación del cuerpo y los sentimientos e incluso enfermedades de las mujeres. Consideraciones finales: la discriminación experimentada en diversos entornos ha causado sufrimiento, vergüenza, sentimientos negativos, vergüenza, aislamiento y pérdida en la vida de las mujeres.

RESUMO Objetivo: compreender a vivência da discriminação percebida por mulheres com excesso de peso. Métodos: pesquisa qualitativa desenvolvida em ambulatório, em Salvador, Bahia, onde onze mulheres foram entrevistadas. As entrevistas foram transcritas e submetidas à Análise de Conteúdo Temática. Resultados: a análise dos depoimentos expressou três categorias: Sofrendo discriminação em diferentes contextos sociais: denunciou desrespeito, hostilidade, exclusão velada e/ou explícita, preconceito, injustiça e insultos vividos em transportes coletivos, no trabalho, no ambiente familiar, em eventos sociais e estabelecimentos comerciais; Experienciando sentimentos negativos face à discriminação: revelou inferioridade, tristeza, vergonha, medo, raiva, frustração, baixa da estima e desânimo enfrentados pelas mulheres; Reagindo à discriminação: expressou o isolamento da intimidade conjugal e de encontros sociais, o afastamento do trabalho, a ocultação do corpo e de sentimentos e até mesmo adoecimento de mulheres. Considerações finais: a discriminação vivida em diversos cenários causou sofrimento, constrangimento, sentimentos negativos, vergonha, isolamento e perdas na vida das mulheres.

Caso Venezuela: Reflexiones desde la bioética / Venezuela Case: Reflections from Bioethics / O caso da Venezuela: reflexões da bioética

Resumen: En este artículo se presenta el caso de Venezuela, país que, luego de haber tenido el mayor potencial de desarrollo de Latinoamérica, sufre una debacle política, económica y social que lo ha llevado a convertirse en el más pobre de la región, con la inflación más elevada, y a ser calificado en "emergencia humanitaria compleja". También se describen las graves violaciones a los derechos humanos: civiles, políticos, económicos, sociales, culturales y ambientales que ocurren allí sobre la base de la Declaración Universal sobre Bioética y Derechos Humanos, de la Unesco (2005). Además, se proporciona información sobre el desarrollo y la enseñanza de la bioética en Venezuela. El artículo concluye con el análisis de la situación del país desde otras perspectivas bioéticas enfocadas en Latinoamérica: bioética social y bioética de intervención; las repercusiones del problema en la región y la descripción de los esfuerzos realizados a nivel nacional e internacional para solventar la emergencia humanitaria y recuperar el país.

Abstract: This article presents the case of Venezuela, a country that, after having had the greatest development potential in Latin America, suffers a political, economic and social debacle that led it to become the poorest in the region, with the highest inflation, and to be qualified as a country in a "complex humanitarian emergency". It also describes the serious violations to human rights -civil, political, economic, social, cultural and environmental - that occur there based on the Universal Declaration on Bioethics and Human Rights by Unesco (2005). Additionally, information on the development and teaching of bioethics in Venezuela is provided. The article ends with an analysis of the country situation from other bioethical perspectives focused on Latin-America: social bioethics and intervention bioethics; the repercussions of the problem in the region and the description of the efforts made at national and international level to solve the humanitarian emergency and to recover the country.

Resumo: Este artigo apresenta o caso da Venezuela que, depois de ter o maior potencial de desenvolvimento da América Latina, sofre um desastre político, económico e social que a levou a se tornar o país mais pobre da região, além de apresentar a mais alta taxa de inflação e estar sob "emergência humanitária complexa". Também há relatos de graves violações dos direitos humanos (civil, político, económico, social, cultural e ambiental), com base na Declaração Universal de Bioética e Direitos Humanos, da Unesco (2005). Além disso, algumas informações sobre o desenvolvimento e ensino da bioética na Venezuela são fornecidas. O artigo é concluído com a análise da situação desse país, a partir de outras perspectivas bioéticas que estão enfocadas na América Latina, como a bioética social e a bioética de intervenção, as repercussões do problema na região e a descrição dos esforços realizados, em nível nacional e internacional, para solucionar a emergência humanitária e recuperar esse país.

Remission in Crohn's disease is accompanied by alterations in the gut microbiota and mucins production.

Previous studies have demonstrated that patients with Crohn's disease (CD) in remission do not exhibit an improvement in gut microbiota composition, which might trigger relapses. The present study investigated the dysbiosis and mucins production in CD patients during remission. We performed an analytical cross-sectional single center study, which recruited 18 CD patients and 18 healthy controls (CG) residing in the same home, meaning that all of the participants experienced the same environmental factors, with similar hygiene status, diet, pollution and other common lifestyle characteristics that may influence the composition of the gut microbiota. When compared to healthy controls, the CD patients exhibited lower microbial α-diversity (p = 0.047), a greater abundance of the Proteobacteria phylum (p = 0.037) and a reduction in the Deltaproteobacteria class (p = 0.0006). There was also a reduction in the Akkermansia (p = 0.002) and Oscillospira (p = 0.024) genera and in the proportion of the yeast Saccharomyces cerevisiae (p = 0.01). Additionally, CD patients in remission presented increased neutral (p = 0.001) and acid mucin (p = 0.002) concentrations. The reductions in the proportions of Oscollospira and Akkermansia genera, sulfate-reducing bacteria and Saccharomyces cerevisiae, observed in the CD group, may account for the increased mucins production observed in these patients.

Serotonin contribution to cardiac valve degeneration: new insights for novel therapies?

Heart valve disease (HVD) is a complex entity made by different pathological processes that ultimately lead to the abnormal structure and disorganization of extracellular matrix proteins resulting to dysfunction of the leaflets. At its final evolutionary step, treatments are limited to the percutaneous or surgical valve replacement, whatever the original cause of the degeneration. Understanding early molecular mechanisms that regulate valve interstitial cells remodeling and disease progression is challenging and could pave the way for future drugs aiming to prevent and/or reverse the process. Some valve degenerative processes such as the carcinoid heart disease, drug-induced valvulopathy and degenerative mitral valve disease in small-breed dogs are clearly linked to serotonin. The carcinoid heart is typically characterized by a right-sided valve dysfunction, observed in patients with carcinoid tumors developed from serotonin-producing gut enterochromaffin cells. Fenfluramine or ergot derivatives were linked to mitral and aortic valve dysfunction and share in common the pharmacological property of being 5-HT2B receptor agonists. Finally, some small-breed dogs, such as the Cavalier King Charles Spaniel are highly prone to degenerative mitral valve disease with a prevalence of 40% at 4 years-old, 70% at 7 years-old and 100% in 10-year-old animals. This degeneration has been linked to high serum serotonin, 5-HT2B receptor overexpression and SERT downregulation. Through the comprehension of serotonergic mechanisms involved into these specific situations, new therapeutic approaches could be extended to HVD in general. More recently, a serotonin dependent/ receptor independent mechanism has been suggested in congenital mitral valve prolapse through the filamin-A serotonylation. This review summarizes clinical and molecular mechanisms linking the serotonergic system and heart valve disease, opening the way for future pharmacological research in the field.

Avaliação da capacidade funcional, qualidade de vida e do sono em indivíduos com doença pulmonar obstrutiva crônica / Evaluation of functional capacity, quality of life and quality of sleep in people with chronic obstructive pulmonary disease

Objetivo: Avaliar a capacidade funcional, a qualidade de vida e do sono em pacientes portadores de doença pulmonar obstru-tiva crônica (DPOC). Material e Métodos: Estudo quantitativo do tipo transversal, no qual foram avaliados 11 voluntários com diagnóstico clínico e espirométrico de DPOC em atendimento no Centro de Reabilitação II (UEPA) e 15 voluntários saudáveis (grupo controle). Foi aplicada uma ficha de avaliação para registro dos dados clínicos e demográficos dos voluntários. A avaliação da capacidade funcional foi realizada por meio do Teste de caminhada de 6 minutos (TC6min); a qualidade de vida, por meio da utilização do Questionário de Qualidade de Vida SF36 (Medical Outcomes Study 36 ­ Item Short ­ Form Health Survey) e da avaliação da qualidade do sono por meio do Índice de Qualidade de Sono de Pittsburgh (IQSP). As informações coletadas foram armazenadas no software Excel 2007™ (Microsoft Corporation, Redmond, USA) e analisadas por meio dos softwares BIO ESTAT versão 5.0™. Foi adotado o nível α de 0.05 para rejeição da hipótese nula. Resultados:A média da distância percorrida no TC6 foi de 398.0±18.44 m para o DPOC e 523.9±15.41m para os saudáveis (p-valor <0.0001). Todos os domínios do SF36 encontraram-se alterados no DPOC e houve significância estatística quando comparados os grupos. O IQSP indicou que a maioria dos indivíduos com DPOC possui má qualidade do sono. Conclusão: O estudo trouxe resultados significativos, mostrando que os indivíduos atendidos no Centro de Reabilitação II, encontram-se limitados no que diz respeito ao exercício, qualidade de vida e do sono, indicando a necessidade de avaliar o indivíduo com DPOC de maneira biopsicossocial. (AU)

Objective: To evaluate functional capacity, quality of life and quality of sleep in COPD patients. Methods: 11 Volunteers with a clinical spirometryc diagnosis of COPD, of both genders, on treatment at the CER II, and 15 healthy volunteers (control group) .To evaluate the volunteers, it was used: an evaluation sheet, containing the volunteer's identification and clinical data, the Six minute walk test (6WT) to evaluate the patient's functional capacity, the Medical Outcomes Study 36­ Item Short ­ Form Health Survey to assess quality of life, and the Pittsburgh Sleep Quality Index(PSQI) to evaluate quality of sleep. All data collected was stored in the software Excel 2007™ (Microsoft Corporation, Redmond, USA), and analyzed through the software BIO ESTAT 5.0™. The α level of 0.05 was be applied to reject the null hypothesis. Results: The mean value for distance among the COPD group was 398.0±18.44 m and 523.9±15.41m for the control group (p-value <0.0001). All do-mains of the SF-36 were altered. The PSQI indicated that most individuals with COPD have bad quality of sleep. Conclusion:This study had significative results, showing that the subjects of this study are limited, when it comes to exercise, quality of life and quality of sleep, indicating the need to evaluate COPD individuals in a biopsychosocial manner. (AU)

The role of 5-HT2B receptors in mitral valvulopathy: bone marrow mobilization of endothelial progenitors.

BACKGROUND AND PURPOSE: Valvular heart disease (VHD) is highly prevalent in industrialized countries. Chronic use of anorexigens, amphetamine or ergot derivatives targeting the 5-HT system is associated with VHD. Here, we investigated the contribution of 5-HT receptors in a model of valve degeneration induced by nordexfenfluramine, the main metabolite of the anorexigens, dexfenfluramine and benfluorex. EXPERIMENTAL APPROACH: Nordexfenfluramine was infused chronically (28 days) in mice ((WT and transgenic Htr2B -/- , Htr2A -/- , and Htr2B/2A -/- ) to induce mitral valve lesions. Bone marrow transplantation was also carried out. Haemodynamics were measured with echocardiography; tissues and cells were analysed by histology, immunocytochemistry, flow cytometry and RT -qPCR. Samples of human prolapsed mitral valves were also analysed. KEY RESULTS: Chronic treatment of mice with nordexfenfluramine activated 5-HT2B receptors and increased valve thickness and cell density in a thick extracellular matrix, mimicking early steps of mitral valve remodelling. Lesions were prevented by 5-HT2A or 5-HT2B receptor antagonists and in transgenic Htr2B -/- or Htr2A/2B -/- mice. Surprisingly, valve lesions were mainly formed by numerous non-proliferative CD34+ endothelial progenitors. These progenitors originated from bone marrow (BM) as revealed by BM transplantation. The initial steps of mitral valve remodelling involved mobilization of BM-derived CD34+ CD31+ cells by 5-HT2B receptor stimulation. Analysis of human prolapsed mitral valves showing spontaneous degenerative lesions, demonstrated the presence of non-proliferating CD34+ /CD309+ /NOS3+ endothelial progenitors expressing 5-HT2B receptors. CONCLUSIONS AND IMPLICATIONS: BM-derived endothelial progenitor cells make a crucial contribution to the remodelling of mitral valve tissue. Our data describe a new and important mechanism underlying human VHD.