Cannabidiol improves maternal obesity-induced behavioral, neuroinflammatory and neurochemical dysfunctions in the juvenile offspring.

Maternal obesity is associated with an increased risk of psychiatric disorders such as anxiety, depression, schizophrenia and autism spectrum disorder in the offspring. While numerous studies focus on preventive measures targeting the mothers, only a limited number provide practical approaches for addressing the damages once they are already established. We have recently demonstrated the interplay between maternal obesity and treatment with cannabidiol (CBD) on hypothalamic inflammation and metabolic disturbances, however, little is known about this relationship on behavioral manifestations and neurochemical imbalances in other brain regions. Therefore, here we tested whether CBD treatment could mitigate anxiety-like and social behavioral alterations, as well as neurochemical disruptions in both male and female offspring of obese dams. Female Wistar rats were fed a cafeteria diet for 12 weeks prior to mating, and during gestation and lactation. Offspring received CBD (50 mg/kg) from weaning for 3 weeks. Behavioral tests assessed anxiety-like manifestations and social behavior, while neuroinflammatory and neurochemical markers were evaluated in the prefrontal cortex (PFC) and hippocampus. CBD treatment attenuated maternal obesity-induced anxiety-like and social behavioral alterations, followed by rescuing effects on imbalanced neurotransmitter and endocannabinoid concentrations and altered expression of glial markers, CB1, oxytocin and dopamine receptors, with important differences between sexes. Overall, the findings of this study provide insight into the signaling pathways for the therapeutic benefits of CBD on neuroinflammation and neurochemical imbalances caused by perinatal maternal obesity in the PFC and the hippocampus, which translates into the behavioral manifestations, highlighting the sexual dimorphism encompassing both the transgenerational effect of obesity and the endocannabinoid system.

Omega-3 Attenuates Disrupted Neurotransmission and Partially Protects Metabolic Dysfunction Caused by Obesity in Wistar Rats.

Omega-3 (n3) is a polyunsaturated fatty acid well known for its anti-inflammatory and neuroprotective properties. Obesity is linked to chronic inflammation that disrupts metabolism, the intestine physiology and the central nervous system functioning. This study aims to determine if n3 supplementation can interfere with the effects of obesity on the mitochondrial activity, intestinal barrier, and neurotransmitter levels in the brain of Wistar rats that received cafeteria diet (CAF). We examined adipose tissue, skeletal muscle, plasma, intestine, and the cerebral cortex of four groups: CT (control diet), CTn3 (control diet with n3 supplementation), CAF, and CAFn3 (CAF and n3). Diets were offered for 13 weeks, with n3 supplementation in the final 5 weeks. Adipose tissue Electron Transport Chain complexes I, II, and III showed higher activity in CAF groups, as did complexes III and IV in skeletal muscle. Acetate levels in plasma were reduced in CAF groups, and Lipopolysaccharide (LPS) was higher in the CAF group but reduced in CAFn3 group. Claudin-5 in the intestine was lower in CAF groups, with no n3 supplementation effect. In the cerebral cortex, dopamine levels were decreased with CAF, which was reversed by n3. DOPAC, a dopamine metabolite, also showed a supplementation effect, and HVA, a diet effect. Serotonin levels increased in the CAF group that received supplementation. Therefore, we demonstrate disturbances in mitochondria, plasma, intestine and brain of rats submitted to CAF and the potential benefit of n3 supplementation in endotoxemia and neurotransmitter levels.

Quality of life may be a more valuable prognostic factor than depression in older hemodialysis patients.

PURPOSE: Depression and impairment of quality of life (QoL) reduce the survival of individual on hemodialysis (HD). However, few studies evaluated the impact of these conditions on the survival of older patients undergoing HD. METHODS: A retrospective cohort study was performed including patients aged ≥ 60 years on HD in Recife, Brazil, assessed in 2013 and monitored until 2017. Depression was evaluated with the Mini-International Neuropsychiatric Interview and QoL with the Control, Autonomy, Self-realization, and Pleasure Questionnaire (CASP-16). Survival differences according to the depression and QoL status were measured by Kaplan-Meier analysis and Cox regression. Death Certificates were analyzed to assess the cause of death. RESULTS: A total of 171 patients were included (mean age 68.7 ± 6.9 years). The mean follow-up time was 3 years (maximum 4.5 years) and there were 98 deaths (57.3% of the sample). In a multivariate model that included depression and QoL, only QoL impairment was associated with a higher risk of death (HR 1.62, p = 0.035). Among CASP domains, only "Control" was associated with survival (HR 0.90, p = 0.014). Depression was unrelated to the cause of death, but there was a trend for death by endocrine diseases if QoL was impaired (p = 0.057). CONCLUSION: QoL impairment is a key predictor of prognosis in older patients on HD and may be more important than depression. It is important that teams dealing with this population include in protocols an assessment of QoL, in order to offer a range of care according to the needs of these patients.

Calorie Restriction Attenuates Memory Impairment and Reduces Neuroinflammation in Obese Aged Rats.

Obesity and aging collectively potentiate inflammatory responses, particularly within the central nervous system. Managing obesity presents a significant challenge, even more so considering the context of aging. Caloric restriction (CR) has been extensively documented in the literature for its multiple health benefits. Motivated by these findings, we hypothesized that CR could serve as a valuable intervention to address the brain alterations and cognitive decline associated with obesity in aged rats. Our investigation revealed that cafeteria diet increased hippocampal and hypothalamic transcripts related to neuroinflammation, along with cognitive deficits determined in the object recognition test in 18-month-old male rats. Western blot data indicate that the obesogenic diet may disrupt the blood-brain barrier and lead to an increase in Toll-like receptor 4 in the hippocampus, events that could contribute to the cognitive deficits observed. Implementing CR after the onset of obesity mitigated neuroinflammatory changes and cognitive impairments. We found that CR increases GABA levels in the hippocampus of aged animals, as demonstrated by liquid chromatography coupled with mass spectrometry analysis. These findings underscore the potential of CR as a therapeutic opportunity to ameliorate the neuroinflammatory and cognitive alterations of obesity, especially in the context of aging.

Cannabidiol treatment improves metabolic profile and decreases hypothalamic inflammation caused by maternal obesity.

Introduction: The implications of maternal overnutrition on offspring metabolic and neuroimmune development are well-known. Increasing evidence now suggests that maternal obesity and poor dietary habits during pregnancy and lactation can increase the risk of central and peripheral metabolic dysregulation in the offspring, but the mechanisms are not sufficiently established. Furthermore, despite many studies addressing preventive measures targeted at the mother, very few propose practical approaches to treat the damages when they are already installed. Methods: Here we investigated the potential of cannabidiol (CBD) treatment to attenuate the effects of maternal obesity induced by a cafeteria diet on hypothalamic inflammation and the peripheral metabolic profile of the offspring in Wistar rats. Results: We have observed that maternal obesity induced a range of metabolic imbalances in the offspring in a sex-dependant manner, with higher deposition of visceral white adipose tissue, increased plasma fasting glucose and lipopolysaccharides (LPS) levels in both sexes, but the increase in serum cholesterol and triglycerides only occurred in females, while the increase in plasma insulin and the homeostatic model assessment index (HOMA-IR) was only observed in male offspring. We also found an overexpression of the pro-inflammatory cytokines tumor necrosis factor-alpha (TNFα), interleukin (IL) 6, and interleukin (IL) 1ß in the hypothalamus, a trademark of neuroinflammation. Interestingly, the expression of GFAP, a marker for astrogliosis, was reduced in the offspring of obese mothers, indicating an adaptive mechanism to in utero neuroinflammation. Treatment with 50 mg/kg CBD oil by oral gavage was able to reduce white adipose tissue and revert insulin resistance in males, reduce plasma triglycerides in females, and attenuate plasma LPS levels and overexpression of TNFα and IL6 in the hypothalamus of both sexes. Discussion: Together, these results indicate an intricate interplay between peripheral and central counterparts in both the pathogenicity of maternal obesity and the therapeutic effects of CBD. In this context, the impairment of internal hypothalamic circuitry caused by neuroinflammation runs in tandem with the disruptions of important metabolic processes, which can be attenuated by CBD treatment in both ends.

Individual-based model of Chironomus riparius population dynamics over several generations to explore adaptation following exposure to uranium-spiked sediments.

Natural populations are chronically exposed to various pollutants over many generations. It is thus crucial to understand and quantify adaptive dynamics of stressed populations in order to increase the relevance of ecotoxicological risk assessment. However, long-term consequences to population exposure are not much studied yet. The present study investigated evolutionary responses of Chironomus riparius populations exposed to uranium (heavy metal pollutant) and to assess the underlying mechanisms. To fulfil our objective, we produced data with organisms exposed to four relevant concentrations of uranium through eight successive generations. We built an individual-based (IBM) model of C. riparius population dynamics to analyse these data and to test several assumptions about the mechanisms involved in the phenotypic changes. The IBM was based on a dynamic energy budget (DEB) model for C. riparius by Pery et al. (2002). DEB models account mathematically for the acquisition and use of energy to describe and predict growth, maintenance, development and reproduction of living organisms. The IBM accounted for the influence of the test conditions on the observations over eight generations and highlighted some trait evolution such as time to emergence and adult size in control conditions. The model was then used to analyse the exposed population data. Our results showed that exposure to uranium led to a phenotypic selection via a differential survival characterised by longer time to emergence and smaller larval maximal size. As a general conclusion, IBMs based on DEB-based modelling developed to analyse multi-generation experiments are very promising for understanding and quantifying long term selection and tolerance mechanisms in a population under toxic stress.

The first baseline of ALDFG generated by the artisanal fishery during the SARS-CoV-2 pandemic on the north coast of Pernambuco, Brazil.

To prevent the spread of the COVID-19 contagion, some regions of Brazil implemented a prohibition of beach use, which contributed to a reduction of artisanal fishing activity. This study aimed to evaluate the influence of these beach closures on the incidence of abandoned, lost, or discarded fishing gear (ALDFG) along four beaches located on the northern coast of Pernambuco, Brazil. The absolute and relative frequency of occurrence and the number of observations per unit of effort (OPUE) between the periods before and after the prohibition period were analyzed. A total of 1935 fishing gear residues were found (63% before and 37% after prohibition). There was also a significant reduction in OPUE and in absolute frequency (p < 0.05) between these two periods. Although beach closures appear to have contributed to a reduction in the amount of ALDFG in the region, it does not indicate a complete pause in fishing activities.

Evaluation of Promega PowerSeq™ Auto/Y systems prototype on an admixed sample of Rio de Janeiro, Brazil: Population data, sensitivity, stutter and mixture studies.

Forensic DNA typing typically relies on the length-based (LB) separation of PCR products containing short tandem repeat loci (STRs). Massively parallel sequencing (MPS) elucidates an additional level of STR motif and flanking region variation. Also, MPS enables simultaneous analysis of different marker-types - autosomal STRs, SNPs for lineage and identification purposes, reducing both the amount of sample used and the turn-around-time of analysis. Therefore, MPS methodologies are being considered as an additional tool in forensic genetic casework. The PowerSeq™ Auto/Y System (Promega Corp), a multiplex forensic kit for MPS, enables analysis of the 22 autosomal STR markers (plus Amelogenin) from the PowerPlex® Fusion 6C kit and 23 Y-STR markers from the PowerPlex® Y23 kit. Population data were generated from 140 individuals from an admixed sample from Rio de Janeiro, Brazil. All samples were processed according to the manufacturers' recommended protocols. Raw data (FastQ) were generated for each indexed sample and analyzed using STRait Razor v2s and PowerSeqv2.config file. The subsequent population data showed the largest increase in expected heterozygosity (23%), from LB to sequence-based (SB) analyses at the D5S818 locus. Unreported allele was found at the D21S11 locus. The random match probability across all loci decreased from 5.9 × 10-28 to 7.6 × 10-33. Sensitivity studies using 1, 0.25, 0.062 and 0.016 ng of DNA input were analyzed in triplicate. Full Y-STR profiles were detected in all samples, and no autosomal allele drop-out was observed with 62 pg of input DNA. For mixture studies, 1 ng of genomic DNA from a male and female sample at 1:1, 1:4, 1:9, 1:19 and 1:49 proportions were analyzed in triplicate. Clearly resolvable alleles (i.e., no stacking or shared alleles) were obtained at a 1:19 male to female contributor ratio. The minus one stutter (-1) increased with the longest uninterrupted stretch (LUS) allele size reads and according to simple or compound/complex repeats. The haplotype-specific stutter rates add more information for mixed samples interpretation. These data support the use of the PowerSeqTM Auto/Y systems prototype kit (22 autosomal STR loci, 23 Y-STR loci and Amelogenin) for forensic genetics applications.

pH interferes in photoinhibitory activity of curcumin nanoencapsulated with pluronic® P123 against Staphylococcus aureus.

Microbial contamination control is a public health concern and challenge for the food industry. Antimicrobial technologies employing natural agents may be useful in the food industry for these purposes. This work aimed to investigate the effect of photodynamic inactivation using curcumin in Pluronic® P123 nanoparticles (Cur/P123) at different pH and blue LED light against Staphylococcus aureus. Bacterial photoinactivation was conducted using different photosensitizer concentrations and exposure times at pH 5.0, 7.2 and 9.0. A mixture design was applied to evaluate the effects of exposure time (dark and light incubation) on the photoinhibitory effect. S. aureus was completely inactivated at pH 5.0 by combining low concentrations of Cur/P123 (7.80-30.25 µmol/L) and light doses (6.50-37.74 J/cm2). According to the mathematical model, dark incubation had low significance in bacterial inactivation at pH 5.0 and 9.0. No effect in bacterial inactivation was observed at pH 7.2. Cur/P123 with blue LED was effective in inactivating S. aureus. The antimicrobial effect of photodynamic inactivation was also pH-dependent.

Evaluation of 16S rRNA Hypervariable Regions for Bioweapon Species Detection by Massively Parallel Sequencing.

Molecular detection and classification of the bacterial groups in a sample are relevant in several areas, including medical research and forensics. Sanger sequencing of the 16S rRNA gene is considered the gold standard for microbial phylogenetic analysis. However, the development of massively parallel sequencing (MPS) offers enhanced sensitivity and specificity for microbiological analyses. In addition, 16S rRNA target amplification followed by MPS facilitates the combined use of multiple markers/regions, better discrimination of sample background, and higher sample throughput. We designed a novel set of 16S rRNA gene primers for detection of bacterial species associated with clinical, bioweapon, and biohazards microorganisms via alignment of 364 sequences representing 19 bacterial species and strains relevant to medical and forensics applications. In silico results indicated that the hypervariable regions (V1V2), (V4V5), and (V6V7V8) support the resolution of a selected group of bacteria. Interspecies and intraspecies comparisons showed 74.23%-85.51% and 94.48%-99.98% sequencing variation among species and strains, respectively. Sequence reads from a simulated scenario of bacterial species mapped to each of the three hypervariable regions of the respective species with different affinities. The minimum limit of detection was achieved using two different MPS platforms. This protocol can be used to detect or monitor as low as 2,000 genome equivalents of bacterial species associated with clinical, bioweapon, and biohazard microorganisms and potentially can distinguish natural outbreaks of pathogenic microorganisms from those occurring by intentional release.

Hypericin-mediated photoinactivation of polymeric nanoparticles against Staphylococcus aureus.

Photoinactivation is a promising technique for Staphylococcus aureus control. This microorganism causes foodborne diseases (DTAs) and forms biofilms that are highly resistant and difficult to eradicate. Thus, the aim of this study was to evaluate the photodynamic activity of hypericin (HYP) in polymeric nanoparticles (Pluronic® P123) against S. aureus planktonic and biofilm cells. Planktonic cells and biofilms of S. aureus (ATCC 25923) were subjected to photoinactivation using low-power orange LED (0.3 mW/cm²) with different HYP formulation concentrations in Pluronic® P123. The P123 molar ratios were 2.5 (HYP/P123-2.5) and 10 (HYP/P123-10), respectively. The treatment times for planktonic cells were proposed by a mixture design, and bacterial photoinactivation was observed in concentrations of 12.5 to 3.12 µmol/L for HYP/P123-2.5 and reductions of ∼ 4.0 log CFU/mL in 12.5 to 0.78 µmol/L for HYP/P123-10. For biofilms, 30 min of darkness and 30 min of illumination were used. Maximum reductions were similar for both formulations and corresponded to approximately 0.9 log CFU/cm². It was concluded that photoinactivation with longer lighting times was effective against planktonic cells and could be potentially applied to control S. aureus.

Depression and quality of life in older adults on hemodialysis.

OBJECTIVE: Depression is highly prevalent in hemodialysis patients, but few studies have evaluated older hemodialysis patients. The aim of this study was to evaluate the prevalence of depression, its associated factors and its impact on quality of life in an older population on hemodialysis. METHODS: This was a cross-sectional study including 173 hemodialysis patients aged 60 years or older in Recife, Brazil. Depression was evaluated using the Mini-International Neuropsychiatric Interview when depressive symptoms (according to the 5-item Geriatric Depression Scale) were present. Quality of life was assessed with the Control, Autonomy, Self-realization and Pleasure Questionnaire (CASP-16). Data were also collected on sociodemographic, laboratory (albumin, parathormone, hemoglobin, and phosphorus) and dialysis (dialysis vintage, vascular access and hemodialysis adequacy) characteristics. RESULTS: Depression was present in 22.5% of the sample. Depressed patients presented low CASP-16 quality of life scores (31.6 vs. 24.2, p < 0.001), twice the odds of albumin levels < 3.8 g/dL (OR 2.36; 95%CI 1.10-5.07; p = 0.027) and higher parathormone levels (OR 1.06; 95%CI 1.00-1.13; p = 0.05). CONCLUSION: Older hemodialysis patients have a high prevalence of depression. Depressed patients presented poor quality of life, lower serum albumin and higher parathormone levels. Teams dealing with older hemodialysis patients should include depression and quality of life assessments in care protocols.

Exposure of Chironomus riparius larvae to uranium: effects on survival, development time, growth, and mouthpart deformities.

Among non-biologically essential metals, data concerning uranium effects on freshwater benthic macroinvertebrates are scarce. The effects of uranium on survival, development time, growth and mouthpart deformities of midge Chironomus riparius were investigated. A 10-day static laboratory bioassay was performed exposing first instar larvae to artificial sediment spiked with four concentrations of uranium (2.97; 6.07; 11.44; 23.84 microg U g(-1) dry wt). As uranium was released from the sediment to the overlying water during this bioassay, both the sediment and the water column act as contamination pathways in giving rise to the observed effects. Significant negative effects on survival, development time, and growth were detected at 6.07, 6.07 and 2.97 microg U g(-1) dry wt, respectively. An LC20 of 2.49 microg U g(-1) dry wt (95% CI=1.48-4.27), and an LC50 of 5.30 microg U g(-1) dry wt (95% CI=3.94-7.25) were estimated. With respect to effects of uranium on larvae mouthpart deformities, we found that the lower the concentrations, the higher the deformity rates. These results highlight the potential impact of uranium at population level in environmentally realistic concentrations.

Contrasting the microbiomes from forest rhizosphere and deeper bulk soil from an Amazon rainforest reserve.

Pristine forest ecosystems provide a unique perspective for the study of plant-associated microbiota since they host a great microbial diversity. Although the Amazon forest is one of the hotspots of biodiversity around the world, few metagenomic studies described its microbial community diversity thus far. Understanding the environmental factors that can cause shifts in microbial profiles is key to improving soil health and biogeochemical cycles. Here we report a taxonomic and functional characterization of the microbiome from the rhizosphere of Brosimum guianense (Snakewood), a native tree, and bulk soil samples from a pristine Brazilian Amazon forest reserve (Cuniã), for the first time by the shotgun approach. We identified several fungi and bacteria taxon significantly enriched in forest rhizosphere compared to bulk soil samples. For archaea, the trend was the opposite, with many archaeal phylum and families being considerably more enriched in bulk soil compared to forest rhizosphere. Several fungal and bacterial decomposers like Postia placenta and Catenulispora acidiphila which help maintain healthy forest ecosystems were found enriched in our samples. Other bacterial species involved in nitrogen (Nitrobacter hamburgensis and Rhodopseudomonas palustris) and carbon cycling (Oligotropha carboxidovorans) were overrepresented in our samples indicating the importance of these metabolic pathways for the Amazon rainforest reserve soil health. Hierarchical clustering based on taxonomic similar microbial profiles grouped the forest rhizosphere samples in a distinct clade separated from bulk soil samples. Principal coordinate analysis of our samples with publicly available metagenomes from the Amazon region showed grouping into specific rhizosphere and bulk soil clusters, further indicating distinct microbial community profiles. In this work, we reported significant shifts in microbial community structure between forest rhizosphere and bulk soil samples from an Amazon forest reserve that are probably caused by more than one environmental factors such as rhizosphere and soil depth.

Microbial enrichment and gene functional categories revealed on the walls of a spent fuel pool of a nuclear power plant.

Microorganisms developing in the liner of the spent fuel pool (SFP) and the fuel transfer channel (FTC) of a Nuclear Power Plant (NPP) can form high radiation resistant biofilms and cause corrosion. Due to difficulties and limitations to obtain large samples from SFP and FTC, cotton swabs were used to collect the biofilm from the wall of these installations. Molecular characterization was performed using massively parallel sequencing to obtain a taxonomic and functional gene classification. Also, samples from the drainage system were evaluated because microorganisms may travel over the 12-meter column of the pool water of the Brazilian Nuclear Power Plant (Angra1), which has been functioning since 1985. Regardless of the treatment of the pool water, our data reveal the unexpected presence of Fungi (Basidiomycota and Ascomycota) as the main contaminators of the SFP and FTC. Ustilaginomycetes (Basidiomycota) was the major class contributor (70%) in the SFP and FTC reflecting the little diversity in these sites; nevertheless, Proteobacteria, Actinobacteria, Firmicutes (Bacilli) were present in small proportions. Mapping total reads against six fungal reference genomes indicate that there is, in fact, a high abundance of fungal sequences in samples collected from SFP and FTC. Analysis of the ribosomal internal transcribed spacer (ITS) 1 and 2 regions and the protein found in the mitochondria of eukaryotic cells, cytochrome b (cytb) grouped our sample fungi in the clade 7 as Ustilago and Pseudozyma. In contrast, in the drainage system, Alphaproteobacteria were present in high abundances (55%). The presence of Sphingopyxis, Mesorhizobium, Erythrobacter, Sphingomonas, Novosphingobium, Sphingobium, Chelativorans, Oceanicaulis, Acidovorax, and Cyanobacteria was observed. Based on genomic annotation data, the assessment of the biological function found a higher proportion of protein-coding sequences related to respiration and protein metabolism in SFP and FTC samples. The knowledge of this biological inventory present in the system may contribute to further studies of potential microorganisms that might be useful for bioremediation of nuclear waste.

Activity of rosemary (Rosmarinus officinalis - Family: Lamiaceae) essential oil compared to peracetic acid in Listeria monocytogenes biofilms

The objective of this study was to evaluate the activity of Rosmarinus officinalis essential oil (EO) compared to peracetic acid (PA) regarding formation and elimination of Listeria monocytogenes biofilms on polystyrene surface. The minimum inhibitory concentration (MIC) was determined according to standard protocol. Isolates were inoculated according to MIC standards polystyrene plate wells, which were then incubated at 37°C/96 hours for evaluation of biofilm formation. Regarding the evaluation of biofilm elimination, the biofilms were treated under MIC for 10 minutes. The MIC obtained were 2.0 and 3.0 mg mL-1 for EO and 0,015% for PA. Therefore, the results showed a reduction in the formation of biofilm with the presence of EO and PA, EO being more efficient (p < 0.05). Both compounds had a good capacity of eliminating biofilms, however the EO reduced the biofilm formation when compared to PA, highlighting its potential as an antibacterial agent and antibiofilm.(AU)

Depression and quality of life in older adults on hemodialysis

Objective: Depression is highly prevalent in hemodialysis patients, but few studies have evaluated older hemodialysis patients. The aim of this study was to evaluate the prevalence of depression, its associated factors and its impact on quality of life in an older population on hemodialysis. Methods: This was a cross-sectional study including 173 hemodialysis patients aged 60 years or older in Recife, Brazil. Depression was evaluated using the Mini-International Neuropsychiatric Interview when depressive symptoms (according to the 5-item Geriatric Depression Scale) were present. Quality of life was assessed with the Control, Autonomy, Self-realization and Pleasure Questionnaire (CASP-16). Data were also collected on sociodemographic, laboratory (albumin, parathormone, hemoglobin, and phosphorus) and dialysis (dialysis vintage, vascular access and hemodialysis adequacy) characteristics. Results: Depression was present in 22.5% of the sample. Depressed patients presented low CASP-16 quality of life scores (31.6 vs. 24.2, p < 0.001), twice the odds of albumin levels < 3.8 g/dL (OR 2.36; 95%CI 1.10-5.07; p = 0.027) and higher parathormone levels (OR 1.06; 95%CI 1.00-1.13; p = 0.05). Conclusion: Older hemodialysis patients have a high prevalence of depression. Depressed patients presented poor quality of life, lower serum albumin and higher parathormone levels. Teams dealing with older hemodialysis patients should include depression and quality of life assessments in care protocols.

Ocorrência de Micobactérias Não Tuberculosas (MNT) em uma unidade de referência do estado do Pará, Brasil / Occurrence of Nontuberculosis Mycotherapies (NTM) in a reference unit of the state of Pará, Brazil

Objetivo: Investigar a ocorrência de micobactérias não tuberculosas (MNT) em uma Unidade de Referência no Estado do Pará, Brasil e apresentar o perfil sociodemográfico e clínico dos pacientes acometidos. Métodos: foi realizada pesquisa descritiva retrospectiva com abordagem quantitativa por meio da coleta de dados no sistema de informação do laboratório que atua como referência para tuberculose nos vinte municípios da região Oeste do Pará no período de abril de 2011 a abril de 2017. Resultados: foram analisadas amostras de 513 pacientes com suspeita de TB, 09 (1,75%) tiveram diagnóstico de MNT, sendo isolados M. avium, M. asiaticum, M. intracellulare, M. paraensis e M. abscessus subsp. bolletii. Conclusão: evidencia­se o potencial das MNT em provocar doença semelhante à tuberculose, havendo a necessidade de melhorar a investigação etiológica para a detecção precoce das micobacterioses, afim de que sejam tomadas medidas adequadas de tratamento e prevenção da transmissão.

Objective: To investigate the occurrence of non­ tuberculous mycobacteria (NTM) in a Reference Unit in the State of Pará, Brazil, and present the sociodemographic and clinical profile of the patients affected. Methods: retrospective descriptive research was carried out using a quantitative approach through the data collection of the laboratory information system which acts as a reference for tuberculosis in the twenty municipalities of the western region of Pará from April 2011 to April 2017. Results: samples from 513 patients with suspected TB were analyzed, 09 (1.75%) were diagnosed with NTM , M. avium, M. asiaticum, M. intracellulare, M. paraenses and M. abscessus subsp. bolletii. Conclusion: the potential of MNT to provoke tuberculosis­like disease is evident, and there is a need to improve epidemiological investigation for the early detection of mycobacteriosis, so that appropriate treatment and prevention measures are taken.

Avaliação da Competência de Estudantes de Medicina em Identificar Riscos à Segurança do Paciente através de Simulação / Evaluation of the Competence of Medical Students in Identifying Risks to the Safety of the Patient through Simulation

RESUMO Introdução A segurança do paciente (SP) está entre os principais temas discutidos pelos profissionais da área de saúde em todo o mundo. No Brasil, em 2016, ocorreram mais de 302 mil mortes por eventos adversos evitáveis e 70% eram de causas preveníveis, que custaram mais de 10,9 bilhões de reais. Objetivo Avaliar os conhecimentos, habilidades e atitudes de estudantes do quarto e oitavo períodos do curso de Medicina sobre segurança do paciente por meio de simulação. Método Foi realizado um estudo transversal. A coleta de dados foi feita por meio de dois instrumentos, um com o perfil sociodemográfico e outro a ser preenchido durante a simulação. A simulação ocorreu numa sala de laboratório preparada para reproduzir um cenário hospitalar. Foram planejados pelos pesquisadores seis riscos a serem identificados no cenário durante o tempo de sete minutos. Os dados foram analisados com uso do Epi-Info 7.1. A pesquisa foi aprovada pelo Comitê de Ética da instituição. Resultado Participaram do estudo 42 estudantes, sendo 24 do quarto período e 18 do oitavo. Nenhum estudante identificou todos os seis riscos. No geral, os alunos apresentaram baixo desempenho, tendo identificado em média de dois a três riscos à segurança do paciente. O risco de administração de medicação equivocada foi percebido por 34 estudantes (81%); a falta de identificação por 15 (36%); o risco de quedas por 11 (26%); problemas de higienização das mãos por 6 (14%); o risco de procedimentos cirúrgicos equivocados por 3 (7%) e o risco de lesões por pressão não foi identificado por nenhum estudante. Três riscos adicionais não planejados pelos pesquisadores foram identificados pelos estudantes, com predomínio de identificação de dois riscos por estudantes do oitavo período. Conclusão Os estudantes apresentaram pouca competência em identificar riscos à segurança do paciente. Contudo, demonstraram melhor desempenho ao longo do curso, revelando quão importante é trabalhar a segurança do paciente já nos primeiros anos de graduação.

ABSTRACT Introduction Patient safety (PS) is among the main topics discussed by healthcare professionals worldwide. In Brazil, more than 302,000 deaths from preventable adverse events were reported in 2016, and 70% had preventable causes that cost more than 10.9 billion reais. Objective To evaluate the knowledge, skills and attitudes, through simulation of students of the medical course of the 4th and 8th semesters regarding the subject of patient safety. Methods A cross-sectional study was conducted. The data was collected through two instruments, one to ascertain the sociodemographic profile and the other to be completed during the simulation. The simulation took place in a laboratory room prepared to reproduce a hospital scenario. The researchers planned six risks to be identified in the scenario with a duration of 7 minutes. All data were analyzed by EPI-INFO 7.1. The research was approved by an ethics committee. Results A total of 42 students participated in the study, 24 and 18 of the 4th and 8th periods, respectively. No student has identified all six risks. Overall, students performed poorly, identifying on average two to three risks to patient safety. The risk of administration of wrong medication was perceived by 34 (81%); lack of identification by 15 (36%); risk of falling by 11 (26%); problems with hand hygiene by 6 (14%); risk of wrong surgical procedures by 3 (7%) and risk of pressure ulcers was not identified by any student. Three additional risks not planned by the researchers were identified by the students, especially two risks identified by 8th-period students. Conclusion Students displayed little ability to identify patient safety risks. However, they demonstrated better performance throughout the course, revealing how important it is to work on patient safety in the early years of undergraduate training.

Cumprimento do calendário de vacinação de crianças em uma unidade de saúde da família / Compliance with the child immunization calendar in family healthcare units

OBJETIVO: Analisar o cumprimento do calendário de vacinação de crianças pelos usuários da Unidade de Saúde da Família Água Cristal bem como possíveis razões para o seu eventual não cumprimento. MÉTODO: O estudo foi prospectivo, transversal e qualitativo, realizado a partir de visitas às residências das crianças pesquisadas, sendo a casuística constituída por 108 pessoas, número obtido através do registro presente nas fichas da família observadas. Incluíram-se crianças de ambos os sexos, analisando-se a faixa etária de 0 a 2 anos de idade, cadastradas na Unidade no ano de 2007. RESULTADOS: Verificou-se que 87,97 por cento das crianças estão com a vacinação atualizada, sendo que 13,89 por cento dessas têm histórico de atrasos. Um fator fortemente atribuído a estes bons índices foi a atuação constante dos agentes comunitários de saúde. Entre aquelas que apresentaram atraso ou não receberam as vacinas, a falta da vacina contra rotavírus foi a mais observada, em 22,46 por cento dos casos. Foram analisados fatores que poderiam contribuir para o índice de atraso, como escolaridade e ocupação dos pais. Nenhum desses foi estatisticamente significante. CONCLUSÃO: Os resultados encontrados são comparáveis a ambulatórios de centros de referência latino-americanos, o que indica a efetividade da atuação do Programa Saúde da Família naquela comunidade. Contudo, a vacinação tem forte apelo na saúde da população e merece iniciativas de fortalecimento das ações, a fim de diminuir e evitar reaparecimento de doenças...

OBJECTIVE: This study evaluated compliance with the child immunization calendar among users of the Água Cristal Family Healthcare Unit and explored the reasons for potential non-compliance. METHOD: This study was prospective and qualitative. It was based on visits to the surveyed children's residences and consisted of a sample of 108 people. The data for this sample were obtained through the current records in the health unit's family files. The sample included children of both genders between the ages of 0 and 2 years who were registered at the Unit in 2007. RESULTS: We found that 87.97 per cent of the children had up-to-date immunizations, and 13.89 per cent had a history of delayed immunizations. The study found that healthcare community agents' regular interventions were strongly linked to the up-to-date immunization results. Among the children who were immunized late or not at all, the Rotavirus was the most common illness, representing 22.46 per cent of the cases. We also analyzed the factors, such as education and parents' occupation, that could contribute to delayed immunizations. None of these were statistically significant. CONCLUSION: The results were comparable to other Latin American healthcare centers and confirmed the efficacy of the Family Healthcare Program in the community. However, immunizations have a strong influence on a population's health, and initiatives should be undertaken to decrease the prevalence of diseases and prevent their recurrence...