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Os transtornos alimentares são caracterizados como distúrbios biopsicossociais nos quais o indivíduo pode apresentar graves complicações físicas e psicológicas. O objetivo neste estudo foi avaliar os níveis de depressão, ansiedade, estresse e qualidade do sono em pacientes com anorexia ou bulimia nervosa. A amostra foi composta por 30 mulheres em atendimento em um Ambulatório Especializado de Saúde Mental do Estado de São Paulo. Os instrumentos utilizados para a coleta de dados foram a Escala DASS-21 e o Questionário de Avaliação do Sono de Toronto. Foram identificados níveis muito graves de depressão em 53,33% das pacientes; níveis muito graves de ansiedade em 60%; e níveis muito graves de estresse em 26,67%. Observou-se correlação positiva significante (p

Maternal periodontal disease (PED) and apical periodontitis (AP) are associated insulin resistance (IR), increased tumor necrosis factor-α (TNF-α) levels, and alterations in insulin signaling (IS) in the gastrocnemius muscle (GM) of adult offspring. TNF-α stimulates I kappa B kinase (IKK) and c-Jun N-terminal protein kinase (JNK), resulting in IS attenuation. However, studies that investigated the maternal true endodontic-periodontal lesion (EPL) in offspring are scarce, and in this case, the impact could be even higher. This study aimed to evaluate the effects of EPL on the IR, IS, and inflammatory pathways on the offspring GM.Female Wistar rats were distributed into control, AP, PED, and EPL groups. After 30 days of oral inflammation induction, rats from all groups were allowed to mate with healthy rats. The body weight of the offspring was assessed from birth to 75 days of age. After 75 days, the following measurements were performed: glycemia, insulinemia, IR, TNF-α content, and IKKα/β, JNK, pp185 (Tyr), and IRS-1 (Ser) phosphorylation status in the GM.Maternal PED and EPL were associated with low birth weights. All maternal oral inflammations promoted IR and IS impairment in the GM and only maternal PED and EPL caused an increase in TNF-α content and IKKα/β phosphorylation status in the GM of offspring. The offspring of the rats with EPL group showed worsening of metabolic changes when compared with offspring of rats with AP or PED.Association of maternal AP and PED promoted a more pronounced worsening in the health of the adult offspring.

Highlights • Periapical lesions promotes higher T-bet expression and lower GATA3 and FOXP3 expression. • Periapical lesion promotes increased GATA3 and decreased FOXP3 expression in the group with 4 periapical lesions (4PL) • The adaptive immune system, with a predominance of the Th1 polarization, may be involved in the development of insulin resistance in rats with Periapical lesions., Objective Apical periodontitis (AP) is a chronic or acute inflammatory disease usually developed from endodontic infections, predominantly due to gram-negative anaerobic bacteria invading the dental pulp. This study aimed to evaluate lymphocyte markers to assess the involvement of adaptive immunity in insulin resistance (IR) in a rat model of AP. Design. Forty-five male Wistar albino rats were divided into 3 groups (control, 1AP and 4AP). AP was induced in the upper right first molar (1AP), and in the first and second upper and lower right molars (4AP). The spleen was collected to evaluate the expression of transcription factors involved in lymphocyte polarization, including T-bet (Th1), GATA3 (Th2), and FOXP3 (Treg). Blood samples were assessed for serum cytokine levels transcribed by the respective lymphocyte polarizations, INF-γ (Th1), IL-4 (Th2) and TGF-β (Treg). In addition, glucose and insulin levels were measured to evaluate IR by the HOMA-IR method. Results The results showed higher T-bet expression on AP groups, along with lower GATA3 and FOXP3 expression in the 1AP, in addition to increased GATA3 and decreased FOXP3 expression in the 4AP group compared to the CN group. There was no difference in the INF-γ levels, while IL-4 was decreased in the AP groups. Taken together, these results suggest that the adaptive immune system, with a predominance of the Th1 polarization, may be involved in the development of IR in rats with AP. Conclusions AP promotes increase in the expression of T-bet (4AP) and decrease of FOXP3 expressions and IL-4 levels (1AP and 4AP). However, depending on the number of lesions (1 or 4 lesions), the expression of GATA3 appears differently. Thus, innate immunity and adaptive immunity may contribute to the IR observed in rats with AP.

Heat shock protein (HSP) A1A protects cells from various stressors. The concentrated liquid of the traditional Japanese rice black vinegar Kurozu increased HSPA1A expression in normal rat liver RLN-10 cells. Lactic acid, the primary component of concentrated Kurozu, induced HSPA1A expression in a concentration-dependent manner. Induction with 4 m m lactic acid increased HSPA1A expression by three times compared with that in the absence of lactic acid. The induction was inhibited by staurosporine or a selective MEK1/2 inhibitor (SL327). The phosphorylation of ERK1/2 was increased by lactic acid. These results suggest that lactic acid induces HSPA1A expression by activating ERK1/2. As well as lactate, 3,5-dihydroxybenzoic acid (DHBA), a ligand for G protein-coupled receptor 81 (GPR81), also induced HSPA1A at lower concentrations than lactate. The increased effect of DHBA on HSPA1A expression as compared with lactate may be related to the higher affinity of DHBA for GPR81 than of lactate.

A variety of substituted azoxybenzenes can be obtained by simple photoreduction of the corresponding nitrobenzene using a flow microreactor. The yield and chemoselectivity of each azoxybenzene depends on the type and position of the substituents. In addition, the use of liquid-liquid slug flow conditions, consisting of an organic solution and a fluorous solvent like tetradecafluorohexane (TDFH) or octadecafluorooctane (ODFO), improves both the conversion and yield of this photoreduction compared to those in simple one-phase flow conditions; these results are due to synergy between the very smooth photoreduction process and the highly efficient mixing obtained under continuous-flow conditions.

Submitted by Renan Akira Fujii de Oliveira (renan.akira@unesp.br) on 2022-10-20T13:25:41Z No. of bitstreams: 1 Dissertação Renan Final 09-08-22.pdf: 1125351 bytes, checksum: eb2b0d0334e21f15f54b476c5c258927 (MD5) Approved for entry into archive by Claudio Hideo Matsumoto null (claudio@foa.unesp.br) on 2022-10-20T14:19:39Z (GMT) No. of bitstreams: 1 oliveira_raf_me_araca_int.pdf: 1125351 bytes, checksum: eb2b0d0334e21f15f54b476c5c258927 (MD5) Made available in DSpace on 2022-10-20T14:19:39Z (GMT). No. of bitstreams: 1 oliveira_raf_me_araca_int.pdf: 1125351 bytes, checksum: eb2b0d0334e21f15f54b476c5c258927 (MD5) Previous issue date: 2022-08-22 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) O diabetes é um severo problema de saúde pública em todo o mundo. Os efeitos da doença e suas complicações vão além do acometimento da saúde do indivíduo, comprometendo suas famílias e a sociedade. A doença tem amplas consequências socioeconômicas, impactando os sistemas de saúde e a economia, especialmente em países de baixa e média renda, nos quais frequentemente apresenta-se acompanhado de outras doenças, evidenciando a importância de estratégias de prevenção e monitoramento. Neste sentido, destaca-se a importância dos estudos que investiguem a relação entre as infecções orais e desordens sistêmicas. A presente pesquisa teve como objetivos: avaliar aspectos relacionados à prevalência, prevenção, assistência e complicações do diabetes em adultos nas unidades federativas (UF) brasileiras; e realizar uma revisão sistemática das evidências sobre o efeito do tratamento da doença periodontal no controle glicemico. A primeira etapa da pesquisa trata-se de um estudo observacional, com análise temporal, realizado em indivíduos adultos das UF brasileiras. Foram coletados dados sobre a prevalência e aspectos relacionados à prevenção, assistência à saúde e complicações do diabetes em indivíduos com 18 anos ou mais, por meio de consulta ao banco de dados da Pesquisa Nacional de Saúde de 2013 e 2019, disponível no sistema público do Instituto Brasileiro de Geografia e Estatística. Houve aumento na prevalência de diabetes em 26 UF (96,30%), com variação de 3,3-9,3%, acompanhado de redução, em todas as UF, na proporção de pessoas que nunca avaliaram a glicemia, com variação de 3,6- 25,9%. Elevou-se a proporção de pessoas que utilizaram medicamentos para o controle da doença em todas as UF, com variação de 48,1-93,7%, entretanto, apenas 5 UF (18,52%) apresentaram aumento na proporção que obteve medicamento por meio do programa "Farmácia Popular". Observou-se aumento na proporção de pessoas que receberam assistência médica no último ano em 22 UF (81,48%), com variação de 53,2-87,3%, contudo, na maioria das UF houve diminuição na proporção que realizou todos os exames complementares (n=17) e todas as consultas com médico especialista (n=18). Em 14 UF (51,85%) observou-se aumento na proporção de internações, com variação de 4,7-31,4%, enquanto a proporção de pessoas com limitações nas atividades habituais diminuiu em 18 UF (66,67%), com variação de 2,4-20,5%. A prevalência do diabetes apresenta crescente aumento no país, evidenciando a necessidade de aprimoramento das estratégias de prevenção, assistência médica e farmacêutica, visando reduzir os agravos causados pela doença e suas complicações. Na revisão sistemática foram incluídos trabalhos nacionais e internacionais publicados nas bases de dados Cochrane, Embase, Portal Regional da Biblioteca Virtual em Saúde (BVS), PubMed, Scientific Electronic Library Online (Scielo), Scopus e Web of Science (WOS). Foram utilizados os seguintes descritores: Periodontal Diseases, Diseases, Periodontal, Parodontosis Parodontoses, Pyorrhea Alveolaris, Blood Sugar, Sugar, Blood, Glucose, Blood, Glycemic Indices, Glycemic Index Number, Glycemic Index Numbers, Dental Care, Dental Anxiety. Foram incluídos estudos clínicos randomizados controlado realizados em seres humanos adultos, que relacionaram diretamente o efeito do tratamento de doeça periodontal sobre o controle glicemico, sem restrições de ano da publicação e idioma. Do total de 2153 artigos encontrados, 16 estudos foram incluídos na revisão. Os textos completos destas publicações foram obtidos para leitura e análise da qualidade metodológica. Verificou-se que 13 estudos (81,25%) demonstraram que o tratamento periodontal promoveu melhora no controle glicemico, com diferenças estatisticamente significativas nos níveis de hemoglobina glicada (HbA1c), enquanto 3 estudos (18,75%) não observaram relação entre o tratamento e o controle glicemico. Salienta-se a importância da realização de novos estudos para confirmar esses achados, considerando a relação bidirecional entre a doença periodontal e o diabetes, a alta prevalência dessas doenças e o potencial impacto negativo do manejo inadequado do diabetes na morbidade, mortalidade e qualidade da vida da população. Diabetes is a serious public health problem worldwide. The effects of the disease and its complications go beyond the individual's health, compromising their families and society. The disease has broad socioeconomic consequences, impacting health systems and the economy, especially in low- and middle-income countries, where it is often accompanied by other diseases, highlighting the importance of prevention and monitoring strategies. In this sense, the importance of studies investigating the relationship between oral infections and systemic disorders is highlighted. The present research aimed to: evaluate aspects related to the prevalence, prevention, care and complications of diabetes in adults in Brazilian federative units (FU); and perform a systematic review of the evidence on the effect of periodontal disease treatment on glycemic control. The first stage of the research is an observational study, with temporal analysis, carried out in adult individuals from Brazilian FUs. Data were collected on the prevalence and aspects related to prevention, health care and complications of diabetes in individuals aged 18 years and over, by consulting the 2013 and 2019 National Health Survey database, available in the public system of the country. Brazilian Institute of Geography and Statistics. There was an increase in the prevalence of diabetes in 26 FUs (96.30%), with a variation of 3.3-9.3%, followed by a reduction, in all FUs, in the proportion of people who had never evaluated their blood glucose, with a variation of 3.6-25.9%. The proportion of people who used medication to control the disease increased in all FUs, ranging from 48.1 to 93.7%, however, only 5 FUs (18.52%) showed an increase in the proportion that obtained medication through the "Popular Pharmacy" program. There was an increase in the proportion of people who received medical care in the last year in 22 FUs (81.48%), with a variation from 53.2-87.3%, however, in most FUs there was a decrease in the proportion that performed all complementary exams (n=17) and all consultations with a specialist doctor (n=18). In 14 FUs (51.85%) there was an increase in the proportion of hospitalizations, ranging from 4.7 to 31.4%, while the proportion of people with limitations in their usual activities decreased in 18 FUs (66.67%). , with a variation of 2.4-20.5%. The prevalence of diabetes is increasing in the country, highlighting the need to improve prevention strategies, medical and pharmaceutical care, in order to reduce the diseases caused by the disease and its complications. The systematic review included national and international studies published in the Cochrane, Embase, Regional Portal of the Virtual Health Library (VHL), PubMed, Scientific Electronic Library Online (Scielo), Scopus and Web of Science (WOS) databases. The following descriptors were used: Periodontal Diseases, Diseases, Periodontal, Parodontosis Parodontoses, Pyorrhea Alveolaris, Blood Sugar, Sugar, Blood, Glucose, Blood, Glycemic Indices, Glycemic Index Number, Glycemic Index Numbers, Dental Care, Dental Anxiety. CAPES: 001

Introdução: A adolescência possui peculiaridades que merecem atenção diferenciada nos serviços de saúde. Objetivos: Compreender a percepção dos adolescentes sobre saúde bucal e identificar suas atitudes, espaços e comportamentos. Métodos: Pesquisa qualitativa com 44 adolescentes, de 12 a 17 anos, de escolas de bairros periféricos de um município paulista. Realizou-se entrevistas utilizando um roteiro de perguntas abrangendo enfoque social, afetivo e cognitivo, as quais foram gravadas e transcritas para análise, utilizando a metodologia do Discurso do Sujeito Coletivo. Resultados: As atividades de lazer mais referidas foram o esporte ou ficar em casa; os adolescentes consideram a escola um local para promoção de saúde; a estética tem grande importância; ter dentes bons foi aliado ao convívio social e profissional; e saúde bucal resumiu-se a ter higiene e dentes limpos. Conclusão: A promoção de saúde para adolescentes pode refletir na saúde populacional em geral, pois serão adultos com compreensão da importância da prevenção, gerando uma sociedade saudável e com qualidade de vida.

espanolEl presente estudio tuvo como objetivo evaluar los efectos del entrenamiento de resistencia (RT) sobre la glucemia, insulinemia, sensibilidad a la insulina, senalizacion de insulina (IS) y niveles de factor de necrosis tumoral-α (TNF-α) en ratas con periodontitis. 40 ratas Wistar macho se dividieron en 4 grupos: grupo de control sedentario (SCN), grupo de control con ejercicio (ExCN), grupo de periodontitis inducida por ligadura sedentaria (SPD) y grupo de periodontitis inducida por ligadura con ejercicio (ExPD). 28 dias despues de inducir la periodontitis se inicio la RT (14 semanas). Se analizaron la glucemia, la insulina, los niveles de TNF-α y la sensibilidad a la insulina utilizando varios metodos. La IS se evaluo midiendo pp185 fosforilada en tirosina en tejidos sensibles a la insulina (Western). Se observaron niveles mas altos de insulina, HOMA-IR y TNF-α, y una disminucion en la sensibilidad a la insulina en el grupo SPD, que tambien tuvo niveles disminuidos de pp185 fosforilada en tirosina estimulada por insulina en el musculo y el tejido adiposo, en comparacion con los otros grupos. El grupo ExPD tenia niveles aumentados de pp185 fosforilada con tirosina estimulada por insulina en comparacion con el grupo SPD, pero no mostro diferencias significativas en comparacion con los grupos SCN y ExCN. La RT invirtio tanto las alteraciones de resistencia a la insulina (IR) como las de IS en ratas con periodontitis inducida y disminuyo insulina y TNF-α. Los resultados muestran la importancia de la RT para prevenir o revertir la IR en ratas con periodontitis. portuguesO objetivo do presente estudo foi avaliar os efeitos do treinamento de resistencia (TR) na glicemia, insulinemia, sensibilidade a insulina, sinalizacao a insulina (SI) e niveis de fator de necrose tumoral-α (TNF-α) em ratos com periodontite. 40 ratos Wistar machos foram distribuidos em 4 grupos: grupo controle sedentario (SCN), grupo controle exercitado (ExCN), grupo doenca periodontal induzida por ligadura sedentaria (SPD) e grupo doenca periodontal induzida por ligadura exercitada (ExPD). 28 dias apos a inducao da periodontite iniciou a RT (14 semanas). Glicemia, insulina, niveis de TNF-α e sensibilidade a insulina foram analisados ​​usando varios metodos. IS foi avaliado medindo pp185 com tirosina fosforilada em tecidos sensiveis a insulina (metodo de western blot). Niveis mais elevados de insulina, HOMA-IR e TNF-α e diminuicao da sensibilidade a insulina foram observados no grupo SPD, que tambem apresentou diminuicao dos niveis de tirosina fosforilada por insulina estimulada em pp185 no musculo e tecido adiposo, quando comparado aos outros grupos. O grupo ExPD apresentou niveis aumentados de pp185 tirosina fosforilada estimulada por insulina em comparacao ao grupo SPD, mas nao apresentou diferenca significativa quando comparado aos grupos SCN e ExCN. A RT reverteu as alteracoes de RI e SI em ratos com periodontite induzida e tambem diminuiu os niveis de insulina e TNF-α. Portanto, os resultados mostram a importância do TR na prevencao ou reversao da RI em ratos com periodontite. EnglishThe present study, aimed to evaluate the effects of resistance training (RT) on glycemia, insulinemia, insulin sensitivity, insulin signaling (IS), and tumor necrosis factor-α (TNF-α) levels in rats with periodontitis. 40 male Wistar rats were distributed into 4 groups: sedentary control group (SCN), exercised control group (ExCN), sedentary ligature-induced periodontal disease group (SPD), and exercised ligature-induced periodontal disease group (ExPD). 28 days after inducing periodontitis the RT started (14-week). Glycemia, insulin, TNF-α levels, and insulin sensitivity were analyzed using various methods. IS was evaluated by measuring tyrosine phosphorylated pp185 in insulin-sensitive tissues (western blot method). Higher levels of insulin, HOMA-IR, and TNF-α, and a decrease in insulin sensitivity were observed in the SPD group, which also had decreased levels of insulin-stimulated tyrosine phosphorylated pp185 in muscle and adipose tissue, when compared to the other groups. The ExPD group had increased levels of insulin-stimulated tyrosine phosphorylated pp185 compared to the SPD group, but showed no significant difference when compared to the SCN and ExCN groups. RT reversed both the insulin resistance (IR) and the IS alterations in rats with induced periodontitis, and decreased the insulin and TNF-α levels. Therefore, the results of show the importance of RT in preventing or reversing IR in rats with periodontitis.

The biphasic nucleophilic aromatic substitution of 4-fluoronitrobenzene was carried out using a microreactor. To realize an efficient reaction process, we performed microflow reactions under droplet formation conditions to give the substituted products in excellent yields. The solvent effect was also investigated, and it was found that the use of diisobutyl ketone as an organic phase greatly accelerated the reaction.

Background: Frequent premature ventricular contractions (PVCs) are often amenable to catheter ablation. However, a deep intramural focus may lead to failure due to inability of standard ablation techniques to penetrate the focus. We sought to assess the efficacy and safety of infusion needle ablation (INA) for PVCs that are refractory to standard radiofrequency ablation. Methods: Under 2 Food and Drug Administration approved protocols, INA was evaluated in patients with frequent PVCs that were refractory to standard ablation. Initial targets for ablation were selected by standard mapping techniques. INA was performed with a deflectable catheter equipped with an extendable/retractable needle at the tip that can be extended up to 12 mm into the myocardium and is capable of pacing and recording. After contrast injection for location assessment, radiofrequency ablation was performed with the needle tip using a temperature-controlled mode (maximum temperature 60 °C) with saline infusion from the needle. The primary end point was a decrease in PVC burden to Results: At 4 centers, 35 patients (age 55.3±16.9 years, 74.2% male) underwent INA. The baseline median PVC burden was 25.4% (interquartile range, 18.4%–33.9%) and mean left ventricular ejection fraction was 37.7±12.3%. Delivering 10.3±8.0 INA lesions/patient (91% had adjunctive standard radiofrequency ablation also) resulted in acute PVC elimination in 71.4%. After a mean follow-up of 156±109 days, the primary efficacy end point was met in 73.3%. The median PVC burden decreased to 0.8% (interquartile range, 0.1%–6.0%; P Conclusions: INA is effective for the elimination of frequent PVCs that are refractory to conventional ablation and is associated with an acceptable safety profile. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01791543 and NCT03204981.

Aims Traditional criteria for heart transplantation by cardiopulmonary exercise testing (CPX) include peak oxygen uptake (VO2)

The iron-catalyzed cross-coupling reaction between an aromatic Grignard reagent and a haloalkane was investigated under micro-flow conditions. The reaction proceeded smoothly by the separate feeding of the substrate solutions to give the desired cross-coupling product. Compared to the previously reported batch reaction, the effect of additives was more predominant in the micro-flow reaction. The flow reactor system appears to contribute to the stabilization and rapid trapping of the unstable catalytic species.

Background We aimed to reveal sex differences in depression comprehension by reanalyzing data from a previous study of patients who were administered antidepressants. Methods A total of 424 outpatients were enrolled in the study. Participants were provided an original self-administered questionnaire that comprised eight items: depressive symptoms, course of depression, cause of depression, treatment plan, duration of antidepressant use, how to discontinue antidepressants, side effects of antidepressants, and psychotherapy. Each item consisted of the following two questions: "Have you received an explanation from the doctor in charge?" and "How much do you understand about your treatment?" The level of patients' comprehension of these questions was rated on a scale of 0-10 (11 anchor points). Symptoms were evaluated using the Quick Inventory for Depressive Symptomatology, Japanese version, and other scales. Patients were divided on the basis of sex, regardless of whether they were in remission. Results Compared with male patients, female patients with depression exhibited lower levels of depression and did not receive adequate psychoeducation from their physicians. While depression comprehension of female patients might not necessarily be associated with remission, male patients in remission received more explanations about depression and understood more compared with female patients. Conclusion Depression comprehension of male patients might be associated with remission, and psychoeducation should be sex-oriented to improve treatment responses.

Introduction Atrial fibrillation (AF) promotes left atrial (LA) remodeling and vice versa. LA volume index (LAVI) ≥34 mL/m2 is an established cut-off value for identifying an enlarged left atrium. Catheter ablation has become an established therapy for AF and provides a reduction of LA volume by maintaining sinus rhythm (reverse remodeling). However, the definition of LA reverse remodeling after AF ablation is undetermined. Purpose We hypothesized that patients with LA dilatation who obtain normal LA volume (LAVI Methods We enrolled 140 AF patients with baseline LAVI ≥34 mL/m2, without AF recurrence for 1 year after the initial AF ablation. We acquired conventional and speckle-tracking echocardiographic parameters within 24 h and at 1 year after the procedure. Late recurrence was defined as AF recurrence >1 year after the initial ablation. To define the normal range of LA function, age-and sex-matched 140 controls without a history of AF were also enrolled. Results After restoration of sinus rhythm, overall LA structural and functional parameters were significantly improved, and 75 patients (54%) had normal LA volume at the time of follow-up (Table). During a median follow-up of 44 (31–61) months, 32 patients (23%) experienced a late recurrence of AF. Patients who obtained normal LA volume after AF ablation had fewer late recurrences than those who did not (P Conclusion Patients who obtain normal LA volume have better long-term outcomes of AF ablation than those who do not. Although AF ablation promotes beneficial effects on LA structure and function, LA function cannot be normalized even in patients who obtain normal LA volume after successful ablation. Thus, physicians should carefully consider long-term follow-up and residual AF risks, regardless of sinus rhythm restoration by catheter ablation. Funding Acknowledgement Type of funding sources: None.

Yasushi Kawamata,1 Norio Sugawara,1,2 Masamichi Ishioka,3 Kazutoshi Kubo,4 Katsuji Suzuki,5 Akira Fujii,6 Hanako Furukori,7 Taku Nakagami,8 Norio Yasui-Furukori,1,2 Kazutaka Shimoda1 1Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan; 2Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; 3Department of Psychiatry, Minato Hospital, Hachinohe, Japan; 4Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan; 5Department of Psychiatry, Aomori Central Hospital, Aomori, Japan; 6Department of Neuropsychiatry, Mutsu General Hospital, Mutsu, Japan; 7Department of Neuropsychiatry, Kuroishi-Akebono Hospital, Kuroishi, Japan; 8Department of Psychiatry, Nakagami Mental Clinic, Ohdate, JapanCorrespondence: Norio Yasui-FurukoriDepartment of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, JapanTel +81-28-287-2153Fax +81-28-286-5187Email furukori@dokkyomed.ac.jpBackground: Concern regarding the benefit/risk ratio of the long-term use of benzodiazepines (BDZs) and Z-drugs is increasing. To prevent the risk of dependence in BDZ long-term use, it is essential to understand the attitudes of patients and psychiatrists toward BDZ treatment. The aims of this investigation were to 1) obtain information on patients’ attitudes with long-term BDZ use and their referring psychiatrists’ attitudes toward BDZ treatment, including their perception of the difficulty of reducing the dose of BDZs, and 2) identify discrepancies between patients’ and psychiatrists’ perceptions.Methods: A brief questionnaire was constructed to investigate the attitudes of patients receiving BDZ treatment and their referring psychiatrists. Our sample comprised 155 patients who received BDZ treatment for more than one year and their referring eight psychiatrists. Both the patients and their psychiatrists completed our questionnaire between August 2017 and December 2017.Results: Of the patients, 13% felt that it was more difficult to reduce the dose of BDZs than their referring psychiatrists (type A discrepancy), while 25% felt that it was less difficult (type B discrepancy). In the multivariate logistic regression analysis, the female sex and both the patients’ (“psychotherapy plus BDZs was necessary” and “it was necessary to increase the dose of BDZs”) and psychiatrists’ beliefs (“short-term prescription was justified”) were associated with type A discrepancies. Type B discrepancies were associated with psychiatrists’ beliefs that the patient’s wishes justified the use of BDZs and that the cessation of treatment with BDZs would lead to the deterioration of their rapport with their patients.Conclusion: To overcome the discrepancies in the attitudes of patients and psychiatrists toward the cessation of BDZ treatment, it is necessary to promote patient-centered care involving patient psychoeducation and practice guidelines for the decision-making process. Further studies investigating the promotion of patient-centered care to reduce BDZ use are needed.Keywords: dependence, benzodiazepine receptor agonist, anxiolytics, hypnotics, belief

Background Left atrial volume index (LAVI) of >34 mL/m2 is the cutoff value for identifying an enlarged left atrium. The definition of left atrial (LA) reverse remodeling after atrial fibrillation (AF) ablation is undetermined. We hypothesized that patients with LA dilatation who achieve normal LA volume (LAVI1 year). Patients who achieved normal LA volume after AF ablation had fewer late recurrences than those who did not (P, Patients with LA dilatation, who obtain normal LA volume (LAVI

Diabetes is a chronic disease that represents a severe public health problem. The objective was to evaluate aspects related to the prevalence, prevention, care and complications of diabetes in adults in Brazilian federative units(FU). This is an ecological, documentary study, performed with data from the National Health Survey-2013 and 2019, collected from website of the Brazilian Institute of Geography and Statistics. Data analysis was performed to verify the difference in proportions, according to the investigated variables, between 2013 and 2019. There was an increase in the prevalence of diabetes in 26 FU(96.30%), varying 3.3(9.3%); and reduction, in all FU, in the proportion that never evaluated glycemia, varying 3.6(25.9%). The proportion of people who used drugs to control the disease in all FU increased, varying 48.1(93.7%), however, only 5 FU(18.52%) showed an increase in the proportion who obtained medication at "Farmácia Popular" program. The proportion of people who received medical assistance in the last year increased by 22 FU(81.48%), varying 53.2(87.3%), however, in the majority of FU the proportion that performed all complementary exams decreased(n=17) and all consultations with a specialist doctor(n=18). In 14 FU(51.85%) the proportion of hospitalizations increased, varying 4.7(31.4%), while the proportion of people with limitations in usual activities decreased by 18 FU (66.67%) , varying 2.4(20.5%). The prevalence of the disease has increased in the vast majority of FU, highlighting the need for prevention strategies, medical and pharmaceutical assistance, aiming to reduce the problems caused by the disease. La diabetes es una enfermedad crónica que representa un grave problema de salud pública. El objetivo fue evaluar aspectos relacionados con la prevalencia, prevención, atención y complicaciones de la diabetes en adultos en unidades federativas brasileñas (UF). Se trata de estudio estudio ecológico documental, realizado con datos de la Encuesta Nacional de Salud-2013 y 2019, recopilados del sitio web del Instituto Brasileño de Geografía y Estadística. Se realizó un análisis de datos para verificar la diferencia de proporciones, según las variables investigadas, entre 2013 y 2019. Hubo un aumento en la prevalencia de diabetes en 26UF (96,30%), variando 3,3(9,3%); y reducción, en todas las UF, de la proporción que nunca evaluó glucemia, variando 3,6(25,9%). La proporción de personas que consumían medicamentos para la enfermedad en todas las UF aumentó, variando 48,1 (93,7%), sin embargo, solo 5UF(18,52%) mostraron aumento en la proporción que obtuvieron medicación en el programa "Farmácia Popular". La proporción de personas que recibieron asistencia médica en el último año aumentó en 22UF(81,48%), variando 53,2(87,3%), sin embargo, en la mayoría de UF la proporción que realizó todos los exámenes complementarios disminuyó(n=17) y todos consultas con médico especialista(n=18). En 14UF(51,85%) la proporción de hospitalizaciones aumentó, variando 4,7(31,4%), mientras que la proporción de personas con limitaciones en las actividades habituales disminuyó en 18UF(66,67%), variando 2,4(20,5%). La prevalencia de la enfermedad ha aumentado en la gran mayoría de las UF, destacando la necesidad de estrategias de prevención, asistencia médica y farmacéutica, con el objetivo de reducir los problemas provocados por la enfermedad. O diabetes é uma doença crônica que representa severo problema de saúde pública. Objetivou-se avaliar aspectos relacionados à prevalência, prevenção, assistência e complicações do diabetes em adultos nas unidades federativas (UF) brasileiras. Trata-se de um estudo ecológico, documental, realizado com dados da Pesquisa Nacional de Saúde-2013 e 2019, coletados na página eletrônica do Instituto Brasileiro de Geografia e Estatística. A análise dos dados foi realizada para verificar a diferença nas proporções de indivíduos, segundo as variáveis investigadas, entre 2013 e 2019. Houve aumento na prevalência de diabetes em 26 UF (96,30%), com variação de 3,3(9,3%); e redução, em todas as UF, na proporção que nunca avaliou a glicemia, com variação de 3,6(25,9%). Elevou-se a proporção de pessoas que utilizaram medicamentos para controle da doença em todas as UF, com variação de 48,1(93,7%), entretanto, apenas 5 UF (18,52%) apresentaram aumento na proporção que obteve medicamento pelo programa "Farmácia Popular". Aumentou a proporção de pessoas que receberam assistência médica no último ano em 22 UF (81,48%), com variação de 53,2(87,3%), contudo, na maioria das UF diminuiu a proporção que realizou todos os exames complementares (n=17) e todas as consultas com médico especialista (n=18). Em 14 UF (51,85%) elevou-se a proporção de internações, com variação de 4,7(31,4%), enquanto a proporção de pessoas com limitações nas atividades habituais diminuiu em 18UF (66,67%), com variação de 2,4(20,5%). A prevalência da doença aumentou na ampla maioria das UF, evidenciando a necessidade de estratégias de prevenção, assistência médica e farmacêutica, visando reduzir os agravos causados pela doença.

We prepared gold nanoparticles encapsulated in poly(amidoamine) (PAMAM) dendrimers as templating agents. The resulting gold nanoparticles were used as catalysts for the carboxylative cyclization of propargylic amines with carbon dioxide to afford the corresponding 1,3-oxazolidin-2-ones in yields of up to 99%.

Background: Hepatic steatosis is among the most common causes of chronic liver diseases, although established effective treatments are not evident. Previous studies reported that Kurozu improved hypercholesterolemia and carbohydrate metabolism. However, the effect of Kurozu on the incidence of hepatic steatosis is not clear. Objective: The effect of Kurozu on the onset of hepatic steatosis by administering a high-fat diet (HFD) for 110 weeks was evaluated in C57BL/6J mice. Methods: HFD treatment for 110 weeks accelerated the onset of hepatic steatosis more than a standard diet, whereas concentrated Kurozu (CK) supplementation ameliorated the effect of an HFD feeding. The effect of supplementation with resveratrol in an HFD on the onset of hepatic steatosis was also evaluated. To elucidate the mechanism of the effect of Kurozu on the expression of lipid metabolism genes, acute treatment for 10 days with Kurozu was also examined. Results: Supplementation with resveratrol in HFD-fed mice did not ameliorate hepatic steatosis. Body weights were significantly lower in the CK + HFD and Resveratrol + HFD groups than in the control HFD group in middle age. No significant differences in all-cause mortality were observed following supplementation with CK or resveratrol. CK and resveratrol supplements significantly inhibited decreases in dehydroepiandrosterone sulphate serum levels at postnatal week 120. CK and resveratrol supplements did not affect the survival of mice. The ingestion of Kurozu for 10 days significantly elevated the expression levels of Sirt1 , Pgc-1α , Lpin1 , and Igfbp1 in the liver. Conclusion: These results suggest that ingesting CK may delay the onset of hepatic steatosis HFD feeding causes. Keywords : Kurozu, steatosis, Sirt1, Igfbp1, Lpin1, Pgc-1α, resveratrol

Herein, we report a highly selective preparation method of azoxybenzenes from nitrobenzenes by visible-light irradiation. In a batch, this reaction method affords the corresponding aniline derivatives or intermediates (nitrosobenzene or phenyl hydroxylamine); however, in flow microreactors, azoxybenzenes are successfully obtained with very high selectivity.

Hippocampal somatostatin (SST)-neprilysin (NEP) system functions as a defense system against neurotoxic soluble amyloid-β oligomers associated with onset of Alzheimer’s disease. However, it remains unknown whether royal jelly (RJ) could impact the defense system. In this study using primary cultures of hippocampal neurons, including SST-positive and NEP-positive neuronal subsets, we evaluated the ability of DMSO-soluble fraction of RJ (DRJ) to enhance SST and NEP genes expression. The DRJ potently facilitated CRE-mediated transcription, and raised SST-immunoreactivity in an SST-positive neuronal subset, where elevated phospho-CREB immunoreactivity was simultaneously observed. Chromatin immunoprecipitation-qPCR assays uncovered that the DRJ mechanistically facilitated CREB-binding to a CRE present at the promoter region of SST. Moreover, in a distinct NEP-positive neuronal subset, the DRJ led to elevation of NEP immunoreactivity, which was abolished by cyclosomatostatin, a non-selective SST receptors antagonist. Collectively, these findings provide the first evidence that the RJ possesses potential to activate the hippocampal SST-NEP system.

Natsumi Tarakita,1,2 Kazutaka Yoshida,1 Norio Sugawara,3 Kazutoshi Kubo,1,4 Hanako Furukori,5 Akira Fujii,2 Kazuhiko Nakamura,1 Norio Yasui-Furukori1 1Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan; 2Department of Mental Health, Mutsu City Hospital, Mutsu, Japan; 3Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; 4Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan; 5Department of Neuropsychiatry, Kuroishi-Akebono Hospital, Kuroishi, Japan Objectives: To determine whether etiological beliefs are different among schizophrenia patients, their family, and medical staff. Patients and methods: A cross-sectional study was performed at five hospitals and one mental clinic and included 212 patients, 144 family members, and 347 medical staff other than psychiatrists. A questionnaire about the possible etiological causes of schizophrenia was used. Results: There were significant differences in response scores among the three groups on using Angermeyer’s and Goulding’s classifications. Factor analyses revealed the following four subscales: Psychosocial, Biological, Environmental, and Cultural connotations. The structure varied among patients, family, and medical staff. Conclusion: The perspectives of schizophrenia etiology were different among patients, family, and medical staff. Keywords: schizophrenia, etiology, perception, family, caregivers, beliefs, etiological causes, patients, medical staff

Objetivo: analisar a dispensação de medicamentos na atenção primária do Sistema Único de Saúde em um município do Estado de São Paulo. Metodologia: realizou-se análise documental dos boletins de movimentação de medicamentos das farmácias das 19 Unidades Básicas de Saúde do município de Araçatuba-SP, sede do Departamento Regional de Saúde II-SP, durante 12 meses. Os medicamentos foram agregados segundo o sistema de classificação Anatomical Therapeutic Chemical e ação farmacológica. Analisou-se o total de medicamentos dispensados e o saldo final dos principais tipos de fármacos. Resultados: foram dispensados 60.479.959 medicamentos, sendo 53,10% antibióticos, 15,42% anti-hipertensivos, 5,09% antidepressivos, 4,81% hipoglicemiantes, 3,16% ansiolíticos, 2,82% complexos vitamínicos e minerais, 2,17% antipsicóticos, 1,99% analgésicos, dentre outros tipos (11,45%). Permaneceram disponíveis 8.778.863 medicamentos, sendo os anti-hipertensivos, antidepressivos e ansiolíticos os que representam a maior proporção entre estes. Os antibióticos apresentaram a menor proporção de unidades disponíveis, com aproximadamente 2%. Os hipoglicemiantes apresentaram maior diversidade de fármacos sem unidades disponíveis para dispensação. Conclusão: os principais tipos de medicamentos dispensados foram antibióticos, anti-hipertensivos, antidepressivos e hipoglicemiantes. A dispensação de medicamentos foi satisfatória, considerando que mesmo os medicamentos que não apresentaram saldo residual positivo foram substituídos por outros de propriedades farmacológicas similares.