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Although the treatment currently recommended for snakebite accidents is serum therapy using antivenom, a need for adjunctive therapy associated with serum therapy for treating the local effects caused by snakebites is an effort of the WHO to reduce local signals and symptoms. Photobiomodulation with laser or LED therapy is one of the primary examples of adjuvant therapy to serum therapy to lessen these local effects caused by snakebite envenoming. For this purpose, the project aims to study the action of photobiomodulation with LED therapy in isolated thioglycolate-elicited macrophages stimulated with Bothrops jararacussu venom (BjV) and isolated bothropstoxins BthTX-I and BthTX-II focusing on cell dead mechanism such as necrosis and apoptosis, mitochondrial membrane potential, and cytokines [Interleukin (IL)-1β, IL-10, IL-6], and [tumor necrosis factor (TNF)-α] and lipid mediator [prostaglandin (PG)E2] liberation. Briefly, thioglycollate-elicited macrophages were harvested from Swiss male mice incubated with BjV or BthTXs irradiated or not with LED, and the following parameters were analyzed: necrosis and apoptosis, mitochondrial membrane potential, cytokines, and lipid mediator liberation. Herein, results showed that LED therapy was able to decrease necrosis cell death, caspase-3 activity, and TNF-α liberation. In addition, LED therapy induces mitochondrial membrane potential and modulates gene expression of lipid mediators. In conclusion, the data of this study support the use of phototherapy as an adjuvant therapeutical approach in combination with serum therapy to mitigate the local effects resulting from snakebite envenoming.

Azithromycin (AZM) is a macrolide-type antibiotic used to prevent and treat serious infections (mycobacteria or MAC) that significantly inhibit bacterial growth. Knowledge of the predominant conformation in solution is of fundamental importance for advancing our understanding of the intermolecular interactions of AZM with biological targets. We report an extensive density functional theory (DFT) study of plausible AZM structures in solution considering implicit and explicit solvent effects. The best match between the experimental and theoretical nuclear magnetic resonance (NMR) profiles was used to assign the preferred conformer in solution, which was supported by the thermodynamic analysis. Among the 15 distinct AZM structures, conformer M14, having a short intramolecular C6-OH … N H-bond, is predicted to be dominant in water and dimethyl sulfoxide (DMSO) solutions. The results indicated that the X-ray structure backbone is mostly conserved in solution, showing that large flexible molecules with several possible conformations may assume a preferential spatial orientation in solution, which is the molecular structure that ultimately interacts with biological targets.

It has been suggested in the medical literature that in the last period of his life King David (c. 1040–970 BCE) suffered from dementia, osteoporosis, hyperparathyroidism, Parkinson's disease, autonomic neuropathy, major depression, and malignancy. The goal of this study was to identify, based on the “Succession Narrative (SN),” a historically objective section of the Old Testament, the clinical syndrome presented by King David and to determine whether an impaired decision making capacity may have been manipulated by his courtiers to influence his succession's politics. The “SN” indicates that besides forgetfulness and trouble in thinking, King David suffered from marked cold intolerance and sexual dysfunction. The symptom triad consisting of cognitive impairment, cold intolerance, and sexual dysfunction is more strongly suggestive of hypothyroidism than of any other diagnoses proposed in the medical literature so far. We hypothesized that hypothyroidism was the underlying cause of the elderly King David's clinical picture and that his sometimes troubled thinking was successfully manipulated by the courtiers to favor his son Solomon's accession to the throne, with profound historical consequences.

Abstract Convulxin (CVX), a C-type lectin-like protein isolated from the venom of the snake species, Crotalus durissus terrificus, stimulates platelet aggregation by acting as a collagen receptor agonist for glycoprotein VI found in the platelets. The effect of CVX on platelets has been studied, but its effect on human peripheral blood mononuclear cells (PBMCs) remains unclear. Given the significance of PBMCs in inflammation, this study explored the effect of CVX on PBMCs, specifically regarding NLRP3 inflammasome activation by assessing cell viability, ability to induce cell proliferation, reactive oxygen species (ROS) and nitric oxide production, interleukin (IL)-2 and IL-10 secretion, NLRP3 complex activation, and the role of C-type lectin-like receptors (CTLRs) in these. CVX was not toxic to PBMCs at the investigated concentrations and did not increase PBMC growth or IL-2 release; however, CVX induced IL-10 release and ROS generation via monocyte activation. It also activated the NLRP3 complex, resulting in IL-1β induction. Furthermore, the interaction between CVX and Dectin-2, a CTLR, induced IL-10 production. CVX interaction with CTLR has been demonstrated by laminarin therapy. Because of the involvement of residues near the Dectin-2 carbohydrate-recognition site, the generation of ROS resulted in inflammasome activation and IL-1β secretion. Overall, this work helps elucidate the function of CVX in immune system cells.

L-Amino acid oxidase (LAAO) is an enzyme found in snake venom that has multifaceted effects, including the generation of hydrogen peroxide (H2O2) during oxidative reactions, leading to various biological and pharmacological outcomes such as apoptosis, cytotoxicity, modulation of platelet aggregation, hemorrhage, and neutrophil activation. Human neutrophils respond to LAAO by enhancing chemotaxis, and phagocytosis, and releasing reactive oxygen species (ROS) and pro-inflammatory mediators. Exosomes cellular nanovesicles play vital roles in intercellular communication, including immune responses. This study investigates the impact of Calloselasma rhodostoma snake venom-derived LAAO (Cr-LAAO) on human neutrophil exosome release, including activation patterns, exosome formation, and content. Neutrophils isolated from healthy donors were stimulated with Cr-LAAO (100 μg/mL) for 3 h, followed by exosome isolation and analysis. Results show that Cr-LAAO induces the release of exosomes with distinct protein content compared to the negative control. Proteomic analysis reveals proteins related to the regulation of immune responses and blood coagulation. This study uncovers Cr-LAAO’s ability to activate human neutrophils, leading to exosome release and facilitating intercellular communication, offering insights into potential therapeutic approaches for inflammatory and immunological disorders.

BackgroundDementia is a clinical syndrome which is more common in elderly people. Dementia with Lewy bodies (LBD) is not so rare in elderly people, with cognitive impairment in about 30% over age 65. The clinical picture is characterized by fluctuation in cognitive functions, recurrent, well-formed, detailed visual hallucinations, and Parkinsonism, with rigidity, tremor, bradykinesia, and slurred speech.Case presentationWe present a case report of LBD in a 73-year-old retired teacher, which a initial wrong diagnosis of refractory depression for at least 3 years. We also conduct a review of recent works on theme.ConclusionLBD diagnosis can be neglected for years, with a legal and clinical issues to patients and their families. Detailed medical research, including differential diagnosis, are very necessary on those cases, specially when they are called refractory. We encourage new research and adequate clinical training to prevent damage.

Baecke questionnaire have been widely used to assess physical activity. However, the role of educational level on validity and reliability of Baecke questionnaire is still not stablished, being a factor that can potentially influence the accuracy of self-reported measures. The present study aimed to verify the validity and reliability of Baecke questionnaire for the measurement of physical activity in community dwelling adults according to education level. The sample included 251 adults (42.4±17.0 years, 55% of women). Physical activity was self-reported by Baecke questionnaire and objectively measured by accelerometer. The education level (EL) was classified by years of study into low (11 years). A 7-day test-retest reliability was analyzed by intraclass correlation coefficient. The relationship, agreement and validity of the Baecke questionnaire against accelerometry were analyzed by Spearman's correlation, Kappa index, and ROC curve, respectively. The reliability of Baecke questionnaire were r = 0.97 (high EL), r = 0.78 (medium EL), and r = 0.68 (low EL). Sensitivity and specificity were 77% and 71% in high EL, 54% and 80% in medium EL and 33% and 89% in the low EL. Baecke questionnaire proved to be reliable and a valid measurement of habitual physical activity in adults with medium and high EL.

Plastoquinone is a key electron carrier in photosynthesis and an essential cofactor for the biosynthesis of carotenoids. p-Hydroxyphenylpyruvate dioxygenase (HPPD) is a vital enzymatic step in plastoquinone biosynthesis that is the target of triketone herbicides, such as those derived from the pharmacophore backbone of the natural product leptospermone. In this work, the inhibitory activity of a series of 2-acyl-cyclohexane-1,3-diones congeners derived from Peperomia natural products was tested on plant HPPD. The most active compound was a 2-acyl-cyclohexane-1,3-dione with a C11 alkyl side chain (5d; I50app: 0.18 ± 0.02 μM) that was slightly more potent than the commercial triketone herbicide sulcotrione (I50app: 0.25 ± 0.02 μM). QSAR analysis and docking studies were performed to further characterize the key structural features imparting activity. A 1,3-dione feature was required for inhibition of HPPD. Molecules with a side chain of 11 carbons were found to be optimal for inhibition, while the presence of a double bond, hydroxy, or methyl beyond the required structural features on the cyclohexane ring generally decreased HPPD inhibiting activity.

Bothrops envenomation is associated with a cellular inflammatory response, characterized by pronounced neutrophil infiltration at the site of injury. Neutrophils act as the first line of defence, owing to their ability to migrate to the infected tissue, promoting an acute inflammatory response. At the site of inflammation, neutrophils perform defence functions such as phagocytosis, release of proteolytic enzymes, generation of reactive oxygen species (ROS), and synthesis of inflammatory mediators such as cytokines and lipid mediators. Neutrophils can also form neutrophil extracellular nets (NETs), webs composed of chromatin and granule proteins. This occurs after neutrophil activation and delivers high concentrations of anti-microbial molecules to the site of injury. This study evaluated the impact of BaTX-II, an Asp49 phospholipase A2 (PLA2) isolated from Bothrops atrox snake venom on human neutrophils in vitro. At non-toxic concentrations, BaTX-II induced hydrogen peroxide production by neutrophils, and this was reduced by wortmannin, a PI3K inhibitor. BaTX-II stimulated IL-1β, IL-8, LTB4, myeloperoxidase (MPO), and DNA content release, consistent with NET formation. This is the first study to show the triggering of relevant pro-inflammatory events by PLA2 Asp49 isolated from secretory venom.

We report here the characterization of two new polymeric copper(II) complexes containing 2-chlorobenzhydrazide (2-CH) and two N,N-donor ligands, namely, 1,10-phenanthroline (phen) and 4-4′-dimethoxy-2-2′-bipyridine (dmb). The structure of a new polymeric copper(II) complex in which a perchlorate anion acts as a bridge ligand is discussed in detail. In both complexes, spectral data reveals a bidentate coordination mode for hydrazide, perchlorate and N,N-donor ligand. These metal complexes and their free ligands were evaluated for their trypanocidal and cytotoxic activities and the complex with 1,10-phenanthroline has been much more active than benznidazole, a drug used in the treatment of Chagas disease. Keywords: Copper(II) complexes, Crystal structure, Trypanosoma cruzi, Cytotoxic activity

Alguns compostos de platina (II), como por exemplo, cisplatina, carboplatina e oxaloplati- na, têm sido utilizados como agentes quimioterápicos no tratamento de vários tipos de câncer. Contudo, na tentativa de reduzir a toxicidade e ampliar o espectro de atividade da cisplatina e de seus análogos, milhares de complexos têm sido preparados variando a natureza dos ligantes. Este trabalho descreve a síntese e caracterização de novos complexos de platina, tendo iodeto e derivados do furano como ligantes. Os complexos foram caracterizados por RMN, IV e análise elementar.

The present work develops a simplified computational methodology to predict brackets’ mechanical behavior to support mooring systems’ fairleads under maximum environmental loads. The methodology consists of estimating environmental loads in Campos’s basin (Brazil) using standards available in the literature and applying them to determine the stress distribution in the brackets’ solid domain using a code based on the Finite Element Method. The brackets studied here are composed of AH36 steel plates. Six different geometric configurations for the brackets considering thinner plates than those ordinarily employed in the existent brackets of the P-66 Petrobras oil production platform were studied. Theoretical recommendations about geometric configurations to reduce the von Mises maximum stress in brackets’ plates were determined in the light of constructal design. The results proved the importance of the geometric investigation in this problem. For instance, for the accidental limit state (ALS) the best configuration leads to a mechanical performance two times superior to that reached for the worst one, which had a maximum stress superior to the yielding limit. Moreover, the best designs for the superior and inferior brackets in the ALS have different configurations.

Meta-analyses have shown that supervised isometric handgrip training reduces blood pressure in hypertensives. However, the mechanism(s) underlying these effects in medicated hypertensive patients, as well as the effects from home-based exercise training, is uncertain. The purpose of this study was to compare the effects of supervised and home-based isometric handgrip training on cardiovascular parameters in medicated hypertensives. In this randomized controlled trial, 72 hypertensive individuals (38–79 years old, 70% female) were randomly assigned to three groups: home-based, supervised isometric handgrip training or control groups. Home-based and supervised isometric handgrip training was completed thrice weekly (4 × 2 min at 30% of maximal voluntary contraction, with 1-min rest between bouts, alternating the hands). Before and after 12 weeks brachial, central and ambulatory blood pressures (BP), arterial stiffness, heart rate variability, vascular function, oxidative stress and inflammation markers were obtained. No significant (p > 0.05) effect was observed for ambulatory BP, arterial stiffness, heart rate variability, vascular function and oxidative stress and inflammatory markers in all three groups. Brachial BP decreased in the supervised group (Systolic: 132 ± 4 vs. 120 ± 3 mmHg; Diastolic: 71 ± 2 vs. 66 ± 2 mmHg, p < 0.05), whereas no significant differences were observed in the home-based (Systolic: 130 ± 4 vs. 126 ± 3 mmHg; diastolic: 73 ± 3 vs. 71 ± 3 mmHg) and control groups (p > 0.05). Supervised handgrip exercise also reduced central BP systolic (120 ± 5 vs. 109 ± 5 mmHg), diastolic (73 ± 2 vs. 67 ± 2 mmHg); and mean BP (93 ± 3 vs. 84 ± 3 mmHg), whereas no significant effects were found in the home-based (Systolic: 119 ± 4 vs. 115 ± 3 mmHg; Diastolic: 74 ± 3 vs. 71 ± 3 mmHg) and control groups (p > 0.05). In conclusion, supervised, but not home-based, isometric training lowered brachial and central BP in hypertensives.

Abstract Meta-analytical studies have indicated that isometric handgrip training promotes significant reduction in blood pressure in hypertensive patients with similar or greater decreases in blood pressure than observed after aerobic and dynamic resistance training. However, several gaps in the literature still need to be addressed. Thus, we designed the ISOPRESS network group, which consists of a task force of different research groups aimed at analyzing the effects of isometric handgrip training on different contexts, parameters, and populations. Thus, the aim of this study was to describe the rationale and design behind the ISOPRESS, presenting the methods employed. The ISOPRESS questions involve whether isometric handgrip training is effective in hypertensives in different settings (ISOPRESS 1 - unsupervised training and ISOPRESS 2 - public health system), whether it works in patients with other cardiovascular diseases (ISOPRESS 3 - obstructive sleep apnea and ISOPRESS 4 - peripheral artery disease) and what are the mechanisms underlying the effects of isometric handgrip training in hypertensives (ISOPRESS 5 - neural mechanism). The study will yield information on the effectiveness of isometric handgrip training in different settings and patients with other cardiovascular diseases. Finally, it will help to understand the mechanisms involved in reducing blood pressure in hypertensives.

In the past few years, photoredox catalysis has become a powerful tool in the field of organic synthesis. Using this efficient method, it is possible to excite organic compounds from visible light and attain alternative mechanistic pathways for the formation of chemical bonds, a result which is not obtainable by classical methods. The rapid growth of work in the area of photoredox catalysis is due to its low cost, broad chemical utility protocols, and, especially, its relevancy from the green and sustainable chemistry viewpoints. Thus, this study proposes a brief theoretical discussion of and highlights recent advances in visible-light-induced photoredox catalysis through the analysis of catalytic cycles and intermediates.

Objective: Peritraumatic reactions feature prominently among the main predictors for development of posttraumatic stress disorder (PTSD). Peritraumatic tonic immobility (PTI), a less investigated but equally important type of peritraumatic response, has been recently attracting the attention of researchers and clinicians for its close association with traumatic reactions and PTSD. Our objective was to investigate the role of PTI, peritraumatic panic, and dissociation as predictors of PTSD symptoms in a cohort of police recruits (n=132). Methods: Participants were asked to complete the following questionnaires during academy training and after the first year of work: Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C), Physical Reactions Subscale (PRS), Peritraumatic Dissociative Experiences Questionnaire (PDEQ), Tonic Immobility Scale (TIS), and Critical Incident History Questionnaire. Results: Employing a zero-inflated negative binomial regression model, we found that each additional point in the TIS was associated with a 9% increment in PCL-C mean scores (RM = 1.09), whereas for PRS, the increment was 7% (RM = 1.07). As the severity of peritraumatic dissociation increased one point in the PDEQ, the chance of having at least one symptom in the PCL-C increased 22% (OR = 1.22). Conclusions: Our findings highlight the need to expand investigation on the incidence and impact of PTI on the mental health of police officers.

Background: Physical education (PE) plays a critical role in the healthy development of youth; however, the influence of PE classes in helping to provide students with health-related behavior patterns is not clear. This study aims to analyze whether participation in PE classes is associated with health-related behavior among high school students. Methods: A total of 4210 students attending public high schools in Pernambuco (northeast of Brazil) were selected using random 2-stage cluster sampling. Data were collected by using the Global School-based Student Health Survey. The independent variable was the frequency of participation in PE classes, whereas physical activity, television viewing, smoking, and alcohol, fruit, vegetables and soda consumption were dependent variables. Logistic regressions were carried out to perform crude and adjusted analysis of the association between enrollment in PE classes and health-related behaviors. Results: Sixty-five percent of students do not take part in PE classes, with a significantly higher proportion among females (67.8%). It was observed that enrollment in PE classes was positively associated with physical activity, TV viewing, and fruit consumption, but was negatively associated with soda drinking. The likelihood of reporting being active and eating fruit on a daily basis was 27% and 45% higher, respectively, among those who participate in at least 2 classes per week in comparison with those who do not. Students who participate in PE classes had 28-30% higher likelihood of reporting lower TV viewing during week days. Conclusions: Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students. (Contains 4 tables.)

OBJECTIVE: Tonic immobility is a defensive reaction occurring under extreme life threats. Patients with posttraumatic stress disorder (PTSD) reporting peritraumatic tonic immobility show the most severe symptoms and a poorer response to treatment. This study investigated the predictive falue of tonic immobility for posttraumatic stress symptoms in a non-clinical sample. METHODS: One hundred and ninety-eight college students exposed to various life threatening events were selected to participate. The Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) and tonic immobility questions were used. Linear regression models were fitted to investigate the association between peritraumatic tonic immobility and PCL-C scores. Peritraumatic dissociation, peritraumatic panic reactions, negative affect, gender, type of trauma, and time since trauma were considered as confounding variables. RESULTS: We found significant association between peritraumatic tonic immobility and PTSD symptoms in a non-clinical sample exposed to various traumas, even after regression controlled for confounding variables (β = 1.99, p = 0.017). CONCLUSIONS: This automatic reaction under extreme life threatening stress, although adaptive for defense, may have pathological consequences as implied by its association with PTSD symptoms.OBJETIVO: A imobilidade tônica é uma resposta defensiva que ocorre sob ameaça extrema à vida. Pacientes com transtorno de estresse pós-traumático (TEPT) que relatam imobilidade tônica peritraumática são os que apresentam os sintomas mais graves e a pior resposta ao tratamento. Este estudo investigou o valor preditivo da imobilidade tônica para os sintomas de TEPT em uma amostra não clínica. MÉTODOS: Os participantes da pesquisa foram 198 estudantes universitários expostos a traumas diversos. A versão brasileira do Post-Traumatic Stress Disorder Checklist Civilian Version (PCL-C) e questões referentes à imobilidade tônica foram empregadas. Modelos de regressão linear foram utilizados para investigar a associação dos sintomas de estresse pós-traumático com a imobilidade tônica peritraumática. Foram consideradas como variáveis de confusão a dissociação peritraumática, as reações físicas de pânico peritraumática, o traço de afeto negativo, o gênero, o tipo de trauma e o tempo de trauma. RESULTADOS: Encontrou-se uma associação significativa entre a imobilidade tônica peritraumática e os sintomas de TEPT em uma amostra não clínica exposta a traumas diversos mesmo quando controlada por variáveis de confusão (β = 1,99; p = 0,017). CONCLUSÕES: Esta reação defensiva que ocorre sob intensa ameaça, apesar de adaptativa para a defesa, pode ter consequências patológicas como sugere sua associação aos sintomas de TEPT.

BACKGROUND: Exposure to traumatic events is a necessary but not a sufficient condition for the development of posttraumatic stress disorder (PTSD). Pretrauma, peritrauma and posttrauma factors interact to impact on symptom severity. The aim of the present study is to determine risk factors for PTSD symptoms in Brazilian police officers. METHOD: In a cross-sectional sample of active duty officers (n = 212), participants were asked to complete a socio-demographic questionnaire and self-report scales on affective traits, cumulative critical incident exposure, peritraumatic distress and dissociation, PTSD symptoms, and social support. Hierarchical linear regression analysis was conducted to examine predictors of PTSD symptoms. RESULTS: Variables related to negative affect, job duration, frequency of critical incident exposure, peritraumatic dissociation, and lack of social support remained significant in the final model and explained 55% of the variance in PTSD symptoms. When interaction terms were evaluated, a synergistic effect between negative affect and peritraumatic dissociation was found. CONCLUSIONS: The risk factors found in this study provide clues on how to elaborate primary prevention strategies regarding PTSD symptoms in police officers. Such initiatives may lessen the impact of repeated exposure to traumatic events on police officers over the course of their careers.INTRODUÇÃO: A exposição a eventos traumáticos é uma condição necessária, porém não única, para o desenvolvimento de transtorno de estresse pós-traumático (TEPT). Fatores individuais pré, peri e pós-trauma exercem impacto sobre a gravidade dos sintomas. O objetivo do presente estudo é determinar os fatores de risco para o desenvolvimento de sintomas de TEPT em policiais brasileiros. MÉTODO: Uma amostra transversal de policiais em atividade (n = 212) foi convidada a responder um questionário sóciodemográfico e escalas autoaplicáveis sobre afeto positivo e negativo, frequência de incidentes críticos, sofrimento e dissociação peritraumáticos, sintomas de TEPT e apoio social. Regressão linear hierárquica foi utilizada para avaliar fatores de risco. RESULTADOS: Afeto negativo, tempo de trabalho, frequência de exposição a eventos traumáticos, dissociação peritraumática e apoio social diminuído permaneceram no modelo final e explicaram 55% das variações dos sintomas de TEPT. Foi observado efeito sinérgico entre dissociação peritraumática e afeto negativo. CONCLUSÃO: Baseados nos achados os autores discutem estratégias de prevenção que visam diminuir o impacto da exposição a eventos traumáticos em policiais ao longo de suas carreiras.

Neste artigo, apresentamos relato de uma perícia de um caso de simulação de transtorno de estresse pós-traumático. Nosso objetivo era apresentar o leitor às dificuldades que o perito pode encontrar diante desses casos e demonstrar como um exame atento, combinado com conhecimento das peculiaridades dessa doença, pode contribuir poderosamente para o diagnóstico correto.

OBJETIVO: Atualizar os clínicos sobre a existência de um possível subtipo do transtorno obsessivo-compulsivo caracterizado por pouco insight. MÉTODO: Revisão opinativa baseada em estudos indexados na base de dados PubMed e PsychINFO, identificados por meio dos unitermos "obsessive-compulsive disorder" e "insight" ou "ego-dystonic" e publicados entre 1966 e outubro de 2009. Os resultados foram examinados de acordo com a estratégia utilizada para abordar o insight, i.e. categórica vs. dimensional. RESULTADOS: Análise dos estudos nos permitiu identificar pontos que colocam em dúvida a existência de um subtipo do transtorno obsessivo-compulsivo bem delimitado caracterizado por pouco insight. Estes pontos incluem 1) prevalência extremamente variável do transtorno obsessivo-compulsivo com insight reduzido encontrada em estudos categóricos, 2) homogeneidade dos achados fenotípicos (i.e. maior gravidade) associados a baixo insight em estudos categóricos e dimensionais e 3) ausência de estudos que investigam "zonas de raridade" entre as formas de transtorno obsessivo-compulsivo com pouco e bom insight. CONCLUSÃO: Embora uma abordagem categórica do insight no transtorno obsessivo-compulsivo seja importante em ambientes clínicos, uma vez que neles existem demandas prementes para tomada de decisões, a abordagem dimensional do insight parece refletir de forma mais fidedigna o fenômeno apresentado pelos pacientes em tela.OBJECTIVE: To update clinicians regarding the existence of a putative subtype of obsessive-compulsive disorder based on poor insight. METHOD: Opinionative review based on studies indexed in the PubMed and PsychINFO databases, identified by means of the keywords "obsessive-compulsive disorder" AND "insight" OR "ego-syntonic", and published between 1966 and October 2009. The results were analyzed according to the approach adopted, i.e. a categorical or dimensional view of insight in obsessive-compulsive disorder. RESULTS: The review of recent studies led us to identify some issues that cast doubts over the existence of a clear-cut poor insight subtype of obsessive-compulsive disorder. These issues include 1) an extremely variable prevalence of poor insight obsessive-compulsive disorder in categorical studies, 2) a significant degree of homogeneity in the phenotypical findings (i.e. greater severity) associated with lower levels of insight in obsessive-compulsive disorder in both categorical and dimensional studies and, 3) a lack of studies investigating zones of rarity between poor and good insight obsessive-compulsive disorder. CONCLUSION: Although a categorical approach to the insight issue in obsessive-compulsive disorder is still important in clinical settings, where decision-making is often a critical issue, a dimensional approach seems to reflect levels of impairment in these patients more reliably.

Lídia Ordacgi1, Mauro V Mendlowicz2, Leonardo F Fontenelle11Anxiety and Depression Research Program, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil; 2Department of Psychiatry and Mental Health, Universidade Federal Fluminense (MSM-UFF), Niterói, BrazilAbstract: The pharmacodynamic properties of fluvoxamine maleate include the modulation of different populations of serotonergic, dopaminergic, and sigma receptors and/or transporters, a complex pattern of activity that may account for its efficacy in the treatment of obsessive-compulsive disorder (OCD). Nevertheless, its pharmacokinetic profile and its pattern of side effects may hinder a rapid dose escalation, a therapeutic strategy that might be utterly desirable in patients with OCD. In preclinical studies, the maximum plasma concentration and bioavailability of an extended-release (CR) formulation of fluvoxamine were, respectively, 38% and 16% lower than those of the standard (ie, non-CR) formulation. Recently, the US Food and Drug Administration approved the fluvoxamine CR formulation for the treatment of OCD in adults. This approval was based on the results of a double-blind, placebo-controlled study with 253 OCD patients in which fluvoxamine CR showed a consistently earlier onset of therapeutic effects than other selective serotonin reuptake inhibitors, as reported in previous studies. The use of the CR formulation of fluvoxamine allowed a particularly aggressive dosing strategy at the beginning of the titration phase, ie, treatment could be started with a single dose of fluvoxamine CR 100 mg at bedtime, while keeping the occurrence of side effects and the rate of compliance at levels comparable to those reported for the use of immediate-release fluvoxamine.Keywords: obsessive-compulsive disorder, fluvoxamine, fluvoxamine extended release

A series of 13 compounds analogous of isoniazid condensed with carbohydrate was synthesized and evaluated for their in vitro antibacterial activity against Mycobacterium tuberculosis H37Rv using Alamar Blue susceptibility test and the activity expressed as the minimum inhibitory concentration (MIC90) in μg/mL. Several compounds exhibited antitubercular activity (0.31-3.12 μg/mL) when compared with first line drugs such as isoniazid (INH) and rifampicin (RIP) and could be a good starting point to develop new compounds against tuberculosis.

A number of lipophilic N-acyl-diamines and aldonamides have been synthesized and tested for their in vitro antiproliferative activity against Leishmania amazonensis and L. chagasi. Ribonamides, having one amino group, displayed good to moderate inhibition of parasite growth. The best result was obtained for compounds 10 and 15 with IC50 against L. chagasi below 5 μM.

OBJECTIVES: assess reproducibility and concurrent validity of the questionnaire focusing on a typical physical activity and food intake day (DAFA) to measure physical activity and food intake in children between seven and ten years old. METHODS: sixty nine children recruited in a public school located in Florianópolis, Santa Catarina participated of the survey. Reproducibility was determined by comparing measures of two DAFA applications in a two week interval while concurrent validity of physical activity was assessed by comparing DAFA with a questionnaire filled by parents/teachers. As for food intake, the reference method was a 24 hour recordatory. Analysis included concordance coefficient determination, intraclass correlation, adjusted kappa coefficient and Wilcoxon and Kruskal-Wallis tests. RESULTS: concordance coefficient was of 88% (school commuting) and 68% (physical activity related attitude) while intraclass correlation was of 0.85 for the general measure for physical activity. Using the report of parents/teachers, the children were broken into three groups of physical activities (low/medium/high), it should be considered that DAFA scores differed significantly. As for food intake measuring, 80% of concordance was determined between DAFA applications. Interinstrument convergence was substantial/moderate in relation to 17 food items. CONCLUSIONS: DAFA allows for physical activity and food intake measures in children with good reproducibility and moderate validation evidence.OBJETIVOS: avaliar a reprodutibilidade e validade concorrente do questionário dia típico de atividade física e alimentação (DAFA) para medida de atividade física e consumo alimentar em crianças de sete a dez anos. MÉTODOS: participaram do estudo 69 crianças recrutadas em escola pública de Florianópolis. A reprodutibilidade foi determinada comparando medidas de duas aplicações do DAFA com intervalo de duas semanas, enquanto a validade concorrente das medidas de atividade física foi analisada comparando DAFA com questionário respondido por pais/professores. Quanto ao consumo alimentar, o método de referência foi um recordatório de 24 horas. Análises incluíram determinação do coeficiente de concordância, correlação intraclasse, coeficiente kappa ajustado, e testes de Wilcoxon e Kruskal-Wallis. RESULTADOS: o coeficiente de concordância foi 88% (transporte para escola) e 68% (atitude relativa às atividades físicas), enquanto o coeficiente de correlação intraclasse foi 0,85 para medida geral de atividade física. Utilizando relato de pais/professores, crianças foram classificadas em três grupos de atividade física (baixo/médio/alto), observando-se que os escores DAFA foram significativamente diferentes entre estes. Quanto às medidas de consumo alimentar, observou-se 80% de concordância entre aplicações do DAFA. Convergência de medidas interinstrumentos foi substancial/moderada em 17 itens alimentares. CONCLUSÕES: o DAFA permite coletar medidas de atividade física e consumo alimentar de crianças com boa reprodutibilidade e moderada evidência de validade.

The maltreatment of children and adolescents is a global public health problem that affects high and low-middle income countries (LMICs). In the United States, around 1.2 million children suffer from abuse, while in LMICs such as Brazil these rates are much higher (an estimated 28 million children). Exposition to early environmental stress has been associated with suboptimal physical and brain development, persistent cognitive impairment and behavioral problems. Studies have reported that children exposed to maltreatment are at high risk of behavioral problems, learning disabilities, communication and psychiatric disorders and general clinical conditions such as obesity and systemic inflammation later in life. The aim of this paper is to describe The Equilibrium Program (TEP), a community-based global health program implemented in São Paulo, Brazil to serve traumatized and neglected children and adolescents. We will describe and discuss TEP’s implementation, highlighting its innovation aspects, research projects developed within the program as well as its population profile. Finally, we will discuss TEP’s social impact, challenges and limitations. The program’s goal is to promote the social and family reintegration of maltreated children and adolescents through an interdisciplinary intervention program that provides multi-dimensional bio-psycho-social treatment integrated with the diverse services needed to meet the unique demands of this population. The program’s cost-effectiveness is being evaluated to support the development of more effective treatments and to expand similar programs in other areas of Brazil. Policy makers should encourage early evidence-based interventions for disadvantaged children to promote healthier psychosocial environments and provide them opportunities to become healthy and productive adults. This approach has already shown itself to be a cost-effective strategy to prevent disease and promote health.

The aim of the study was to test the performance of a new definition of metabolic syndrome (MetS), which better describes metabolic dysfunction in children. Methods. 15,794 youths aged 6–18 years participated. Mean z-score for CVD risk factors was calculated. Sensitivity analyses were performed to evaluate which parameters best described the metabolic dysfunction by analysing the score against independent variables not included in the score. Results. More youth had clustering of CVD risk factors (>6.2%) compared to the number selected by existing MetS definitions (International Diabetes Federation (IDF) < 1%). Waist circumference and BMI were interchangeable, but using insulin resistance homeostasis model assessment (HOMA) instead of fasting glucose increased the score. The continuous MetS score was increased when cardiorespiratory fitness (CRF) and leptin were included. A mean z-score of 0.40–0.85 indicated borderline and above 0.85 indicated clustering of risk factors. A noninvasive risk score based on adiposity and CRF showed sensitivity and specificity of 0.85 and an area under the curve of 0.92 against IDF definition of MetS. Conclusions. Diagnosis for MetS in youth can be improved by using continuous variables for risk factors and by including CRF and leptin.

BACKGROUND: Cognitive deficits of late-onset schizophrenia (LOS) patients have been reported as stable, although some prospective studies show that a sub-group develop a significant cognitive decline. Data on LOS from developing countries are scarce. OBJECTIVE: To evaluate the cognitive performance of Brazilian patients with LOS over the course of one year. METHOD: Thirteen LOS patients were evaluated at baseline and after one year with the Mini-Mental State Examination (MMSE), the CAMCOG, the Positive and Negative Symptoms Scale, the Pfeffer’s Activities of Daily Living (ADL), and the Neuropsychiatric Inventory (NPI). RESULTS: Cognition and activities of daily living remained stable over the course of one year [baseline MMSE= 21.31 (4.87) and CAMCOG=80.31 (16.68); end-point MMSE=20.77 (3.86) and CAMCOG=82.92 (14.42) (Z=-0.831; p=0.40); baseline ADL=4.31 (5.65); end-point ADL= 5.92 (3.86) (Z=-0.831; p=0.40)]; end-point NPI=10.54 (10.69) (Z=-0.737; p=0.46]. CONCLUSION: Like patients from developed countries, Brazilian patients with LOS do not seem develop dementia, at least over the course of one year.INTRODUÇÃO: Os déficits cognitivos em pacientes com esquizofrenia tardia têm sido relatados como estáveis, embora alguns estudos prospectivos demonstrem que um sub-grupo evolui com declínio cognitivo significativo. Os dados sobre esquizofrenia de início tardio são escassos nos países em desenvolvimento. OBJETIVO: Avaliar o desempenho cognitivo de pacientes brasileiros com esquizofrenia de início tardio ao longo de um ano. MÉTODO: Os pacientes com esquizofrenia de início tardio (n=13) foram avaliados inicialmente e após um ano com o Mini-Exame do Estado Mental (MMSE), o CAMCOG, a Escala de Sintomas Positivos e Negativos, a Escala de Atividades de Vida Diária de Pfeffer (ADL) e o Inventário Neuropsiquiátrico (NPI). RESULTADOS: A cognição e as atividades de vida diária permaneceram estáveis ao longo de um ano [inicial MMSE= 21,31 (4.87) e CAMCOG=80,31 (16,68); final MMSE=20,77 (3,86) e CAMCOG=82,92 (14,42) (Z=-0,831; p=0,40); inicial ADL=4,31 (5,65); final ADL=5,92 (3,86) (Z=-0,831; p=0,40); inicial NPI=13,92 (16,87); final NPI=10,54 (10,69) (Z=-0,737; p=0,46)]. CONCLUSÃO: Assim como os pacientes de países desenvolvidos, esquizofrênicos de início tardio no Brasil não evoluem para demência, ao menos ao longo de um ano.

OBJECTIVE: We aimed at examining the utility of checking and washing compulsions as markers of valid subtypes of obsessive-compulsive disorder (OCD). METHODS: One hundred and six patients with obsessive-compulsive disorder were evaluated with a socio-demographic and clinical questionnaire, the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the Clinical Global Impression, the Beck Depression Inventory, the Hamilton Rating Scale for Depression, and the Global Assessment of Functioning. These individuals were allocated in one of four subgroups [checkers (OCD-Ch; n = 20), washers (OCD-Wa; n = 13), checkers and washers (OCD-CW; n = 48), and non-checkers and non-washers (OCD non-CW = 25)] on the basis of the presence and the clinical relevance of checking and/or washing compulsive behaviors across their lifetime. Socio-demographic and clinical variables were compared and contrasted between the groups by means of ANOVA followed by post-hoc Least Significant Difference or Dunnett's tests for continuous variables and chi-square tests followed by partitioned chi-square tests for categorical variables. RESULTS: OCD-Ch and OCD-Wa did not differ on most demographic and clinical features, the only exception being the number of different types of obsessions, which were significantly higher in the former group. The OCD-CW group was more likely to exhibit an insidious onset of obsessive-compulsive symptoms, to manifest itself as a mixed subtype of obsessive-compulsive disorder and to display obsessions with contamination themes. On the other hand, the OCD non-CW group was more likely to exhibit an acute onset, a shorter duration of illness, obsessions with religious themes, an episodic course, and less severe obsessive-compulsive symptoms. CONCLUSIONS: In our sample, the probing of the presence of checking and/or washing compulsions has provided significant empirical support to establish valid subtypes of obsessive-compulsive disorder.OBJETIVO: Nós investigamos a utilidade das compulsões de verificação e de lavagem como marcadores de subtipos válidos do transtorno obsessivo-compulsivo (TOC). MÉTODOS: Cento e seis pacientes com transtorno obsessivo-compulsivo foram avaliados com um questionário sociodemográfico e clínico e com a entrevista clínica estruturada para o DSM-IV, a escala de sintomas obsessivo-compulsivos de Yale-Brown, a escala de impressão clínica global, o inventário de depressão de Beck, a escala para avaliação de depressão de Hamilton e a avaliação global de funcionamento. Estes indivíduos foram incluídos em um dos seguintes subgrupos: verificadores (TOC-Ver; n = 20), lavadores (TOC-Lav; n = 13), verificadores e lavadores (TOC-VL; n = 48) e não-verificadores e não-lavadores (TOC-NVL = 25). Esta classificação foi realizada com base na presença e relevância clínica de compulsões de verificação e de lavagem ao longo da vida dos pacientes. As variáveis sociodemográficas e clínicas foram comparadas e contrastadas entre os subgrupos através de uma ANOVA seguida pelos testes LSD ou Dunnett para variáveis contínuas e do teste do qui-quadrado seguido pelo qui-quadrado particionado para variáveis categóricas. RESULTADOS: Os pacientes com TOC-Ver e os pacientes com TOC-Lav não diferiram significativamente entre si na maioria das variáveis incluídas no estudo, com exceção do número de diferentes tipos de obsessões, significativamente maior nos primeiros. Os pacientes com TOC-VL exibiram, com maior freqüência, um início insidioso, o subtipo misto de TOC segundo a CID-10 e obsessões de contaminação. Pacientes com TOC-NVL apresentaram, com maior freqüência, um início súbito, menor duração de sintomas, obsessões de conteúdo religioso, curso episódico e sintomas obsessivo-compulsivos menos graves. CONCLUSÕES: A investigação quanto à presença de compulsões de verificação e lavagem sugeriu que estes sintomas podem contribuir para validar subtipos de transtorno obsessivo-compulsivo.

In this paper we describe a powerful methodology for the regiospecific construction of polysubstituted aromatic and heteroaromatic compounds. The DoM reaction (direct ortho-metalation) comprises the deprotonation in position ortho of a aromatic or heteroaromatic containing DMG (directed metalation group) by strong bases, normally an alkyllithium reagent, leading to an ortho-lithiated species. These species, upon treatment with electrophilic reagents, gives 1,2 disubstituted products.

OBJETIVO: Identificar a prevalência e analisar a associação entre comportamentos de risco à saúde, percepção de estresse e auto-avaliação do nível de saúde, em trabalhadores da indústria. MÉTODOS: Estudo epidemiológico transversal, utilizando questionário previamente testado em estudo-piloto realizado em Santa Catarina, Brasil. Foram coletados dados sobre fumo, abuso de álcool, consumo de frutas e verduras, atividades físicas, percepção de estresse e auto-avaliação do nível de saúde de 4.225 trabalhadores (67,5% homens e 32,5% mulheres). Os sujeitos foram recrutados por meio de amostragem por conglomerados em três estágios (erro de 5%). A análise estatística incluiu o teste de qui-quadrado e a análise de regressão logística, para um nível de significância de pOBJECTIVE: To identify the prevalence and association among health risk behaviors, stress perception, and health status self-assessment among industrial workers. METHODS: A cross-sectional study was performed using a questionnaire previously tested in a pilot study in the State of Santa Catarina, Brazil. Data on smoking, alcohol consumption, fruit and vegetables intake, physical activity, stress perception, and self-assessment of health status were available for 4,225 workers (67.5% males and 32.5% females). Subjects were selected using a 3-stage cluster sampling (5% error margin). Statistical analysis was performed using Chi-square, and logistic regression analysis (p

Eight new furan derivatives have been prepared and characterized. These compounds were obtained by condensation of aminosugar and aminocyclitol intermediates with furan derivatives.

OBJETIVO: Identificar a prevalência e analisar a associação entre comportamentos de risco à saúde, percepção de estresse e auto-avaliação do nível de saúde, em trabalhadores da indústria. MÉTODOS: Estudo epidemiológico transversal, utilizando questionário previamente testado em estudo-piloto realizado em Santa Catarina, Brasil. Foram coletados dados sobre fumo, abuso de álcool, consumo de frutas e verduras, atividades físicas, percepção de estresse e auto-avaliação do nível de saúde de 4.225 trabalhadores (67,5% homens e 32,5% mulheres). Os sujeitos foram recrutados por meio de amostragem por conglomerados em três estágios (erro de 5%). A análise estatística incluiu o teste de qui-quadrado e a análise de regressão logística, para um nível de significância de p