Portuguese and Brazilian guidelines for the treatment of depression: exercise as medicine

Depression is a psychiatric disorder and major contributor to the burden of disease worldwide. The strength of evidence of the benefits of exercise as a therapeutic intervention for patients with depression has expanded in the last 30 years. In fact, the available evidence indicates exercise can not only help manage depressive symptoms, but also effect significant improvements in other health outcomes. Clinical guidelines including such recommendations have been issued by different agencies, namely the UK National Institute for Health and Clinical Excellence (NICE), the American Psychiatric Association (APA), and the Royal Australian and New Zealand College of Psychiatrists (RANZCP). With increasing recognition of the benefits of exercise and shortcomings of healthcare systems, other countries, such as Sweden and Canada, have included exercise in their national guidelines for treating depression. Unfortunately, progress in incorporating exercise guidelines into clinical practice has been slow, and Portugal and Brazil reflect this reality. In this update, we reemphasize the importance of bridging this gap and integrating exercise into clinical practice guidelines as an essential component of depression treatment.

Efeitos do bionator de balters na maxila de pacientes classe II nos diferentes tipos faciais / Balters bionator effects on the maxillae of class II patients on the different facial types

O objetivo desse estudo retrospectivo foi avaliar os efeitos esqueléticos do Bionator de Balters na maxila em pacientes portadores de maloclusão Classe II, divisão 1 de Angle nos diferentes tipos faciais. Foram obtidas radiografias em norma lateral de 60 pacientes divididos por tipo facial (sendo 15 pacientes dolicofaciais, 27 pacientes braquifaciais e 18 pacientes mesofaciais assim classificados, utilizando-se o índice VERT de Ricketts). Os pacientes com idades entre 7 a 12 anos foram tratados por um mesmo ortodontista com mais de 20 anos de experiência por um período médio de 26 meses. Um grupo de 15 pacientes portadores de maloclusão Classe II divisão 1, não tratados com idades entre 8 e 12 anos foi acompanhado por um ano e utilizado como grupo controle. Foram analisadas as medidas do ângulo Ba-Na-A, para avaliar a posição sagital da maxila, e do ângulo S-Na-PP, para avaliar a rotação da maxila. Nenhuma das medidas teve alteração clinicamente significante e também não houve diferenças significantes entre os grupos estudados. Baseado nesses resultados, conclui-se que o Bionator de Balters utilizado no tratamento da maloclusão Classe II de Angle não afeta a posição e inclinação da maxila durante o tratamento deste tipo de maloclusão.

The aim of this retrospective investigation was to evaluate the skeletal effects of the Balters Bionator on the maxillae of patients with Class II-1 malocclusion in the various facial types. Lateral radiographs of 60 patients classified according to the facial type (15 dolichofacial, 27 brachifacial and 18 mesofacial, according to Ricketts VERT index). The patients age ranged from 7 to 12 years and were treated by the same clinician who had more than 20 years of experience for a mean period of 26 months. A group of 15 patients with Class II malocclusion untreated and with age ranging from 8 to 12 years was observed for a year to be used as a control group. The angle Ba-Na-A was used for the evaluation of the sagittal position of the maxillae and the angle S-Na-PP, for the rotation. None of the measurements had any clinically significant change, and there were no statistically significant differences between the studied. Based on these results, it is concluded that the Balters Bionator used on the treatment of the Class II Angle malocclusion, does not affect the position and inclination of the maxillae during the treatment of this type of malocclusion.

Fluorescent membrane markers elucidate the association of Borrelia burgdorferi with tick cell lines

This study aimed to describe the association of Borrelia burgdorferi s.s. with ixodid tick cell lines by flow cytometry and fluorescence and confocal microscopy. Spirochetes were stained with a fluorescent membrane marker (PKH67 or PKH26), inoculated into 8 different tick cell lines and incubated at 30°C for 24 h. PKH efficiently stained B. burgdorferi without affecting bacterial viability or motility. Among the tick cell lines tested, the Rhipicephalus appendiculatus cell line RA243 achieved the highest percentage of association/internalization, with both high (90%) and low (10%) concentrations of BSK-H medium in tick cell culture medium. Treatment with cytochalasin D dramatically reduced the average percentage of cells with internalized spirochetes, which passed through a dramatic morphological change during their internalization by the host cell as observed in time-lapse photography. Almost all of the fluorescent bacteria were seen to be inside the tick cells. PKH labeling of borreliae proved to be a reliable and valuable tool to analyze the association of spirochetes with host cells by flow cytometry, confocal and fluorescence microscopy.

Determination of cefdinir in human plasma using HPLC coupled withtandem mass spectroscopy: application to bioequivalence studies

A sensitive and selective liquid chromatographic method coupled with tandem mass spectrometry has been developedand validated for the determination of cefdinir in human plasma. The analytes cefdinir and cephalexin [internalstandard] were separated on a reversed phase column [Merck, Purospher RP-C18, 30 X 4.6 [mm], 3 micro m] using a mobilephase consisting of an aqueous solution of formic acid in water [0.10 %] and acetonitrile [85: 15 v/v [%]], flow rate0.50 [mL/min.]. Detection utilized a tandem MS/MS, the analytes were ionized using an ESI source in the positive ionmode prior to detection and analysis using Multiple Reaction Monitoring mode [MRM]. The analytes were monitoredat the following transitions [m/z] 396.10 [right arrow] 226.90, and [m/z] 348.24 [right arrow] 158.10 for cefdinir and cephalexinrespectively. Cefdinir linearity was demonstrated over the concentrations ranging from 10 to 1200 [ng/ mL]. Thedeveloped method was fully validated prior to its application on a bioequivalence study involving cefdinir [125 mg/5ml] suspension in healthy volunteers [N= 26] under fasting conditions

Alterações dermatológicas na hepatite C / Dermatological alterations in the hepatitis C

JUSTIFICATIVA E OBJETIVOS: A infecção pelo vírusda hepatite C (VHC) está associada a um amplo espectro de manifestações clínicas: hepáticas, sistêmicas e cutâneas. O objetivo deste estudo foi destacar as principais manifestações cutâneas presentes na hepatite C, pois estas podem representar um sinal precoce da instalação da doença. CONTEÚDO: A hepatite C é uma doença causada pelo VHC, que é transmitido por via sanguínea. Esta é uma importante causa de doença hepática crônica e cirrose hepática. As manifestações cutâneas são muitas vezes os primeiros sinais da infecção pelo VHC. Os médicos devem estar atentos a estas manifestações, pois o diagnóstico precoce é importante para o sucesso terapêutico. Deve-se suspeitar de contaminação pelo VHC em pacientes que apresentem: vasculite leucocitoclástica (púrpura palpável), crioglobulinemia, livedo reticular, líquen plano, síndrome de Sjõgren, prurido inespecífico, porfiria cutânea tarda, poliartrite nodosa e urticária crônica. Nestes casos deve-se solicitar a pesquisa do VHC por Elisa. Em pacientes que vão iniciar terapia com metotrexato e com fármacos potencialmente hepatotóxicos, a pesquisa do vírus também deve ser efetivada. CONCLUSÃO: Podendo ser as lesões cutâneas uma das primeiras manifestações da hepatite C, faz-se necessário por parte do corpo médico, treinamento no reconhecimento das lesões elementares em Dermatologia para que seja aventada a hipótese de coinfecção entre o VHC e doenças dermatológicas.

Bebidas energéticas: componentes e custo-benefício / Power drinks: components and cost-benefit

Neste trabalho, foi mostrada uma análise cuidadosa da composição química dos energéticos, observando-se que a grande maioria consiste numa mistura de carboidratos (cerca de 11 g/dl), taurina (400mg/dl), cafeína (cerca de 32mg/dl), glucoronolactona (cerca de 240 mg/dl) e vitaminas do complexo B (100 por cento da necessidade diária). A ação das bebidas energéticas no organismo também foi avaliada nessa revisão.

Anticoagulación y embarazo / Anticoagulation and pregnancy

Se comentan los aspectos clínicos del tratamiento anticoagulante en la paciente embarazada.

Mecanismo molecular da ação do hormônio tireoideano / Molecular mechanism of thyroid hormone action

Os hormônios tireoideanos (HTs) são necessários para a diferenciação, crescimento e metabolismo de diversos tecidos de vertebrados. Seus efeitos são mediados pelos receptores do hormônio tireoideano (TRs), membros da superfamília dos receptores nucleares. Estes receptores são fatores de transcrição modulares que se ligam em seqüências específicas do DNA denominadas elementos responsivos ao TR, que são encontrados nos promotores dos genes regulados pelo HT. Os TRs são codificados por dois genes distintos, alfae beta, localizados nos cromossomos 17 e 3, respectivamente. Estas isoformas apresentam diferentes funções e sua expressão é específica para cada tecido. O TR se liga ao DNA como monômero, homodímero ou heterodímero com o receptor de retinóide X (RXR). Além disso, o TR modula a atividade transcricional (repressão ou ativação) através da interação com correpressores e co-ativadores, na ausência e na presença do T3, respectivamente. A compreensão do mecanismo molecular da ação do receptor do hormônio tireoideano e a definição de sua estrutura cristalográfica contribuirão para a aquisição de novos conceitos envolvidos na transcrição e nos distúrbios hormonais presentes nas doenças endócrinas, assim como facilitará o desenho de novas drogas, agonistas ou antagonistas, com grande valor terapêutico.

Pulmonary cryptococcosis in a kidney transplant recipient

A case of nodular cavitary pulmonary cryptococcosis, similar to intracavitary aspergilloma is presented, in a 27-year old male patient after renal transplant. After negative diagnostic work-up, thoractomy for diagnosis and treatment was carried out. Diagnosis was made through direct examination, culture and histology of the surgical specimen. Treatment was surgical resection of the lesion associated with fluconazole for six months. Immunosuppression remained stable. At 24 months, the clinical condition of the patient was excellent.

Carboplatino (JM8) en el tratamiento del cáncer metastásico: estudio preliminar sobre toxicidad, tolerabilidad y eficacia / Carboplatinum (JM8) in the treatment of metastatic cancer: preliminary study over toxicity, tolerability and efficacy

Los autores han tratado 31 pacientes afectados con cáncer metastásico (13 cánceres de mama; cuatro de testículo; 14 misceláneos) y parcialmente ya tratados (17 con quimioterapia; cuatro también con radioterapia y cuatro también con hormonoterapia), con un derivado del platino, el carboplatino, solo (400 mg/m* cada 21 días) o en asociación (300 mg/m*) con otros antineoplásicos. Fueron suministrados en total 104 ciclos y la evaluación fue hecha después de por lo menos dos ciclos. En los 31 pacientes tuvimos cinco remisiones completas y siete parciales. En los 13 pacientes con cáncer de mama obtuvimos 46 porciento de remisiones parciales. Recordemos que después de dos ciclos no se evaluaron respuestas a nivel óseo. La mielosupresión fue la toxicidad más alta y frecuente (leucopenia en 54.8 porciento; plaquetopenia 9.6 porciento; anemia 22.5 porciento). La náusea y el vómito fueron bien controlados con los antieméticos usuales. Dos casos de presuntas reacciones alérgicas se resolvieron con el uso oportuno de cortisona y antihistamímicos. Dado que el carboplatino no demostró ser nefrotóxico y no necesitó de terapia hidratante, puede ser usado en pacientes ambulatorios. El estudio se encuentra aún abierto.

DNA sequence amplification in sciarid flies: results and perspectives

The discovery of Dna sequence amplification in sciarid flies and investigations into its control and biological significance are reviewed. Results thus far show that amplification of specific salivary gland polytene chromosome bands is a general phenomenon in sciarids. It brought about as part of a final endoreplication cycle by the rising titer of ecdysterone that occurs as the Larvae approach the prepupal period. Amplification and transcription of these bands is a late, multistep effect of this hormone.The Dna puffs which form in amplified region produce mRNAs which are translated into polypeptides that appear to be involved in coccon formation. Application of molecular cloning techniques to the study of Dna amplification has allowed precise quantitation of amplification for several Dna puffs and is yielding maps of their transcription units.These techniques will ultimately help to define the origins of Dna puff replication and contribute to an understanding of the mechanism and control of the amplification phenomenon in sciaridae. Projections for future experimental approaches are presented

In vivo effects of ecdysterone on puff formation, and RNA and protein synthesis in the salivary glands of Rhynchosciara americana

1. Fourth-instar larvae of Rhynchosciara americana were injected with the insect molting hormone, ecdysterone, giving final hemolymph concentrations from 4.46 to 223µM. 2. Induction of the DNA puff, B2b, in the proximal (S1) region of the salivary glands of Rhynchosciara americana by 22.6 µM ecdyesterone, was accompanied by the production of an mRNA and a polypeptide with the same characteristics as B2b products produced during normal development. This mRNA and polypeptide were restricted to the proximal region of the gland, as is the B2b puff. 3. Synthesis of other poly (A) +RNAs was also stimulated in S1 by ecdysterone, and other puffs that appear during normal development were induced. However, rRNA production in S1 goes through a pattern of inhibition, followed by recovery when B2b is puffed, and subsequent inhibition. 4. Low molecular weight RNA, with a peak in the region of 4S, is stimulated after ecdysterone administration

Megacaliosis congenita. / Congenital megacaliosis

Se describe un caso de megacaliosis en un recien nacido con multiples anomalias y rinomes aumentados de tamano. Se le practicaron estudios urorradiologicos, TAC, ultrosonido y medicina nuclear. La urografia excretora fue la mejor tecnica para demostrar esta entidad caracterizada por grandes rinomes y dilatacion uniforme de todos los calices; el resto del sistema colector fur normal. La cistouretrografia fue normal, asi como las pruebas de funcion renal. Esta rara entidad urologica es una forma de displasia renal que pueda ser confundida con obstruccion o hidronefrosis por reflujo en la cual la cirugia esta contrindicada