Histórias de vida sobre o fenômeno depressivo / Life stories on depressive phenomenon

OBJETIVO: Avaliar a importância do processo narrativo na descrição dos significados envolvidos no fenômeno depressivo. MÉTODOS: A população pesquisada compreendeu 324 pacientes, que procuraram os serviços clínicos e psicológicos no Posto de Saúde Auta Alves Ferreira, na cidade de Aparecida e no Hospital Municipal de Santa Cruz, localizados no interior da Paraíba, tendo como motivo da consulta sofrimento e/ou dor psíquica. Desses, foi composta uma amostra de 159 pacientes, incluindo adolescentes e adultos, de ambos os sexos. Para coleta de dados, utilizou-se a entrevista narrativa. A análise das entrevistas seguiu o procedimento delineado por Schutz. RESULTADOS: As narrativas proporcionam a oportunidade ímpar de rever conceitos, discutir histórias de vida e ouvir posicionamentos no (re)contar episódios relativos à depressão. CONCLUSÃO: As narrativas constituem-se em fator determinante no considerar, por meio da palavra, os conflitos inerentes à tentativa de uma escuta comprometida à vivência da depressão.

OBJETIVOS: To evaluate the importance of a descriptive narrative process of the meanings involved in a depressive phenomenon. METHODS: The research population consisted of 324 patients, who attended the Posto de Saúde Auta Alves Ferreira, in the city of Aparecida and Hospital Municipal de Santa Cruz, located in the central area of the Paraiba State, for clinical and psychological health care. The main reason for consultation was suffering and/or psychological pain. A sample of 159 patients was taken, including male and female adolescents and adults. Data were collected through a narrative interview. Shutz' procedure was used for information analysis. RESULTS: The obtained data offered the opportunity to review concepts, to discuss life history, and to listen to narrative positioning episodes of manifested depression. CONCLUSION: The narratives were considered to be a determinant factor to consider inherent conflicts of a compromised listening to the depression living.

Brazilian air traffic controllers exhibit excessive sleepiness / Controladores de tráfego aéreo brasileiros apresentam sonolência excessiva

Abstract ­ Excessive sleepiness (ES) is an increased tendency to initiate involuntary sleep for naps at inappropriate times. Objective: The objective of this study was to assess ES in air traffic controllers (ATCo). Methods: 45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo≥10, n=15) and ATCo with less than ten years in the profession (ATCo<10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS≥10, n=8) and AIS with less than ten years in the profession (AIS<10, n=7), who were included as the control group. The Epworth Sleepiness Scale and Maintenance of Wakefulness Test were used for evaluating subjective and objective excessive sleepiness. Kruskal-Wallis was used for ES and Mann-Whitney for sleep latency (SL), collection time in minutes (mins), and expressed as Median (Minimum-Maximum), p<0.05. Results: ATCo≥10 12 (6-14) mins and ATCo<10 10 (1-15) mins showed greater sleepiness compared to CONTROL1 7 (3-8) mins and CONTROL2 6 (4-6) mins, p=0.001*. A total of 77.27% of the ATCo and 16.67% of the AIS had an SL of less than 20 minutes. The ATCo presented an SL of 16.59 (3.25-40), lower than that of the AIS of 31.71 (10.63-40) mins, p<0.05*. Conclusion: Brazilian air traffic controllers exhibit excessive sleepiness.

Resumo ­ A sonolência excessiva (SE) é a uma tendência aumentada de se iniciar o sono por cochilos involuntários em momentos inapropriados. Objetivo: O objetivo deste trabalho foi avaliar SE em controladores de trafego aéreo (CTA). Métodos: Foram avaliados 45 profissionais de proteção ao voo, sendo 30 CTA, subdivididos em CTA com dez ou mais anos na profissão (CTA≥10, n=15) e CTA com menos de dez anos na profissão (CTA<10, n=15) e 15 operadores de serviços de informações aeronáuticas (AIS), subdivididos em AIS com dez anos ou mais na profissão (AIS≥10, n=8) e AIS com menos de dez anos na profissão (AIS<10, n=7). A Escala de Sonolência de Epworth e o Teste de Manutenção da Vigília foram empregados para avaliação subjetiva e objetiva de sonolência excessiva. Utilizou-se: Kruskal-Wallis para os dados de SE e Mann-Whitney para a latência de sono. Tempo coletado em minutos (mins). Todos os dados foram expressos em mediana (mínimo-máximo), p<0,05). Resultados: CTA≥10 12 (6-14) mins e CTA<10 10 (1-15) mins apresentaram um aumento de sonolência, quando comparados ao CONTROLE1 7 (3-8) mins e ao CONTROLE2 6 (4-6) mins, p=0,001*. 77,27% dos CTA e 16,67% dos AIS apresentaram latência de sono abaixo de 20 minutos. Os CTA apresentaram uma latência de sono de 16,59 (3,25-40) mins abaixo dos AIS 31,71(10,63-40), p<0,05*. Conclusão: Controladores de tráfego aéreo apresentam sonolência excessiva

Transmission electron microscopy studies of the vestibulocochlear nerve in chronic diabetic rats / Estudios de microscopía electrónica de transmisión del nervio vestibulococlear en ratas diabéticas crónicas

It is widely described in the literature that diabetic patients present hearing impairment. Despite the histological alterations of the internal ear structures in these patients as well as in experimental models of diabetes, to the best of our knowledge, an histological evaluation of the vestibulocochlear nerve have not been performed. In the present study, ultrastructural alterations are described and compared between a spinal nerves and a cranial nerve in rats with chronic induced diabetes. Male Wistar rats (n = 12), fed with standard diet from the animal care facility at 42 days of age were used. Induced diabetic animals (n=6) were fasted for 12 hours prior to being injected intraperitoneally with streptozotocin (STZ - 60mg/kg) in a single dose. Control animals (n=6) received (0.01 mol/l citrate buffer, pH 4.5) vehicle alone. Ten weeks after STZ injection the animals were perfused intracardially with Karnovsky solution. Right and left vestibulocochlear nerves were dissected and histologically processed for epoxy resin embedding. Samples were imaged with the transmission electron microscope. Large myelinated fibers with morphological signs of axonal atrophy in the vestibulocochlear nerves were readily observed. These results suggest that chronic STZ-induced diabetes in rats caused alterations in the myelinated fibers and Schwann cells, compatible to the classic diabetes signs and symptoms. Morphological alterations of the vestibulocochlear nerve in diabetes is described for the first time and contributes information for a better understanding of why there are changes in hearing observed in diabetic patients.

Se ha descrito ampliamente en la literatura que los pacientes diabéticos presentan discapacidad auditiva. En estos pacientes, a pesar de las alteraciones histológicas de las estructuras del oído interno, así como en modelos experimentales de diabetes, que mejoran nuestro conocimiento, la evaluación histológica del nervio vestibulococlear no ha sido realizada. Se describen y comparan las alteraciones ultraestructurales entre un nervio espinal y uno craneal en ratas con diabetes crónica inducida. Fueron utilizadas 12 ratas Wistar machos, de 42 días de edad, alimentadas con dieta estándar. Los animales diabéticos inducidos (n = 6) se mantuvieron en ayuno por 12 horas antes de ser inyectados por vía intraperitoneal con estreptozotocina (STZ - 60mg/kg) en una sola dosis. Los animales control (n = 6) sólo recibieron inyección de 0.01 mol/l buffer, citrato pH 4,5. Diez semanas después de la inyección de STZ, los animales fueron perfundidos intracardiacamente con solución de Karnovsky. Los nervios vestibulococlear derecho e izquierdo fueron disecados y procesados histológicamente para ser incluidos en resina epoxy. Las muestras fueron estudiadas con microscopio electrónico de transmisión. Fueron observadas fácilmente, grandes fibras mielinizadas con signos morfológicos de atrofia axonal en los nervios vestibulococlear. Estos resultados sugieren que la diabetes crónica inducida por STZ en ratas causó alteraciones en las fibras mielínicas y células del neurilema, compatible, con los signos y síntomas clásicos de la diabetes. Alteraciones morfológicas del nervio vestibulococlear en la diabetes son descritas por primera vez, lo que aporta información para una mejor comprensión de por qué hay cambios en la audición en los pacientes diabéticos.

Air traffic control activity increases attention capacity in air traffic controllers / Atividade de controle de tráfego aéreo aumenta a capacidade de atenção em controladores de vôo

Abstract. Air traffic controllers simultaneously develop complex and multiple tasks in the course of their activities. In this context, concern is raised over the high level of attention needed by these professionals which can ultimately be affected by stress and fatigue. Objectives: The objective of this study was to assess attention level in air traffic controllers (ATCo). Methods: 45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo³10, n=15) and ATCo with less than ten years in the profession (ATCo <10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS³10, n=8) and AIS with less than ten years in the profession (AIS <10, n=7), who were included as the control group. The digit symbol, d2 (the individual marks the letter d on a specific form containing 14 lines with 47 letters in each, maintaining focus on letter d followed by two dashes), forward digit span, backward digit span and PASAT (paced auditory serial addition test) attention tests were used. Kruskal-Wallis was used and data expressed as Median (Minimum and Maximum) with p<0.05. Results: The ATCo³10 presented greater focus of attention, sustained attention, mental manipulation and resistance to interference capacity compared to the AIS³10. Comparison of ATCo³10 to the AIS<10 showed they presented only greater resistance to interference, and when compared to the ATCo<10 presented lower focus. Conclusions: The air traffic control activity after ten years may be associated with a high level of attention.

Resumo. Os controladores de tráfego aéreo (CTA) desenvolvem em suas atividades tarefas complexas e múltiplas simultaneamente. Nesse contexto, surge a preocupação com a necessidade de um maior nível de atenção desses profissionais que pode ser afetada pelo estresse e fadiga. Objetivos: O objetivo deste trabalho foi avaliar o nível de atenção em controladores de tráfego aéreo (CTA). Métodos: Foram avaliados 45 profissionais de proteção ao vôo, sendo 30 CTA, subdivididos em CTA com dez ou mais anos na profissão (CTA³10, n=15) e CTA com menos de dez anos na profissão (CTA<10, n=15) e 15 operadores de serviços de informações aeronáuticas (AIS), subdivididos em AIS com dez anos ou mais na profissão (AIS³10, n=8) e AIS com menos de dez anos na profissão (AIS<10, n=7). Foram utilizados os testes de atenção digit symbol, d2 (o indivíduo deve marcar a letra d em um formulário específico, contendo 14 linhas com 47 letras cada, mantendo sempre o foco na letra d que aparece acompanhada de dois traços), span de dígitos em ordem direta e inversa e teste de dependência auditiva para adição em série (PASAT). Foi utilizado o Kruskal-Wallis e os dados expressos em mediana (mínimo e máximo), p<0,05. Resultados: Os CTA³10 apresentaram maior foco de atenção, manutenção do foco, capacidade de manipulação mental e resistência à interferência, quando comparados aos AIS³10, mas quando comparados aos AIS<10 apresentaram somente maior resistência à interferência e quando comparados aos CTA<10, menor foco. Conclusões: A atividade de controle de tráfego aéreo após dez anos pode apresentar um alto nível de atenção.

Diabetic peripheral neuropathies: a morphometric overview / Neuropatías diabéticas periféricas: una visión general morfométrica

Diabetes is now considered one of the main threats to human health in the 21st century and many researchers are dedicated to investigate the physiopathology of the disease, with further insights on the managements of its major complications. Since understanding the pathophysiology of the major complications of diabetes and their underlying processes is mandatory, experimental models of the disease may be useful as they allow the recognition of the early mechanisms involved in the long-term complications of diabetes. Peripheral nerve involvement is highly frequent in diabetes mellitus and it has been documented that one third of diabetic patients have peripheral neuropathy. The true prevalence is not known and reports vary from 10 percent to 90 percent in diabetic patients, depending on the criteria and methods used to define neuropathy. In this review, the most common experimental models of diabetes are presented and the pathological findings on major peripheral nerves are discussed. Also, the insights brought by morphometry to the diabetic neuropathy research are highlighted.

La diabetes es considerada hoy una de las principales amenazas para la salud humana en el siglo 21 y muchos investigadores se dedican a investigar la fisiopatología de la enfermedad, con otras visiones sobre el manejo de sus principales complicaciones. Dado que la comprensión de la fisiopatología de las principales complicaciones de la diabetes y sus procesos subyacentes es obligatorio, modelos experimentales de la enfermedad pueden ser útiles ya que permiten el reconocimiento de los primeros mecanismos implicados en las complicaciones a largo plazo de la diabetes. El compromiso de los nervios periféricos es muy frecuente en la diabetes mellitus y se ha documentado que un tercio de los pacientes diabéticos tiene neuropatía periférica. La prevalencia es desconocida y los informes varían de 10 por ciento a 90 por ciento en los pacientes diabéticos, en función de los criterios y métodos utilizados para definir la neuropatía. En esta revisión, se presentan los modelos experimentales más comunes de diabetes y se discuten los hallazgos patológicos en los principales nervios periféricos. Además, se destacan las visiones presentadas por la morfometría de la investigación la neuropatía diabética.

Acute tryptophan administration impairs cortical spreading depression propagation in REM sleep deprived and non-deprived adult rats

The enhanced availability of tryptophan in the brain, as a consequence of exogenous tryptophan administration, can increase neuronal serotonin synthesis and this can interfere with brain function. REM sleep deprivation (D) constitutes another external factor that can change brain excitability, facilitating, in some cases, the manifestation of neurological diseases like epilepsy. Here we used cortical spreading depression (CSD) as a neurophysiological parameter to investigate the effects of a single L-tryptophan intraperitoneal injection combined or not with 72h D-condition (water-tank technique) in rats. A 1h baseline CSD-recording was performed under urethane+chloralose (1g/kg + 40mg/kg) anesthesia and revealed increased CSD propagation velocities in D rats, as compared with non-deprived (ND), or pseudo-deprived (Pseudo) controls. After the baseline CSD recording, L-tryptophan was immediately injected (125 mg/kg ip, dissolved in water at pH about 3) and this was followed by a significant decrease of CSD propagation velocities, as compared to the baseline values in the same animals of the Pseudo, ND and D condition. In an additional control group (ND rats injected with the vehicle), no CSD propagation change was seen. Our findings indicate an important acute antagonistic influence of tryptophan on CSD propagation, which is not affected by REM sleep deprivation. We suggest that this tryptophan effect may be due to a serotonin-mediated action, probably caused by increased serotonin synthesis as a consequence of enhanced tryptophan availability in the brain.