Psychometric properties of the Brazilian Portuguese version of the UPPS-P impulsive behavior scale for children and adolescents

Abstract Objective: To translate and validate the version for children and adolescents of the UPPS-P scale into Brazilian Portuguese. Method: After a five-step translation process, the final draft was submitted to a panel of 12 different specialties experts. Subsequently, the application of the scale was applied concomitantly with the "Swanson, Nolan, and Pelham Scale - Version IV" (SNAP-IV) and the "Child and Adolescent Behavior Inventory" (CABI) scale to analyze the correlation between them. Content Validity Index (CVI) and reliability were estimated by calculating internal consistency and analyzing its test-retest stability. Results: The items whose CVI was lower than 80% underwent a detailed analysis to verify the reason for the bad evaluation. Five items (3, 7, 11, 22 and 35) scored below 80% and were reassessed. There was high internal consistency in all parameters: Lack of premeditation (McDonald's omega = 0.806; Cronbach's alpha = 0.801), Negative Urgency (McDonald's omega = 0.838; Cronbach's alpha = 0.836), Sensation seeking (McDonald's omega = 0.826; Cronbach's alpha = 0.810), Lack of Perseverance (McDonald's omega = 0.800; Cronbach's alpha = 0.799) and Positive Urgency (McDonald's omega = 0.936; Cronbach's alpha = 0.934). A strong correlation was observed between UPPS-P features and impulsivity in behavioral assessments. Conclusions: The Brazilian Portuguese version of the UPPS-P scale is a good instrument to assess impulsivity in children and adolescents.

Translation and validity of the Multidimensional Individual and Interpersonal Resilience Measure / Tradução e validação do Multidimensional Individual and Interpersonal Resilience Measure / Traducción y validación del Multidimensional Individual and Interpersonal Resilience Measure

ABSTRACT Objective: to translate, culturally adapt and validate the Multidimensional Individual and Interpersonal Resilience Measure to Brazilian Portuguese. Method: after initial translation, the pre-final version underwent rigorous cultural adaptation procedures. As a result, the final adapted version was submitted to a validity study. Results: adaptation procedures provided equivalence between the pre-final and the original versions in semantic, idiomatic, experiential and conceptual terms. A total of 187 older adults were included in the validity study. Exploratory factorial analysis (EFA) generated a model of five factors ((RMSEA = 0.030; TLI = 0.959; X2 = 151.590 p> 0.05). Final version showed adequate consistency (Cronbach's α = 0.705) and test-retest reliability (ICC=0.835). No statistically significant correlation was found between resilience and sociodemographic and epidemiological variables assessed in this study. Conclusion: EMRII-BR is a valid and reliable instrument for measuring resilience in Brazilian older adults.

RESUMO Objetivo: traduzir, adaptar culturalmente e validar o Multidimensional Individual and Interpersonal Resilience Measure para o português brasileiro. Método: após a tradução inicial, a versão pré-final passou por rigorosos procedimentos de adaptação cultural. Como resultado, a versão final adaptada foi submetida a um estudo de validade. Resultados: os procedimentos de adaptação proporcionaram equivalência entre as versões pré-final e original em termos semânticos, idiomáticos, experienciais e conceituais. Um total de 187 idosos foram incluídos no estudo de validade. A análise fatorial exploratória (AFE) gerou um modelo de cinco fatores ((RMSEA = 0,030; TLI = 0,959; X2 = 151,590 p> 0,05). A versão final apresentou consistência adequada (α de Cronbach = 0,705) e confiabilidade teste-reteste (ICC=0,835). Não foi encontrada correlação estatisticamente significativa entre a resiliência e as variáveis sociodemográficas e epidemiológicas avaliadas neste estudo. Conclusão: o EMRII-BR é um instrumento válido e confiável para mensurar a resiliência em idosos brasileiros.

RESUMEN Objetivo: traducir, adaptar culturalmente y validar el Multidimensional Individual and Interpersonal Resilience Measure para el portugués brasileño. Método: después de la traducción inicial, la versión pre-final pasó por rigurosos procedimientos de adaptación cultural. Como resultado, la versión final adaptada fue sometida a un estudio de validez. Resultados: los procedimientos de adaptación proporcionaron equivalencia entre las versiones pre-final y original en términos semánticos, idiomáticos, experienciales y conceptuales. Un total de 187 ancianos fueron incluidos en el estudio de validez. El análisis factorial exploratorio (AFE) generó un modelo de cinco factores ((RMSEA = 0,030; TLI = 0,959; X2 = 151,590 p> 0,05). La versión final mostró adecuada consistencia (α de Cronbach = 0,705) y confiabilidad prueba-reprueba (ICC=0,835). No se encontró correlación estadísticamente significativa entre la resiliencia y las variables sociodemográficas y epidemiológicas evaluadas en este estudio. Conclusión: EMRII-BR es un instrumento válido y confiable para medir la resiliencia en ancianos brasileños.

The mental health of Brazilian healthcare professionals during the COVID-19 pandemic: a longitudinal study

Objective: To compare the distress level among Brazilian healthcare professionals during the coronavirus disease 2019 (COVID-19) pandemic and estimate risks by sex, age, and occupation. Methods: In a longitudinal cohort design, a nationally distributed online survey was used to collect data from 10,490 active healthcare professionals who worked during the pandemic. Participants were mostly female, aged 18 to 82 years; 13 different health professions and all states of Brazil were represented. Results: The most frequent professions were psychology, dentistry, and nursing. The Brief Symptom Inventory (BSI) score suggested an increased distress perception among health professionals. Females showed poorer mental health than males, but the absolute rise in Global Severity Index (GSI) score was larger in males than in females. Younger adults reported more symptoms of psychological distress than older adults. The most impacted age group was between 30-39 years. Nurse technicians presented the highest risk of distress. Conclusion: Health professionals are essential to overcoming the pandemic; thus, their mental health status should be monitored, and features associated with increased distress should be identified. Our findings suggest distress risk should be stratified by occupation, age, and sex. Health professionals showed an increased distress perception. Women, individuals between the ages of 30 and 39, nursing personnel, and physicians were more likely to report distress compared with other health professionals.

The Autism Spectrum Quotient in a sample of Brazilian adults: analyses of normative data and performance / O quociente do espectro do autismo em uma amostra de adultos brasileiros: análises de dados normativos e de desempenho

ABSTRACT. Autism spectrum disorder (ASD) is characterized by difficulties in social interaction and inflexible behaviors/interests. To quantify ASD traits in adults with preserved intelligence, the Autism Spectrum Quotient (AQ) was developed, which is a self-report instrument and one of the most used and recommended tools. Objectives: We aimed to present a descriptive analysis of the AQ in a sample of Brazilian adults with neurotypical development (n=385) and investigate how the scale performs in a clinical subsample (n=33). Methods: We recruited 1,024 participants. They answered the Self-Reporting Questionnaire-20 (SRQ-20), AQ, and about their psychiatric record. Then, we selected 385 participants without any psychiatric diagnosis to describe the distribution of the ASD traits. To investigate the AQ performance, we evaluated 33 adults with ASD and 19 adults with neurotypical development from the total sample (n=1,024). Results: ASD traits were normally distributed in the population, with high internal consistency. Of a total of 91 men, volunteers with 32 points (clinical cutoff point) or more scored higher than 93% of the control sample. Of a total of 294 women, those who got a clinical score on the scale scored higher than 97%. In the clinical subsample (n=33), the positive predictive value (PPV) of the AQ was 0.84, and the negative predictive value (NPV) was 0.7. Conclusions: The study population has a different profile compared to the original study regarding the AQ scale. ASD traits were normally distributed in the neurotypical sample, and the scale seems to have a satisfactory performance to predict ASD. Future studies are required to adequate the use of the scale in the Brazilian population.

RESUMO. O transtorno do espectro do autismo (TEA) é caracterizado por dificuldades na interação social e comportamentos/interesses inflexíveis. Com o intuito de quantificar os traços de TEA em adultos com inteligência preservada, foi desenvolvido o quociente do espectro do autismo (QA), um instrumento de autorrelato muito utilizado e recomendado. Objetivos: Nosso objetivo foi apresentar uma análise descritiva do QA em uma amostra de adultos brasileiros com desenvolvimento neurotípico (n=385) e investigar o desempenho da escala em uma subamostra clínica (n=33). Métodos: Foram recrutados 1.024 participantes, que responderam ao Self-Reporting Questionnaire-20 (SRQ-20), ao QA e a questões sobre o seu histórico psiquiátrico. Em seguida, selecionamos 385 participantes sem qualquer diagnóstico psiquiátrico para descrever a distribuição dos traços de TEA. Para investigar o desempenho do QA, avaliamos 33 adultos com TEA e 19 adultos com desenvolvimento neurotípico da amostra total (n=1024). Resultados: As características do TEA apresentaram distribuição normal na amostra, com alta consistência interna. Do total de 91 homens, os voluntários com 32 pontos (ponto de corte clínico) ou mais pontuaram acima de 93% da amostra de controle. De 294 mulheres, aquelas que obtiveram pontuação clínica na escala pontuaram acima de 97%. Na subamostra clínica (n=33), o valor preditivo positivo do QA foi de 0,84 e o valor preditivo negativo foi de 0,7. Conclusões: A população estudada apresenta um perfil diferente comparada à população do estudo original, no que se refere à escala QA. Os traços de TEA foram normalmente distribuídos na amostra neurotípica, e a escala parece ter um desempenho satisfatório para predizer autismo. Estudos futuros são necessários para adequar o uso da escala na população brasileira.

Analgesic and side effects of intravenous recombinant Ph alfa 1 beta

Background: Intrathecal injection of voltage-sensitive calcium channel blocker peptide toxins exerts analgesic effect in several animal models of pain. Upon intrathecal administration, recombinant Phα1β exerts the same analgesic effects as the those of the native toxin. However, from a clinical perspective, the intrathecal administration limits the use of anesthetic drugs in patients. Therefore, this study aimed to investigate the possible antinociceptive effect of intravenous recombinant Phα1β in rat models of neuropathic pain, as well as its side effects on motor, cardiac (heart rate and blood pressure), and biochemical parameters. Methods: Male Wistar rats and male Balb-C mice were used in this study. Giotto Biotech® synthesized the recombinant version of Phα1β using Escherichia coli expression. In rats, neuropathic pain was induced by chronic constriction of the sciatic nerve and paclitaxel-induced acute and chronic pain. Mechanical sensitivity was evaluated using von Frey filaments. A radiotelemeter transmitter (TA11PA-C10; Data Sciences, St. Paul, MN, USA) was placed on the left carotid of mice for investigation of cardiovascular side effects. Locomotor activity data were evaluated using the open-field paradigm, and serum CKMB, TGO, TGP, LDH, lactate, creatinine, and urea levels were examined. Results: Intravenous administration of recombinant Phα1β toxin induced analgesia for up to 4 h, with ED50 of 0.02 (0.01-0.03) mg/kg, and reached the maximal effect (Emax = 100% antinociception) at a dose of 0.2 mg/kg. No significant changes were observed in any of the evaluated motor, cardiac or biochemical parameters. Conclusion: Our data suggest that intravenous administration of recombinant Phα1β may be feasible for drug-induced analgesia, without causing any severe side effects.

Analgesic and side effects of intravenous recombinant Phα1ß

Intrathecal injection of voltage-sensitive calcium channel blocker peptide toxins exerts analgesic effect in several animal models of pain. Upon intrathecal administration, recombinant Phα1ß exerts the same analgesic effects as the those of the native toxin. However, from a clinical perspective, the intrathecal administration limits the use of anesthetic drugs in patients. Therefore, this study aimed to investigate the possible antinociceptive effect of intravenous recombinant Phα1ß in rat models of neuropathic pain, as well as its side effects on motor, cardiac (heart rate and blood pressure), and biochemical parameters. Methods: Male Wistar rats and male Balb-C mice were used in this study. Giotto Biotech® synthesized the recombinant version of Phα1ß using Escherichia coli expression. In rats, neuropathic pain was induced by chronic constriction of the sciatic nerve and paclitaxel-induced acute and chronic pain. Mechanical sensitivity was evaluated using von Frey filaments. A radiotelemeter transmitter (TA11PA-C10; Data Sciences, St. Paul, MN, USA) was placed on the left carotid of mice for investigation of cardiovascular side effects. Locomotor activity data were evaluated using the open-field paradigm, and serum CKMB, TGO, TGP, LDH, lactate, creatinine, and urea levels were examined. Results: Intravenous administration of recombinant Phα1ß toxin induced analgesia for up to 4 h, with ED50 of 0.02 (0.01-0.03) mg/kg, and reached the maximal effect (Emax = 100% antinociception) at a dose of 0.2 mg/kg. No significant changes were observed in any of the evaluated motor, cardiac or biochemical parameters. Conclusion: Our data suggest that intravenous administration of recombinant Phα1ß may be feasible for drug-induced analgesia, without causing any severe side effects.(AU)

Immunomodulatory action of jacalin from Artocarpus integrifolia and mannoprotein from Saccharomyces uvarum on the humoral immunity of laying hens / Avaliação da ação imunomoduladora do Jacalin de Artocarpus integrifolia e mannoprotein de Saccharomyces uvarum na imunidade humoral das galinhas poedeiras

ABSTRACT: Advances in the fields of glycobiology and immunology have provided many insights into the role of carbohydrate-protein interactions in the immune system. Jacalin of Artocarpus integrifolia (JCA) and structural mannoprotein of Saccharomyces uvarum (MPS) are molecules with immunomodulatory properties. JCA is an IgA human lectin binding molecule that causes the mitogenic stimulation of immune cells, production of cytokines, chemotaxis, and activation of leukocytes. Studies on the immunomodulatory properties of JCA and MPS in mammals and fish suggest that they have an action on antibody production. The aim of this study was to investigate the possible action of JCA and MPS on the production of specific antibodies in laying hens. For this, laying hens were inoculated with an intra abdominal injection of sheep red blood cells (SRBC) with either JCA (0.075 µg, 0.75 µg, and 7.5 µg) or MPS (20 µg and 100 µg). Levels of anti-SRBC antibodies of the IgY, IgM, and IgA classes were evaluated by ELISA. Results showed that JCA and MPS have immunomodulatory effects on levels of anti-SRBC IgM, IgA, and IgY. An immunostimulatory effect of JCA was observed in primary immune response on anti-SRBC IgY, while an inhibitory effect of JCA and MPS was observed in secondary immune response on the production of IgM and IgA anti-SRBC. These results suggested that MPS and JCA have immunomodulatory effects on antibody production and could be used in future studies on humoral immune response in poultry.

RESUMO: Avanços nos campos glicobiologia e imunologia forneceram muitas informações sobre o papel das interações da proteína-carboidrato na modulação do sistema imunológico. A jacalina extraída de Artocarpus integrifolia (JCA) e a manoproteína da parede celular de Saccharomyces uvarum (MPS) são moléculas com propriedades imunomoduladoras. JCA é uma lectina com afinidade pela IgA humana e tem ação mitogênica sobre células do sistema imunológico estimulando a produção de citocinas, a quimiotaxia e a ativação de leucócitos. Estudos sobre as propriedades imunomoduladoras de JCA e MPS em mamíferos e peixes sugerem que essas moléculas podem ter um efeito sobre a produção de anticorpos. O objetivo deste estudo foi investigar a ação da JCA e MPS sobre a produção de anticorpos específicos em galinhas poedeiras. Para isso, galinhas poedeiras foram inoculadas por via intra-abdominal com eritrócitos de carneiro (SRBC) em associação com o JCA (0,075 µg, 0,75 µg, e 7,5 µg) ou MPS (20 µg e 100 µg). Os níveis de anticorpos anti-SRBC das classes IgY, IgM, e IgA foram avaliados por ELISA. Os resultados mostraram que a JCA e a MPS têm um efeito imunomodulador sobre a produção IgY, IgM, ou IgA anti-SRBC. Um efeito imunoestimulador da JCA foi observado sobre a produção de anticorpos IgY na resposta imune primária, enquanto um efeito imuno inibitório da JCA e da MPS sobre a produção de IgM e IgA anti-SRBC na resposta imune secundária. Estes resultados sugerem que o MPS e JCA tem efeito modulador sobre a produção de anticorpos e podem ser utilizados em estudos futuros sobre a imunidade humoral em aves comerciais.

O direito à saúde de pessoas trans* no Distrito Federal: entre o direito de existir e o direito à equidade / The right to health of transgender people in Federal District, Brazil: between the right to exist and the right to equity

Objetivo: compreender como os movimentos sociais trans* do Distrito Federal entendem o direito à saúde. Método: tratou-se de uma pesquisa qualitativa realizada com líderes de movimentos sociais trans* do Distrito Federal em que foram realizadas entrevistas semiestruturadas e os dados foram analisados por intermédio da técnica de análise de conteúdo e agrupados em unidades temáticas. Resultado: foi possível compreender que os movimentos sociais trans* compreendem o direito à saúde como o direito de existir e o direito à equidade. Além disso, entendem também que a implementação do ambulatório trans* no Distrito Federal é uma conquista de direito à saúde. Conclusão: as pessoas trans* estão buscando serem reconhecidas como sujeitos de direito, tanto à saúde como ao direito humano mais básico, o direito de existir. (AU)

Objective: to understand how the social movements trans* of Federal District, Brazil understand the right to health. Method: This was a qualitative research carried out with leaders of social movements trans* of Federal District, Brazil, in which semi-structured interviews were conducted and the data were analyzed through the technique of content analysis and grouped into thematic units. Results: it was possible to understand that trans* social movements include the right to health as the right to exist and the right to equity. In addition, they also understand that the implementation of the trans* ambulatory in Federal District, Brazil, is an achievement of the right to health. Conclusion: trans* people are seeking to be recognized as subjects of right, both to health and to the most basic human right, the right to exist. (AU)

Objetivo: comprender cómo los movimientos sociales del Distrito Federal, Brasil, entienden el derecho a la salud. Método: se trató de una investigación cualitativa realizada con líderes de movimientos sociales trans* del Distrito Federal, Brasil, en que se realizaron entrevistas semiestructuradas y los datos fueron analizados por intermedio de la técnica de análisis de contenido y agrupados en unidades temáticas. Resultado: fue posible comprender que los movimientos sociales trans* comprenden el derecho a la salud como el derecho de existir y el derecho a la equidad. Además, entienden también que la implementación del ambulatorio trans en Distrito Federal, Brasil, es una conquista de derecho a la salud. Conclusión: las personas trans* están buscando ser reconocidas como sujetos de derecho, tanto a la salud y al derecho humano más básico, el derecho de existir. (AU)

Análise estatística da caracterização gravimétrica de resíduos sólidos domiciliares: estudo de caso do município de Juiz de Fora, Minas Gerais / Statistical analysis of the gravimetric characterization of household solid waste: a case study from the city of Juiz de Fora, Minas Gerais, Brazil

RESUMO Parte dos resíduos coletados nos municípios brasileiros ainda são destinados de forma inadequada, resultando em transtornos à qualidade de vida e à saúde pública. Assim, a caracterização gravimétrica dos resíduos é um importante instrumento de gestão integrada, uma vez que permite conhecer quantitativamente as frações geradas. Nesse sentido, o presente estudo teve por objetivo analisar estatisticamente a composição gravimétrica dos resíduos sólidos domésticos de Juiz de Fora, Minas Gerais, em função das sete regiões urbanas do município e da renda domiciliar da população. Cerca de 140.500 toneladas de resíduos sólidos domésticos foram coletadas no município em 2015, representando uma geração per capita de 0,7 kg/hab./dia. Foram feitos testes estatísticos de hipóteses a 5% de significância em avaliações comparativas, além de testes de correlação para as frações majoritárias (orgânicos e recicláveis) e as respectivas rendas domiciliares. Os resultados indicaram que a fração de orgânicos corresponde a 43,81% dos resíduos gerados no município, 31,74% são passíveis de reciclagem, 14,36% são resíduos potencialmente contaminantes e 10,10% são rejeitos diversos. Observou-se que o resíduo gerado por famílias de alto poder aquisitivo tende a conter maiores percentuais de recicláveis, enquanto em famílias de menor poder aquisitivo os maiores percentuais tendem a ser de orgânicos. A grande incidência de orgânicos e recicláveis evidencia um potencial a ser explorado, apontando a necessidade de reavaliação da estrutura da coleta seletiva e possível instalação da usina de compostagem, mediante estudo de viabilidade técnica e econômica. Por fim, espera-se que o estudo auxilie o poder público local, norteando o planejamento e o dimensionamento de sistemas de coleta, tratamento e destinação de resíduos, além de projetos de educação ambiental, servindo de modelo para outras municipalidades.

ABSTRACT Much of the solid waste collected in Brazilian municipalities is still inappropriately destined, resulting in disorders related to quality of life and public health. Thus, the gravimetric characterization of household solid wastes is an important instrument of integrated management, since it quantitatively indicates the fractions generated. In this sense, the present study aims to analyse statistically the gravimetric composition of solid household waste from Juiz de Fora, Minas Gerais, Brazil, generated in 2015 regarding the seven urban regions of the city and the domestic income of the population. Statistical tests of hypothesis were carried out at 5% significance in comparative assessments, as well as correlation tests for organic and recyclable fractions and their respective domestic incomes. The results indicated that the organic fraction corresponds to 43.81% of the solid waste generated in the municipality, 31.74% is the recyclable fraction, 14.36% to potentially contaminant wastes and 10.10% of others. It was observed a trend of greater generation of recyclables in regions with higher socioeconomic status; on the other hand, regions with a predominance of families with lower incomes there was an increase in organic fraction. The high incidence of organic and recyclable materials indicates a potential to be explored, pointing out the need of re-evaluating the structure of the selective collection and the possible installation of a composting plant by a technical and economical feasibility study. Therefore, it is expected that the study supports the local public power, guiding the plan and design of solid waste collection, treatment and disposal systems, as well as environmental education projects and serving as a model for other municipalities.

Development of a natural molluscicide prototype kit (MoluSchall) for the control of schistosomiasis mansoni transmission

Abstract INTRODUCTION In Brazil, Biomphalaria glabrata, B. tenagophila, and B. straminea are intermediate hosts of Schistosoma mansoni, the etiological agent of schistosomiasis mansoni. Molluscicide use is recommended by the WHO for controlling the transmission of this parasite. Euphorbia milii latex has shown promising results as an alternative molluscicide. Thus, a natural molluscicide prototype kit based on freeze-dried E. milii latex was developed and evaluated against Biomphalaria spp. METHODS E. milii latex was collected, processed, and lyophilized. Two diluents were defined for freeze-dried latex rehydration, and a prototype kit, called MoluSchall, was produced. A stability test was conducted using prototype kits stored at different temperatures, and a toxicity assay was performed using Danio rerio. Additionally, MoluSchall was tested against B. glabrata under semi-natural conditions according to defined conditions in the laboratory. RESULTS MoluSchall was lethal to three Brazilian snail species while exhibiting low toxicity to D. rerio. Regardless of storage temperature, MoluSchall was stable for 24 months and was effective against B. glabrata under semi-natural conditions, with the same LD100 as observed under laboratory conditions. CONCLUSIONS MoluSchall is a natural, effective, and inexpensive molluscicide with lower environmental toxicity than existing molluscicides. Its production offers a possible alternative strategy for controlling S. mansoni transmission.

Psychometric properties of a Brazilian Portuguese version of the Children's Revised Impact of Event Scale (CRIES-8)

Abstract Background: Children and adolescents are considered a population at risk for developing posttraumatic stress disorder (PTSD) after a traumatic event. The Children's Revised Impact Scale (CRIES-8) is a self-report scale with 8 items that investigates avoidance and intrusion behaviors related to posttraumatic stress symptoms. Objective: The study consisted of translation and transcultural adaptation of CRIES-8 to Brazilian Portuguese and evaluation of its psychometric properties. Methods: A sample of 235 Brazilian children and adolescents exposed to natural hazards (drought or flood) and non-exposed children participated in the study. The methodological procedure for translation and cultural adaptation were in accordance with the principles described by ISPOR Task Force for Translation and Cultural Adaptation. We also evaluated test reliability and validity based on test content, the relations to other variables, and internal structure. Results: The procedures lead to a final Portuguese version proofread and cultural-adapted. Empirical evidence supports CRIES-8's division in two latent constructs (Intrusion and Avoidance), as well convergence correlations with other measures of child mental health and high reliability. Discussion: A Brazilian-Portuguese version of CRIES-8 is an important tool for a better screening of PTSD among youth who face traumatic events, being a potential informative instrument to identify children at risk.

Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial

OBJECTIVE: This randomized clinical trial evaluated the possibility of not draining the axilla following axillary dissection. METHODS: The study included 240 breast cancer patients who underwent axillary dissection as part of conservative treatment. The patients were divided into two groups depending on whether or not they were subjected to axillary drainage. ClinicalTrials.gov: NCT01267552. RESULTS: The median volume of fluid aspirated was significantly lower in the axillary drainage group (0.00 ml; 0.00 - 270.00) compared to the no drain group (522.50 ml; 130.00 - 1148.75). The median number of aspirations performed during conservative breast cancer treatment was significantly lower in the drainage group (0.5; 0.0 - 4.0) compared to the no drain group (5.0; 3.0 - 7.0). The total volume of serous fluid produced (the volume of fluid obtained from drainage added to the volume of aspirated fluid) was similar in the two groups. Regarding complications, two cases (2.4%) of wound dehiscence occurred in the drainage group compared to 13 cases (13.5%) in the group in which drainage was not performed, with this difference being statistically significant. Rates of infection, necrosis and hematoma were similar in both groups. CONCLUSION: Safety rates were similar in both study groups; hence, axillary dissection can feasibly be performed without drainage. However, more needle aspirations could be required, and there could be more cases of wound dehiscence in patients who do not undergo auxiliary drainage.

A proposal for a new Brazilian six-item version of the Edinburgh Postnatal Depression Scale / Proposta para uma nova versão brasileira de seis itens da Escala de Depressão Pós-Parto de Edimburgo

Abstract Introduction: Factor analysis of the Edinburgh Postnatal Depression Scale (EPDS) could result in a shorter and easier to handle screening tool. Therefore, the aim of this study was to check and compare the metrics of two different 6-item EPDS subscales. Methods: We administered the EPDS to a total of 3,891 women who had given birth between 1 and 3 months previously. We conducted confirmatory and exploratory factor analyses and plotted receiver-operating characteristics (ROC) curves to, respectively, determine construct validity, scale items' fit to the data, and ideal cutoff scores for the short versions. Results: A previously defined 6-item scale did not exhibit construct validity for our sample. Nevertheless, we used exploratory factor analysis to derive a new 6-item scale with very good construct validity. The area under the ROC curve of the new 6-item scale was 0.986 and the ideal cutoff score was ≥ 6. Conclusions: The new 6-item scale has adequate psychometric properties and similar ROC curve values to the10-item version and offers a means of reducing the cost and time taken to administer the instrument.

Resumo Introdução: A análise fatorial da Escala de Depressão Pós-Parto de Edimburgo (Edinburgh Postnatal Depression Scale, EPDS) poderia resultar em uma ferramenta de triagem mais curta e mais fácil de aplicar. Portanto, o objetivo deste estudo foi verificar e comparar as métricas de duas subescalas EPDS de 6 itens. Métodos: Administramos a EPDS a um total de 3.891 mulheres que deram à luz entre 1 e 3 meses antes da aplicação. Foram realizadas análises fatoriais confirmatórias e exploratórias e geradas curvas ROC (receiver-operating characteristics) para determinar, respectivamente, a validade do construto, o ajuste dos itens da escala aos dados, e os pontos de corte ideais para as versões curtas. Resultados: A escala de 6 itens previamente publicada não apresentou validade de construto para nossa amostra. No entanto, utilizamos a análise fatorial exploratória para derivar uma nova escala de 6 itens, que apresentou boa validade de construto. A área sob a curva ROC da nova escala de 6 itens foi 0,986, e o ponto de corte ideal foi ≥ 6. Conclusão: A nova escala de 6 itens possui propriedades psicométricas adequadas e valores de curva ROC semelhantes à versão de 10 itens e oferece um meio de reduzir o custo e o tempo necessário para administrar o instrumento.

Transcranial direct current stimulation and manual asymmetries: the effect of the stimulation on the manual dexterity / Estimulação transcraniana por corrente contínua (etcc) e assimetrias manuais: o efeito da estimulação na destreza manual

ABSTRACT The aim of this study was to evaluate the effect of transcranial direct-current stimulation (tDCS) on the primary motor cortex (M1) in the manual performance asymmetries in a manual dexterity tasks. The sample consisted of 28 volunteers, right-handed, men and without neurological impairment. The task (Grooved Pegboard) consisted of inserting 25 pins in 25 receptacles, as soon as possible. The task was executed in the pretest with both hands to define the level of manual asymmetry. tDCS or Sham were applied a week after the pretest, then the subjects were evaluated in the post-test. The results revealed that the effects of tDCS in M1 did not reduce asymmetries in a manual dexterity task. However, only the tDCS group improved the performance from pretest to the posttest (p <0.05) in both hands. Stimulation of the right M1 may have generated benefits in the contralateral M1.

RESUMO O objetivo foi avaliar os efeitos da estimulação transcraniana por corrente contínua (ETCC) sobre o córtex motor primário (M1) nas assimetrias de desempenho manual em uma tarefa de destreza manual. A amostra foi composta por 28 voluntários, destros, do sexo masculino e sem comprometimento neurológico. A tarefa (Grooved Pegboard) consistiu em encaixar 25 pinos em 25 receptáculos, o mais rápido possível. A tarefa foi executada no pré-teste com ambas as mãos para definição do nível de assimetria manual. Uma semana após o pré-teste foi aplicado a ETCC ou placebo, em seguida os sujeitos foram avaliados no pós-teste. Os resultados revelaram que os efeitos da ETCC no M1 não foram capazes de diminuir as assimetrias manuais em uma tarefa de destreza manual em sujeitos destros. Entretanto, somente o grupo ETCC melhorou o desempenho do pré-teste para o pós-teste (p<0,05) em ambas as mãos. A estimulação do M1 direito pode ter gerado benefícios no M1 contralateral.

Lack of association between genetic polymorphism of FTO, AKT1 and AKTIP in childhood overweight and obesity / Falta de associação entre o polimorfismo genético do FTO, AKT1 e AKTIP e o sobrepeso e a obesidade infantis

Abstract Objective: Obesity is a chronic disease caused by both environmental and genetic factors. Epidemiological studies have documented that increased energy intake and sedentary lifestyle, as well as a genetic contribution, are forces behind the obesity epidemic. Knowledge about the interaction between genetic and environmental components can facilitate the choice of the most effective and specific measures for the prevention of obesity. The aim of this study was to assess the association between the FTO, AKT1, and AKTIP genes and childhood obesity and insulin resistance. Methods: This was a case-control study in which SNPs in the FTO (rs99396096), AKT1, and AKTIP genes were genotyped in groups of controls and obese/overweight children. The study included 195 obese/overweight children and 153 control subjects. Results: As expected, the obese/overweight group subjects had higher body mass index, higher fasting glucose, HOMA-IR index, total cholesterol, low-density lipoprotein, and triglycerides. However, no significant differences were observed in genes polymorphisms genotype or allele frequencies. Conclusion: The present results suggest that AKT1, FTO, and AKTIP polymorphisms were not associated with obesity/overweight in Brazilians children. Future studies on the genetics of obesity in Brazilian children and their environment interactions are needed.

Resumo Objetivo A obesidade é uma doença crônica sustentada por fatores ambientais e genéticos. Estudos epidemiológicos documentaram que maior ingestão de energia e um estilo de vida sedentário, bem como a contribuição genética, são forças por trás da epidemia de obesidade. O conhecimento sobre a interação entre os componentes genéticos e ambientais pode facilitar a escolha das medidas mais efetivas e específicas para a prevenção da obesidade. O objetivo deste estudo foi avaliar a relação entre os genes associado à massa de gordura e à obesidade (FTO), homólogo 1 do oncogene viral v-akt de timoma murino (AKT1) e de ligação AKT1 (AKTIP) e a obesidade infantil e a resistência à insulina. Métodos Estudo de caso-controle no qual os polimorfismos de nucleotídeo simples (SNPs) nos genes FTO (rs99396096), AKT1 e AKTIP foram genotipados em grupos de controle e de crianças obesas/acima do peso. Foram recrutadas 195 crianças obesas/acima do peso e 153 indivíduos controle. Resultados Como esperado, os indivíduos do grupo obeso/acima do peso apresentaram maior índice de massa corporal, maior glicemia de jejum, índice do modelo de avaliação de homeostase (HOMA-IR), colesterol total, lipoproteína de baixa densidade e triglicerídeos. Contudo, não encontramos diferenças significativas no genótipo de polimorfismos gênicos ou nas frequências alélicas. Conclusão Nossos resultados sugerem que os polimorfismos AKT1, FTO e AKTIP não estavam associados à obesidade/sobrepeso em crianças brasileiras. São necessários estudos futuros sobre a genética da obesidade em crianças brasileiras e suas interações ambientais.

Papel do estresse oxidativo na fisiopatologia da esquizofrenia / Role of oxidative stress in the pathophysiology of schizophrenia

Introdução: a fisiopatologia da esquizofrenia é ainda pouco esclarecida. Vários estudos descrevem o importante papel da inflamação e do estresse oxidativo nessa explicação. Esquizofrênicos parecem ter seus mecanismos de defesa alterados e resposta distinta dos controles ao estresse oxidativo, que é lesivo a várias estruturas celulares, entre elas a matriz extracelular (MEC). Uma MEC íntegra e estruturada é essencialpara a boa condução sináptica. Objetivo: avaliar a resposta de genes que codificam proteínas da MEC ao estresse oxidativo em esquizofrênicos crônicos e controles. Metodologia: foi feita cultura de fibroblastos a partir de biópsias de pele de esquizofrênicos e controles. Estas foram tratadas com TBHQ, um pró-oxidante, ou DMSO, o veículo, e então se quantificou a expressão dos genes MMP16, GALNT6, SULF1, ADAMTS1 e ACSL1pelo método de PCR em tempo real e dos seus produtos por western blot. Resultados: existe resposta de ambos os grupos ao estresse oxidativo, no entanto, essa resposta é distinta entre pacientes e controles, com esquizofrênicos expressando menos o gene GALNT6 e sua proteína. Conclusão: o gene GALNT6 codifica uma enzima responsável por glicosilar componentes da MEC. Pode-se hipotetizar que a resposta de esquizofrê-nicos ao estresse oxidativo torna essa MEC mais suscetível aos seus efeitos deletérios, colaborando com a fisiopatologia da doença.

Introduction: The pathophysiology of schizophrenia is still poorly understood. Several studies suggest an important role of inflammation and oxidative stress in this explanation. Schizophrenics seem to have altered defense mechanisms and a distinct response to oxidative stress than that of controls. Oxidative stress is harmful to various cellular structures,among them the extracellular matrix (ECM). A intact and structured ECM is essential for proper synaptic signaling. Objective: To evaluate the response of genes encoding ECM proteins to oxidative stress in chronic schizophrenics and controls. Methodology: Fibroblasts were cultivated from schizophrenic and controls? skin biopsies. They were treatedwith TBHQ, a pro-oxidant, or DMSO (the vehicle), and then had the expression of MMP16, GALNT6, SULF1, ADAMTS1 and ACSL1 genes quantified by the method of real time PCR and their products by the method of Western blot. Results: There was response from both groups to oxidative stress, however, this response was different between patients and controls, with schizophrenics expressing less the GALNT6 gene and its protein. Conclusion: GALNT6 gene encodes an enzyme responsible for glycosylating ECM components. We can hypothesize that the schizophrenic?s response to oxidative stress renders the ECM moresusceptible to its harmful effects, contributing to the pathophysiology of the disease.

Reabilitação da estética na recuperação da harmonia do sorriso: relato de caso / Rehabilitation of esthetics in recovering smile harmony: case report

Objetivo: este trabalho tem o objetivo de relatar um caso clínico no qual a abordagem restauradora direta com resina composta foi empregada para remodelação estética após tratamento ortodôntico em uma pacientecom os incisivos laterais superiores com morfologia conoide. Relato de caso: o paciente, 24 anos, gênero feminino, procurou tratamento odontológico queixando-se da aparência dos incisivos laterais superiores, que se apresentavam fora dos padrões de tamanho e forma devido à existência de uma alteração de estrutura. No exame clínico, constatou-se a presença dos incisivos laterais conoides, dentes 12 e 22. Após o exame radiográfico, que demonstrou ausência de alteração da forma radicular desses elementos, foi planejada a reabilitação funcional e a recuperação estética por meio de restaurações diretas com resina composta. Para reabilitar os elementos estética e funcionalmente, optou-se pela reanatomização, utilizando-se resina composta pela técnica da mão livre, por ser um procedimento mais rápido e de menor custo, por dispensar a etapa de enceramento e moldagem. Todavia, essa técnica apresenta comodesvantagem a necessidade de mais habilidade e treinamento do operador. Considerações finais: as resinas compostas permitem uma resolução de maneira rápida e com elevado desempenho estético, apresentando resultado satisfatório, desde que sejam respeitadas suas indicações, compreendidas suas limitações e que a etapa de ajuste oclusal não seja negligenciada.

Doenças crônicas, cognição, declínio funcional e Índice de Charlson em idosos com demência / Chronic diseases, cognition, functional decline, and the Charlson index in elderly people with dementia

OBJETIVO: Este estudo avaliou a associação entre as doenças crônico-degenerativas e o declínio funcional, a cognição e a predição da mortalidade. MÉTODOS: Um estudo transversal foi realizado em um Serviço de Geriatria em Belo Horizonte, Brasil, envolvendo 424 pacientes subdivididos em dois grupos: controle e com demência. Foram analisados dados sociodemográficos e ambientais, doenças crônicas degenerativas, o Índice de Charlson, dados sobre a demência, funcionais e de cognição. RESULTADOS: Após análise univariada, houve maior frequência de acidente vascular encefálico (AVE), incontinência urinária, constipação intestinal e distúrbio do sono no grupo demência, enquanto na análise multivariada houve maior número de fatores ambientais e distúrbio do sono. Quanto ao Mini Exame do Estado Mental (MEEM), pacientes com doença pulmonar obstrutiva crônica (DPOC), AVE e insuficiência cardíaca apresentaram escores mais baixos. Em relação ao Índice de Charlson, houve maior pontuação no grupo com demência. CONCLUSÃO: As comorbidades foram associadas ao declínio funcional nos idosos com demência.

OBJECTIVE: To assess the association between chronic degenerative diseases and functional decline, cognition, and mortality prediction. METHODS: A cross-sectional study was conducted in a geriatrics service in Belo Horizonte, Brazil, involving 424 patients subdivided into two groups: control and dementia. The study analyzed socio-demographic and environmental data, chronic degenerative diseases, the Charlson index, and data on functional and cognitive dementia. RESULTS: After a univariate analysis, there was a greater frequency of cerebrovascular accident (CVA), urinary incontinence, constipation, and sleep disorder in the dementia group, while the multivariate analysis showed a greater number of environmental factors and sleep disorder. Regarding the Mini Mental State Examination (MMSE), patients with chronic obstructive pulmonary disease (COPD), CVA, and heart failure presented lower scores. There was a greater score in the dementia group with regarding the Charlson index. CONCLUSION: These comorbidities were associated with the functional decline in elderly people with dementia.