Patients' Comprehension of Mindfulness-Based Cognitive Behavioral Therapy in an Outpatient Clinic for Resistant Depression: A Cross-Sectional Study.

The current study investigated the comprehension of mindfulness-based cognitive behavioral therapy (MBCT) by patients with resistant depression at the Psychiatry Institute of the Federal University of Rio de Janeiro, Brazil. This was the first time the model was used in the institution to treat these patients. In this study, 45 patients were invited to participate in a baseline session of MBCT that consisted in the explanation of the model and experimental exercises conducted by two experienced therapists. Twenty eight patients accepted to participate. At the end of the intervention, the patients completed a self-administered questionnaire designed by our ambulatory to assess their understanding of the method's goals. Patients with anxiety disorder was also accessed for group comparison. More than 75% of the patients rated the intervention as comprehensible and workable. Compared to patients with depression, patients with anxiety had a better understanding of the mindfulness framework (6.5%) and the meaning of cognitive behavioral therapy (17.6%). Patients that completed the intervention described the baseline session of MBCT as comprehensive and acceptable. These results may allow possible future developments in the practice of mindfulness as a treatment applicable in many condition and settings even in the Brazilian context.

Prenatal undernutrition changes renovascular responses of nimesulide in rat kidneys.

Several studies in the Northeastern region of Brazil have demonstrated an association between hypertension in adult populations and prenatal and postnatal undernutrition. The central hypothesis we proposed was that hypertension could be favoured by programmed alterations in branches of the renal arachidonic pathway and consequently in counter-balancing the renin angiotensin system, especially during treatments with cyclooxygenase inhibitors. We assessed the influence of subchronic (21 days) and acute administration of nimesulide, a preferential cyclooxygenase-2 (COX-2) inhibitor, on mean blood pressure (MAP), renal blood flow (RBF), glomerular filtration rate (GFR) and urinary output (U(v)) in adult rats that were prenatally undernourished. Undernutrition per se led to the onset of mild hypertension in adult offspring, whereas subchronic nimesulide treatment increased MAP in control and elicited further augmentation in undernourished animals. The drug (i) decreased RBF and GFR in controls by 50%, whereas no effect was detected in the undernourished group, and (ii) increased U(v) by 25% in controls, an effect that was potentiated by 200% in programmed animals. In contrast, acute nimesulide administration decreased U(v) , with the hypertensive effect of the drug being potentiated during dehydration. These findings demonstrate that prenatal nutritional programming differentially modulates adult renovascular responses to nimesulide in the cortex and medulla, which may exacerbate the deleterious effects of COX-2 inhibition in the kidney.

Repercussion of acetylsalicylic acid during fetal development on later renal hemodynamics of rats.

Acetylsalicylic acid (ASA) during pregnancy reaches the fetus. It seems important to know possible repercussions of ASA on later renal function of the offspring, as well as repercussions of this drug on factors that may influence fetal development, such as maternal plasma volume and placental oxidative stress. It was evaluated whether ASA changes maternal plasma volume and/or placental oxidative stress, fetal weight and renal function of the offspring at adult life. ASA (100 mg/kg/day, p.o., dissolved in ETOH 10%) or ETOH 10% was administered to Wistar rat dams, from the day 7 to day 20 of pregnancy/parturition. Plasma volume and the placental oxidative stress were evaluated on day 20 of pregnancy, using, respectively, the Evans blue dye and the thiobarbituric acid reactive substances methods. Mean arterial pressure, renal blood flow (RBF) and glomerular filtration rate (GFR) were evaluated in the anesthetized offspring, at the age of 90 days, using a blood pressure transducer, a flow probe and inulin clearance respectively. Plasma volume was 76% (P < 0.05) higher in ASA compared with that in control dams, but placental oxidative stress was the same for both groups. Fetal body weight, the number of nephrons, GFR, RBF and renal vascular resistance were similar for the same gender among the offspring of the two groups. However, reduced hematocrit (9.8%, P < 0.05), increased renal plasma flow (27%, P < 0.05) and reduced filtration fraction (32%, P < 0.05) were seen in the female offspring. In conclusion, although ASA had increased maternal plasma volume, it did not change nephrogenesis nor GFR in the adult offspring. The changes in renal plasma flow and filtration fraction seen in the ASA female offspring might partially be due to the reduced hematocrit.