A TLR4 agonist improves immune checkpoint blockade treatment by increasing the ratio of effector to regulatory cells within the tumor microenvironment.

Brucella lumazine synthase (BLS) is a homodecameric protein that activates dendritic cells via toll like receptor 4, inducing the secretion of pro-inflammatory cytokines and chemokines. We have previously shown that BLS has a therapeutic effect in B16 melanoma-bearing mice only when administered at early stages of tumor growth. In this work, we study the mechanisms underlying the therapeutic effect of BLS, by analyzing the tumor microenvironment. Administration of BLS at early stages of tumor growth induces high levels of serum IFN-γ, as well as an increment of hematopoietic immune cells within the tumor. Moreover, BLS-treatment increases the ratio of effector to regulatory cells. However, all treated mice eventually succumb to the tumors. Therefore, we combined BLS administration with anti-PD-1 treatment. Combined treatment increases the outcome of both monotherapies. In conclusion, we show that the absence of the therapeutic effect at late stages of tumor growth correlates with low levels of serum IFN-γ and lower infiltration of immune cells in the tumor, both of which are essential to delay tumor growth. Furthermore, the combined treatment of BLS and PD-1 blockade shows that BLS could be exploited as an essential immunomodulator in combination therapy with an immune checkpoint blockade to treat skin cancer.

Neuropsychological and behavioural profiles of students with intellectual development disorder on parents and teachers' perceptions.

BACKGROUND: Children with intellectual development disorder (IDD) have high rates of comorbid neuropsychological and behavioural problems. However, there are not many studies on this population in middle-income and low-income countries. Therefore, we aimed to investigate the prevalence of neuropsychological and behavioural problems in students with and without IDD and to assess the correlation between the responses from informants (parents and teachers) and the clinical diagnoses in Brazil. METHODS: After clinical diagnosis, 78 male and female students (7-15 years old) were divided into two groups: children with IDD (n = 39) and children without IDD (n = 39). The Child Behaviour Checklist (CBCL) and Teacher's Report Form (TRF) scales were used to track neuropsychological and behavioural problems. Calculations of prevalence ratios were performed using Poisson regression with Wald tests. The CBCL and TRF results were compared between groups with Mann-Whitney U-tests and receiver operating characteristic (ROC) analyses. The agreement between scales was assessed using the Spearman correlation test. RESULTS: Neuropsychological and behavioural problems were significantly more prevalent in students with IDD. The average amount of CBCL problems was significantly higher than that of TRF in the dimensions of thought, attention, somatic, attention deficit/hyperactivity, opposition defiant and total problems. Low-to-moderate correlations between CBCL and TRF dimensions in the IDD group were observed. ROC analyses revealed that the dimensions of internalising problems and total scores reflecting CBCL and TRF problems were the most important factors for identifying neuropsychological and behavioural problems in the IDD group. CONCLUSIONS: Students with IDD require early identification of behavioural and emotional symptoms to avoid the underdiagnoses of various mental health problems, especially those with internalising characteristics. The CBCL and TRF may assist in the early screening of these comorbidities.

Proposal of a pathway for enteric virus groups detection as indicators of faecal contamination to enhance the evaluation of microbiological quality in freshwater in Argentina.

An environmental survey was conducted in order to assess the frequency of detection of picobirnavirus (PBV), human adenovirus (HAdV) and infective enterovirus (iEV) as indicators of faecal contamination in freshwater, and to determine their potential as reporters of the presence of other enteric viruses, such as group A rotavirus (RVA). The study was carried out over a three-year period (2013-2015) in the San Roque Dam, Córdoba, Argentina. The overall frequency detection was 62.9% for PBV, 64.2% for HAdV and 70.4% for iEV. No significant differences were observed in the rates of detection for any of these viruses through the years studied, and a seasonal pattern was not present. Whenever there was RVA detection in the samples analyzed, there was also detection of iEV and/or HAdV and/or PBV. At least one of the viral groups analyzed was demonstrated in the 100% of the samples with faecal coliforms values within the guideline limits. In this setting, especially in those samples which reveal faecal indicator bacteria within the guideline limit, we propose to carry out a pathway, involving PBV, HAdV and iEV detection in order to enhance the evaluation of microbiological quality in freshwater in Argentina. The proposed methodological strategy could report faecal contamination in water, mainly of human origin, and the condition of the matrix to maintain viral viability. In addition, the viral groups selected could report the presence of RV.

Neuroinflammation at single cell level: What is new?

Multiple sclerosis is a chronic and demyelinating disease of the central nervous system (CNS), most prevalent in women, and with an important social and economic cost worldwide. It is triggered by self-reacting lymphocytes that infiltrate the CNS and initiate neuroinflammation. Further, axonal loss and neuronal death takes place, leading to neurodegeneration and brain atrophy. The murine model for studying MS, experimental autoimmune encephalomyelitis (EAE), consists in immunizing mice with myelin-derived epitopes. APCs activate encephalitogenic T CD4 and CD8 lymphocytes that migrate mainly to the spinal cord resulting in neuroinflammation. Most of the knowledge on the pathophysiology and treatment of MS was obtained from EAE experiments, as Th17 cells, anti-alpha4 blocking Abs and the role of microbiota. Conversely, recent technology breakthroughs, such as CyTOF and single-cell RNA-seq, promise to revolutionize our understanding on the mechanisms involved both in MS and EAE. In fact, the importance of specific cellular populations and key molecules in MS/EAE is a constant matter of debate. It is well accepted that both Th1 and Th17 T CD4 lymphocytes play a relevant role in disease initiation after re-activation in situ. What is still under constant investigation, however, is the plasticity of the lymphocyte population, and the individual contribution of both resident and inflammatory cells for the progression or recovery of the disease. Thus, in this review, new findings obtained after single-cell analysis of blood and central nervous system infiltrating cells from MS/EAE and how they have contributed to a better knowledge on the cellular and molecular mechanisms of neuroinflammation are discussed.

Antibacterial activity of Barbatimão (Stryphnodendron adstringens) against Staphylococcus aureus: in vitro and in silico studies.

We evaluated the activity of the aqueous fraction and the ethyl acetate fraction of Stryphnodendron adstringens against Staphylococcus aureus and proposed their mechanism of action. The antibacterial activity of S. adstringens fractions was evaluated against S. aureus and the cell targets were rated by docking. The fractions showed moderate antibacterial activity against S. aureus without toxicity on two mammalian cell lines. They also showed synergistic antibacterial activity with tannic acid (TA). In silico assays indicated FabG, FabZ and FabI as probable targets. The metabolic pathway for fatty acid biosynthesis in S. aureus was affected by components of S. adstringens. The synergistic effect when combining TA with S. adstringens fractions suggests a natural alternative to S. aureus control. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study describing the possible targets of action of Stryphnodendron adstringens on Staphylococcus aureus. Molecular dynamics simulations showed that the components of S. adstringens affected the metabolic pathway for fatty acid biosynthesis (FAS II) in S. aureus, inhibiting the FabI, FabG and FabZ enzymes. As tannic acid (TA) is a known inhibitor of some targets identified, we showed synergistic antibacterial activity of S. adstringens in combination with TA. This combination did not show toxicity against HaCaT and Vero cells and based on all these results we suggest that S. adstringens can be a natural and sustainable alternative to S. aureus control.

Early and late neuropathological features of meningoencephalitis associated with Maraba virus infection.

Maraba virus is a member of the genus Vesiculovirus of the Rhabdoviridae family that was isolated in 1983 from sandflies captured in the municipality of Maraba, state of Pará, Amazônia, Brazil. Despite 30 years having passed since its isolation, little is known about the neuropathology induced by the Maraba virus. Accordingly, in this study the histopathological features, inflammatory glial changes, cytokine concentrations, and nitric oxide activity in the encephalon of adult mice subjected to Maraba virus nostril infection were evaluated. The results showed that 6 days after intranasal inoculation, severe neuropathological-associated disease signs appeared, including edema, necrosis and pyknosis of neurons, generalized congestion of encephalic vessels, and intra- and perivascular meningeal lymphocytic infiltrates in several brain regions. Immunolabeling of viral antigens was observed in almost all central nervous system (CNS) areas and this was associated with intense microglial activation and astrogliosis. Compared to control animals, infected mice showed significant increases in interleukin (IL)-6, tumor necrosis factor (TNF)-α, interferon (INF)-γ, MCP-1, nitric oxide, and encephalic cytokine levels. We suggest that an exacerbated inflammatory response in several regions of the CNS of adult BALB/c mice might be responsible for their deaths.

The Iberian legacy into a young genetic xeroderma pigmentosum cluster in central Brazil.

In central Brazil, in the municipality of Faina (state of Goiás), the small and isolated village of Araras comprises a genetic cluster of xeroderma pigmentosum (XP) patients. The high level of consanguinity and the geographical isolation gave rise to a high frequency of XP patients. Recently, two founder events were identified affecting that community, with two independent mutations at the POLH gene, c.764 + 1 G > A (intron 6) and c.907 C > T; p.Arg303* (exon 8). These deleterious mutations lead to the xeroderma pigmentosum variant syndrome (XP-V). Previous reports identified both mutations in other countries: the intron 6 mutation in six patients (four families) from Northern Spain (Basque Country and Cantabria) and the exon 8 mutation in two patients from different families in Europe, one of them from Kosovo. In order to investigate the ancestry of the XP patients and the age for these mutations at Araras, we generated genotyping information for 22 XP-V patients from Brazil (16), Spain (6) and Kosovo (1). The local genomic ancestry and the shared haplotype segments among the patients showed that the intron 6 mutation at Araras is associated with an Iberian genetic legacy. All patients from Goiás, homozygotes for intron 6 mutation, share with the Spanish patients identical-by-descent (IBD) genomic segments comprising the mutation. The entrance date for the Iberian haplotype at the village was calculated to be approximately 200 years old. This result is in agreement with the historical arrival of Iberian individuals at the Goiás state (BR). Patients from Goiás and the three families from Spain share 1.8 cM (family 14), 1.7 cM (family 15), and a more significant segment of 4.7 cM within family 13. On the other hand, the patients carrying the exon 8 mutation do not share any specific genetic segment, indicating an old genetic distance between them or even no common ancestry.

Quantum states of an electromagnetic field interacting with a classical current and their applications to radiation problems.

Synchrotron radiation was originally studied by classical methods using the Liénard-Wiechert potentials of electric currents. Subsequently, quantum corrections to the classical formulas were studied, considering the emission of photons arising from electronic transitions between spectral levels, described in terms of the Dirac equation. In this paper, an intermediate approach is considered, in which electric currents generating the radiation are considered classically while the quantum nature of the radiation is taken into account exactly. Such an approximate approach may be helpful in some cases; it allows one to study one-photon and multi-photon radiation without complicating calculations using corresponding solutions of the Dirac equation. Here, exact quantum states of an electromagnetic field interacting with classical currents are constructed and their properties studied. With their help, the probability of photon emission by classical currents is calculated and relatively simple formulas for one-photon and multi-photon radiation are obtained. Using the specific circular electric current, the corresponding synchrotron radiation is calculated. The relationship between the obtained results and those known before are discussed, for example with the Schott formula, with Schwinger calculations, with one-photon radiation of scalar particles due to transitions between Landau levels, and with some previous results of calculating two-photon synchrotron radiation.

Early and late neuropathological features of meningoencephalitis associated with Maraba virus infection

Maraba virus is a member of the genus Vesiculovirus of the Rhabdoviridae family that was isolated in 1983 from sandflies captured in the municipality of Maraba, state of Pará, Amazônia, Brazil. Despite 30 years having passed since its isolation, little is known about the neuropathology induced by the Maraba virus. Accordingly, in this study the histopathological features, inflammatory glial changes, cytokine concentrations, and nitric oxide activity in the encephalon of adult mice subjected to Maraba virus nostril infection were evaluated. The results showed that 6 days after intranasal inoculation, severe neuropathological-associated disease signs appeared, including edema, necrosis and pyknosis of neurons, generalized congestion of encephalic vessels, and intra- and perivascular meningeal lymphocytic infiltrates in several brain regions. Immunolabeling of viral antigens was observed in almost all central nervous system (CNS) areas and this was associated with intense microglial activation and astrogliosis. Compared to control animals, infected mice showed significant increases in interleukin (IL)-6, tumor necrosis factor (TNF)-α, interferon (INF)-γ, MCP-1, nitric oxide, and encephalic cytokine levels. We suggest that an exacerbated inflammatory response in several regions of the CNS of adult BALB/c mice might be responsible for their deaths.

Impact of xerostomia on the quality of life of patients submitted to head and neck radiotherapy.

BACKGROUND: The aim of the present work was to evaluate the impact of xerostomia on the quality of life of patients who underwent radiotherapy in the head and neck region. MATERIAL AND METHODS: This was a cross-sectional, quantitative study. The sample comprised 40 patients whose xerostomia was classified through the xerostomia inventory and the quality of life evaluated through the oral health impact profile questionnaire (OHIP). RESULTS: The majority of participants were male (75%), mean age 58.7 years. According to the degree of severity of the xerostomia, the average score among the participants was 36 points, this being considered moderate xerostomia. A significant impact was observed, with the median score 11 points, with the highest scores in the domains related to functional limitation, physical pain and physical disability. The majority of the participants (97.5%) had reduced salivary flow after the end of radiotherapy. There was a significant positive correlation between the degree of xerostomia and reduced quality of life, Pearson correlation 0.5421, (p<0.05). CONCLUSION: Based upon the results it is concluded that xerostomia has a negative impact on the quality of life of patients who undergo radiotherapy in the head and neck region.

Activación Hemisférica Cerebral en Adultos Jóvenes Mientras Ejecutan Tareas Ortográficas Utilizando fMRI / Hemispheric Brain Activation in Young Adults While Performing Orthographic Tasks Using fMRI

Resumen El dominio del lenguaje escrito se basa en la consolidación de representaciones neurales complejas de los patrones ortográficos de las palabras. En virtud de explorar las características presentes en procesos neurales relacionados con la especialización ortográfica, se estudiaron con métodos de imagen por resonancia magnética funcional los niveles neurales de activación intrahemisférica de 27 jóvenes con alto y bajo rendimiento ortográfico mientras ejecutaban tareas ortográficas. Los resultados sugieren que, en participantes con alto rendimiento ortográfico, la intensidad de activación neural en el hemisferio izquierdo no difiere ante el estímulo de palabras o pseudohomófonos (palabras con error ortográfico); en cambio, difieren cuando se emiten respuestas correctas vs. incorrectas. En participantes con bajo rendimiento ortográfico no se encontró diferencia interhemisférica en ninguna tarea. Se encontró tendencia de que los participantes con bajo rendimiento ortográfico tienen mayor dispersión de la activación neural, respecto a los participantes con alto rendimiento, en el hemisferio derecho e izquierdo, además, en participantes con bajo rendimiento ortográfico se encontró tendencia de que la detección consciente aumenta la variación de la activación neural; sin embargo, no se encontró evidencia estadística concluyente. Este estudio ha abonado a la evidencia de la existencia de la especialización neural orientada a habilidades ortográficas.

Abstract The written language domain is based on the consolidation of complex neural representations of words' orthographic patterns. Here, we studied the characteristics and differences of the neural activation levels that occur in the neural processes related to orthographic specialization, with functional magnetic resonance imaging, in each hemisphere, of 27 young adults with low and high orthographic abilities when they performed orthographic tasks. The results suggest that in high-orthographic-performance participants' left hemispheric neural activation does not vary between words and pseudohomophones; otherwise, their neural activation variates in incorrect vs. correct responses. There were not found interhemispheric differences in low-orthographic-performance participants where they performed any type of task. There were some tendency in the low-orthographic-performance participants to have greater neural activation dispersion, regarding the high-orthographic-performance participants, in both hemispheres, also, there were found tendency in low-orthographic-performance participants to have greater neural activation variation in explicit tasks; nevertheless, there is not enough conclusive statistic evidence. This study increases the evidence of lateralized neural specialization of orthographic abilities.

Anterior chamber associated immune deviation to cytosolic neural antigens avoids self-reactivity after optic nerve injury and polarizes the retinal environment to an anti-inflammatory profile.

It has been hypothesized that anterior chamber-associated immune deviation (ACAID) to neural antigens induced prior to central nervous system injury can inhibit self-reactivity and lessen secondary degeneration. This work evaluated the effect of ACAID induced to three neural tissue-derived extracts (whole extract, cytosolic extract, CE; or organelle-membrane extract) prior to optic nerve injury on retinal ganglion cell (RGC) survival. The results show that only ACAID to the CE increased RGC survival at 7 and14 days post-injury (dpi). This effect was achieved by retinal polarization towards an anti-inflammatory profile, driven by regulatory T cells and M2-type macrophages at 7 dpi.

Evolution of Biomarkers of Atherogenic Risk in Liver Transplantation Recipients.

BACKGROUND: Cardiovascular disease is a major contributing factor to long-term mortality after liver transplantation (LT). METHODS: This study evaluated the evolution of atherogenic risk in liver transplant recipients (LTRs). Thirty-six subjects were prospectively enrolled at 12 months and followed for 48 months after liver transplantation. Serum biomarkers of endothelial dysfunction (sICAM-1 and sVCAM-1), chronic inflammation (serum amyloid A), and oxidative stress (myeloperoxidase) were measured at 12 and 48 months after LT. Additionally, at 12 months all patients underwent a cardiac computed tomography (CT) scan and a coronary artery calcium score (CACS). RESULTS: The prevalence of risk factors of metabolic syndrome (MS) increased over the course of the study. The patients' sVCAM-1 and sICAM-1 increased from 1.82 ± 0.44 ng/mL to 9.10 ± 5.82 ng/mL (P < .001) and 0.23 ± 0.09 ng/mL to 2.7 ± 3.3 ng/mL, respectively from month 12 to 48. Serum myeloperoxidase increased from 0.09 ± 0.07 ng/mL to 3.46 ± 3.92 ng/mL (P < .001) over the course of the study. Serum amyloid A also increased from 21.4 ± 40.7 ng/mL at entry to 91.5 ± 143.6 ng/mL at end of study (P < .001). CONCLUSION: No association between these biomarkers and MS was noted. The cardiac CT revealed mild and moderate disease in 19% and 25% of the cohort, respectively. No association between serum biomarkers and CACS was noted. Serum biomarkers of atherogenic risk increase rapidly in LTRs and precede coronary plaques.

Wharton's jelly cells from sheep umbilical cord maintained with different culture media are permissive to in vitro infection by Small Ruminant Lentiviruses / Células da geleia de Wharton do cordão umbilical ovino mantidas em diferentes meios de cultivo são permissivas à infecção in vitro por lentivírus de pequenos ruminantes

This study aimed to isolate cells from the Wharton's jelly of umbilical cord (WJUC) of sheep collected during natural parturition using different culture media, in addition to reporting for the first time the permissiveness of these cells to in vitro infection by small ruminant lentiviruses. Ten umbilical cords were collected from healthy sheep. Each cord explants were grown in different media consisting of MEM, low glucose DMEM, M199, and RPMI-1640. The permissiveness of infection of sheep cells from WJUC was tested with CAEV-Cork and MVV-K1514 strains, inoculating 0.1 MOI of each viral strain. Four supernatants from each strain were obtained from WJUC sheep cell cultures infected in different media. The results demonstrated the presence of cytopathic effect after the in vitro infection by CAEV-Cork and MVV-K1514 with all of the tested culture media. Nested-PCR detected proviral DNA in all supernatants. Supernatants containing CAEV-Cork viruses had TCID 50/ml titres of 10 5.5 in MEM, 10 4.0 in low glucose DMEM, 105.0 in M199, and 10 5.7 in RPMI-1640. Supernatants containing the MVV-K1514 virus had TCID 50/ml titres of 10 4.3 in MEM, 10 3.5 in low-glucose DMEM, 10 4.7 in M199, and 10 3.5 in RPMI-1640. Sheep cells from WJUC are permissive to in vitro infection by small ruminant lentivirus.(AU)

O objetivo deste estudo foi isolar células da geleia de Wharton do cordão umbilical (GWCU) ovino coletado por ocasião do parto natural, utilizando-se diferentes meios de cultivo, além de relatar, pela primeira vez, sua permissividade à infecção in vitro por lentivírus de pequenos ruminantes (LVPRs). Dez cordões umbilicais foram coletados de ovelhas hígidas e soronegativas para LVPRs pelo teste de imunodifusão em gel de agarose (IDGA). De cada cordão, explantes foram cultivados em quatro meios distintos que consistiram em MEM, DMEM baixa glicose, meio 199 e RPMI-1640, todos acrescidos de 10% de soro fetal bovino em estufa com atmosfera úmida e 5% de CO2 a 37ºC. A permissividade de infecção das células GWCU ovino foi testada frente às cepas CAEV-Cork e MVV-K1514, inoculando-se 0,1 MOI de cada cepa viral e corando as monocamadas com May Grunwald Giemsa para visualização do efeito citopático. Foram obtidos quatro sobrenadantes CAEV-Cork e quatro MVV-K1514, provenientes do cultivo de células GWCU ovino infectadas por 21 dias em meios distintos, dos quais foram realizadas titulação em membrana sinovial caprina e extração do DNA pró-viral para realização de nested-PCR e eletroforese em gel de agarose a 2%. Os resultados demonstraram a presença de efeito citopático na infecção in vitro tanto por CAEV-Cork como por MVV-K1514 em todos os meios de cultivo, sendo visualizados sincícios e lise celular em microscópio invertido. A nested-PCR detectou o DNA pró-viral tanto do CAEV-Cork como do MVV-K1514 em todos os sobrenadantes. Os sobrenadantes contendo o vírus CAEV-Cork apresentaram títulos em TCID50/mL de 10 5,5 em MEM, 10 4,0 em DMEM baixa glicose, 10 5,0 em meio 199 e 10 5,7 em RPMI-1640. Os sobrenadantes contendo o vírus MVV-K1514 apresentaram título em TCID 50/mL de 10 4,3 em MEM, 10 3,5 em DMEM baixa glicose, 10 4,7 em meio 199 e 10 3,5 em RPMI-1640. Células GWCU ovino são permissivas à infecção in vitro pelos lentivírus de pequenos ruminantes CAEV-Cork e MVV-K1514.(AU)

Light pollution reduces activity, food consumption and growth rates in a sandy beach invertebrate.

The continued growth of human activity and infrastructure has translated into a widespread increase in light pollution. Natural daylight and moonlight cycles play a fundamental role for many organisms and ecological processes, so an increase in light pollution may have profound effects on communities and ecosystem services. Studies assessing ecological light pollution (ELP) effects on sandy beach organisms have lagged behind the study of other sources of disturbance. Hence, we assessed the influence of this stressor on locomotor activity, foraging behavior, absorption efficiency and growth rate of adults of the talitrid amphipod Orchestoidea tuberculata. In the field, an artificial light system was assembled to assess the local influence of artificial light conditions on the amphipod's locomotor activity and use of food patches in comparison to natural (ambient) conditions. Meanwhile in the laboratory, two experimental chambers were set to assess amphipod locomotor activity, consumption rates, absorption efficiency and growth under artificial light in comparison to natural light-dark cycles. Our results indicate that artificial light have significantly adverse effects on the activity patterns and foraging behavior of the amphipods, resulting on reduced consumption and growth rates. Given the steady increase in artificial light pollution here and elsewhere, sandy beach communities could be negatively affected, with unexpected consequences for the whole ecosystem.

ACAID as a potential therapeutic approach to modulate inflammation in neurodegenerative diseases.

The progressive loss of neurons and inflammation characterizes neurodegenerative diseases. Although the etiology, progression and outcome of different neurodegenerative diseases are varied, they share chronic inflammation maintained largely by central nervous system (CNS)-derived antigens recognized by T cells. Inflammation can be beneficial by recruiting immune cells to kill pathogens or to clear cell debris resulting from the primary insult. However, chronic inflammation exacerbates and perpetuates tissue damage. An increasing number of therapies that attempt to modulate neuroinflammation have been developed. However, so far none has succeeded in decreasing the secondary damage associated with chronic inflammation. A potential strategy to modulate the immune system is related to the induction of tolerance to CNS antigens. In this line, it is our hypothesis that this could be accomplished by using anterior chamber associated immune deviation (ACAID) as a strategy. Thus, we review current knowledge regarding some neurodegenerative diseases and the associated immune response that causes inflammation. In addition, we discuss further our hypothesis of the possible usefulness of ACAID as a therapeutic strategy to ameliorate damage to the CNS.

Influence of the use of medicinal plants in medication adherence in elderly people.

OBJECTIVE: The objective of this study was to investigate the relationship between the use of medicinal plants and medication adherence in elderly people. METHODS: Observational, cross-sectional study of elderly residents in Cuité-PB, Northeastern Brazil, through a household survey. A stratified proportional and systematic random sample of 240 elders was interviewed in their homes and the use of pharmaceutical medicines and of medicinal plants was assessed by direct examination. The association of medication adherence with socio-demographic, clinical, medication and use of medicinal plants was analysed with multiple logistic regression. RESULTS: The results showed that medication non-adherence increases with use of herbal medicines (adjusted odds ratio 2.022, 95% CI 1.059-3.862, p = 0.03), as well as with the number of different medicinal plants used (adjusted odds ratio 1.937, 95% CI 1.265-2.965, p = 0.002). CONCLUSION/INTERPRETATION: This study provides first-hand evidence that the use of herbal medicines is associated with poor medication adherence. Given the high frequency of the use of herbal medicines, further research into the mechanisms of this association is justified.

Uso de pacientes estandarizados para la adquisición de conocimientos teórico-clínicos en estudiantes de pregrado / Use of standardized patients to the acquisition of clinical-theoretical knowledge by nursing undergraduate students / Uso de pacientes estandardizados para a aquisição de conhecimentos teórico-clínicos em estudantes de pregado

La práctica docente obliga a innovar con metodologías que faciliten el aprendizaje y resguarden los principios éticos que fundamentan el quehacer profesional, como es el caso del uso de los pacientes estandarizados (PE). Objetivo: Evaluar el efecto en los conocimientos sobre esquizofrenia y trastornos del ánimo de una intervención que combina clases teóricas estandarizadas y uso de PE en estudiantes universitarios de pregrado de la asignatura de enfermería psiquiátrica. Método: Diseño cuantitativo descriptivo sobre un universo de 157 estudiantes de enfermería de quinto y sexto semestre de formación. La recolección de los datos se realizó a través de un instrumento de medición de conocimientos sometido a pruebas de validación de contenido. Para el análisis de los datos se utilizó el programa SPSS(r). Resultados: Al medir el efecto de la intervención en la adquisición de conocimientos, se observa que la metodología de clase estandarizada incrementa en promedio un 34% los conocimientos de los estudiantes y el uso de PE contribuye con sobre un 10% adicional. Al combinar ambas estrategias, los conocimientos de los estudiantes se incrementan en 49.3% y 41.9% para esquizofrenia y trastornos del ánimo respectivamente, sin que el estudiante participe de otra instancia de estudio o profundización de los contenidos. Conclusión. El uso de estrategias metodológicas combinadas contribuye a la adquisición de los conocimientos necesarios para la formación de estudiantes de pregrado de enfermería psiquiátrica.

Teaching needs to innovate with methodologies which foster learning while, at the same time, maintain the ethical principles which give base to the professional activities. Such is the case of the use of standardized patients (SP). Objective: To assess the effects of an intervention which combines standardized theoretical classes with the use of SP, on the knowledge which undergraduate students, undergoing their psychiatric nursing subject, have on schizophrenia and mood disorders. Method This was a qualitative and descriptive study on a universe of 157 nursing students from the fifth and sixth semesters of their program. Data collection was conducted through a knowledge assessment instrument which was submitted to content validity tests. The SPSS(r) program was used to analyze these data. Results: From the intervention, it was observed that the methodology of standardized class increments in an average of 34% the students' knowledge, while the use of SP contributes with an additional 10%. When combining both methodologies, and without any other content-deepening technique, the students' knowledge on schizophrenia increased 49.4% while their knowledge on mood disorders increased 41.9%. Conclusion: The use of combined methodological strategies contributes to the acquisition of formation-needed knowledge by undergraduate psychiatric nursing students.

A prática docente obriga a inovar com metodologias que facilitem a aprendizagem e a salvaguardar os princípios éticos que fundamentam o fazer profissional, como é o caso do uso 2 pacientes estandardizados (PE). Objetivo: Avaliar o efeito nos conhecimentos sobre esquizofrenia e transtornos de ânimo de uma intervenção que combina aulas teóricas estandardizadas e uso de PE nos estudantes universitários de pregado da matéria de enfermagem psiquiátrica. Método: Desenho quantitativo descritivo sobre o universo de 157 estudantes de enfermagem de quinto e sexto semestre de formação. A recoleta 2 dados realizou-se a través de um instrumento de medição de conhecimentos submetido a testes de validação de conteúdo. Para a análise de dados utilizou-se o programa SPSS(r). Resultados Ao medir o efeito da intervenção na aquisição de conhecimentos, observa-se que a metodologia de classe estandardizada incrementa em média um 34% os conhecimentos 2 estudantes e o uso de PE contribui sobre um 10% adicional. Ao combinar ambas as estratégias, os conhecimentos 2 estudantes incrementam-se em 49.4% e 41.9% para esquizofrenia e transtornos de ânimo respectivamente, sem que o estudante participe de outra instância de estúdio e/ou aprofundamento 2 conteúdos. Conclusão: O uso de estratégias metodológicas combinadas contribui à aquisição de conhecimentos necessários para a formação de estudantes de pregado de enfermagem psiquiátrica.