Neuroserpin, IL-33 and IL-17A as potential markers of mild symptoms of depressive syndrome in Toxoplasma gondii-infected pregnant women.

Introduction: Depressive syndrome (DS) is a common complication during pregnancy and the postpartum period, and is triggered by multiple organic/genetic and environmental factors. Clinical and biochemical follow-up is essential for the early diagnosis and prognosis of DS. The protozoan Toxoplasma gondii causes infectious damage to the fetus during parasite primary-infection. However, in long-term infections, pregnant women develop immune protection to protect the fetus, although they remain susceptible to pathological or inflammatory effects induced by T. gondii. This study aimed to investigate plasma inflammatory biomarkers in pregnant women seropositive and seronegative for T. gondii, with diagnoses of minor and moderate/severe DS. Methods: Pregnant women (n=45; age=18-39 years) were recruited during prenatal care at health centers in Ouro Preto, Minas Gerais, Brazil. Participants were asked to complete a socio-demographic questionnaire to be submitted to well-standardized DS scale calculators (Beck Depression Inventory Questionnaire, Edinburgh Postnatal Depression Scale, and Major Depressive Episode Module). Additionally, 4 mL of blood was collected for plasma neuroserpin, CCL2, IL-17A, and IL-33 analysis. Results: Pregnant volunteers with chronic T. gondii contact were all IgG+ (44%; n=21) and exhibited increased plasma IL-33, IL-17A, and neuroserpin levels, but not CCL2, compared to uninfected pregnant women. Using Beck's depression inventory, we observed an increase in plasma IL-17A and IL-33 in women with T. gondii infeCction diagnosed with mild DS, whereas neuroserpin was associated with minor and moderate/severe DS. Discussion: Our data suggest a close relationship between DS in pregnant women with chronic T. gondii infection and neurological conditions, which may be partially mediated by plasma neuroserpin, IL-33, and IL-17A levels.

Theracurmin Modulates Cardiac Inflammation in Experimental Model of Trypanosoma cruzi Infection.

Theracurmin is a nanoparticle formulation derived from curcumin, a bioactive compound known for its antioxidant and anti-inflammatory properties. Trypanosoma cruzi, the etiological agent of Chagas disease, triggers an intense inflammatory response in mammals and also causes severe tissue damage. To evaluate the immunomodulatory and antiparasitic effects of Theracurmin, Swiss mice were experimentally infected with 103 trypomastigote forms of the Colombian strain of T. cruzi and submitted to daily therapy with 30 mg/kg of Theracurmin. In addition, daily benznidazole therapy (100 mg/kg) was performed as a positive control. We evaluated the systemic and tissue parasitism, the survival and the body mass rate, the release of inflammatory mediators (TNF, IL-6, IL-15, CCL2 and creatine kinase) and the tissue inflammation at day 30 post-infection. Theracurmin therapy reduced the parasitemia curve without altering the animals' survival rate, and it protected mice from losing body mass. Theracurmin also reduced CCL2 in cardiac tissue, IL-15 in cardiac and skeletal tissue, and plasma CK. Even without effects on TNF and IL-6 production and tissue amastigote nests, Theracurmin reduced the leukocyte infiltrate in both evaluated tissues, even in the case of more effective results observed to the benznidazole treatment. Our data suggest Theracurmin has an immunomodulatory (CCL2, IL-15, CK and tissue leukocyte infiltration) and a trypanocidal effect (on circulating parasites) during experimental infection triggered by the Colombian strain of T. cruzi. Further investigations are necessary to comprehend the Theracurmin role performed in combination with benznidazole or other potential anti-T. cruzi chemical compounds.

Protective effects of Theracurmin treatment during experimental infection of the Colombian strain of Trypanosoma cruzi at the testicular site.

Introduction: Chagas' disease is a tropical neglected illness caused by Trypanosoma cruzi and remains one of the most significant causes of morbidity and mortality in South and Central Americas. The disease is caused by a moderate to intense and persistent inflammatory response characterized by local upregulated expression and production of inflammatory mediators that favors the activation and recruitment of distinct cells of the immune system into different tissues to eliminate the parasites. Theracurmin is a curcumin's derived formulation of nanoparticles. Its anti-inflammatory properties make this bioactive compound a mitigating factor in pathological cases after an overwhelming inflammatory response. Methods: Our research focused on the testicular investigation in 28 mice infected by 103 trypomastigote forms of Colombian strain of T. cruzi and preventively treated with Theracurmin. The mice were treated with 30 mg/Kg of Theracurmin during the period of 30 days. At the 30th day post infection animals were euthanized, and its testicles were collected to morphological and immunological assays. Results: The animals infected and treated with Theracurmin presented a reduction in the testicular levels of IL-15 and IL-6. The volume density (%) of the tunica propria was also higher in all infected animals, but Theracurmin decreased this parameter in the treated animals. In the intertubular area, the percentage of some intertubular components was decreased in the infected animals such as the percentage and volume of Leydig cells, connective tissue, and macrophages. Discussion: Furthermore, our data pointed to the daily use of Theracurmin in the diet as a protective element of the testicular function.

Insights into CX3CL1/Fractalkine during experimental Trypanosoma cruzi infection.

Trypanosoma cruzi triggers a progressive myocarditis in mammalians through activation and recruitment of leukocytes and release of inflammatory mediators. The chemokine CX3CL1 has been highlighted for its potential role in the parasite controlling in end-pathological status of infected hosts. This study investigated the systemic and cardiac release of CX3CL1 in experimental T. cruzi infection and how this chemokine correlates with endothelin-1 and TNF. Male Fisher rats (n = 20) were infected, or not, by the Y strain of T. cruzi and parasitemia was daily evaluated and immunoassays performed in the cardiac tissue macerated supernatant and in serum to evaluate CX3CL1, endothelin, and TNF production on days 5 and 15 of infection. T. cruzi infection induced a higher serum and cardiac production of these mediators on days 5 and 15 of infection. In both periods of infection, respectively, CX3CL1 showed a positive correlation with TNF (r = 0.833, p < 0.001 and r = 0.723, p < 0.001) and endothelin-1 (r = 0.801, p < 0.05 and r = 0.857, p < 0.001), which reinforce its participation in the T. cruzi-induced myocarditis development.

Considerações sobre a prática clínica da psicologia no ensino superior / Considerations about clinical practice of psychology in college education / Consideraciones sobre la práctica clínica de la psicología en la educación superior

Este estudo tem por objetivo discutir a atuação clínica da Psicologia em um serviço de apoio ao estudante universitário dentro de uma Instituição de Ensino Superior pública, por meio de um relato de experiência. Apresenta-se uma breve descrição do serviço, a implementação de um processo de triagem, a relação terapeuta e paciente, a psicoterapia breve, algumas queixas mais recorrentes no serviço, bem como limitações e potencialidades da atuação. Assim, entende-se que o trabalho psicoterapêutico de caráter breve, ainda que seja atravessado por desafios institucionais de ordem burocrática e administrativa, consegue ser efetivo e é valorizado pela comunidade acadêmica. Evidencia-se que a atuação clínica no contexto da educação superior é um campo profissional que pode ser mais explorado pela Psicologia.

In this article, we aim to discuss the clinical performance of Psychology in support service for university students within a Public Higher Education Institution, through an experience report. We present a brief description of the service, the implementation of a screening process, the relationship between therapist and patient, brief psychotherapy, more recurring complaints in the service, as well as limitations and potentialities of performance. Thus, we understand that psychotherapeutic work of a brief nature, even though it is traversed by institutional bureaucratic and administrative challenges, manages to be effective and is valued by the academic community. It is evident then that clinical practice in the context of College Education is a professional field that can be further explored by Psychology.

En este artículo, nuestro objetivo es discutir el desempeño clínico de la Psicología en un servicio de apoyo para estudiantes universitarios dentro de una institución pública de educación superior, a través de un informe de experiencia. Presentamos una breve descripción del servicio, la implementación de un proceso de detección, la relación entre terapeuta y paciente, psicoterapia breve, quejas más frecuentes en el servicio, así como limitaciones y potencialidades de desempeño. Así, entendemos que el trabajo psicoterapéutico breve, aunque esté atravesado por desafíos institucionales burocráticos y administrativos, logra ser efectivo y es valorado por la comunidad académica. Es evidente entonces que la práctica clínica en el contexto de la Educación Superior es un campo profesional que la Psicología puede seguir explorando.

A leukotriene-dependent spleen-liver axis drives TNF production in systemic inflammation.

Production of the proinflammatory cytokine tumor necrosis factor (TNF) must be precisely regulated for effective host immunity without the induction of collateral tissue damage. Here, we showed that TNF production was driven by a spleen-liver axis in a rat model of systemic inflammation induced by bacterial lipopolysaccharide (LPS). Analysis of cytokine expression and secretion in combination with splenectomy and hepatectomy revealed that the spleen generated not only TNF but also factors that enhanced TNF production by the liver, the latter of which accounted for nearly half of the TNF secreted into the circulation. Using mass spectrometry-based lipidomics, we identified leukotriene B4 (LTB4) as a candidate blood-borne messenger in this spleen-liver axis. LTB4 was essential for spleen-liver communication in vivo, as well as for humoral signaling between splenic macrophages and Kupffer cells in vitro. LPS stimulated the splenic macrophages to secrete LTB4, which primed Kupffer cells to secrete more TNF in response to LPS in a manner dependent on LTB4 receptors. These findings provide a framework to understand how systemic inflammation can be regulated at the level of interorgan communication.

DIREITOS HUMANOS NA ATUAÇÃO DE PSICÓLOGOS NA SOCIOEDUCAÇÃO / HUMAN RIGHTS IN THE PRACTICE OF PSYCHOLOGISTS IN SOCIO-EDUCATION / LOS DERECHOS HUMANOS EN EL DESEMPEÑO DE LOS PSICÓLOGOS EN SOCIOEDUCACIÓN

O estudo tem como objetivo investigar como a medida socioeducativa - MSE, na concepção dos profissionais participantes, vem influenciando na proteção e promoção dos direitos dos adolescentes em cumprimento de medida socioeducativa. Foram realizadas entrevistas semiestruturadas com seis psicólogos que trabalham com MSE. As entrevistas foram transcritas e analisadas qualitativamente. As respostas revelam o aspecto negativo das concepções socioculturais e das informações midiáticas sobre o adolescente em MSE, configurando inclusive em um desserviço ao desenvolvimento das Medidas de forma que impactam em desarticulações na rede de atendimento e inflam os preconceitos sociais. Quanto às garantias de direitos analisou-se pontos como: estrutura física, acesso à educação, respeito às individualidades dos adolescentes e acesso aos serviços básicos de saúde e assistência. Destaca-se a relevância de investir em capacitações para os profissionais não somente do sistema socioeducativo, mas de todas as políticas que devem assistir os adolescentes em cumprimento de MSE.

The study aims to investigate as a socio-educational measure - MSE, in the conception of participating professionals, which influences the protection and promotion of the rights of adolescents in compliance with socio-educational measure. Semi-structured interviews were conducted with six psychologists who work with MSE. The interviews were transcribed and analyzed qualitatively. The answers reveal the negative aspect of socio-cultural conceptions and media information about the adolescent in MSE, which also constitutes a disservice to the development of Measures in a way that impacts disarticulations in the service network and inflames social prejudices. As for the guarantee of rights, points were analyzed such as: physical structure, access to education, respect for the adolescents' individualities and access to basic health and assistance services. The relevance of investing in training for professionals is highlighted, not only from the socio-educational system, but from all policies that should assist adolescents in compliance with MSE.

El estudio tiene como objetivo investigar cómo la medida socioeducativa - MSE, en opinión de los profesionales participantes, ha influido en la protección y promoción de los derechos de los adolescentes en cumplimiento de la medida socioeducativa. Se realizaron entrevistas semiestructuradas con seis psicólogos que trabajan con MSE. Las entrevistas fueron transcritas y analizadas cualitativamente. Las respuestas revelan el aspecto negativo de las concepciones socioculturales y la información de los medios sobre los adolescentes en MSE, configurar incluso un perjuicio para el desarrollo de las Medidas de manera que afecte las interrupciones en la red de servicios e infla los prejuicios sociales. En cuanto a las garantías de derechos, se analizaron puntos como: estructura física, acceso a la educación, respeto a las individualidades de los adolescentes y acceso a servicios básicos de salud y asistencia. Se destaca la importancia de invertir en capacitación para profesionales, no solo desde el sistema socioeducativo, sino desde todas las políticas que deberían ayudar a los adolescentes a cumplir con las MSE.

Causas institucionais para cancelamento de cirurgias eletivas / Institutional causes for elective surgery cancellation / Causas institucionales para la cancelación de cirugías electivas

Objetivo: Analisar as produções científicas sobre cancelamento de cirurgias eletivas pelas causas institucionais. Método: Revisão integrativa da literatura, sistematizada pelo acrônimo Participante, Interesse e Contexto (PICo), de acordo com a estratégia PICo e procedimentos definidos pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca bibliográfica foi realizada em setembro de 2018 e atualizada em maio de 2020, nas bases de dados Sistema Online de Busca e Análise de Literatura Médica (MEDLINE)/PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Base de Dados em Enfermagem (BDEnf ) da Biblioteca Virtual em Saúde (BVS), Scopus (Elsevier) do Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e Biblioteca Eletrônica Científica Online (SciELO). Foram consideradas publicações de 2008 até 2020, nos idiomas português, inglês e espanhol. Resultados: Foram identificados, na busca bibliográfica, 920 estudos, sendo 263 duplicados, restando 657 para seleção. Ao final, foram incluídos 15 estudos na síntese. Conclusão: As causas institucionais identificadas foram o avanço de horário da cirurgia anterior, gerando a indisponibilidade de salas cirúrgicas, problemas estruturais, falta ou defeitos em equipamentos e recursos humanos insuficientes.

Objective: To analyze scientific productions about elective surgery cancellation due to institutional causes. Method: Integrative literature review, systematized by the acronym Problem, Interest, and Context (PICo), according to PICo strategy and procedures defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Bibliographic search was carried out in September 2018 and updated in May 2020 in the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE)/PubMed, Latin American and Caribbean Health Sciences Literature (Lilacs), Nursing Database (BDEnf ) of the Virtual Health Library (VHL), Scopus (Elsevier) of the Periodical Portal of the Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior ­ CAPES), and Scientific Electronic Library Online (SciELO). Publications from 2008 to 2020 in Portuguese, English, and Spanish were retrieved. Results: We found 920 studies in the bibliographic search, 263 of them were duplicates, and 657 remained for selection. In the end, 15 studies were included in the review. Conclusion: The institutional causes identified were delay in the previous surgery, leading to unavailability of operating rooms, structural problems, lack of or defects in equipment, and insufficient human resources.

Objetivo: Analizar producciones científicas sobre la cancelación de cirugías electivas por causas institucionales. Método: Revisión bibliográfica integral, sistematizada por el acrónimo Participante, Interés y Contexto (PICo), de acuerdo con la estrategia y los procedimientos PICo definidos por el Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). La búsqueda bibliográfica se realizó en septiembre de 2018 y se actualizó en mayo de 2020, en las bases de datos MEDLINE/Pubmed, LILACS y BDEnf de la Biblioteca Virtual en Salud, SCOPUS (Elsevier) del Portal de revistas Capes y SciELO. Consideró publicaciones de 2008 a 2020, en portugués, inglés y español. Resultados: En la búsqueda bibliográfica, se identificaron 920 estudios, 263 de los cuales se duplicaron, dejando 657 para la selección. Al final, se incluyeron 15 estudios en la síntesis. Conclusión: Las causas institucionales identificadas fueron el tiempo de avance de la cirugía previa, generando la falta de disponibilidad de quirófanos, problemas estructurales, falta o defectos en los equipos y recursos humanos insuficientes.

X-ray Spectroscopy Fostering the Understanding of Foliar Uptake and Transport of Mn by Soybean (Glycine max L. Merril): Kinetics, Chemical Speciation, and Effects of Glyphosate.

Increasing the yield of soybean is a challenge to humankind dependent on several management practices, such as fertilizing and weed control. While glyphosate contributes to controlling weeds, it can interfere with spray mixture stability and, supposedly, complex with micronutrients within the plant tissue. This study investigated the effects of glyphosate on soybean foliar uptake and transport of Mn supplied as MnSO4, MnHPO3, Mn-ethylenediamine tetraacetic acid (EDTA), and MnCO3. These fertilizers induced ultrastructural changes in the leaf cuticle, regardless of the glyphosate mixture. Except for MnCO3, all tested sources increased the Mn content in the petiole. The mixture of glyphosate impaired Mn transport from MnSO4 and MnHPO3, but no evidence of Mn-glyphosate complexation within the plant was found. Manganese is rather transported in a similar chemical environment regardless of the source, except for Mn-EDTA, which was absorbed and transported in its pristine form. Interferences of glyphosate seem to be related to complexations in the tank mixture rather than affecting nutrients' metabolism.

In Vivo Evaluation of Zn Foliar Uptake and Transport in Soybean Using X-ray Absorption and Fluorescence Spectroscopy.

Understanding the mechanisms of absorption and transport of foliar nutrition is a key step towards the development of advanced fertilization methods. This study employed X-ray fluorescence (XRF) and X-ray absorption near edge spectroscopy (XANES) to trace the in vivo absorption and transport of ZnO and ZnSO4(aq) to soybean leaves (Glycine max). XRF maps monitored over 48 h showed a shape change of the dried ZnSO4(aq) droplet, indicating Zn2+ absorption. Conversely, these maps did not show short movement of Zn from ZnO. XRF measurements on petioles of leaves that received Zn2+ treatments clarified that the Zn absorption and transport in the form of ZnSO4(aq) was faster that of ZnO. Solubility was the major factor driving ZnSO4(aq) absorption. XANES speciation showed that in planta Zn is transported coordinated with organic acids. Because plants demand Zn during their entire lifecycle, the utilization of sources with different solubilities can increase Zn use efficiency.

Higher IL-6 peri-tumoural expression is associated with gastro-intestinal neuroendocrine tumour progression.

An association of well-differentiated gastroenteropancreatic neuroendocrine tumours (WD GEP NETs) with metabolic syndrome (MetS) was recently described. Yet no molecular mechanisms linking the two conditions are known. This study's aim was to identify putative molecular signatures linking WD GEP NETs and MetS to gain further insight into potential mechanisms for this association. Patients with WD GEP NETs (n=39), pancreatic (panNET) and gastro-intestinal (GI-NET), were clinically evaluated for presence of MetS. WD GEP NETs immunohistochemistry staining for Forkhead box protein M1 (FOXM1), insulin growth factor 1 receptor (IGF1R), Ki-67 and interleukin 6 (IL-6) was performed and quantified by computerised morphometric analysis. FOXM1, Ki-67, IGF1R or IL-6 expression in WD GEP NETs was not influenced by the presence of MetS. IL-6 peritumoural expression was higher in GI-NETs of patients with low HDL cholesterol (0.018±0.005% vs 0.030±0.005%, p=0.02). In GI-NETs, a higher IL-6 expression was also associated with disease progression (0.026±0.004% vs 0.016±0.002%, p=0.03). In WD GEP-NETs, MetS did not influence FOXM1, IGF1R and IL-6 expression. In GI-NETs, IL-6 expression was influenced by the MetS feature low HDL, and positively associated with disease progression. These data suggest that local and systemic inflammatory status can potentially modulate GI-NET behaviour.

The challenge of diagnosing a malignancy metastatic to the ovary: clinicopathological characteristics vary and morphology can be different from that of the corresponding primary tumor.

An accurate diagnosis of metastases to the ovary is essential for adequate patient management. The aim of this retrospective study was to characterize clinicopathological features of metastatic malignancies that presented as an ovarian mass and compare them with their corresponding primary tumors. We reviewed clinical files and histological material of 120 patients with metastases to the ovary, diagnosed in our center between 2000 and 2014. Metastases were diagnosed before (18 %), synchronously (33 %), or after (49 %) the primary tumor was identified; 25 % were single, 40 % were unilateral; 47 % were ≥13 cm. Most originated from the gastrointestinal tract (73 %), followed by breast (13 %), and female reproductive organs (10 %). Gross features varied with primary tumor site. Metastases from gastrointestinal malignancies were significantly larger and frequently showed necrosis. Metastases to the appendix were cystic (94 %), and almost all metastases to the stomach (96 %) and breast (87 %) were solid. The predominant histological pattern was discordant in 44 % cases, mostly due to cystic changes in ovarian metastases which were observed across several histological types. Other metastases showed a predominant histological pattern which was present only focally in the primary tumor. Metastases showed significantly more edema, necrosis, and hemorrhage, but less lymphovascular invasion and inflammatory infiltrate than the corresponding primary tumors. Metastases to the ovary present highly variable clinicopathological features which frequently differ from those of the corresponding primary tumor. A metastasis should always be considered in the differential diagnosis of an ovarian mass. All clinical, imaging, macroscopic, and histological aspects must be taken into account to establish a correct diagnosis which is essential for adequate treatment.

A formação ética do fisioterapeuta / Physical therapist ethical formation

No passado, havia estreita relação entre a filosofia e os indivíduos que se dedicavam à área de saúde. O avanço tecnológico exigiu ritmo por parte dos profisisonais para dar conta de acompanhar as novidades. Houve o surgimento das especialidades e paralelamente o desinteresse pelas disciplinas voltadas para orientação da conduta. Os próprios currículos já não prestigiam tais disciplinas. Observa-se que a construção do sujeito ético ocorre por meio da educação. Se esta deixa de cumprir este papel, o prejuízo é percebido na própria sociedade, principalmente na área de saúde, onde se lida com angústias e sofrimento. Muito se tem falado em humanização na assistência à saúde, muitos investimentos são feitos em tecnologia, mas o investimento que mais benefícios oferece consiste em formar profissionais éticos

In past there was narrow relation between Philosophy and individuals who was dedicated to health. The technological advance demanded rhythm sped up of the professionals to follow the new features. It had the sprouting of the specialties and parallel the disinterest for discipline that toward orientation of the behavior. The proper curriculum already do not values such disciplines. The construction of ethical citizen occurs by education. If this leaves this paper the damage is perceived in the society, mainly in the health area where if it deals with anguishes and suffering. Much has been said about humanization in health assistance, many investments is done in technology, but the investment that more benefits it offers consists of forming ethical professionals.