Antiphospholipid Syndrome and Patent Foramen Ovale: A Case Report and Literature Review.

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial, venous, or microvascular thrombosis, pregnancy morbidity, or non-thrombotic manifestations in patients with persistent antiphospholipid antibodies (aPL). Catastrophic APS is a rare and severe form of APS that is defined by the presence of multiple vascular occlusive events. When a patent foramen ovale (PFO) is present, paradoxical embolization can occur, simultaneously leading to arterial and venous thrombosis. We present a complex clinical case of a patient who presented with multiple arterial and venous thrombotic events with positive aPL. The suspicion of catastrophic APS was removed when a PFO was found in a transesophageal echocardiogram, justifying paradoxical embolization. This emphasizes the importance of searching for PFO in patients with APS presenting with simultaneous venous and arterial thrombosis for management and prognosis purposes.

Epigenetic reprogramming as a key to reverse ageing and increase longevity.

The pursuit for the fountain of youth has long been a fascination amongst scientists and humanity. Ageing is broadly characterized by a cellular decline with increased susceptibility to age-related diseases, being intimately associated with epigenetic modifications. Recently, reprogramming-induced rejuvenation strategies have begun to greatly alter longevity research not only to tackle age-related defects but also to possibly reverse the cellular ageing process. Hence, in this review, we highlight the major epigenetic changes during ageing and the state-of-art of the current emerging epigenetic reprogramming strategies leveraging on transcription factors. Notably, partial reprogramming enables the resetting of the ageing clock without erasing cellular identity. Promising chemical-based rejuvenation strategies harnessing small molecules, including DNA methyltransferase and histone deacetylase inhibitors are also discussed. Moreover, in parallel to longevity interventions, the foundations of epigenetic clocks for accurate ageing assessment and evaluation of reprogramming approaches are briefly presented. Going further, with such scientific breakthroughs, we are witnessing a rise in the longevity biotech industry aiming to extend the health span and ideally achieve human rejuvenation one day. In this context, we overview the main scenarios proposed for the future of the socio-economic and ethical challenges associated with such an emerging field. Ultimately, this review aims to inspire future research on interventions that promote healthy ageing for all.

A Rare Case of Autoimmune Enteropathy Associated with Autoimmune Hepatitis.

A 74-year-old woman was admitted for weight loss, abdominal pain and diarrhea for a year. Blood tests showed elevated transaminases, cholestasis and hyperbilirubinemia. Capsule endoscopy revealed extensively scattered lymphangiectasias, shortened villi and erosions in the jejunum and ileum. The histological examination of the small bowel mucosa biopsies evidenced severe mucosal atrophy and crypt hyperplasia, without significant intraepithelial lymphocytosis. The clinical picture, lack of response to a gluten-free diet and endoscopic and histopathologic findings were compatible with autoimmune enteropathy. Simultaneously, autoimmune hepatitis was also diagnosed. The patient showed significant improvement after starting treatment with prednisolone and azathioprine. To our knowledge, this is the first case of autoimmune enteropathy diagnosed simultaneously with autoimmune hepatitis.

Participation in night time activities in the genesis of depression in public school teachers from the State of Pernambuco, Brazil / Participação eventual de atividdes noturnas na gênese da depressão em professoores da rede pública do Estado de Pernambuco, Brasil

Teachers often undertake nighttime work involving exam corrections, projects and devising lesson plans in theirhomes. Many present excessive daytime sleepiness (EDS) and depression. Objective: The objective of this study was toevaluate EDS and depression in teachers from public schools. Methods: 201 female teachers were evaluated in the districtof Quipapá/PE, Brazil. Among the study sample, 38 working 1 shift (CONTROL 1), 40 working 2 shifts (CONTROL 2) and123 working 3 shifts (WTeachers-3T). The subjects were submitted to evaluation by the Epworth Sleepiness Scale and Beck Depression Inventory (BDI).The EDS data were analyzed by the Kruskal-Wallis test with Dunns multiple comparison, p<0.05and expressed in MEDIAN (MINIMUM - MAXIMUM) whereas the depression data were analyzed by the Chi-square test,with p<0.05, expressed in percentage. Results: WTeachers-3T presented excessive daytime sleepiness and higher ratesof mild (24%) and moderate (37%) depression compared to controls - Control 1: mild (8%) and moderate (11%) - Control2: mild (5%) and moderate (15%). Conclusion: This study found that teachers in the Quipapá municipality of Penambucostate working three shifts showed excessive daytime sleepiness and a higher percentage of mild and moderate depression compared to teachers working only one (1) or two (2) shifts.

Professores têm trabalhado muito no período noturno com correções de provas, trabalhos e elaborando planejamento de ensino em suas casas. Muitos estão apresentando sonolência excessiva diurna (SED) e depressão.Objetivo: O objetivo deste trabalho foi avaliar sonolência excessiva diurna e depressão em professoras da rede pública. Métodos: Foram avaliadas 201 professoras do município de Quipapá/PE, Brasil, sendo 38 que trabalham em 1 turno(CONTROLE 1), 40 que trabalham em 2 turnos (CONTROLE 2) e 123 que trabalham em 3 turnos (PROFas-3T). Os sujeitos foram avaliados pela Escala de Sonolência de Epworth e pelo Inventário de Depressão de Beck. Os dados referentes à SE foram analisados pelo teste Kruskal-Wallis com comparação múltipla em Dunn, p<0,05 e expressos em MEDIANA(MÍNIMO - MÁXIMO) e os dados referentes à depressão foram analisados pelo teste qui-quadrado, com p<0,05, expressos em percentuais. Resultados: PROFas-3T apresentam sonolência excessiva e apresentam maior percentual de depressão leve (24%) e moderada (37%) comparadas a seus controles - CONTROLE 1: leve (8%) e moderada (11%) -CONTROLE2: leve (5%) e moderada (15%). Conclusão: Este estudo observou que professoras da rede municipal de Quipapá/PE que trabalham em 3 turnos apresentam sonolência excessiva e maior percentual de depressão leve e moderada comparadasàs professoras que trabalham em 1 (um) ou em 2 (dois) turnos.

Participation in nighttime activities in the genesis of depression in public school teachers from the State of Pernambuco, Brazil.

Teachers often undertake nighttime work involving exam corrections, projects and devising lesson plans in their homes. Many present excessive daytime sleepiness (EDS) and depression. OBJECTIVE: The objective of this study was to evaluate EDS and depression in teachers from public schools. METHODS: 201 female teachers were evaluated in the district of Quipapá/PE, Brazil. Among the study sample, 38 working 1 shift (CONTROL 1), 40 working 2 shifts (CONTROL 2) and 123 working 3 shifts (WTeachers-3T). The subjects were submitted to evaluation by the Epworth Sleepiness Scale and Beck Depression Inventory (BDI).The EDS data were analyzed by the Kruskal-Wallis test with Dunn's multiple comparison, p<0.05and expressed in MEDIAN (MINIMUM - MAXIMUM) whereas the depression data were analyzed by the Chi-square test, with p<0.05, expressed in percentage. RESULTS: WTeachers-3T presented excessive daytime sleepiness and higher rates of mild (24%) and moderate (37%) depression compared to controls - Control 1: mild (8%) and moderate (11%) - Control 2: mild (5%) and moderate (15%). CONCLUSION: This study found that teachers in the Quipapá municipality of Penambuco state working three shifts showed excessive daytime sleepiness and a higher percentage of mild and moderate depression compared to teachers working only one (1) or two (2) shifts.

Professores têm trabalhado muito no período noturno com correções de provas, trabalhos e elaborando planejamento de ensino em suas casas. Muitos estão apresentando sonolência excessiva diurna (SED) e depressão. OBJETIVO: O objetivo deste trabalho foi avaliar sonolência excessiva diurna e depressão em professoras da rede pública. MÉTODOS: Foram avaliadas 201 professoras do município de Quipapá/PE, Brasil, sendo 38 que trabalham em 1 turno (CONTROLE 1), 40 que trabalham em 2 turnos (CONTROLE 2) e 123 que trabalham em 3 turnos (PROFas-3T). Os sujeitos foram avaliados pela Escala de Sonolência de Epworth e pelo Inventário de Depressão de Beck. Os dados referentes à SE foram analisados pelo teste Kruskal-Wallis com comparação múltipla em Dunn, p<0,05 e expressos em MEDIANA (MÍNIMO - MÁXIMO) e os dados referentes à depressão foram analisados pelo teste qui-quadrado, com p<0,05, expressos em percentuais. RESULTADOS: PROFas-3T apresentam sonolência excessiva e apresentam maior percentual de depressão leve (24%) e moderada (37%) comparadas a seus controles - CONTROLE 1: leve (8%) e moderada (11%) - CONTROLE 2: leve (5%) e moderada (15%). CONCLUSÃO: Este estudo observou que professoras da rede municipal de Quipapá/PE que trabalham em 3 turnos apresentam sonolência excessiva e maior percentual de depressão leve e moderada comparadas às professoras que trabalham em 1 (um) ou em 2 (dois) turnos.