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BACKGROUND: In response to inflammation and other stressors, tryptophan is catalyzed by Tryptophan 2,3-Dioxygenase (TDO), which leads to activation of the kynurenine pathway. Sepsis is a serious condition in which the body responds improperly to an infection, and the brain is the inflammation target in this condition. OBJECTIVE: This study aimed to determine if the induction of TDO contributes to the permeability of the Blood-Brain Barrier (BBB), mortality, neuroinflammation, oxidative stress, and mitochondrial dysfunction, besides long-term behavioral alterations in a preclinical model of sepsis. METHODS: Male Wistar rats with two months of age were submitted to the sepsis model using Cecal Ligation and Perforation (CLP). The rats received allopurinol (Allo, 20 mg/kg, gavage), a TDO inhibitor, or a vehicle once a day for seven days. RESULTS: Sepsis induction increased BBB permeability, IL-6 level, neutrophil infiltrate, nitric oxide formation, and oxidative stress, resulting in energy impairment in 24h after CLP and Allo administration restored these parameters. Regarding memory, Allo restored short-term memory impairment and decreased depressive behavior. However, no change in survival rate was verified. CONCLUSION: In summary, TDO inhibition effectively prevented depressive behavior and memory impairment 10 days after CLP by reducing acute BBB permeability, neuroinflammation, oxidative stress, and mitochondrial alteration.
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Sepsis is a life-threatening condition induced by a deregulated host response to infection. Post-sepsis injury includes long-term cognitive impairment, whose neurobiological mechanisms and effective treatment remain unknown. The present study was designed to determine the potential effects of cannabidiol (CBD) in a sepsis-associated encephalopathy (SAE) model and explore if peroxisome proliferator activated receptor gamma (PPARγ) is the putative mechanism underpinning the beneficial effects. SAE was induced in Wistar rats by cecal ligation and puncture (CLP) or sham (control). CLP rats received vehicle, CBD (10 mg/kg), PPARγ inhibitor (GW9662 - 1 mg/kg), or GW9662 (1 mg/kg) + CBD (10 mg/kg) intraperitoneally for ten days. During this period, the survival rate was recorded, and at the end of 10 days, a memory test was performed, and the prefrontal cortex and hippocampus were removed to verify brain-derived neurotrophic factor (BDNF), cytokines (IL-1ß, IL-6 and IL-10), myeloperoxidase activity, nitrite nitrate concentration, and lipid and protein carbonylation and catalase activity. Septic rats presented cognitive decline and an increase in mortality following CLP. Only CBD alone improved the cognitive impairment, which was accompanied by restoration of BDNF, reduced neuroinflammation, and oxidative stress, mainly in the hippocampus. This study shows that CLP induces an increase in brain damage and CBD has neuroprotective effects on memory impairment and neurotrophins, as well as against neuroinflammation and oxidative stress, and is mediated by PPARγ activation.
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Anilidas , Canabidiol , Disfunção Cognitiva , Encefalopatia Associada a Sepse , Sepse , Ratos , Animais , PPAR gama/metabolismo , Canabidiol/farmacologia , Canabidiol/metabolismo , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Ratos Wistar , Doenças Neuroinflamatórias , Encéfalo/metabolismo , Encefalopatia Associada a Sepse/tratamento farmacológico , Encefalopatia Associada a Sepse/metabolismo , Sepse/complicações , Sepse/tratamento farmacológico , Sepse/metabolismo , Antioxidantes/farmacologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/complicações , Modelos Animais de DoençasRESUMO
BACKGROUND: Due to social and geographical isolation, indigenous people are more vulnerable to adverse conditions; however, there is a lack of data on the epidemics' impact on these populations. Thus, this article's objective was to describe the epidemiological situation of COVID-19 in indigenous communities in Brazil. METHODS: This descriptive observational study was carried out in indigenous communities in the municipality of Amaturá (Amazonas, Brazil). Individuals from the Alto Rio Solimões Special Indigenous Sanitary District (DSEI) who met the Sars-Cov-2 infection case definitions during the period between January and August 2020 were included. For case notification, the definitions adopted by the Ministry of Health of Brazil and by the Special Secretariat for Indigenous Health were considered. RESULTS: Out of the entire population served by the Alto Rio Solimões DSEI (n = 2890), 109 indigenous people were suspected of having been infected with Sars-Cov-R during the study period; a total of 89 cases were actually confirmed (rate: 3.08 cases/100,000 inhabitants). Most patients diagnosed with COVID-19 were female (56.2%), with a mean age of 32.4 (± 23.6) years. Predominant symptoms were fever (76.4%), dry cough (64%), and headache (60.7%). Complications occurred in 7.9% of the patients; no deaths were reported. CONCLUSION: These results enhance the observation that indigenous populations, even if relatively isolated, are exposed to COVID-19. The disease cases assessed showed a favorable evolution, which does not mean reducing the need for caring of this population.
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COVID-19 , Adulto , Brasil/epidemiologia , Cidades , Feminino , Humanos , Povos Indígenas , Masculino , SARS-CoV-2RESUMO
ABSTRACT Objective: To examine the rates of psychiatric hospitalization and the average length of stay, in Brazil, from 2009 to 2019, according to sociodemographic variables and character of the hospitalization (elective or urgency). Methods: This is an ecological study, with data collected from the Hospital Information System of the Unified Health System (SIH/SUS). Hospital admission rates were described according to diagnosis, sex, and age group. Percentage variation and rate ratios were calculated. To evaluate the time series, the data were submitted to linear regression analysis. Results: The rate of hospitalization for mental disorders decreased from 14.2/10,000 in 2009 to 11.2 in 2019, with the most significant variation occurring between mental and behavioral disorders due to alcohol use. The men had about twice as many episodes as the women in all the years evaluated. Higher rates were found in the age group of 30 and 59 years. The length of stay also decreased in the period. Besides, the urgency character presented almost 82% of the total hospitalizations. Conclusions: There was a reduction in hospital admissions for mental disorders in the analyzed period, demonstrating the relevance of mental health care changes resulting from the Psychiatric Reform.
RESUMO Objetivo: Examinar as taxas de hospitalização psiquiátrica e o tempo médio dessas internações, no Sistema Único de Saúde (SUS) do Brasil, de 2009 a 2019, segundo variáveis sociodemográficas e caráter da internação (eletiva ou urgência). Métodos: Trata-se de um estudo ecológico, com dados coletados do Sistema de Informações Hospitalares (SIH/SUS). Foram descritas as taxas de internação hospitalar conforme diagnóstico, sexo e faixa etária. Calcularam-se a variação percentual e a razão das taxas. Para avaliação da série temporal, os dados foram submetidos à análise de regressão linear. Resultados: A taxa de internação hospitalar por transtornos mentais reduziu de 14,2/10.000 em 2009 para 11,2 em 2019, tendo a maior variação ocorrido entre os transtornos mentais e comportamentais devidos ao uso de álcool. O sexo masculino apresentou cerca de duas vezes mais episódios que o sexo feminino, em todos os anos avaliados. Maiores taxas foram verificadas na faixa etária de 30 e 59 anos. O tempo de internação também apresentou redução no período. Além disso, o caráter de urgência apresentou quase 82% do total de internações. Conclusões: Houve redução das internações hospitalares por transtornos mentais no período analisado, demonstrando a relevância das mudanças na assistência em saúde mental advindas da Reforma Psiquiátrica.
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The intrauterine environment is infl uenced by several factors, genetic or environmental, which are essential in understanding the pathophysiological mechanisms of some diseases. In this study, the aim was to investigate the impact of prenatal lipopolysaccharide exposure on the development of rats. Fifty pregnant rats received intraperitoneal administration of lipopolysaccharide (100 µg/kg), or saline at the same dose, on the 9.5th day of pregnancy. The offspring of these rats were analyzed for indicators of brain and somatic development and maturation of physical characteristics. Refl ex ontogenesis was also analyzed by vibrissae placement, negative geotaxis, palmar grasp, precipice aversion, decubitus recovery and acceleration reaction. Administration of lipopolysaccharide on the 9.5th gestational day caused delayed opening of the auditory pavilion, reduction in the length of the tail, body, cranial axes, and body weight. Thus, maternal infections can interfere in the intrauterine environment, impairing functional and structural aspects of the central nervous system, as well as the maturation of physical characteristics.
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Lipopolissacarídeos , Efeitos Tardios da Exposição Pré-Natal , Fatores Etários , Animais , Animais Recém-Nascidos , Comportamento Animal , Peso Corporal , Feminino , Lipopolissacarídeos/toxicidade , Gravidez , Ratos , CaudaRESUMO
Introdução: A internet tem se mostrado como um meio de comunicação cada vez mais acessível a toda a população. Seu uso pode gerar benefícios e malefícios na saúde dos seus usuários, principalmente nos jovens, que são a grande maioria dos usuários da internet. Sendo assim, o presente estudo pretende avaliar uma possível associação entre a dependência de internet e sintomas depressivos nos estudantes de Medicina de Tubarão, Santa Catarina. Métodos: Estudo do tipo transversal no qual foram entrevistados 301 acadêmicos de Medicina da Universidade do Sul de Santa Catarina (UNISUL) devidamente matriculados no período de Fevereiro a Julho de 2015. Foram respondidos três questionários auto administrados: Inventário de depressão de Beck (BDI-II), Questionário de Dependência de Internet (AIT) e um questionário com dados sociodemográficos e hábitos de vida. Resultados: Os alunos com dependência moderada a internet pelo questionário AIT apresentaram uma prevalência quatro vezes maior de depressão moderada/grave quando comparados 'aqueles com dependência leve/sem (RP:4,41; IC:95%: 2,24 a 18,42; p=0,0005). A associação entre dependência de internet e depressão também foi observada para os níveis leve, moderado ou grave. Conclusão: O estudo revelou que a dependência de internet apareceu como um fator associado à depressão. Esse fato foi estatisticamente relevante, principalmente, quando relacionada dependência moderada de internet com depressão moderada/grave.
Introduction: Worldwide, the internet has been a widely available mean of communication. Internet usage, however, can bring benefits and harm to its users, especially in the young, who are the majority of users. Therefore, this study intended to evaluate a possible association between internet addiction and depressive symptoms in medical students enrolled at a university in Tubarão, Santa Catarina. Methods: Cross-sectional study in which 301 medical students from Universidade do Sul de SC (UNISUL), properly enrolled in the period of February to July of 2015, were interviewed. Three self-administred questionnaires were answered: Beck Depression Inventory (BDI-II), Internet Addiction Test (IAT) and a questionnaire containing sociodemographic and lifestyle data. Results: Students with moderate internet addiction by the AIT questionnaire presented a prevalence four times higher of severe/moderate depression when compared to those with light/without addiction (RP:4,41; IC:95%: 2,24 a 18,42; p=0,0005). The association between internet addiction was also assessed for light, moderate or severe levels. Conclusion: The study showed that internet addicion appeared as a factor associated to depression. This fact was statistically relevant, mainly when moderate depression was related to moderate/severe depression.