RESUMO
The impact of childhood experiences on the development of psychopathology is well established in the literature. Few studies, however, have assessed parental bonding during childhood as a predictor of response to anxiety disorders treatment. The aim of the study was to examine whether emotional memories of childhood parenting could predict short-term and long-term outcome in three different interventions for patients with generalized anxiety disorder (GAD): mindfulness-based intervention (Body in Mind Training [BMT]), fluoxetine (FLX), and an active control group (quality of life [QoL]). A total of 124 participants from a randomized controlled trial for GAD treatment were evaluated pre- and post-treatment and after 18 months. Patients were assessed for the severity of GAD symptoms (GAD-7, PSWQ, and DERS), early memories of warmth and safeness (EMWSS), and recall of perceived threat and subordination/submission in childhood (ELES). Negative childhood memories predicted a greater reduction in anxiety symptoms on BMT treatment compared to FLX and QoL, whereas positive childhood memories predicted more symptomatic improvement in the QoL group. Our findings suggest that individuals with GAD who have early memories of subordination and threat appear to benefit more from interventions that focus on developing emotion-regulation strategies and enhancing self-compassion, such as mindfulness-based interventions.
Assuntos
Emoções , Qualidade de Vida , Humanos , Adulto , Transtornos de Ansiedade/terapia , Ansiedade , Rememoração MentalRESUMO
The virus responsible for COVID-19 is designated "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2), a highly transmissible and pathogenic coronavirus. Although people of all ages are susceptible to SARS-CoV-2 infection, clinical manifestations may vary with age. The response of neonates to SARS-CoV-2 infection or exposure differs from that of children and adults. Encephalitis due to viral infections in the central nervous system (CNS) and childhood multisystem inflammatory syndrome (MIS-C) are some of the possible neonatal consequences of SARS-CoV-2 infection. This review aims to verify possible neonatal neurological outcomes after SARS-CoV-2 infection. Overall, the cellular and molecular basis of the neurological sequelae of SARS-CoV-2 in neonates remains unclear, and attempts to elucidate the pathophysiology of COVID-19 involve a comparison with the mechanism of other viral diseases. There are a considerable number of case reports in the literature exploring neurological outcomes in the neonatal period. In this review, we present possible effects of SARS-CoV-2 in neonates, emphasizing the importance of monitoring this group. The mechanisms of SARS-CoV-2 entry into the CNS have not yet been fully elucidated, and the potential severity of SARS-CoV-2 infection in neonates, as well as the possible short- and long-term neurological sequelae, remain unclear.
Assuntos
COVID-19 , COVID-19/complicações , Criança , Humanos , Recém-Nascido , SARS-CoV-2 , Síndrome de Resposta Inflamatória SistêmicaRESUMO
BACKGROUND: The term sepsis is used to designate a systemic condition of infection and inflammation associated with hemodynamic changes that result in organic dysfunction. Gestational sepsis can impair the development of the central nervous system and may promote permanent behavior alterations in the offspring. The aim of our work was to evaluate the effects of maternal sepsis on inflammatory cytokine levels and synaptic proteins in the hippocampus, neocortex, frontal cortex, and cerebellum of neonatal, young, and adult mice. Additionally, we analyzed the motor development, behavioral features, and cognitive impairments in neonatal, young and adult offspring. METHODS: Pregnant mice at the 14th embryonic day (E14) were intratracheally instilled with saline 0.9% solution (control group) or Klebsiella spp. (3 × 108 CFU) (sepsis group) and started on meropenem after 5 h. The offspring was sacrificed at postnatal day (P) 2, P8, P30, and P60 and samples of liver, lung, and brain were collected for TNF-α, IL-1ß, and IL-6 measurements by ELISA. Synaptophysin, PSD95, and ß-tubulin levels were analyzed by Western blot. Motor tests were performed at all analyzed ages and behavioral assessments were performed in offspring at P30 and P60. RESULTS: Gestational sepsis induces a systemic pro-inflammatory response in neonates at P2 and P8 characterized by an increase in cytokine levels. Maternal sepsis induced systemic downregulation of pro-inflammatory cytokines, while in the hippocampus, neocortex, frontal cortex, and cerebellum an inflammatory response was detected. These changes in the brain immunity were accompanied by a reduction of synaptophysin and PSD95 levels in the hippocampus, neocortex, frontal cortex, and cerebellum, in all ages. Behavioral tests demonstrated motor impairment in neonates, and depressive-like behavior, fear-conditioned memory, and learning impairments in animals at P30 and P60, while spatial memory abilities were affected only at P60, indicating that gestational sepsis not only induces an inflammatory response in neonatal mouse brains, but also affects neurodevelopment, and leads to a plethora of behavioral alterations and cognitive impairments in the offspring. CONCLUSION: These data suggest that maternal sepsis may be causatively related to the development of depression, learning, and memory impairments in the litter.
Assuntos
Encéfalo/imunologia , Efeitos Tardios da Exposição Pré-Natal/imunologia , Sepse/imunologia , Animais , Comportamento Animal , Encéfalo/metabolismo , Disfunção Cognitiva/etiologia , Feminino , Inflamação , Camundongos , Atividade Motora/fisiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Sepse/complicações , Sinapses/metabolismoRESUMO
BACKGROUND: This report presents the Brazilian experience on the elaboration of a matrix of children's environmental health indicators to the Brazilian Health Surveillance System. This experience was part of a project with the financial support of the Ministry of Health of Brazil to develop appropriate indicators for identification, measuring, and monitoring of the environmental risk factors to the children's health. METHODS: The methodology adopted for the development of the matrix of indicators of children's environmental health to Brazil comprised 3 steps. In the first step, the main causes of morbidity and mortality in the Brazilian population, aged 0-14 years, were identified, according to the data available from the Ministry of Health. The second step consisted of the identification of the Brazilian public-access information systems, with available official data regarding environmental, health, and socioeconomic conditions. In the third step, a preliminary matrix was elaborated. Correlation analyses were done to determine the indicators that would constitute the final matrix. FINDINGS: The selected indicators allowed the identification and surveillance of cancer, injuries, adverse birth outcomes, diarrheic and respiratory diseases, associated with environmental risk factors, in the Brazilian child population. The existing Brazilian official information systems provided data with the necessary quality for the construction of children's environmental health indicators. Nevertheless, some official systems on health information presented limitations related to the data availability over the course of time and timeliness of data capture. Concerning the environmental information, the major limitation was accessibility. CONCLUSIONS: A matrix of indicators of children's environmental health to Brazil can come to contribute to the implementation of a surveillance system of children's exposure to environmental contaminants in Brazil.
Assuntos
Poluentes Atmosféricos/efeitos adversos , Exposição Ambiental/efeitos adversos , Saúde Ambiental , Brasil , Criança , Meio Ambiente , Monitoramento Ambiental , Nível de Saúde , Humanos , Fatores de RiscoRESUMO
OBJECTIVES: The aim of this study was to analyze the expression of CD24, CD44, CD133, ALDH1, CD29 (integrin-ß1), and Ki-67 in squamous cell carcinoma of the oral cavity and oropharynx. STUDY DESIGN: Fifty-two tumors and 21 metastatic lymph nodes were evaluated by using immunohistochemistry. RESULTS: Seven of 52 cases (13.5%) showed positive cytoplasmic staining of aldehyde dehydrogenase 1; integrin-ß1 was expressed in 45 of 50 cases (90%); 30 of 52 cases (57.7%) had positive membranous staining of CD44; CD24 was expressed in 44 of 50 cases (88%); and three of 52 cases (5.8%) stained positively for membranous CD133. Median proliferation rate, measured by Ki-67, was 37.1% for tumors. Five-year cancer-specific survival rates for the CD44-negative and CD44-positive groups were 74% and 38%, respectively, although this difference did not reach statistical significance (P = .052). CONCLUSIONS: Our study demonstrated the expression of putative stem cell markers in squamous cell carcinoma of the oral cavity and oropharynx, with participation of CD44-positive cells in association with poor survival outcome.
Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/metabolismo , Neoplasias Bucais/metabolismo , Neoplasias Orofaríngeas/metabolismo , Células-Tronco/metabolismo , Antígeno AC133/metabolismo , Família Aldeído Desidrogenase 1 , Antígeno CD24/metabolismo , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Receptores de Hialuronatos/metabolismo , Imuno-Histoquímica , Integrina beta1/metabolismo , Isoenzimas/metabolismo , Antígeno Ki-67/metabolismo , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/patologia , Retinal Desidrogenase/metabolismo , Taxa de SobrevidaRESUMO
BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is primarily a locoregional disease in which the cervical lymph nodes are the chief site of metastasis. The purpose of this study was to examine the relationship between lymphangiogenesis and clinicopathological aspects of HNSCC and its metastasis. METHODS: Fifty-two patients with HNSCC and metastatic lymph nodes from 21 of these subjects were analyzed by immunohistochemistry. RESULTS: The HNSCC samples were predominantly negative for vascular endothelial growth factor (VEGF)-C, VEGF-D, and vascular endothelial growth factor receptor (VEGFR)3. There was an association between the density of lymph vessels (measured by D2-40 staining) in the lymph nodes and advanced-stage tumors. There was no link between the expression of these proteins and survival rates. CONCLUSION: Although lymphatic spread is a significant event in the progression of HNSCC, the expression of VEGF-C, VEGF-D, and VEGFR3 does not correlate with clinicopathological characteristics, suggesting that other signaling pathways mediate lymphangiogenesis in HNSCC.