Luciana Carvalho Fernandes

Depression Scores Associate With Chronotype and Social Jetlag in a Rural Population

In public health, mood disorders are among the most important mental impairments. Patients with depressive episodes exhibit daily mood variations, abnormal patterns in sleep-wake behavior, and in the daily rhythms of several endocrine-metabolic parameters. Although the relationship between the sleep/circadian processes and mood disorders is poorly understood, clock-related therapies, such as light therapy, sleep deprivation, and rigid sleep schedules, have been shown to be effective treatments. Several studies investigated the relationship between circadian phenotype (chronotype) and depression. These focused mainly on urban populations and assessed diurnal preferences (Morningness-Eveningness score) rather than the actual timing of sleep and activity. Here, we used the Beck Depression Inventory (BDI) in an essentially rural population (N = 4051), and investigated its relation to circadian phenotype (chronotype and social jetlag), assessed with the Munich Chronotype Questionnaire (MCTQ). In our study design, we (i) normalized both chronotype and BDI scores for age and sex (MSFsas and BDIas, respectively); (ii) calculated individual social jetlag (misalignment of the biological and social time); and (iii) investigated the relationship between circadian phenotypes and BDI scores in a population homogeneous in respect to culture, socioeconomic factors, and daily light exposure. A 15.65% (N = 634) of the participants showed mild to severe depressive BDI scores. Late chronotypes had a higher BDIas than intermediate and early types, which was independent of whether or not the participants were smokers. Both chronotype and BDIas correlated positively with social jetlag. BDIas was significantly higher in subjects with >2 h of social jetlag than in the rest of the population—again independent of smoking status. We also compared chronotype and social jetlag distributions between BDI categories (no symptoms, minimal symptoms, and mild to severe symptoms of depression) separately for men and women and for four age groups; specifically in the age group 31–40 yrs, subjects with mild to severe BDI scores were significantly later chronotypes and suffered from higher social jetlag. Our results indicate that misalignment of circadian and social time may be a risk factor for developing depression, especially in 31- to 40-yr-olds. These relationships should be further investigated in longitudinal studies to reveal if reduction of social jetlag should be part of prevention strategies. (Author correspondence: karla.allebrandt@med.uni-muenchen.de)

Avaliação do impacto da exposição a agrotóxicos sobre a saúde de população rural: Vale do Taquari (RS, Brasil)

The scope of this cross-sectional study was to assess a possible link between contact with pesticides and the prevalence of chronic disease in the rural population in the south of Brazil. Three municipalities were randomly chosen. The sample selected was recruited over three months (2005) and was composed of 298 subjects of both sexes, between 18 and 65 years of age, who frequented public or private pharmacies for the purchase of medication. Data obtained by means of structured interviews revealed that 68.4% of those interviewed worked in rural activities, and 74.8% of these were members of families working in agriculture with contact with pesticides. The average age was 51+16.5 years of age for the interviewees with contact with pesticides and 50+17.9 years for those without contact. The sample was composed of 36.2% of men, and 57.7% of the individuals had more than four years of education. Direct or indirect contact with pesticides was associated with the report of several diseases, with neurological and oral diseases being the most prevalent. There was a link with painful conditions and individuals with contact with pesticides reported twice as many diseases. The data corroborate the literature and draw attention to the need for promoting measures to protect the health of the rural population.

Fentanyl administration in infant rats produces long-term behavioral responses.

Considering the importance of studies in animal models that are focused on systems involved in pain mechanisms, this investigation aimed to evaluate the effects of pharmacological treatments on the behavioral responses of younger animals. To this end, we evaluated the effect of an acute dose of fentanyl (FEN) or S(+)‐ketamine (KET) at postnatal day 14 (P14) upon behavioral responses in the short‐ (P14), medium‐ (P30) and long‐term (P60) using the open field (OF), elevated plus‐maze (EPM) and formalin tests (FT) and tail‐flick latency. Fourteen‐day‐old male Wistar rats were divided into three groups: control (CT), fentanyl (FEN) and S(+)ketamine (KET) groups for statistical analysis, it was performed two‐way ANOVA followed by Bonferroni. We found that, regardless of the test performed (OF or EPM), between‐group differences occurred over time in all behaviors analyzed, including in the second phase of FT. In addition, EPM showed significant differences in behavioral responses related to acute administration (at P14) of fentanyl or S(+)‐ketamine, in behaviors such as number of entries in open and closed arms, time spent in open and closed arms, and number of head‐dipping. In relation to nociceptive response, the FEN group exhibited a decrease in the first phase of FT. These results indicate that unique administration of fentanyl or S(+)ketamine in an early period of life (P14) can promote changes in behavioral responses. In addition, our findings highlight the importance of extending the investigation of the effect of drug administration in young rats into adulthood.

Papel do agente comunitário de saúde no controle do estoque domiciliar de medicamentos em comunidades atendidas pela estratégia de saúde da família

The scope of this study was to investigate the in-house stock of medication in communities served by the Family Health Strategy (FHS) in a city located in the south of Brazil. A sample of 10% of households in five FHS areas was studied. Data were collected by Community Healthcare Workers using the adapted Fernandes questionnaire (2000). The mean age of the interviewees was 42 years and of the residents was 16 years, 51% of which were female. Low income (1 to 3 minimum wages) was observed (69.1%), and low education levels (0 to 4 years of study) (42%). Of the households visited 98.7% had at least one medication in stock. In 533 of the storage places located, 43.5% of such places were exposed to heat, 39.6% were exposed to humidity and 16.51% to light. Of the 2,717 medicines found, 6.9% were past the validity date, 35.3% were not in the secondary wrapping and 67.9% were without the patient information leaflet. Analgesics were the most common medications in in-house stock (21%). This study revealed the need for a multi-professional team to promote health and the rationalization of in-house stock since the Community Healthcare Worker is an indispensable professional to promote the rational use of medication.