Luciane Bisognin Ceretta

Imipramine treatment reverses depressive-like behavior in alloxan-diabetic rats.

A growing body of evidence has shown an association between diabetes and depression, as well a role of brain‐derived neurotrophic factor (BDNF) in diabetes and depression. The present study was designed to evaluate the behavioural and molecular effects of the anti‐depressant imipramine in diabetic rats.

Antioxidant treatment ameliorates experimental diabetes‐induced depressive‐like behaviour and reduces oxidative stress in brain and pancreas

Studies have shown a relationship between diabetes mellitus (DM) and the development of major depressive disorder. Alterations in oxidative stress are associated with the pathophysiology of both diabetes mellitus and major depressive disorder. This study aimed to evaluate the effects of antioxidants N‐acetylcysteine and deferoxamine on behaviour and oxidative stress parameters in diabetic rats. To this aim, after induction of diabetes by a single dose of alloxan, Wistar rats were treated with N‐acetylcysteine or deferoxamine for 14 days, and then depressive‐like behaviour was evaluated. Oxidative stress parameters were assessed in the prefrontal cortex, hippocampus, amygdala, nucleus accumbens and pancreas. Diabetic rats displayed depressive‐like behaviour, and treatment with N‐acetylcysteine reversed this alteration. Carbonyl protein levels were increased in the prefrontal cortex, hippocampus and pancreas of diabetic rats, and both N‐acetylcysteine and deferoxamine reversed these alterations. Lipid damage was increased in the prefrontal cortex, hippocampus, amygdala and pancreas; however, treatment with N‐acetylcysteine or deferoxamine reversed lipid damage only in the hippocampus and pancreas. Superoxide dismutase activity was decreased in the amygdala, nucleus accumbens and pancreas of diabetic rats. In diabetic rats, there was a decrease in catalase enzyme activity in the prefrontal cortex, amygdala, nucleus accumbens and pancreas, but an increase in the hippocampus. Treatment with antioxidants did not have an effect on the activity of antioxidant enzymes. In conclusion, animal model of diabetes produced depressive‐like behaviour and oxidative stress in the brain and periphery. Treatment with antioxidants could be a viable alternative to treat behavioural and biochemical alterations induced by diabetes. Copyright

Detection of the Hepatitis C virus in a population of adults

El estudio tuvo como objetivo determinar la presencia del virus de la Hepatitis C (VHC) en adultos de la ciudad de Criciuma-SC y buscar factores relacionados a la transmision viral. Metodos: en una campana de salud sobre Hepatitis C fue aplicado un cuestionario sobre factores relacionados a la transmision del VHC; se realizaron pruebas para detectar el virus. Se establecio, como muestra representativa, la participacion de 300 individuos de la poblacion. Fueron aplicadas los pruebas Exato de Fischer, Mann-Whitney y Kappa (con valores significativos de p<0,05). Resultados: La Hepatitis C fue detectada en 7/457 participantes (1,53%). Los individuos con VHC positivo tuvieron un promedio de 5,7 (+/4,1 DE) companeros sexuales en los ultimos 10 anos y ese valor fue significativamente mas elevado que los que presentaron el resultado de VHC negativo (promedio de 2 companeros +/2,5 DE) (p= 0,01). Conclusion: La seropresencia de VHC en una poblacion voluntaria de adultos de Criciuma-SC fue elevada, habiendo una asociacion entre la presencia del VHC y el mayor numero de companeros sexuales.UNLABELLED The objective of this study was to determine the prevalence of Hepatitis C virus (HCV) in adults from Criciuma-SC and to search factors associated with the viral transmission. METHODS During a health campaign, a questionnaire about factors associated to HCV transmission and tests to detect HCV were applied. A representative sample of the population was considered with 300 voluntaries. Fishers Exact test, Mann-Whitney and Kappa tests were performed (p values < 0.05 were considered significant). RESULTS HCV was detected in 7/ 457 (1.53 %) voluntaries. Subjects with positive HCV had a mean of 5.7 (+/- 4.1 SD) sexual partners in the last 10 years, which was significantly higher than those with negative anti-HCV (mean sexual partners 2 +/- 2.5 SD) (p= 0.01). CONCLUSION The prevalence of HCV in a voluntary population of adults from Criciuma-SC was high and there was significant association between positive anti-HCV and higher number of sexual partners.

Anxiety disorders are associated with quality of life impairment in patients with insulin-dependent type 2 diabetes: a case-control study

OBJECTIVE To assess the presence of anxiety disorders and quality of life in patients with insulin-dependent type 2 diabetes. METHODS Case-control study of 996 patients with type 2 diabetes and 2,145 individuals without diabetes. The sole inclusion criterion for the case group was insulin-dependent type 2 diabetes. We compared the case and control groups for sociodemographic variables, laboratory and clinical data, and presence of anxiety disorders. Quality of life was evaluated using the WHOQOL-BREF instrument, and the prevalence of anxiety disorder was evaluated by the Mini International Neuropsychiatric Interview (MINI). RESULTS Patients with diabetes had a higher prevalence of generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder. The presence of these disorders in combination with type 2 diabetes was associated with worse quality of life in the physical, social, psychological, and environmental domains. CONCLUSIONS This study demonstrates the importance of diagnosing and treating anxiety disorders in patients with diabetes, so as to prevent more serious complications associated with these comorbidities.

Pathophysiological mechanisms involved in the relationship between diabetes and major depressive disorder

ABSTRACT Diabetes mellitus (DM) and major depressive disorder (MDD) are diseases that are expanding globally. Separately, each presents with several comorbidities for patients. When the two diseases present simultaneously in the same subject, there is a drastic worsening in the quality of life of the patient. This study reviewed the literature relating to the relationship between MDD and DM, bringing forward studies showing that DM develops due to MDD, and others that report the opposite. According to the studies reviewed, DM and MDD are both debilitating conditions that are associated with significant morbidity, mortality, and healthcare costs. When these two diseases coexist, the association results in a decreased adherence to treatment, poor metabolic control, higher rates of complications, a decrease in the quality of life for the patient, increased healthcare use and cost, increased disability and lost productivity, and an increased risk of death. Therefore, it becomes essential that there are larger studies targeting the association of these two diseases, as for the patient, preventing even one of them will ensure improvements in their quality of life.

Características y calidad del sueño de pacientes hipertensos

ObjetivoAnalisar a qualidade do sono de hipertensos registrados no sistema nacional de cadastramento e acompanhamento de hipertensos.MetodoEstudo transversal, quantitativo e descritivo realizado com 280 usuarios hipertensos cadastrados no Programa Nacional de Hipertensao e Diabetes do Governo Federal nos meses de agosto a outubro de 2011. Foram aplicados questionarios que permitiram tracar o perfil sociodemografico, dados sobre hipertensao arterial sistemica e Indice de Qualidade de Sono de Pittsburgh.ResultadosVerificou-se predominio da qualidade de sono ruim entre os entrevistados (156 hipertensos) e altas taxas de uso de medicacoes para dormir (106 hipertensos). Outro dado relevante refere-se a qualidade de sono entre hipertensos que utilizam medicacao para dormir comparados aqueles que nao utilizam (p≤0,01).ConclusaoIndividuos com hipertensao arterial sistemica apresentam associacao negativa com a qualidade do sono.OBJECTIVE Analyzing the quality of sleep of hypertensive patients registered in the national registration system and monitoring of hypertensive patients. METHODS A cross-sectional study of quantitative and descriptive analyses with 280 hypertensive patients registered in the National Program of Hypertension and Diabetes of the Federal Government in the months from August to October 2011. Questionnaires were used which allowed for tracking sociodemographic data on hypertension and Pittsburgh Sleep Quality Index (PSQI). RESULTS The prevalence of poor sleep quality among respondents (156 hypertensive patients) and high rates of using medication for sleeping (106 hypertensive patients) was observed. Other relevant data refers to the quality of sleep among hypertensive patients using sleep medication compared to those who do not use it (p≤0.01). CONCLUSION Individuals with high blood pressure have a negative association with sleep quality.

The quality and characteristics of sleep of hypertensive patients

ObjetivoAnalisar a qualidade do sono de hipertensos registrados no sistema nacional de cadastramento e acompanhamento de hipertensos.MetodoEstudo transversal, quantitativo e descritivo realizado com 280 usuarios hipertensos cadastrados no Programa Nacional de Hipertensao e Diabetes do Governo Federal nos meses de agosto a outubro de 2011. Foram aplicados questionarios que permitiram tracar o perfil sociodemografico, dados sobre hipertensao arterial sistemica e Indice de Qualidade de Sono de Pittsburgh.ResultadosVerificou-se predominio da qualidade de sono ruim entre os entrevistados (156 hipertensos) e altas taxas de uso de medicacoes para dormir (106 hipertensos). Outro dado relevante refere-se a qualidade de sono entre hipertensos que utilizam medicacao para dormir comparados aqueles que nao utilizam (p≤0,01).ConclusaoIndividuos com hipertensao arterial sistemica apresentam associacao negativa com a qualidade do sono.OBJECTIVE Analyzing the quality of sleep of hypertensive patients registered in the national registration system and monitoring of hypertensive patients. METHODS A cross-sectional study of quantitative and descriptive analyses with 280 hypertensive patients registered in the National Program of Hypertension and Diabetes of the Federal Government in the months from August to October 2011. Questionnaires were used which allowed for tracking sociodemographic data on hypertension and Pittsburgh Sleep Quality Index (PSQI). RESULTS The prevalence of poor sleep quality among respondents (156 hypertensive patients) and high rates of using medication for sleeping (106 hypertensive patients) was observed. Other relevant data refers to the quality of sleep among hypertensive patients using sleep medication compared to those who do not use it (p≤0.01). CONCLUSION Individuals with high blood pressure have a negative association with sleep quality.

Sobrecarga no cuidado, estresse e impacto na qualidade de vida de cuidadores domiciliares assistidos na atenção básica

This is a descriptive, cross-sectional study with quantitative approach and population census configured. The instruments used for the implementation of this research were the Inventory of Symptoms of Stress for adults of Lipp, the Functional Independence Measure, the Brazilian version of the quality of life questionnaire SF-36, and the Questionnaire for Assessing the Informal Caregiver Overload. Most caregivers were female (90.9%) with an average age of 51.7 (± 11.0) years; in relation to the degree of relatedness, 45.5% were the subjects’ children, and the Overall Functional Independence Measure of the subjects to whom the care was dedicated was 70.2 (± 40.1). Most caregivers showed stress (81.8%) and reported high overload. A moderate positive correlation (rs = 0.571) between the Functional Independence Measure and Pain (SF-36) was also observed, which was considered to be statistically significant (p = 0.001). To direct the attention to caregivers and understand the physical, social and emotional barriers involved in the action of caring, becomes indispensable in the context of public health not only to provide greater quality of life and lower overload on caregivers, but also on who is being cared.

Effects of ketamine administration on the phosphorylation levels of CREB and TrKB and on oxidative damage after infusion of MEK inhibitor

BACKGROUND Ketamine, an antagonist of N-methyl-d-aspartate (NMDA) receptors, has presented antidepressant effects in basic and clinical studies. The MAPK kinase (MEK) signaling pathway could be a target for novel antidepressant drugs and an important pathway involved in neuronal plasticity. Thus, this study evaluated the effects of the administration of ketamine on the phosphorylation of TrKB and CREB, and oxidative stress parameters in the prefrontal cortex (PFC), hippocampus, amygdala, and nucleus accumbens (NAc) rats, after the inhibition of MAPK pathway (PD184161). METHODS Male adult Wistar rats were submitted to a surgical procedure to receive a single dose of a pharmacological inhibitor of MAPK (PD184161) at a dose of (0.1μg/μl) or vehicle. Then, they were divided: 1) vehicle+saline; 2) inhibitor PD184161+saline; 3) vehicle+ketamine 15mg/kg; and 4) inhibitor PD184161+ketamine 15mg/kg. RESULTS MEK inhibitor and ketamine increased the phosphorylation of the transcription factor cAMP response element-binding protein (pCREB) and neurotrophic factor/tropomyosin related kinase B receptor (pTrKB) in the PFC, and decreased pCREB in the hippocampus. The MEK inhibitor abolished ketamines effects in the hippocampus. In the amygdala, pCREB was decreased, and pTrKB was increased after MEK inhibitor plus ketamine. Ketamine increased the thiobarbituric acid reactive species (TBARS) in the PFC, hippocampus, amygdala, and NAc; MEK inhibitor antagonized these effects. The carbonyl was increased in the PFC by both ketamine and MEK inhibitor, but inhibitor infusion plus ketamine administration reduced this effect. In the amygdala, MEK inhibitor increased carbonyl. CONCLUSION Ketamines effects on pCREB, pTrKB, and oxidative stress are mediated, at least in part, by a mechanism dependent of MAPK signaling inhibition.

Incidence of hepatitis C in Brazil

INTRODUCTION Hepatitis C is a public health problem of global dimensions, affecting approximately 200 million people worldwide. The main objective of this study was to estimate the incidence rate of hepatitis C in Brazil during the period between 2001 and 2012. METHODS An epidemiological, temporal, and descriptive study was performed using data from the Information System for Reportable Diseases. RESULTS Between 2001 and 2012, a total of 151,056 hepatitis C cases were recorded, accounting for 30.3% of all hepatitis notifications in Brazil. The average gross coefficient for the analysis period was 6.7 new cases per 100,000 inhabitants. The regions with the highest rates were the Southeast region (8.7 new cases/100,000 inhabitants) and the South (13.9 new cases/100,000 inhabitants). There was a predominance of men with respect to the incidence rate (8.0 new cases/100,000 inhabitants) compared to women (5.5 new cases/100,000 inhabitants). Injection drug use was the most common source of infection, and members of the white race, residents of urban areas, and those aged 60 to 64 years had the highest incidences. CONCLUSIONS Over the last 10 years, the incidence of hepatitis C in Brazil has increased, mainly in the South and Southeast. The adoption of fast, accurate diagnostic methods, together with epidemiological awareness, can facilitate early intervention measures for adequate control of the disease.