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Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

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World Journal of Psychiatry 2024年第4期14卷 489-493页

作者： Edison Iglesias de Oliveira Vidal Luiz Fernando Alvarenga Ribeiro Marco Antonio de carvalho-Filho fernanda Bono Fukushima Internal Medicine Department Botucatu Medical SchoolSao Paulo State University(UNESP)Botucatu 18618-687SPBrazil Wenckebach Institute for Education and Training LEARN-Lifelong LearningEducation and Assessment Research NetworkUniversity Medical Center GroningenGroningen 9713AVGroningenNetherlands Assertiva Mindfulness Botucatu 18603-970SPBrazil Surgical Specialties and Anesthesiology Department Botucatu Medical SchoolSão Paulo State University(UNESP)Botucatu 18618-687SPBrazil

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our *** contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of ***,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational ***,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their *** we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

关键词： Mindfulness Medical education Mental capital Mental health Medical students Resilience

Feasibility of performing the 3-minute step test with remote supervision in children and adolescents with cystic fibrosis: A comparative study

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Pediatric Investigation 2024年第2期8卷 83-90页

作者： fernanda Maria Vendrusculo Gisele Apolinario da costa Maria Amelia Bagatini Brenda Maria Henrique Maia Lemes Carolina Aguiar Faria Larissa Carvalhaes de Oliveira Evanirso da Silva Aquino Marcio Vinicius Fagundes Donadio Laboratory of Pediatric Physical Activity Infant CenterPontificia Universidade Catolica do Rio Grande do Sul(PUCRS)Porto AlegreBrazil Hospital Infantil Joao Paulo II-Fundacao Hospitalar do Estado de Minas Gerais(FHEMIG) Belo HorizonteBrazil Departament of Physiotherapy Pontificia Universidade Catolica de Minas Gerais(PUCMG)-Campus BetimBetimBrazil Department of Physiotherapy Faculty of Medicine and Health SciencesUniversitat Internacional de Catalunya(UIC)BarcelonaSpain

Importance:The 3-min step test is a simple option to monitor submaximal exercise capacity,although its use via remote video monitoring has not been investigated in children with cystic fibrosis(CF).Objective:This study aimed to assess the feasibility and reproducibility of performing the 3-min step test with remote ***:A cross-sectional study including CF patients(6-18 years)from two CF services were ***,anthropometric,clinical,and lung function data were collected and two 3-min step tests were performed:(i)in-person supervision,and(ii)remotely supervised by video *** and after the tests,heart rate(HR),oxygen saturation(SpO_(2)),and the Borg score for dyspnea and lower limb fatigue were ***:Twenty-three patients(10.7±3.7 years)with a mean FEV1 of 89.5%±23.2%were *** were no significant differences between tests,with mean differences(95%confidence intervals)in final HR of-3.3(-8.9,2.4),change in HR of-1.9(-6.1,2.1),final SpO_(2) of 0.3(-0.4,1.0),and final dyspnea of 0.1(-0.8,0.9).The intraclass correlation coefficient was 0.852(final HR),0.762(final SpO_(2)),and 0.775(final lower limb fatigue).Significant and moderate correlations were found between tests for final HR(r=0.75),change in HR(r=0.61),and final SpO_(2)(r=0.61).The Bland-Altman analysis showed a mean difference in final SpO_(2) between tests of 0.3%(limit of agreement-3.0%,3.5%).Interpretation:Physiological responses between tests were similar,indicating it was feasible to perform the 3-min step test with remote supervision in CF children.

关键词： Children Cystic fibrosis Exercise test Telehealth

Plasma Lysophosphatidylcholine and Phospholipase A2 Activity in Chagas Disease Patients: A Comparative Analysis

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Advances in Bioscience and Biotechnology 2024年第8期15卷 462-473页

作者： Maria fernanda carvalho de Araujo Bruna Maria Ferreira Iaciura Fillipe Araujo de Sá Georgia Correa Atella Laboratrio de Bioqumica de Lipdios e Lipoprotenas Instituto de Bioqumica Mdica Leopoldo de Meis Universidade Federal do Rio de Janeiro Rio de Janeiro Brazil Instituto Nacional de Cincia e Tecnologia em Entomologia Molecular (INCT-EM) Universidade Federal do Rio de Janeiro Rio de Janeiro Brazil Laboratrio de Sinalizao Celular Instituto de Bioqumica Mdica Leopoldo de Meis Universidade Federal do Rio de Janeiro Rio de Janeiro Brazil

Chagas disease (CD) affects 21 countries in the Americas and is caused by the parasite Trypanosoma cruzi. A key molecule involved in CD is lysophosphatidylcholine (LPC), which has been studied in various contexts: in the saliva of insect vectors, during the establishment of infection in the vertebrate host, and for the parasite itself. This lipid can be produced by the action of phospholipases A2 (PLA2), enzymes that catalyze the hydrolysis of phospholipids releasing fatty acids and lysophospholipids, such as LPC. This study investigates LPC levels and PLA2 activities in the plasma of CD patients and compares these levels with those in healthy individuals and patients with idiopathic dilated cardiomyopathy (IDCM). Plasma from 64 CD patients, 54 healthy individuals, and 16 IDCM patients were analyzed. LPC levels and the activity of two types of phospholipase A2: secreted (sPLA2) and lipoprotein-associated (Lp-PLA2) were measured. LPC levels and sPLA2 activity were similar between CD patients and the control groups. However, there were notable differences in LPC levels and sPLA2 activity between subgroups of CD patients and IDCM patients. This study is the first to identify LPC in patients with CD across various stages of the disease. It also offers new insights into the biochemical changes observed in the plasma of patients with IDCM.

关键词： Lysophosphatidylcholine Phospholipase A2 Plasma Chagas Disease Idiopathic Dilated Cardiomyopathy

Delay Times and Clinical Outcomes in Acute Myocardial Infarction: Comparison of Periods before and during the COVID-19 Pandemic—Myocardial Infarction and the Pandemic

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World Journal of Cardiovascular Diseases 2024年第6期14卷 392-400页

作者： Clarice Teixeira Silva Araújo Arnon Salviato Mameri Thúlio Carrera Guarçoni Venturini Marcus Tadeu Aguilar Constantino Matos Igor Morais Araujo Lopes Luiz Gustavo Ribeiro de carvalho Murad Cleberson Duartes Ovani Guilherme Vassalo Morais fernanda Venturini de Castro Danielle Lopes Rocha Lucas Crespo de Barros Rodolfo costa Sylvestre Luiz Fernando Machado Barbosa Roberto Ramos Barbosa Internal Medicine Universidade Federal do Esprito Santo (UFES) Vitria Brazil Hospital Santa Casa de Misericrdia de Vitria Vitria Brazil Hospital Santa Rita de Cssia Vitria Brazil Hospital Estadual Dr. Jayme Santos Neves Serra Brazil Grupo Kora Sade Vitria Brazil Hospital Estadual Infantil e Maternidade Alzir Bernardino Alves (HIMABA) Vila Velha Brazil

Introduction: At the beginning of the COVID-19 pandemic, a drop in the number of patients treated for cardiac emergencies raised concern about cardiovascular mortality in that period. An increase in care delay for patients with ST-segment elevation myocardial infarction (STEMI) may have affected clinical outcomes. Objectives: To analyze delay times and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), before and during the COVID-19 pandemic. Methods: Retrospective observational study that included patients with STEMI undergoing PPCI from December 2018 to July 2021. The COVID-19 pandemic cases were divided into two groups: pandemic I—from March to August 2020;and pandemic II—from September 2020 to July 2021. Patients were compared according to the period of hospitalization. Primary outcomes were delay times in assistance and clinical outcomes (acute kidney injury [AKI], post-procedural vascular complications and in-hospital mortality). Results: 108 patients were included, 39 (36.1%) in the pre-pandemic period, 13 (12.1%) in pandemic I and 56 (51.8%) in pandemic II. Time from onset of symptoms to arrival at the service and door-to-balloon time did not differ significantly among groups. Vascular complications were more frequent during the pandemic (I and II) than in the pre-pandemic period (2.5% pre-pandemic vs 15.4% pandemic vs 12.5% pandemic II;p = 0.03). AKI incidence was similar in all three periods. There was a non-significant increase in in-hospital mortality during the COVID-19 pandemic. Conclusion: In patients with STEMI, there was an increase in vascular complications and a trend toward increased mortality during the COVID-19 pandemic. Delay times to admission and reperfusion did not differ significantly between before and during the pandemic.

关键词： Myocardial Infarction Primary Percutaneous Coronary Intervention Coronary Reperfusion Pandemic COVID-19

Clinicopathological Description of a Chronic Lymphocytic Leukemia in a Dog

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Open Journal of Veterinary Medicine 2024年第7期14卷 155-162页

作者： Maria Clara Boni Raffi Giovanna Valverde Magalhães Barbosa Alana Carolina Capais Rodrigues Sheila Canevese Rahal John P. Kastelic Luíz Guilherme Dercore Benevenuto Iolanda Simões Braga Beatriz Poloni Batista Felipe César Da Silva Brasileiro fernanda Barthelson carvalho de Moura Priscylla Tatiana Chalfun Guimarães Okamoto Regina Kiomi Takahira Alessandra Melchert Noeme Sousa Rocha Department of Veterinary Clinics School of Veterinary Medicine and Animal Science So Paulo State UniversityUNESP Botucatu SP Brazil Independent Veterinary Practitioner Department of Veterinary Surgery and Animal Reproduction School of Veterinary Medicine and Animal Science So Paulo State UniversityUNESP Botucatu SP Brazil Faculty of Veterinary Medicine University of Calgary Calgary Canada

Hematopoietic tumors are associated with diagnostic and therapeutic challenges and a poor prognosis. Furthermore, their pathophysiology in dogs is not well understood. Chronic lymphocytic leukemia has been rarely reported in golden retrievers, perhaps due to difficulties in diagnosis and care. An 8-year-old spayed female golden retriever was referred to our hospital with a 2-month history of fatigue, weakness, and selective appetite. The dog was diagnosed with chronic lymphocytic leukemia based on blood smear evaluation. Despite treatment, the dog deteriorated and the owners opted for euthanasia. Histopathological examination revealed atypical lymphocytes in the spleen, extramedullary hematopoiesis in the spleen and liver, bone marrow depletion, moderate neutrophilic myocarditis, and acute renal tubular necrosis. In an immunohistochemical panel, cells in the spleen and bone marrow were positive for anti-CD20, anti-CD45, anti-CD3, anti-IBA-1, anti-Ki67, anti-MUM-1, and anti-PAX-5. In conclusion, the leukemia diagnosis was confirmed through reactive histiocytosis, marked extramedullary hematopoiesis, and other clinical and laboratory findings. Herein, we report a case of chronic lymphocytic leukemia in a female dog with clinical, laboratory, and necroscopy findings.

关键词： Canine Cancer Neoplasia Therapeutics

Decontamination of mobile phones and electronic devices for health care professionals using a chlorhexidine/carbomer 940■gel

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Frontiers of Chemical Science and Engineering 2019年第1期13卷 192-198页

作者： Rafael Muniz de Oliveira Nereida Mello da Rosa Gioppo Jancineide Oliveirade carvalho Francilio carvalho Oliveira Thomas Jay Webster fernanda Roberta Marciano Anderson Oliveira Lobo University Hospital of the West of Parana State University of West of Parana Cascavel PR Brazil University Center for Health. Humanities and Technology of Piaui (UNINOVAFAPI). Piaui Brazil Science and Technology Institute Brasil University Itaquera SP Brazil Nanomedicine Laboratory Department of Chemical Engineering Northeastern University MA 02115 USA Materials Science and Engineering graduation program Technology Center Federal University of Piaui. PI Brazil

Though they reduce microorganism growth, current hospital disinfectants also damage many of today’s modern electronic devices such as tablets and smartphones. Herein, the efficacy of a new chlorhexidine digluconate gel (CDG) was tested as a disinfectant for mobile and electronic devices in a clinical environment. Specifically, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus were used to infect the screen of eight smartphones. The CDG was prepared at concentrations of 2%, 4% and 6%, and tested on paper disks infected with these bacteria before being tested on the smartphones. The devices were disinfected with the CDG gel (4%) at two times: immediately and after 5 min of the bacterial contamination. In all cases, the CDG gel eliminated 100% of gram-positive and gram-negative microorganisms compared to the control (without any agent). In addition, the gel did not damage the smartphones. Therefore, our study suggests that the CDG gel may be applied to disinfect a wide range of electronic devices for health care professionals in the hospital environment.

关键词： smartphones disinfection clinical environment chlorhexidine bacteria

Silymarin Attenuates Hepatic and Pancreatic Redox Imbalance Independent of Glycemic Regulation in the Alloxan-induced Diabetic Rat Model

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Biomedical and Environmental Sciences 2020年第9期33卷 690-700页

作者： Miranda Laise Mara Oliveira Agostini Livia da Cunha Lima Wanderson Geraldo de Camini fernanda Caetano costa Daniela Caldeira Programa de Pos-graduagao em Saude e Nutricao Escola de NutricaoUniversidade Federal de Ouro PretoOuro PretoMinas Gerais 35400-000Brazil Escola de Farmacia Universidade Federal de Ouro Preto.Ouro PretoMinas Gerais 35400-000Brazil Laboratorio de Morfopatologia Departamento de Ciencias BioldgicasUniversidade Federal de Ouro PretoOuro Preto 35400-000Brazil Programa de Pos-graduaqao em Ciencias Bioldgicas Nucleo de Pesquisas em Ciencias BiologicasUniversidade Federal de Ouro Preto.Ouro Preto 35400-000Brazil Laboratorio de Bioquimica Metabolica Departamento de Ciencias BiologicasUniversidade Federal de Ouro PretoOuro Preto 35400-000Brazil

Objective To evaluate the efficiency of silymarin(SMN) in modulating metabolic parameters and redox status in rats with type 1 diabetes mellitus(T1 DM).Methods Diabetes was induced by intraperitoneal injection of alloxan. The diabetic rats were administered with SMN at doses of 50 and 100 mg/kg body weight/d for 30 consecutive days. The rats were divided into the following four groups: vehicle control, diabetic(alloxan-treated), DS50(alloxan +50 mg/kg body weight/d of SMN), and DS100(alloxan + 100 mg/kg body weight/d of SMN) groups. The bodyweight and food and water intake were evaluated. After 30 d, the animals were euthanized and the blood was collected for measuring the serum levels of glucose, triacylglycerol(TAG), urea, and creatinine. The liver and pancreas were collected for measuring the activities of superoxide dismutase(SOD) and catalase(CAT), and the levels of carbonylated protein(PC). The pancreas sample was also used for histological *** SMN reduced hepatic(P < 0.001) and pancreatic(P < 0.001) protein damage and creatinine levels(P = 0.0141) in addition to decreasing food(P < 0.001) and water intake(P < 0.001). However,treatment with SMN did not improve beta-cell function or decrease blood glucose levels in diabetic *** SMN improved polyphagia and polydipsia, renal function, and protected the liver and pancreas against protein damage without affecting hyperglycemia in diabetic animals.

关键词： Silymarin Silybum marianum Type 1 diabetes Oxidative stress

Queens remate despite traumatic mating in stingless bees

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Current Zoology 2022年第1期68卷 81-92页

作者： Jamille costa VEIGA Gustavo Rodrigo Sanches RUIZ Gislene Almeida carvalho-ZILSE Cristiano MENEZES Felipe Andres Leon CONTRERA Bee Biology and Ecology Lab Instituto de Ciencias BiologicasUniversidade Federal do ParaBelem66075-110 ParaBrazil Biodiversity and Ecosystem Services Research Group Instituto Tecnologico Vale-Desenvolvimento SustentavelBelem66055-090 ParaBrazil Ecology and Zoology of Invertebrates Lab Instituto de Ciencias BiologicasUniversidade Federal do ParaBelem66075-110 ParaBrazil Bee Research Group Instituto Nacional de Pesquisas da AmazoniaManaus69067-375 AmazonasBrazil Research and Development Embrapa Meio AmbienteJaguariuna13820-000 Sao PauloBrazil

Males can control female reproduction using genital plugs to impede access by *** social bees,ants,and wasps,plugging may involve traumatic mating,with females being *** stingless bees,chances are that plugs may promote ovarian activan,and are thought to ensure single mating—a general tendency among the social ***,understanding on relationships between mating plugs,traumatic mating,and mating systems in stingless bees remains *** address this,we(1)compared mated queens of 7 Neotropical species to understand the patterns of copulatory marks in females and(2)compared pre-and post-mating genitalia of males and females in Melipona fasciculata to depict plug functional *** revealed an unprecedented consequence of mating in stingless bees:the characteristic marks left by mating plugs on female abdomens and the inferences that can be made from *** our surprise,in 1 species *** we found that queens retain the plug long after mating,and may carry it for the rest of their *** the other 6 species retained the plug for only a short *** queens were only found in ***,whose multiple copulatory marks match previous findings of polyandry in this *** study shows that queens can remate,and suggests that male genital morphology may determine in part the time persistence of *** conclude that traumatic mating plugs do not fully prevent remating in stingless bees and that mating systems are not uniform in this ***,exceptional cases of facultative polyandry in social insects—for example,when mating plugs fail—may confirm a general tendency for single mating in close link with efficient mating plugs.

关键词： copulatory marks facultative polyandry genital morphology male harm sexual conflict

Methods and parameters of melting curve analysis for identification of Leishmania species:A scoping review

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Asian Pacific Journal of Tropical Medicine 2021年第12期14卷 528-542页

作者： Juliana J G Ferreira fernanda S Nascimento Glaucia E B Marcon Eros A de Almeida Sandra C B costa Laboratório de Diagnóstico de Doenças Infecciosas por Técnicas de Biologia Molecular Departamento de Clínica MédicaFaculdade de Ciências MédicasUniversidade Estadual de Campinas(UNICAMP)Campinas13083-887SPBrazil Fundação Oswaldo Cruz Mato Grosso do Sul(FIOCRUZ MS) Rua Gabriel Abrão92Jardim das NaçõesCampo Grande79081-746 MSBrazil Grupo de Estudos em Doença de Chagas Departamento de Clínica MédicaFaculdade de Ciências MédicasUniversidade Estadual de Campinas(UNICAMP)Campinas13083-887SPBrazil

Leishmaniasis is a set of diseases with a worldwide distribution that affects mainly economically underprivileged populations in developing countries. It has a major impact on public health, with a global cost of billions of dollars per year. The treatment and control of leishmaniasis vary according to the Leishmania species involved, which require reliable methods for species identification. Since most of the currently used methods have limitations, there is a need for assays that allow rapid, precise identification of the offending species. Real-time polymerase chain reactions in conjunction with dissociation curve analysis have been used to detect differences in the DNA composition of selected genes of Leishmania spp. Kinetoplast DNA is the main molecular target used because of its high copy number per parasite, but other targets have also been studied. As part of an effort to establish melting temperature standards for each target gene, we have reviewed the pertinent literature available in public databases, including Pub Med, Web of Science, Sci ELO and LILACS, using the keywords "Leishmania", "leishmaniasis", "realtime PCR", "melting temperature", and "melting curve", alone or in combination. After applying eligibility criteria, 27 articles were selected for analysis. A considerable variation in the methodologies analyzed was found regarding molecular targets, standardization of the methods, reproducibility and specificity. Because of this, statistical analysis was not performed. In most cases, the methods were able to differentiate the parasite at the subgenus level or few species regardless of the target chosen.

关键词： Leishmaniasis Melting temperature Real-time PCR