α1-Microglobulin (α1M) is a low molecular weight protein and has been best characterized for detecting acute lesions of proximal tubules (Bonventre in Contrib Nephrol 156:213-219, 2007). This study has tried to evaluate the use of α1M for the differential diagnosis of chronic interstitial nephropathy. 145 patients were recruited [81 men and 64 women, mean age 61.8 ± 16.7 years, 64.8 % have an estimated glomerular filtration (GFR) <60 ml/min]. Urinary α1M was evaluated using an immunonephelometric assay. 82 patients were diagnosed as having chronic interstitial nephritis (CIN), and 46 patients have been previously diagnosed of glomerulonephritis (GN). A group of hypertensive patients without renal disease was used as control (n = 17). Patients in GN group had the highest α1M excretion (15.05 mg/24 h). When the α1M/albuminuria rates were calculated, the CIN group had the highest rate (1.03 mg/mg) and the GN group had the lowest rate (0.04 mg/mg) (p < 0.001). When the α1M/proteinuria rates were calculated, the results were rather similar. The AUC for CIN group was 0.785, and the one for GN group was 0.139. Patients with estimated GFR <60 ml/min showed a higher excretion of α1M (18.75, 8.75-40.00 mg/24 h). Nevertheless, α1M/albuminuria and α1M/proteinuria rates were still higher in CIN patients with GFR ≥60 ml/min. α1M urinary excretion is increased in chronic interstitial nephropathy and glomerulonephritis as well as in patients with GFR <60 ml/min. The α1M/albuminuria rate and the α1M/proteinuria quotient are increased in chronic interstitial nephropathies but decreased in glomerular diseases.
In Portugal, the number of elderlies living alone and being institutionalized are rising. Institutionalized elderlies are susceptible to loneliness. Loneliness is associated with depression, anxiety, poor sleep quality, and cognitive decline. Determining which variables predict loneliness in institutionalized elderlies may allow appropriate targeting interventions in loneliness to potentially preserve mental and cognitive health.We want to explore the prevalence of loneliness in a sample of institutionalized elderly, and determining which variables predict loneliness.Loneliness was measured using UCLA loneliness scale. We also included a measure of socio-demographic aspects and health-related variables, the Mini-Mental State Examination, the Geriatric Depression Scale, the Geriatric Anxiety Inventory, the Satisfaction with Life Scale, and the Sleep Subjective Index for Elderly.Our sample included 539 elderly (60-100 years, mean age = 80.03 ± 7.38), mostly women (75.8%), widowed (60.3%), with primary basic education (39.5%), frequenting day care center (61.0%) or living in retirement home (39.0%).The prevalence of loneliness feelings was 68.2%. Loneliness was significantly related with more anxiety and depressive symptoms, poor sleep quality, and poor life satisfaction. Women and elderlies without partner had also more loneliness feelings. Loneliness was not associated with age, education, living alone/accompanied, number of social contacts, nor with cognitive performance or sensorial problems (low vision and poor hearing). After the multiple logistic regression of the significant variables, only satisfaction with live predicted loneliness (OR = 1.07, p = 0.05).In conclusion, satisfaction with live may affect feelings of loneliness. More studies with non-institutionalized are needed for appropriated targeting interventions.
IntroductionPost-traumatic stress disorder (PTSD) is often a chronic condition, despite the existence of evidence-based treatment options. Psychotherapy is the designated first line treatment for PTSD, although high rates of psychiatric and medical comorbidity are observed among patients who have undergone treatment. The psychoactive properties of psychedelics may be of particular interest within a substance-assisted psychotherapy approach, offering new treatment opportunities for this debilitating disorder.ObjectivesReview current evidence, therapeutic context, and possible mechanisms of action of different types of psychedelics in the treatment of PTSD.MethodsLiterature review using Medline database.Results3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy appears to be a potentially safe, effective, and durable treatment for individuals with treatment-refractory PTSD. Based on a small number of studies, ketamine administration appears to result in temporary symptom relief and may, in combination with psychotherapy, lead to lasting reductions in PTSD symptoms. Although these have not yet been investigated in controlled studies, it is known that psilocybin and LSD induce psychoactive effects that could as well contribute to the psychotherapeutic treatment of PTSD.ConclusionsThe use of psychedelic compounds within a substance-assisted psychotherapy framework offers a novel method for pharmacotherapy-psychotherapy integration, although there is still much to learn from both a clinical and neurobiological perspective. It is necessary to generate more data regarding the safety and efficacy of psychedelics, in addition to research on cost-effectiveness, its use in mental health care infrastructure and also regarding the training of specialized therapists.
RESUMO O objetivo do presente trabalho foi estimar a soroprevalência de anticorpos contra o vírus da influenza equina utilizando como unidades de análise os equídeos e as propriedades rurais do tipo familiar do Município de Uruará, PA. A presença de anticorpos contra o vírus da influenza equina A/Eq1/SP/56 (H7N7) e A/Eq2/SP/1/85 (H3N8) foi avaliada pela técnica de inibição da hemaglutinação (HI). O tamanho da amostra foi estimado a partir de um total de 2.069 propriedades, caracterizadas por agricultura familiar e ausência de vacinações contra qualquer enfermidade específica dos equídeos. Foi adotado o nível de confiança de 90%, com precisão de 15% e prevalência estimada de 50%. As seguintes prevalências de animais soro reagentes para os diferentes vírus foram observadas: 55,6% (45/81) (IC 49,8 a 61,3) para o vírus A/Eq1/SP/56 (H7N7) e 76,5% (62/81) (IC 70,7 a 82,3) para o vírus A/Eq2/SP/1/85 (H3N8). Todas as propriedades apresentaram pelo menos um animal soropositivo para os dois subtipos virais. Conclui-se que ambos os subtipos (H3N8 e H7N7) do vírus da influenza equina estavam circulando entre os equídeos e presentes em todas as propriedades estudadas no Município de Uruará, PA, Brasil, Amazônia Oriental, no ano de 1998.
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