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PURPOSE: Scientific evidence indicates that depression and anxiety symptoms may be understood as risk factors associated with the incidence and progression of chronic diseases. Considering the lack of mental health assessment tools that meet strict methodological standards, the authors have chosen to validate the psychometric properties of Anxiety and Depression Item Banks - Emotional Distress domain of the Patient-Reported Outcomes Measurement Information System (PROMIS®) for the Brazilian population. METHODS: In this study, 606 adults responded to the self-administered Anxiety and Depression Item Banks, which were calibrated using Factor Analyses (Exploratory and Confirmatory analysis) and adjustment of the Graded Response Model. Transcultural validity was assessed by Differential Item Functioning (DIF). RESULTS: The two-factor analysis confirmed the unidimensionality of Emotional Distress Items (CFI = 0.96, TLI = 0.96, RMSEA = 0.05). The residual correlation matrix did not identify item pairs with local dependence. Indicators marked with DIF presented a low impact for gender, age, and language variables. The instrument demonstrated greater reliability in the moderate-severe range, indicating that the error reduction is reflected in the - 1.0 to + 3.0 amplitude. CONCLUSION: The psychometric measurements of Anxiety and Depression Item Banks in the Brazilian version were equivalent to those in the original version. Additional research contemplating patients with different levels of emotional distress are necessary to better comprehend the results obtained in this study.

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INTRODUCTION AND HYPOTHESIS: Perineal preparation techniques for childbirth have been used with the aim of reducing perineal tears during the expulsive phase of labor. However, no studies were found to investigate the effects of instrument-assisted stretching versus perineal massage on pelvic floor muscle (PFM) variables. Therefore, the aim of this study was to evaluate the effect of instrument-assisted stretching versus perineal massage on the extensibility and strength of the PFMs. METHODS: Primiparous women were randomized to the instrument-assisted stretching (IStr) group (n = 13) and perineal massage (PnM) group (n = 14). The groups participated in eight sessions, twice weekly, beginning at the 34th gestational week. The IStr group underwent the intervention for 15 min using EPI-NO®. The PnM group underwent a perineal massage protocol for 10 min. Each woman was evaluated by a blinded physiotherapist before, after four and after eight sessions for primary (PFM extensibility using the EPI-NO® circumference) and secondary (PFM strength using a manometer) outcomes. Covariate analysis (ANCOVA) was used to compare the groups using the baseline values as a covariate. RESULTS: Both groups showed an increase in PFM extensibility compared with the evaluations before and after four and eight sessions (PnM group from 17.6 ± 1.8 to 20.2 ± 1.9 cm; IStr group from 19.9 ± 1.6 to 22.9 ± 1.6 cm;p < 0.001). There was no difference between groups. Regarding muscle strength, no statistical differences were observed between evaluations or between groups. CONCLUSIONS: Instrument-assisted stretching and perineal massage increase extensibility and do not alter the strength of PFMs in pregnant women.

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Species of Hepatozoon are parasites frequently recorded in snakes. The species identification of this genus was based mostly on the gametocyte morphology and morphometric calculations. For more reliable results, molecular characterization, an initial step for the correct identification of Hepatozoon species, has been used. This study aimed to determine the prevalence and identification of Hepatozoon species in captive snakes from Brazil. To that end, morphological, morphometric, and molecular data were obtained. A total of 157 snakes; 128 venomous (Crotalus durissus) and 29 non-venomous (Epicrates crassus and Boa constrictor) were screened for Hepatozoon blood parasites. Using light microscopy, 20 (12.78%) snakes were found positive for Hepatozoon spp., of which 6/29 (20.7%) were non-venomous and 14/128 (10.9%) were venomous; all with low parasitemia. Polymerase chain reaction (PCR), performed with the primers HepF300/Hep900, confirmed all 20 (100%) samples positive for hemogregarines. Species of Hepatozoon were identified from eight sequenced samples. Two previously described species, Hepatozoon cuestensis and Hepatozoon musa, were identified. The present study is the first to report H. musa within the snake hosts E. crassus and C. durrisus. In addition, a potentially new Hepatozoon species from B. constrictor was identified.

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Based on morphological, morphometric, and molecular data, we describe a new hemoparasite of the genus Haemogregarina Danilewsky 1885, isolated from the Brazilian aquatic turtle Podocnemis unifilis (Testudines: Podocnemididae). The new species, Haemogregarina podocnemis sp. nov. (Apicomplexa: Haemogregarinidae), is characterized by small trophozoites with a single cytoplasmic vacuole on one side; pre-meronts with nuclear chromatin dispersed in the cytoplasm, with or without cytoplasmic vacuoles; meronts that are usually broad and slightly curved (kidney-shaped), with an average of eight small rectangular nuclei; immature gamonts (bean-shaped) with two morphological types: one with nuclear chromatin dispersed in the cytoplasm and the other with nuclei in the middle of the cell; mature gamonts of two morphological types: one with a length equal to or greater than that of the erythrocyte and the width of the nuclei similar to that of the hemoparasite and the other smaller than the erythrocyte with the width of the nuclei less than that of the hemoparasite. This is the first hemogregarine species described that infects the Brazilian turtle Po. unifilis. These findings highlight the need for further studies of Haemogregarina spp. to better determine the biodiversity of this understudied parasite group.

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BACKGROUND: Individuals with diabetes who are smokers have higher risks of cardiovascular disease, premature death, and microvascular complications. The present study aims to determine the prevalence of symptoms of depression and anxiety in smokers with type 2 diabetes mellitus (T2D) and to evaluate if the prevalence of symptoms of depression and anxiety differ between the three groups studied (patients with T2D who smoke; patients with T2D who do not smoke; smokers without T2D), and finally determine if the degree of nicotine dependence is related to symptoms of anxiety and depression in smokers (with or without T2D). METHODS: Three study groups were formed: 46 T2D smokers (DS), 46 T2D non-smokers (D), and 46 smokers without diabetes (S), totaling 138 participants. Hospital Anxiety and Depression (HAD) scale and Fagerström Test were applied. RESULTS: The prevalence of symptoms of depression and anxiety in smokers with T2D was 30.4% and 50%, respectively. There was no significant difference in the proportion of individuals with symptoms of anxiety (p = 0.072) or depression (p = 0.657) in the DS group compared to group D or S. Among male patients with T2D, the smokers had a higher prevalence of anxiety symptoms (19.6%) than non-smokers (4,3%) (p = 0,025). The prevalence of high nicotine dependence among smokers with and without T2D was 39.1% and 37.1%, respectively (p = 0.999). Fagerström scores showed no significant correlation with the scores obtained on the subscale of anxiety (p = 0,735) or depression (p = 0,364). CONCLUSIONS: The prevalence of depression and anxiety among smokers with and without diabetes and non-smokers T2D is similar. Among male individuals with T2D, the smokers have more symptoms of anxiety than the non-smokers. There is no difference in the prevalence of nicotine dependence among smokers with and without diabetes. The presence of symptoms of anxiety or depression is similar between patients who are dependent and not dependent on nicotine.