RESUMO
Genetic and non-genetic factors contribute to obsessive-compulsive disorder (OCD), with strong evidence of familial clustering. Genomic studies in psychiatry have used the concepts of families that are "simplex" (one affected) versus "multiplex" (multiple affected). Our study compares demographic and clinical data from OCD probands in simplex and multiplex families to uncover potential differences. We analyzed 994 OCD probands (501 multiplex, 493 simplex) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinicians administered the Structured Clinical Interview for DSM-IV (SCID-IV) to diagnose, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess severity, and Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) to assess symptom dimensionality. Demographics, clinical history, and family data were collected. Compared to simplex probands, multiplex probands had earlier onset, higher sexual/religious and hoarding dimensions severity, increased comorbidity with other obsessive-compulsive-related disorders (OCRD), and higher family history of psychiatric disorders. These comparisons provide the first insights into demographic and clinical differences between Latin American simplex and multiplex families with OCD. Distinct clinical patterns may suggest diverse genetic and environmental influences. Further research is needed to clarify these differences, which have implications for symptom monitoring and management.
Assuntos
Transtorno Obsessivo-Compulsivo , Humanos , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/genética , Transtorno Obsessivo-Compulsivo/diagnóstico , Comorbidade , Transtorno da Personalidade Compulsiva , Brasil/epidemiologia , Comportamento SexualRESUMO
An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive-compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.
Assuntos
Transtorno Obsessivo-Compulsivo , Humanos , Neuroimagem , Transtorno Obsessivo-Compulsivo/terapiaRESUMO
The present study was conducted to evaluate the intake, digestibility and nitrogen balance of diets for finishing sheep, containing leucaena hay as a source of effective fibre and forage palm. Twenty-one male sheep were used in a randomized block design with three treatments, represented by total diets, where the forage was leucaena hay and forage palm in natura in proportions 350:650, 450:550 and 550:450 g/kg respectively. For the pH and NH3 -N in the ruminal fluid, and urea in the blood serum, plots split in time were adopted. Dry matter and nutrient digestibility, and the nitrogen balance were not influenced (p > .05) by the diets. The neutral detergent fibre digestibility decreased (p < .05) as the proportions of leucaena hay in the diets increased. The pH and NH3 -N were suitable for ruminal fermentation, and blood urea was maintained under normal physiological conditions for sheep. Combining 350 to 550 g/kg of leucaena hay with 450 to 650 g/kg of forage palm in total diets with a forage:concentrate ratio of 60:40 in late-maturing sheep meets the nutritional requirements for daily gain 200 g, characterizing leucaena hay as important source of effective fibre and nutrients in diets.
Assuntos
Ração Animal , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Dieta/veterinária , Fibras na Dieta/administração & dosagem , Fabaceae , Nutrientes/administração & dosagem , Ovinos/metabolismo , Ovinos/fisiologia , Animais , Brasil , Digestão/fisiologia , Metabolismo Energético , Masculino , Nitrogênio/metabolismoRESUMO
Biosecurity is defined as the set of practices carried out to prevent the introduction and spread of infectious agents in a herd. These practices are essential in swine production, especially for highly infectious agents such as porcine reproductive and respiratory syndrome virus (PRRSv). Even with years of research and experience over the last three decades, PRRSv is still causing productivity losses and is the major health problem affecting the global swine industry. Despite knowledge of the various ways in which the virus can be transmitted from one herd to another (e.g. animals, semen, truck, air, and people), determining the most frequent ways in which the virus is transmitted in the field is difficult. A systematic approach to assess vulnerabilities at a herd level related to PRRSv transmission could help producers prioritize biosecurity practices to reduce or avoid the occurrence of outbreaks. The aim of this study was to develop a biosecurity vulnerability score that represents the relative vulnerability of swine breeding herds to the introduction of PRRSv. To create the biosecurity vulnerability score (outcome), a multi-criteria decision analysis methodology was used to rank and quantify biosecurity practices based on expert opinion. To validate the biosecurity vulnerability score, a survey of biosecurity practices and PRRS outbreak histories in 125 breed-to-wean herds in the U.S. swine industry was used. Data on the frequency of PRRS outbreaks was used to test the hypothesis that biosecurity vulnerability scores were different between farms that have a low incidence of PRRS outbreaks, compared to farms that have a high incidence. In the two databases used, the scores consistently showed that farms with higher scores have a higher frequency of PRRS outbreaks. In the first validation, farms that had never had an outbreak investigation before had a significant (p < 0.02) lower score (0.29; 0.21-0.37) when compared to farms that had 2 or more outbreaks (0.43; 0.39-0.46). In the second, the farms of the control group also had significant (p < 0.004) lower scores (0.30; 0.27-0.33) compared to the case group (0.35; 0.33-0.38). Also, the results suggest that events related to swine movements, transmission by air and water, and people movements should be prioritized. The biosecurity vulnerability scores may be useful to assess vulnerabilities on biosecurity protocols in order to reduce the frequency of PRRS outbreaks and may help producers and veterinarians prioritize investments in improving biosecurity practices over time.
Assuntos
Síndrome Respiratória e Reprodutiva Suína/etiologia , Vírus da Síndrome Respiratória e Reprodutiva Suína , Criação de Animais Domésticos/métodos , Animais , Surtos de Doenças/prevenção & controle , Surtos de Doenças/veterinária , Suscetibilidade a Doenças/veterinária , Feminino , Síndrome Respiratória e Reprodutiva Suína/transmissão , Gravidez , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Inquéritos e Questionários , SuínosRESUMO
OBJECTIVE: To evaluate the efficacy of serotonin reuptake inhibitor (SRI) augmentation with N-acetylcysteine (NAC), a glutamate modulator and antioxidant medication, for treatment-resistant obsessive-compulsive disorder (OCD). METHODS: We conducted a randomized, double-blind, placebo-controlled, 16-week trial of NAC (3,000 mg daily) in adults (aged 18-65 years) with treatment-resistant OCD, established according to DSM-IV criteria. Forty subjects were recruited at an OCD-specialized outpatient clinic at a tertiary hospital (May 2012-October 2014). The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores. To evaluate the variables group, time, and interaction effects for Y-BOCS scores at all time points, we used nonparametric analysis of variance with repeated measures. Secondary outcomes were the severity scores for anxiety, depression, specific OCD symptom dimensions, and insight. RESULTS: Both groups showed a significant reduction of baseline Y-BOCS scores at week 16: the NAC group had a reduction of 4.3 points (25.6 to 21.3), compared with 3.0 points (24.8 to 21.8) for the placebo group. However, there were no significant differences between groups (P = .92). Adding NAC was superior to placebo in reducing anxiety symptoms (P = .02), but not depression severity or specific OCD symptom dimensions. In general, NAC was well tolerated, despite abdominal pain being more frequently reported in the NAC group (n [%]: NAC = 9 [60.0], placebo = 2 [13.3]; P < .01). CONCLUSIONS: Our trial did not demonstrate a significant benefit of NAC in reducing OCD severity in treatment-resistant OCD adults. Secondary analysis suggested that NAC might have some benefit in reducing anxiety symptoms in treatment-resistant OCD patients. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01555970.
Assuntos
Acetilcisteína/uso terapêutico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Acetilcisteína/efeitos adversos , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/psicologia , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/psicologia , Método Duplo-Cego , Resistência a Medicamentos , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Psicometria , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Adulto JovemRESUMO
This study investigated the effect of CO2 laser irradiation on the inhibition of secondary caries on root surfaces adjacent to glass ionomer cement (GIC) or composite resin (CR) restorations. 40 dental blocks were divided into 4 groups: G1 (negative control): cavity preparation + adhesive restoration with CR; G2: (positive control) cavity preparation + GIC restoration; G3: equal to group 1 + CO2 laser with 6 J/cm(2); G4: equal to group 2 + CO2 laser. The blocks were submitted to thermal and pH cycling. Dental demineralization around restorations was quantified using microhardness analyses and Light-Induced Fluorescence (QLF). The groups showed no significant differences in mineral loss at depths between 20 µm and 40 µm. At 60 µm, G2 and G3 ≠ G1, but G4 = G1, G2 and G3. At 80 µm, G4 ≠ G1, and at 100 µm, G4 = G2 = G1. At 140 and 220 µm, G2, G3, and G4 = G1. The averages obtained using QFL in groups 1, 2, 3, and 4 were 0.637, 0.162, 0.095, and 0.048, respectively. QLF and microhardness analyses showed that CO2 laser irradiation reduced mineral loss around the CR restorations but that it did not increase the anticariogenic effect of GIC restorations.
Assuntos
Resinas Compostas , Cárie Dentária/cirurgia , Reparação de Restauração Dentária , Cimentos de Ionômeros de Vidro , Lasers de Gás , Humanos , Resultado do TratamentoRESUMO
This study aimed to investigate the phenomenology of obsessive-compulsive disorder (OCD), addressing specific questions about the nature of obsessions and compulsions, and to contribute to the World Health Organization's (WHO) revision of OCD diagnostic guidelines. Data from 1001 patients from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders were used. Patients were evaluated by trained clinicians using validated instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale, the University of Sao Paulo Sensory Phenomena Scale, and the Brown Assessment of Beliefs Scale. The aims were to compare the types of sensory phenomena (SP, subjective experiences that precede or accompany compulsions) in OCD patients with and without tic disorders and to determine the frequency of mental compulsions, the co-occurrence of obsessions and compulsions, and the range of insight. SP were common in the whole sample, but patients with tic disorders were more likely to have physical sensations and urges only. Mental compulsions occurred in the majority of OCD patients. It was extremely rare for OCD patients to have obsessions without compulsions. A wide range of insight into OCD beliefs was observed, with a small subset presenting no insight. The data generated from this large sample will help practicing clinicians appreciate the full range of OCD symptoms and confirm prior studies in smaller samples the degree to which insight varies. These findings also support specific revisions to the WHO's diagnostic guidelines for OCD, such as describing sensory phenomena, mental compulsions and level of insight, so that the world-wide recognition of this disabling disorder is increased.
Assuntos
Comportamento Compulsivo/diagnóstico , Comportamento Obsessivo/diagnóstico , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Determinação da Personalidade/normas , Escalas de Graduação Psiquiátrica/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Comportamento Compulsivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Obsessivo/psicologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Adulto JovemRESUMO
OBJECTIVE: Panic Disorder (PD) and agoraphobia (AG) are frequently comorbid with obsessive-compulsive disorder (OCD), but the correlates of these comorbidities in OCD are fairly unknown. The study aims were to: 1) estimate the prevalence of PD with or without AG (PD), AG without panic (AG) and PD and/or AG (PD/AG) in a large clinical sample of OCD patients and 2) compare the characteristics of individuals with and without these comorbid conditions. METHOD: A cross-sectional study with 1001 patients of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders using several assessment instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Bivariate analyses were followed by logistic regression models. RESULTS: The lifetime prevalence of PD was 15.3% (N=153), of AG 4.9% (N=49), and of PD/AG 20.2% (N=202). After logistic regression, hypochondriasis and specific phobia were common correlates of the three study groups. PD comorbidity was also associated with higher levels of anxiety, having children, major depression, bipolar I, generalized anxiety and posttraumatic stress disorders. Other independent correlates of AG were: dysthymia, bipolar II disorder, social phobia, impulsive-compulsive internet use, bulimia nervosa and binge eating disorder. Patients with PD/AG were also more likely to be married and to present high anxiety, separation anxiety disorder, major depression, impulsive-compulsive internet use, generalized anxiety, posttraumatic stress and binge eating disorders. CONCLUSIONS: Some distinct correlates were obtained for PD and AG in OCD patients, indicating the need for more specific and tailored treatment strategies for individuals with each of these clinical profiles.
Assuntos
Agorafobia/epidemiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno de Pânico/epidemiologia , Adulto , Agorafobia/terapia , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Transtorno de Pânico/terapia , Prevalência , Adulto JovemRESUMO
OBJETIVO: Verificar a induçäo de angiogênese miocárdica pela injeçäo transmural de plasmídeo VEGF 165 (Genentech/ USA) em zonas do infarto agudo do miocárdio (IAM) de cäes, mediante avaliaçäo por cintilografia miocárdica e estudo histológico. MÉTODOS: Em onze cäes anestesiados o coraçäo foi abordado em toracotomia antero-lateral esquerda e produzido IAM pela ligadura simples de ramo diagonal da artéria coronária descendente anterior. Em cada de 10 pontos selecionados da área infartada e sua periferia foi realizada a injeçäo de um total de 1 ml de soluçäo salina (grupo controle: cinco cäes) ou de soluçäo contendo plasmídeo VEGF 165 na concentraçäo de 200 ug/ml (grupo tratado: seis cäes). Os animais foram recuperados e realizada cintilografia miocárdica com Tecnécio imediatamente e 14 dias após IAM. Os animais foram sacrificados e o coraçäo retirado para estudo histológico da área de infarto, de sua periferia e de área da parede ventricular posterior, visando contagem eletrônica de capilares e arteríolas. RESULTADOS: Cintilografia mostrou modificações na perfusäo miocárdica comparáveis entre os grupos quanto ao estudo imediato e 15 dias após IAM, sendo que os dois grupos mostraram uma recuperaçäo de 70 a 90 % da hipoperfusäo demonstrada no 1o exame. O estudo histológico da área de transiçäo do IAM revelou um maior número de vasos no grupo tratado em relaçäo ao grupo controle (média de 123,81 + 21,48 e 40 + 6,13, respectivamente; p <0,01). Este crescimento do número de vasos é atribuível principalmente ao aumento do número de capilares (97,5 + 16,04 no grupo tratado e 22,18 + 3,25 no grupo controle, p < 0,01), sendo que em relaçäo ao número de arteríolas o aumento näo foi significativo (25,16 + 10,89 e 16,8 + 4,75; NS). A comparaçäo entre a regiäo de transiçäo do IAM do grupo tratado e de área normal, revelou um maior número de vasos na regiäo tratada, ainda que a diferença näo fosse significativa (respectivamente 123,81 + 21,48 e 95,14 + 41,19, p > 0,05). CONCLUSÕES: Injeçäo transmural de plasmídeo VEGF 165 resultou em significativo aumento no número de capilares na zona de transiçäo do IAM experimental. O aumento de capilares pela terapia gênica tem presumível efeito benéfico na reduçäo e recuperaçäo da área isquêmica.