Universidade Federal da Paraíba

Electroconvulsive therapy (ECT) proves to be an effective intervention in severe cases of major depressive disorder (MDD), especially when there is resistance to pharmacological treatment. The neurotrophic hypothesis proposes that an increase in brain-derived neurotrophic factor (BDNF) is one of the mechanisms responsible for the therapeutic response. The aim of this study is to investigate the effects of ECT on peripheral levels of BDNF, measured in serum and plasma, and analyze clinical outcomes associated with this intervention, as well as identify methodological variables that may influence findings. A systematic review and meta-analysis of studies published between 1995 and 2025 on the PubMed, Scopus and Web of Science databases were conducted, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies of BDNF in serum (14) and plasma (6) were performed separately. Clinical effectiveness was evaluated according to average standardized differences in depression scores. Meta-regressions in the R software identified the impact of four moderators: type of ECT, number of sessions, type of anesthetic and the time blood sample was taken. ECT was associated with an increase in BDNF levels in both biological matrices, especially in studies with plasma (I2=0%). Significant reductions in depression symptoms were also observed. These meta-regressions indicate that the kind of anesthetic used and the time the blood sample was taken greatly influence BDNF levels. The biological matrix used, as well as specific methodological variables, affects the measurement of BDNF, reinforcing the need to standardize future studies.

The application of positive pressure (CPAP) improves pulmonary ventilation, but may negatively impact diaphragm geometry and function. Diaphragm mobility and strength are essential for lung function. Consequently, impairment of the diaphragm can reduce respiratory capacity. This study aims to evaluate the effects of positive pressure on diaphragm mobility in healthy individuals during spontaneous breathing. This is a randomised, crossover, double-blind clinical trial involving asymptomatic individuals aged 18-50 years. Participants randomly received the following non-invasive ventilation: continuous positive airway pressure (CPAP) of 5, 10, and 15 cmH2O, or bi-level inspiratory positive airway pressure (IPAP) of 10, 12, and 15 cmH2O with Positive end-expiratory pressure (PEEP) of 5 cmH2O. Diaphragm mobility was assessed using ultrasound imaging during spontaneous breathing and the six levels of positive pressure. Data were analysed using a mixed linear model and Dunn-Sidak post-test. The study included 82 volunteers. Diaphragmatic mobility increased during CPAP at 15 cmH2O and in bi-level modes with inspiratory positive airway pressures (IPAPs) of 10, 12, and 15 cmH2O (with PEEP fixed at 5 cmH2O), compared to spontaneous breathing. The mean differences and confidence intervals for these comparisons were as follows: [CPAP 15 cmH2O versus spontaneous breathing (SB) ( 3.81 mm; 95% CI: 0.95-6.67), IPAP 10 PEEP 5 cmH2O versus SB ( 3.44 mm; 95% CI: 0.58-6.30), IPAP 12 PEEP 5 cmH2O versus SB ( 3.96 mm; 95% CI: 1.10-6.82), and IPAP 15 PEEP 5 cmH2O versus SB ( 6.21 mm; 95% CI: 3.35-9.07)]. The positive inspiratory and expiratory pressures were sufficient to increase diaphragmatic kinetics, particularly when higher positive pressures were used.

Dihydroquinazolin-4(3H)-imines have emerged as a promising scaffold for developing novel antimycobacterial agents. Here, we integrated QSAR modeling, in vitro screening, molecular dynamics (MD), binding free-energy calculations, and in vivo toxicity assessment to identify potent inhibitors against Mycobacterium tuberculosis (Mtb). Four QSAR models demonstrated strong internal and external reliability (R2>0.68; Q2LOO>0.62; R2extup to 0.82). Additional validation parameters met recommended thresholds (Q2-F1/F2/F3≥0.72; CCCext≥0.88; r2m aver≥0.72; r2m delta: 0.04), and Williams plots confirmed that all predictions fell within the applicability domain (h*: 0.286). Biological assays identified 11 active compounds, with MIC values ranging from 25 to 200μM. Compound 2c (p-methylphenyl derivative) and 3d (m, p-dichlorophenyl analog) were the most potent, displaying MIC values of 50 and 25μM, respectively. MD simulations revealed stable and specific interactions with Eis, an acetyltransferase linked to kanamycin resistance. Compound 2c exhibited a mean ΔGbind of -52.19±3.21kcal/mol, while 3d showed a more favorable ΔGbind of -73.15±3.16kcal/mol, consistent with its superior in vitro potency. Distinct interaction profiles-especially the engagement of Tyr126 and hydrophobic clusters-help explain their differential affinities. Moreover, both leads demonstrated low to moderate in vitro cytotoxicity against HepG2 cells at the concentrations evaluated. In vivo acute toxicity in Zophobas morio indicated LD₅₀ values of 500mg/kg for 2c and 100mg/kg for 3d, with transient tremors and melanization observed only for 3d. Since compound 2c exhibited a safer in vivo toxicity profile, this compound was investigated for its association with antimicrobial drugs. These compounds were validated as promising anti-TB candidates, supported by robust QSAR predictivity, favorable binding energetics, and measurable in vitro and in vivo toxicity profiles, reinforcing their potentials for further optimization.

Asthma is one of the most prevalent noncommunicable chronic diseases worldwide. Adolescents' emotional state has been associated with asthma symptoms and disease severity. Given the epidemiological relevance of anxiety and asthma during adolescence, it is important to investigate the association between these conditions. The objective of this study is to analyze the association between social anxiety and asthma in adolescents. This was a cross-sectional school-based study conducted among adolescents aged 14 to 19 years. Data were collected using the adapted Global School-based Student Health Survey (GSHS), the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and the Social Anxiety Scale for Adolescents (SAS-A). Logistic regression analysis was performed to assess the association between asthma and the following variables: social anxiety, age, sex, physical activity level, maternal education, parental asthma, parental smoking, and municipality. A total of 4514 adolescents were assessed, 54.6% of whom were female. Active asthma was present in 26.5% of participants, while severe asthma was reported by 10%. Mild anxiety affected 46.7%, and moderate to intense anxiety was reported by 27.2% of participants. Adolescents with moderate to intense anxiety had a higher likelihood of active asthma (OR=1.6; 95%CI: 1.3-2.0) and more than twice the risk of severe asthma (OR=2.1; 95%CI: 1.5-3.0). An association was found between asthma and social anxiety symptoms, with increased anxiety levels correlating with greater asthma severity. These findings highlight the potential relevance of considering mental health in asthma management strategies.

Brazil is characterized by significant income inequality across regions and among individuals. This study analyzes intergenerational educational mobility in Brazil, comparing families residing in the Northeast with those whose parents (born in the Northeast) migrated to other regions. This study uses microdata from the 2010 Demographic Census to examine intergenerational educational mobility in Brazil and employs parametric and non-parametric methods like transition matrices and mobility indices. The findings indicate that families led by migrants experience higher intergenerational educational mobility. Children of migrant parents, especially those in more developed regions such as the Southeast (particularly São Paulo), demonstrate greater educational mobility. Families that remain in the Northeast show lower mobility, reflecting structural barriers prevalent in underdeveloped regions. Additionally, return migrants to the Northeast experience higher mobility than non-migrants.

A organização das políticas de prevenção e controle de doenças no Brasil acompanha a evolução das ações de imunização e da vigilância em saúde no âmbito do SUS. A pesquisa teve como objetivo analisar os marcos históricos das políticas de prevenção e controle de doenças no Brasil, a partir da evolução do PNI até a consolidação da vigilância em saúde. Para isso, realizou-se uma pesquisa qualitativa, descritiva e exploratória, desenvolvida por meio de revisão narrativa da literatura. A busca foi realizada nas bases PubMed/MEDLINE, SciELO e Biblioteca Virtual em Saúde, além de documentos oficiais do Ministério da Saúde. Observou-se que ao longo do tempo, as ações de prevenção deixaram de ser pontuais e passaram a integrar rotinas dos serviços de saúde. A criação do PNI organizou a vacinação em todo o país, ampliou o acesso e contribuiu para reduzir doenças evitáveis. Com o SUS, a imunização passou a dialogar diretamente com a vigilância em saúde, permitindo acompanhar dados, identificar áreas com baixa cobertura e orientar intervenções mais direcionadas. A presença da Atenção Primária mostrou-se central nesse processo, especialmente pelo contato direto com a população e pelo acompanhamento contínuo no território. esses fatores ajudam a explicar diferenças nas coberturas vacinais entre regiões e reforçam a necessidade de ações mais próximas da realidade local. Conclui-se que a efetividade das políticas depende da articulação entre imunização, vigilância, organização dos serviços e comunicação em saúde.