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The occurrence and infection dynamics of Anisakis larvae in the black-scabbard fish, Aphanopus carbo, chub mackerel, Scomber japonicus, and oceanic horse mackerel, Trachurus picturatus from Madeira, Portugal
- G. Costa, T. Pontes, S. Mattiucci, S. D'Amélio
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- Journal of Helminthology / Volume 77 / Issue 2 / June 2003
- Published online by Cambridge University Press:
- 12 April 2024, pp. 163-166
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Larval stages of Anisakis spp. (Nematoda: Anisakidae) were found encapsulated or free in the viscera and abdominal cavity of the black-scabbard fish, Aphanopus carbo, chub mackerel, Scomber japonicus and oceanic horse mackerel, Trachurus picturatus in Madeiran waters. The prevalence of infection reached 97.2% (n=142) for A. carbo, 69.5% (n=154) for S. japonicus and 62.5% (n=40) for T. picturatus. Considerable differences in parasite intensities between A. carbo and both S. japonicus and T. picturatus were found, with mean intensities up to 69.6 in A. carbo, while in the other two fish hosts the intensity reached only a maximum of 2.6. These differences were probably due to different feeding behaviours of the hosts. Intensities of Anisakis sp. in A. carbo were high irrespective of sex and season. No relationship between host length and prevalence of infection was observed for A. carbo, while for S. japonicus a weak positive significant relationship was found.
Quantification and Characterization of Maghemite in Soils Derived from Volcanic Rocks in Southern Brazil
- Antonio Carlos S. da Costa, Jerry M. Bigham, Fred E. Rhoton, Samuel J. Traina
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- Clays and Clay Minerals / Volume 47 / Issue 4 / August 1999
- Published online by Cambridge University Press:
- 28 February 2024, pp. 466-473
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Many soils developed from volcanic rocks in southern Brazil exhibit spontaneous magnetization caused by the presence of fine-grained maghemite (γ-Fe2O3), but few attempts were made to quantify or characterize this important soil component. To that end, clays were separated from freely drained soils derived from acid (≥63% SiO2), intermediate (54–62% SiO2), and basic (≤53% SiO2) igneous rocks produced by the Paraná flood volcanism. The sample set included soils with a wide range of pedogenic development on different landscape positions. The Fe oxide mineralogy of these samples was examined by using a combination of selective dissolution, magnetic susceptibility, and X-ray diffraction (XRD) techniques. Hematite and maghemite were the primary Fe oxides in mature soils (Oxisols, Ultisols, and Alfisols) developed from basic rocks; whereas goethite was dominant in all other soils, especially those formed from acid-intermediate rocks. The association of maghemite with basic rock materials suggests that it was primarily formed by oxidation of lithogenic magnetite. A strong, positive correlation (R2 = 0.89) was obtained between mass specific magnetic susceptibility (χ) of the clay fractions and maghemite contents estimated by XRD. Either method could be used for quantitative analyses, but χ was more sensitive than XRD at low maghemite concentrations (<2 wt. %). The clay-sized maghem-ites were superparamagnetic with an estimated value for the mass specific magnetic susceptibility (χlf) value of 91,000 × 10−8 m3 kg−1 and frequency dependent variations of 10–15%. The maghemites also had low unit cell constants, which, if attributed entirely to replacement of Fe by Al, would correlate with Al substitutions in the range of 5–16 mole %. Selective dissolution of the soil maghemites was achieved by treatment of Fe oxide concentrates with 1.8 M H2SO4 at 75°C for 2 h.
Social connections and risk of incident mild cognitive impairment, dementia, and mortality in 13 longitudinal cohort studies of ageing
- Gowsaly Mahalingam, Suraj Samtani, Ben Chun Pan Lam, Darren M Lipnicki, Maria Fernanda Lima-Costa, Sergio Luis Blay, Erico Castro-Costa, Xiao Shifu, Maëlenn Guerchet, Pierre-Marie Preux, Antoine Gbessemehlan, Ingmar Skoog, Jenna Najar, Therese Rydberg Sterner, Nikolaos Scarmeas, Mary Yannakoulia, Themis Dardiotis, Ki-Woong Kim, Steffi Riedel-Heller, Susanne Röhr, Alexander Pabst, Suzana Shahar, Katya Numbers, Mary Ganguli, Tiffany F. Hughes, Ching-Chou H. Chang, Michael Crowe, Tze Pin Ng, Xinyi Gwee, Denise Qian Ling Chua, representatives from SHARED work packages, Joanna Rymaszewska, Karin Wolf-Ostermann, Anna-Karin Welmer, Jean Stafford, Myrra Vernooij-Dassen, Yun-Hee Jeon, Perminder S Sachdev, Henry Brodaty
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 16-17
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Background:
Good social connections are proposed to positively influence the course of cognitive decline by stimulating cognitive reserve and buffering harmful stress-related health effects. Prior meta-analytic research has uncovered links between social connections and the risk of poor health outcomes such as mild cognitive impairment, dementia, and mortality. These studies have primarily used aggregate data from North America and Europe with limited markers of social connections. Further research is required to explore these associations longitudinally across a wider range of social connection markers in a global setting.
Research Objective:We examined the associations between social connection structure, function, and quality and the risk of our primary outcomes (mild cognitive impairment, dementia, and mortality).
Method:Individual participant-level data were obtained from 13 longitudinal studies of ageing from across the globe. We conducted survival analysis using Cox regression models and combined estimates from each study using two-stage meta-analysis. We examined three social constructs: connection structure (living situation, relationship status, interactions with friends/family, community group engagement), function (social support, having a confidante) and quality (relationship satisfaction, loneliness) in relation to the risks of three primary outcomes (mild cognitive impairment, dementia, and mortality). In our partially adjusted models, we included age, sex, and education and in fully adjusted models used these variables as well as diabetes, hypertension, smoking, cardiovascular risk, and depression.
Preliminary results of the ongoing study:In our fully adjusted models we observed: a lower risk of mild cognitive impairment was associated with being married/in a relationship (vs. being single), weekly community group engagement (vs. no engagement), weekly family/friend interactions (vs. not interacting), and never feeling lonely (vs. often feeling lonely); a lower risk of dementia was associated with monthly/weekly family/friend interactions and having a confidante (vs. no confidante); a lower risk of mortality was associated with living with others (vs. living alone), yearly/monthly/weekly community group engagement, and having a confidante.
Conclusion:Good social connection structure, function, and quality are associated with reduced risk of incident MCI, dementia, and mortality. Our results provide actionable evidence that social connections are required for healthy ageing.
Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
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Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
Mineralogical, Chemical, and Physical Characterization of Synthetic Al-Substituted Maghemites (γ−Fe2−xAlxO3)
- Marcelo A. Batista, Antonio C. S. da Costa, Jerry M. Bigham, Henrique de Santana, Dimas A. M. Zaia, Ivan G. de Souza junior
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- Clays and Clay Minerals / Volume 58 / Issue 4 / August 2010
- Published online by Cambridge University Press:
- 01 January 2024, pp. 451-461
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Maghemite (γ-Fe2O3) is a ferrimagnetic Fe oxide commonly found in tropical and subtropical soils, especially in the topsoil where it is usually a product of burning. Isomorphic substitution (IS) of the Fe in maghemite by different metals (mainly Al3+) can modify its mineralogical and chemical attributes, and these modifications may be important to understanding the formation and properties of this mineral in soils and sediments. The objective of this work was to evaluate the crystallochemical alterations of synthetic, Al-substituted maghemites prepared by the precipitation of magnetites from alkaline aqueous media containing FeSO4·7H2O with increasing amounts of Al2(SO4)3·7H2O to obtain hypothetical Al3+ for Fe3+ substitutions ranging from 0.0 to 40.0 mol %. The Al-substituted magnetites were washed and dried, and then heated to 250ºC for 4 h to form yellowish red maghemites that were characterized by total chemical analysis, X-ray diffraction, specific surface area (SSA), mass-specific magnetic susceptibility, infrared spectroscopy, transmission electronic microscopy, and color. Increasing Al3+ substitution to an experimental maximum of 15.9 mol % decreased both the a0 dimension of the cubic unit cell (a0 = 0.8339 − 396.157 × 10−16 Al, r2 = 0.99) and the mean crystallite dimension (MCD = 76.4–3.15Al, r2 = 0.79) of the maghemites. With the decrease in MCD came a more yellowish color, an increase in SSA, and a decrease in crystallinity as measured through extraction of the samples with acid ammonium oxalate. The mass-specific magnetic susceptibility of the maghemites increased with Al3+ substitution up to 5.3 mol % and then decreased with further replacement of Fe by Al. Solid-phase aluminum in excess of 16 mol % substitution appeared to occur as a separate, poorly crystalline phase that was X-ray amorphous.
Water use efficiency and yield responses of Cenchrus purpureus genotypes under irrigation
- R. E. P. Ribeiro, A. C. L. Mello, M. V. Cunha, M. V. F. Santos, S. B. M. Costa, J. J. Coelho, R. O. Carvalho, V. J. Silva
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- The Journal of Agricultural Science / Volume 161 / Issue 4 / August 2023
- Published online by Cambridge University Press:
- 07 September 2023, pp. 572-580
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In tropical regions, water stress is one of the main causes of the reduction in forage productivity, and irrigation strategies can mitigate the problem, especially for highly productive species. The objective of this study was to evaluate the effects of irrigation, genotype and plant size on productive responses and water use efficiency (WUE) of elephant grass (Cenchrus purpureus [Schumach.] Morrone), in the rainy and dry season. The experimental design was randomized in blocks, arranged in split plots, the main plots were established based on the use of irrigation and the subplots were the tall-sized genotypes (IRI 381 and Elephant B) and dwarfs (Taiwan A-146 2.37 and Mott). The genotypes were evaluated for two years and harvested every 60 days. Water use efficiency, total forage accumulation per year and harvest, forage accumulation rate and forage density were evaluated. There was a significant difference between the genotypes in terms of total forage accumulated (P < 0.05). The most productive genotype was IRI 381, which showed the greatest total forage accumulation (42 168 kg of DM/ha in two years) in the irrigated plots. During the rainy seasons, IRI 381 stood out in terms of forage accumulated (24 667 kg of DM/ha). Irrigation favoured increases in forage accumulation around 60%, in both years of evaluation. Irrigation and plant size influenced the productivity and WUE of elephant grass harvested in 60-day intervals. Tall genotypes and Taiwan A-146 2.37 (dwarf size) stood out in most of the productive traits analysed, while Mott was highlighted by its forage density.
Night-time/daytime Protein S100B serum levels in paranoid schizophrenic patients
- E. Diaz-Mesa, A. Morera-Fumero, L. Torres-Tejera, A. Crisostomo-Siverio, P. Abreu-Gonzalez, R. Zuñiga-Costa, S. Yelmo-Cruz, R. Cejas-Mendez, C. Rodriguez-Jimenez, L. Fernandez-Lopez, M. Henry-Benitez
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S445-S446
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Introduction
S100B is a calcium-binding astrocyte-specific cytokine, that is considered a biomarker of neurodegeneration; which may be involved in the imbalance of the inflammatory response observed in several brain disorders, including major depression and schizophrenia. Two meta-analyses have reported higher serum levels of S100B in patients with schizophrenia respect to healthy controls.
Different studies have described circadian and seasonal variations of biological variables, such as melatonin or cortisol. It has been reported that there is not circadian rhythm of S100B blood levels in healthy subjects. However, it is not known whether there are circadian oscillations in S100B blood concentrations in patients with schizophrenia.
ObjectivesThe aim of this study is to describe S100B serum levels in patients with schizophrenia and to analyse whether they follow a circadian rhythm.
MethodsOur sample consists in 47 patients in acute phase and stabilized status. Blood samples were collected at 12:00 and 00:00 hours by venipuncture. Serum levels of Protein S100B were measured three times: at admission, discharge and three months after discharge. Protein S100B was measured by means of ELISA (Enzyme-linked immunosorbent assay) techniques.
Results12:00 24:00 P ADMISSION 132,95±199,27 85,85±121,44 0,004 DISCHARGE 73,65±71,744 75,80±123,628 0,070 CONTROL 43,49±34,60 40,14±23,08 0,47 P global P Admission Vs. Discharge P Admission Vs. Control P Discharge Vs. Control 0,97 There is a significance difference between 12:00 and 24:00 at admission for the Protein S100B.However, these difference did not occur at discharge and at three months after discharge.It can be interpreted as there is a circadian rhythm of Protein S100B when the patient has got a psychotic outbreak and disappears at discharge and when is psychopathologically stable.
ConclusionsWith respect to our results we can hypothesize that schizophrenic patients in acute relapse present circadian S100B rhythm that is not present when the patients are clinically stable.Furthermore, the decrease of serum protein S100B levels at discharge is indicative of a reduction of the cerebral inflammation, thus it can be a biomarker of cerebral inflammation and this reduction can be the effect of the treatment. Finally, its circadianity could be a guide of this process and clinical improvement.
Disclosure of InterestNone Declared
The Fall of Icarus: Post-psychotic depression - Apropros a clinical case
- S. Jesus, A. R. Costa, G. Simões, M. Almeida, A. Tarelho, P. Garrido
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S843-S844
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Introduction
Depressive symptoms occur in different phases of psychosis, including prodromal, acute and post-psychotic. Post-psychotic depression (PPD) is a phenomenon that presents as a diagnostic and therapeutic challenge. Having been ascribed various descriptions in the past, PPD has been used in a broad manner to describe depressive symptoms that appear in patients with history of psychosis. PPD unveils itself as a separate nosological entity, differing from the adverse effects typically associated with antipsychotics, the negative symptoms of psychosis, and other psychiatric disorders that present with both psychotic and depressive symptoms (e.g. bipolar disorder, schizoaffective disorder, or psychotic depression).
ObjectivesThe authors present a case of a 64 year-old man hospitalized due to inaugural psychosis with persecutory and grandiose delusions as well as auditory hallucinatory activity, who began to develop a depressive clinical picture whilst under treatment. A brief discussion on post-psychotic depression, from its clinical presentation to its treatment and implications in prognosis is also presented.
MethodsA brief non-systematized literature review using the Pubmed platform as well as presentation of a clinical case.
ResultsDepressive complaints are a common complication of psychotic episodes, with the literature estimating that approximately a quarter of psychotic patients present with PPD. Although typically described in association with schizophrenia, recent literature describes PPD occurring alongside other psychotic presentations, including first-episode psychosis. A division between affect and psychosis has been attempted in terms of psychiatric classification, however, the blurred lines between the two continue to contribute to difficulties in differential diagnosis. This becomes a challenge when distinguishing between extrapyramidal symptoms associated with antipsychotics, negative symptoms (i.e apathy, abulia and alogia) and psychiatric disorders with affective-psychotic overlap. Having only recently been considered a distinct clinical entity in psychiatric classification systems, research on its etiology, course, treatment and prognosis are scarce. In regards to the previously described patient, a depressive disorder whilst in treatment for psychosis was identified, and through early recognition of the symptoms treatment with an antidepressant was initiated with favourable response.
ConclusionsPPD is a relatively common phenomenon which is gaining more attention in recent literature. As classifications have begun to consider PPD as a distinct clinical entity, as well as unifying defining criteria, further studies can be developed so as to clarify aspects which remain to be defined. The clinician should be aware of this entity as well as the potentially confounding symptom presentations, so as to provide adequate early treatment thus contributing to improved patient outcomes.
Disclosure of InterestNone Declared
Brief reactive psychosis….again! - Clinical case report
- A. R. Costa, S. Jesus, M. Almeida, C. Vicente
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1045
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Introduction
Brief psychotic disorder according to the DSM-5 is a condition of sudden onset lasting less than 1 month followed by complete remission with possible future relapses, characterized by the development of psychotic conditions. The duration of the illness is a differentiating factor from other disorders such as schizophreniform psychosis or schizophrenia. When there is a stressful event at the origin of the psychotic symptomatology, it is also called brief reactive psychosis. The pathophysiology of BPD is not known, especially given the extremely low incidence of the disorder. This condition most often affects people in their 20s, 30s, and 40s, and its higher prevalence among patients with personality or mood disorders may suggest an underlying biological or psychological susceptibility that may have some genetic influence.
ObjectivesTo describe the main diagnostic considerations, clinical manifestations, treatment, prognosis and prevention of brief reactive psychosis through the description of a clinical case that developed two episodes of brief reactive psychosis in a period of 1 year and to emphasize the importance of maintaining treatment for a period of suitable time.
MethodsCase report and literature search with the terms: brief reactive psychosis, psychosis, neuroleptic, stressor event.
ResultsWe describe the clinical case of a 29-year-old woman, born in S. Tomé and Príncipe, previously healthy, with no personal or family history of mental illness, who had her first brief reactive episode after coming to Portugal. With the introduction of the 2nd generation antipsychotic, paliperidone, there was a substantial improvement in the condition, however, with the development of side effects having subsequently abandoned the treatment. About 1 year after starting work in Portugal, she develops a new event, a new psychotic episode, with characteristics of a brief psychotic disorder.
ConclusionsIt is extremely important to alert patients to the possible side effects of drugs, as well as those who experience a brief psychotic episode, which are the risk factors and the need to comply with treatment in order to avoid a new relapse.
Disclosure of InterestNone Declared
Psychosocial differences in perceived older workers’ work (un)adaptability, effectiveness and workplace age discrimination
- S. von Humboldt, I. Miguel, J. Valentim, A. Costa, G. Low, I. Leal
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S237
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Introduction
The aging population in the developed world has implied increasing age diversity in the workforce of organizations. Consequently, mutual perceptions about one’s co-workers and age discrimination is becoming increasingly important.
ObjectivesThis study aims to explore how perceptions about older workers’ work (un)adaptability, work effectiveness and workplace age discrimination vary according to participants’ psychosocial factors, such as age group, gender, education level and work sector.
MethodsThis study included a sample of 453 workers in Portugal, diverse in terms of age, gender, education level and work sector. Four different instruments were used: (a) a sociodemographic questionnaire; (b) an older workers’ Work Adaptability scale; (c) an older workers’ Work Effectiveness Scale and; (d) the Workplace Age Discrimination Scale (WADS).
ResultsMiddle-aged and older participants perceive older workers as more adaptable than younger participants. The oldest group of participants perceives older workers to be more work-effective and experience the highest levels of age discrimination in the workplace, when compared to the other age groups. Also, participants with lower levels of education tend to perceive higher levels of workplace age discrimination, when compared to participants with high school and higher education.
ConclusionsGenerational perceptions in the workplace are perceived by workers differently, hence organizations should implement age management strategies to address age discrimination, particularly due to the increasing proportion of older workers.
Disclosure of InterestNone Declared
Psychopathology without Borders: Transcultural psychiatry and implications in clinical presentation and practice
- S. Jesus, A. R. Costa, G. Simões, A. I. Gomes, A. Tarelho, P. Garrido
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S823
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Introduction
Existing as an emerging topic in the field and undergoing constant evolution, Transcultural Psychiatry addresses how social and cultural factors influence mental illness. During the second half of the twentieth century, phenomena such as globalization, massive migrations and immigration, occurring in ever increasing frequency, continue to bring this topic to the forefront of discussion as challenges in the treatment of patients from varying cultural backgrounds emerge. Viewed from the biopsychosocial perspective, culture delineates a framework for the evaluation of various expressions of emotion and behaviour as well as defining the limits of what counts as disorder. As border restrictions are lifted, cases which present with these particularities are bound to increase, necessitating an increased attention to the influence that cultural and social factors play in the psychopathological clinical pictures which may present to the practitioner.
ObjectivesThe authors aim to briefly explore the concept of transcultural psychiatry and its importance in clinical presentation and practice with recourse to various clinical cases of international patients hospitalized in a Portuguese Psychiatry ward during a two-year period.
MethodsA brief non-systematized literature review was performed based on works most pertinent to the topic discussed. As compliment to the topic, a discussion of various clinical cases of hospitalized international patients is presented.
ResultsCulture has been demonstrated to contribute to psychopathological presentations in a variety of forms, solidifying the old adage that ‘no man is an island’ and giving reason to the biopsychosocial approach applied in clinical practice. The impact of sociocultural factors is such that the DSM-5-TR includes in its classification culture-specific syndromes. The cases discussed demonstrate the various nuances necessary not only in exploring psychopathology, but also in implementing appropriate standards of care.
ConclusionsTranscultural psychiatry rises as a relatively recent topic as well as raising important philosophical, theoretical and technical challenges for mental health practitioners. Although existing as a subspecialty, each mental health practitioner should strive to be transcultural, taking into consideration the influence that these factors exert on mental illness. The patient should be evaluated with consideration to their cultural background, as well as not neglecting how the culture of the practitioner may influence the interpretation of psychopathological presentation.
Disclosure of InterestNone Declared
The Green-Eyed Monster: A Brief Exploration of the Jealousy Spectrum
- S. Jesus, A. R. Costa, M. Almeida, P. Garrido
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1002
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Introduction
A feeling as ancient as humankind, having been documented in the Bible, represented by mythological figures and appearing as a recurrent theme in art and literature, jealousy is a complex emotion that is non-discriminatory and often associated with negative feelings ranging from insecurity, suspicion, rage, fear to humiliation. Commonly associated with romantic relationships, it typically arises when one perceives a threat, either real or imagined, from a third party in regards to possession or perceived security. Jealousy, like other aspects of the human experience, varies in its expression and intensity, ranging from an adaptive response to a potentially dangerous psychopathological symptom.
ObjectivesThe authors aim to describe jealousy and discuss the spectrum on which it appears, ranging from an adaptive response to a psychopathological manifestation.
MethodsA brief non-structured literature review was carried out with recourse to various databases such as Pubmed as well as complimentary literary sources when deemed pertinent.
ResultsDescribed as a defensive reaction that is expressed as a cognitive, emotional and behavioural response to a perceived threat, jealousy has been discussed in various arenas of thought ranging from evolutionary psychology to philosophy to psychiatry to representation in the arts. It is a difficult term to define as it is a feeling expressed through diverse emotions and behaviours originating from various contexts as well as varying in its intensity. The literature demonstrates that jealousy can exist as an adaptive response, with evolutionary explanations, to a psychopathological expression either as obsessive jealousy or morbid jealousy, also known as Othello’s Syndrome. Each carries its own particularities in terms of expression, clinical significance and intervention. The more often described delusional jealousy, is characterized by the presence of strong, false beliefs that the partner is unfaithful, whereas obsessive jealousy, less commonly described, presents with unpleasant, ego-dystonic and irrational jealous ruminations that the partner could be unfaithful. These thoughts are often accompanied by compulsive verification of the partners’ behaviour. Treatment interventions in these cases are varied and present implications in prognosis.
ConclusionsJealousy is a complex emotional state and has been described as part of the universal human experience, with research indicating its existence across various cultures. The expression of this emotional experience as well as its potential manifestation types should be taken into consideration by the mental health practitioner when carrying out an evaluation, as treatment interventions and prognosis may vary depending on the presentation.
Disclosure of InterestNone Declared
DELUSION OF PREGNANCY IN PATIENT WITH MAJOR NEUROCOGNITIVE DISORDER: A CASE REPORT
- M. O. Pires, S. Mouta, I. Fonseca Vaz, B. Jesus, J. Nunes, A. Pissarra da Costa
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S939-S940
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Introduction
Delusion of pregnancy (DP) is a heterogeneous symptom that can emerge from different neuropsychiatric syndromes, including schizophrenia, bipolar disorders, but also major neurocognitive disorder (MND). According to the Diagnostic and Statistical Manuel of Mental Disorders-5 (DSM-5), DP is an unspecified type of delusional disorder present in the spectrum of schizophrenia and other psychotic disorders This type of delusion, which can affect both sexes, may have numerous determinants to its genesis and may last decades to resolve.
ObjectivesWe aim to present a case and review of DP and its association with dementia/MND, hyperprolactinemia and galactorrhea.
MethodsNon-systematic literature review and case report, based on the search for titles and/or abstracts of articles that address both DP and dementia, and DP and hyperprolactinemia/galactorrhea, including articles published between 2010 and 2022 in English.
ResultsA 71-year-old female patient was admitted to the Psychiatric unit due to a change in usual behavior in the past 6 months: insomnia, anterograde amnesia, delusions of ruin and persecutory and, for the past month, the belief of being pregnant with twins, supported by the galactorrhea she presented after starting Risperidone prescribed by her Family Doctor weeks prior. Shortly after admission, the patient also revealed hearing her fetuses’ voices. DP vanished briefly after admission due to the combination between the change of Risperidone to Aripiprazole (a prolactin-sparing antipsychotic) and psychotherapy to help deconstruct the patient’s cognitive misinterpretations. She was furthermore diagnosed with Alzheimer’s disease and Memantine was started.
ConclusionsThis patient, according to Bera et al. (Bera et.al. Indian J Psychol Med 2015;37:131-7) is part of the 28.6% of patients more than 50 years of age who present DP, 6.0% that report having twins and 8.3% that report hearing voices of their fetuses. No data was found correlating DP and MND directly. Hyperprolactinemia and its consequent galactorrhea represent one of the many explanations behind DP, especially in suggestible demented patients that easily misinterpret somatic sensations, in which delusional thoughts are frequent and contribute to the morbidity.
Disclosure of InterestNone Declared
Suicidality among inpatients - Right under our noses
- A. S. Morais, F. Martins, V. Henriques, P. Casimiro, N. Descalço, R. Diniz Gomes, N. Cunha e Costa, S. Cruz
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1106-S1107
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Introduction
An inpatient suicide is a tragic event that, despite not very prevalent, should not be overlooked. It occurs in 250 in 100 000 psychiatric hospital admissions (which represents a suicide risk fifteen times greater than general population) and in 1.7-1.9 in 100 000 in general hospitals (4-5 times greater risk). Together they constitute 5-6% of all suicides.
ObjectivesThe purpose of the authors is to explore the epidemiology, the risk factors and the prevention of suicide in inpatient setting.
MethodsA brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.
ResultsThe risk was higher at admission (first week) and immediately after discharge (first 24 hours, up to two weeks).
It was found to be correlated to pour staffing, an increased number of patients with severe mental illnesses and accessibility to lethal means. Many risk factors were identified, some of them specific to context. Risk Factors at admission in a psychiatric hospital – personal or familiar suicide history, schizophrenia or mood disorder, alcohol use, involuntary admission, living alone, absence from the service without permission. Later till discharge - personal suicide history (or attempts after admission), relational conflicts, unemployment, living alone, lack of discharge planning and lack of contact in the immediate post-discharge period. In General Hospitals – chronicity and severity of somatic disease, poor coping strategies, psychiatric comorbidities and lack of liaison psychiatry.
Strategies to prevent inpatient suicide should take in environmental modification (specific to environment and specific to patient – as planned levels of supervision), optimisation of the care of the patients at suicidal risk, staff education and involvement of families in care. There are few studies on the efficacy of pharmacotherapy on reducing suicidal ideation in inpatients (just for clozapine and ketamine); some psychotherapies show promising results. The post-suicide approach cannot be neglected, whether in supporting the family, the team involved and even other patients.
ConclusionsThe assumption of the predictive and preventive value of the risk assessment has been under scrutiny. Depressed mood and a prior history of self-harm are well-established independent risk factors for inpatient suicide; however they lose their predictive value due to their high prevalence. Up to 70% of inpatients who committed suicide didn’t express suicidal ideation on the previous interviews. Most effective measures to prevent suicide are environmental modifications and staff education approaches, giving appropriate responses to each patient’s circumstances.
There is a paucity of literature on suicide in this setting. It should become a priority in national programs of Suicide Prevention.
Disclosure of InterestNone Declared
Cut From the Same Cloth: Bipolar disorder and Frontotemporal Dementia – Apropos a Clinical Case
- S. Jesus, A. R. Costa, M. Almeida, P. Garrido
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S709
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Introduction
Mood disorders have been reported in the literature as a risk factor for developing cognitive deficits. Bipolar disorder (BD) and Frontotemporal Dementia (FTD) share many common features, often presenting as a differential diagnostic challenge to the clinician. The clinical features of mania, such as euphoria, hyper-sexuality and difficulties in impulse control can mimic the impaired judgment and loss of inhibition seen in FTD. Depressive features such as anhedonia and social isolation can mimic apathy associated with FTD. Of the various subtypes, the behavioural-variant of FTD (bvFTD) is most similar to a manic episode.
ObjectivesThe authors aim to explore the relationship between BD and FTD, and the implications in differential diagnosis, treatment and prognosis with recourse to a clinical case example.
MethodsA non-systematized review of pertinent literature on the topic with focus on that which is most relevant to the theme was included. The authors present a clinical case of 55 year-old female with history of BD who was hospitalized in the context of a depressive episode with suicidal ideation and disorganized behaviour.
ResultsIt is not uncommon for patients with bvFTD to be initially diagnosed with BD, whereas on the other hand, patients presenting in late with an inaugural manic episode are considered to have dementia. The literature also reports that patients with BD appear to be at increased risk of a later FTD diagnosis, further contributing the diagnostic difficulties. Core symptoms that present in mood disorders, also make-up the clinical picture of FTD, and vice versa. Correct diagnosis is imperative as early-intervention may have significant impact on prognosis of the clinical pictures. The patient underwent complementary diagnostic imaging testing with magnetic resonance imaging, which documented atrophy in the fronto-temporal regions which were not detected on previous exams, thus strongly suggesting a FTD diagnosis in a patient with history of BD.
ConclusionsThe literature establishes, especially through various case reports, an apparent clinical overlap between FTD and mood disorders. A multifaceted connection between BD and FTD appears to exist, with clinical and genetic similarities having been described, although further studies are merited demonstrating this relationship. The clinical case highlights the challenges in FTD diagnosis in a patient with prior history of a mood disorder, especially BD, as well as demonstrating the difficult task in establishing a differential diagnosis between the two conditions when the mood disorder presents late in life. The clinician is alerted to the mimicry between the two conditions, taking into account the possibility of a FTD diagnosis in patients with history of BD presenting with unexpected cognitive and behavioural decline.
Disclosure of InterestNone Declared
You Look Good Enough to Eat: A Brief Exploration of Human Cannibalism and Mental Illness
- S. Jesus, A. R. Costa, G. Simões, A. I. Gomes, P. Garrido
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S961
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Introduction
Although evidence of cannibalism in humans dates back millennia, for most civilized societies, it is an unthinkable act of violence and strictly taboo. It is commonly relegated to the domain of horror films and literature, often associated with the likes of Jeffrey Dahmer or Hannibal Lecter. However, for some, this theme encompasses a pathological or sexual realm. Vorarephilia or sexual cannibalism is, at its simplest level, a psychosexual disorder characterized by the erotic desire to be consumed by, or to personally consume, another human being´s flesh.
ObjectivesThe authors aim to review human sexual cannibalism as a concept and its eventual relationship to mental illness with recourse to the description of cases of human cannibalism documented in the literature.
MethodsA brief non-systematized literature review utilizing various databases including Pubmed and Google Scholar, as well as complimentary literature and case reports when pertinent to the theme was performed.
ResultsAlthough cannibalism is a common phenomenon in the animal kingdom, its expression in humans is assumed to be a minority occurrence and relegated to stories of a more primal past. Pathological cannibalism is an extremely rare occurrence and has been described in association with severe psychotic mental illness and extreme forms of significant paraphilia. Sexual cannibalism appears as a rarity in humans and although the majority with this paraphilia do not partake in actual human consumption, remaining a fantasy-based desire, cases of cannibalism have been reported and tried.
ConclusionsEating the flesh of one’s own species is probably one of the few remaining taboos in modern human societies. In humans, cannibalism is a rare occurrence and has been associated with mental illness. Due to the rarity of this phenomenon, with few cases documented in the literature, the underlying etiology, as well as potential environmental and individual risk factors are still to be defined, indicating a potential for further study.
Disclosure of InterestNone Declared
Frontotemporal dementia – a catastrophic form of dementia praecox
- A. R. Costa, S. Jesus, C. Vicente
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S932
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Introduction
Frontotemporal dementia (FTD) is a devastating neurodegenerative condition with several clinical presentations for which there is currently no effective treatment. Although much less common than Alzheimer’s disease, the impact of FTD is high thanks to its relatively early onset and high heritability. This subtype of brain atrophy production decided the frontal and temporal lobes.
Clinical heterogeneity and overlap with other neurodegenerative and psychiatric syndromes complicate diagnosis. Three different subtypes are recognized: behavioral variant, non-fluent aphasia, and progressive semantic dementia.
ObjectivesClinical review of frontotemporal dementia including the clinics, determination of diagnosis, treatment, and prognosis with a clinical case report.
MethodsBibliographic research with the terms dementia, frontotemporal dementia.
ResultsThe current clinical case follows a patient in her fifties, born in Brazil, who has a child and a poor social support network. No significant history, celebrating at least two years marked by an evolution framework of progressive change in verbal memory, increase in verbal influence, change in executive functions, namely, and definition of verbal decision.
ConclusionsIn general terms, behavioral and language alterations are the dominant aspects of this type of dementia and as characteristics common to the various subgroups of FTD.
FTD is a catastrophic clinical entity thanks to its beginning, the exuberance of the clinical picture, and mainly the lack of treatment with guidance aimed at relieving symptoms and improving the patient’s quality of life.
Disclosure of InterestNone Declared
Physical and psychoeducation combined group intervention: a quasi-experimental study with Portuguese cancer survivors
- A. Torres, A. Ribeiro, C. Matos, J. Costa, A. F. Oliveira, I. M. Santos, S. R. Costa
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S69-S70
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Introduction
Cancer is a major public health problem worldwide and the risk of death from cancer has decreased continuously since 1991, therefore, This translates into an increasing number of cancer survivors (CS) worldwide.
During the survivorship seasons, CS face several short-term, long-term, persistent, and late-emerging health and psychosocial problems, including cancer-related pain, fatigue, menopausal symptoms, anxiety, depression, distress associated with the risk of cancer recurrence, chronic uncertainty, social disruption, alterations of sleep, sexual and cognitive dysfunctions.
Since 2002 that some researchers and clinicians argued that it is important to de-velop and implement rehabilitation programs for cancer patients that integrate both psychosocial and physical rehabilitation.
ObjectivesWith the scarcity of studies on the effectiveness of combined interventions in this population, despite the strong recommendation to perform and study it, and aiming to contribute to a greater knowledge on the theme, the present work aims to build, implement, and evaluate a combined intervention program, which integrates psychoeducational intervention with physical exercise to cancer survivors and relatives, through the following indicators: psychopathological symptoms (anxiety and depression), self-concept, coping strategies, personal growth and QoL.
MethodsA non-probabilistic convenience sample of 70 cancer survivors was assigned to: control (without intervention: n=32), combined intervention (n=21) and psychoedu-cation intervention (n=17) groups. Both intervention groups were 9 consecutive weeks duration. The combined intervention group benefited from 2 weekly exercise sessions additionally. It was administered before and after intervention the following questionnaires: demographic; Hospital Anxiety and Depression Scale (HADS); Clinical Self-concept Inventory (ICAC); Cancer Coping Questionnaire (CCQ); sub-scale of Personal Growth of the Psychological Well-being Scale (EBEP) and the World Health Organization Quality of Life Questionnaire (WHOQOL-Bref).
ResultsIt was observed a statistically significant reduction of anxiety and depression symptoms from the beginning to the end of the intervention, as well as a significative improvement of overall and all do-mains of self-concept and personal growth. It was not observed a significative difference on quality of life.
ConclusionsThe findings of this study contribute to support of the beneficial effect of combined intervention on psychological functioning of cancer survivors. Positive effects of the psychological program were observed but not into the same extent as in the combined intervention.
Disclosure of InterestNone Declared
Anorexia Nervosa and Psychiatric Comorbidities – It’s not all about food
- A. S. Morais, F. Martins, P. Casimiro, V. Henriques, N. Descalço, R. Diniz Gomes, S. Cruz, N. Costa
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S521
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Introduction
Anorexia nervosa (AN) is a severe psychiatric disorder that usually begins during adolescence and is associated with a high risk of mortality and morbidity, its treatment is complex and often ineffective. Psychiatric comorbidity is common in patients with eating disorders (with the prevalence of 20–95%), namely 39% in AN.
ObjectivesThe purpose of the authors is to review the most common areas of psychiatric comorbidity in AN, how it affects the course of both diseases and the potential treatment approaches.
MethodsA brief non-systematized review is presented, using the literature available on PubMed and Google Scholar.
ResultsThe most common psychiatric comorbidities in AN are: Affective disorders in 24-38% (mainly unipolar depression which can appear in up to 75% of patients, compared to 11% in bipolar disorder); Anxiety disorders in 25.5% (11% with panic disorder, 20% social phobia/social anxiety disorder, 15% specific phobias, 10% generalized anxiety disorder, 13% post-traumatic stress disorder); Obsessive compulsive disorder in 12%; Substance use disorders at 17%; Personality disorders around 30%. Other pathologies occur less commonly but can have a significant impact on the patient, namely Autism spectrum disorder (predictive factor for unfavourable outcome) or Schizophrenia (there are reports of reciprocal relationships between the two pathologies).
Some of these comorbidities may increase mortality in AN, namely unipolar depression, personality disorders, alcohol and illicit drug use.
The profound impact that starvation has on mood and cognition is well known. It can condition symptoms that are confused with other psychiatric diseases and change their clinical presentation. As such, the specific clinical characteristics and the therapeutic approach will be presented for each of the psychiatric comorbidities.
ConclusionsEarly diagnosis and treatment of psychiatric comorbidities in AN are essential to improve the prognosis of this eating disorder. The additional treatment of these pathologies will increase complexity of the already challenging treatment of AN, with the additional symptomatology often being perpetuated by an uncontrolled eating disorder and a poor compliance to treatment.
The limited evidence available for approaching these cases is based on the few studies available, most with insufficient samples.
Disclosure of InterestNone Declared
A new specialist group for Brazilian fungi
- Elisandro Ricardo Drechsler-Santos, Francisco J. Simões Calaça, Kelmer Martins-Cunha, Diogo H. Costa-Rezende, Jadson D.P. Bezerra, Larissa Trierveiler-Pereira, Nelson Menolli, Jr., Luciana Canêz, Tiara S. Cabral, Cátia Canteiro, Gregory M. Mueller
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