There is accumulating evidence on the use of N-acetylcysteine (NAC) in the treatment of patients with neuropsychiatric disorders. As a multi-target drug and a glutathione precursor, NAC is a promising molecule in the management of stress-related disorders, for which there is an expanding field of research investigating novel therapies targeting oxidative pathways. The deleterious effects of chronic stress in the central nervous system are a result of glutamatergic hyperactivation, glutathione (GSH) depletion, oxidative stress, and increased inflammatory response, among others. The aim of this study was to investigate the effects of NAC in zebrafish submitted to unpredictable chronic stress (UCS). Animals were initially stressed or not for 7 days, followed by treatment with NAC (1 mg/L, 10 min) or vehicle for 7 days. UCS decreased the number of entries and time spent in the top area in the novel tank test, which indicate increased anxiety levels. It also increased reactive oxygen species (ROS) levels and lipid peroxidation (TBARS) while decreased non-protein thiols (NPSH) and superoxide dismutase (SOD) activity. NAC reversed the anxiety-like behavior and oxidative damage observed in stressed animals. Additional studies are needed to investigate the effects of this agent on glutamatergic modulation and inflammatory markers related to stress. Nevertheless, our study adds to the existing body of evidence supporting the clinical evaluation of NAC in mood disorders, anxiety, post-traumatic stress disorder, and other conditions associated with stress.

Objective To describe the performance of CT and MRI in the assessment of the progression of interstitial lung disease (ILD) associated with systemic sclerosis (SSc) and demonstrate the correlations of MRI with pulmonary function test (PFT) and CT scores. Methods This prospective single-center observational study included patients with SSc diagnoses and MR images were assessed visually using the Scleroderma Lung Study (SLS) I system. Differences in the median scores were assessed with t-test and the Wilcoxon rank-sum test. Pearson’s and Spearman's Rank correlation coefficients were calculated to correlate imaging scores and PFT results. Using disease progression as the gold standard, we calculated the AUCs of the CT and MRI scores with Harrel’s c-index. The best thresholds for the prediction of disease progression were determined by ROC curve analysis with maximum Youden’s Index (p < 0.05). The sensitivity, specificity, PPV, and NPV of the scores were calculated. Results The AUCs for MRI and CT scores were 0.86 (0.72–0.98; p = 0.04) and 0.83 (0.70–0.99; p = 0.05), respectively. CT and MRI scores correlated with FVC% (MR: r = -0.54, p= 0.0045—CT: r = -0.44; p= 0.137) and DCO (MR: r = -0.39; p= 0.007—CT r = -0.36: p= 0.006). The sensitivity, specificity, PPV, and NPV were 85%, 87.5%, 88.34% and 86.11% (MR score) and 84.21%, 82.35%, 84.14% and 82.4% (CT score). Conclusions MRI scores from patients with SSc may be an alternative modality for the assessment of ILD progression in patients with SSc.

PurposeTo analyze and quantify the prevalence of six comorbidities from lung cancer screening (LCS) on computed tomography (CT) scans of patients from developing countries.MethodsFor this retrospective study, low-dose CT scans (n=775) from patients who underwent LCS in a tertiary hospital between 2016 and 2020 were examined. Age and sex- matched control group was obtained for comparison (n=370). Using the software, coronary artery calcification (CAC), the skeletal muscle area (SMA), interstitial lung abnormalities (ILAs), emphysema, osteoporosis, and hepatic steatosis was accessed. Clinical characteristics of each participant were identified. t-test and chi-squared test were used to examine differences between these values. Interclass correlation coefficients (ICCs) and Interobserver agreement (assessed by calculating kappa coefficients) were calculated to assess the correlation of measures interpreted by two observers. p values<0.05 were considered significant.ResultsOne or more comorbidities were identified in 86.6% of the patients and in 40% of the controls. The most prevalent comorbidity was osteoporosis, present in 44.2% of patients and on 24.8% of the controls. New diagnoses of cardiovascular disease, emphysema, and osteoporosis were made in 25%, 7%, and 46% of cases, respectively. The kappa coefficient for CAC was 0.906 (p<0.001). ICCs for measures of liver, spleen, and bone density were 0.88, 0.93, and 0.96, respectively (p<0.001).ConclusionsCT data acquired during LCS led to the identification of previously undiagnosed comorbidities. The LCS is useful to facilitate comorbidity diagnosis in developing countries, providing opportunities for its prevention and treatment.