Neuropsychological manifestations of long COVID in hospitalized and non-hospitalized Brazilian Patients

BACKGROUND

There has been a significant increase in number of patients seeking neuropsychological rehabilitation months after the acute phase of COVID-19 infection.

OBJECTIVE

Identify the cognitive and psychiatric disorders in patients with long COVID or Post-Acute Sequelae of COVID (PASC) and explore the association between disease severity during the acute phase and persistent neuropsychological manifestations.

METHODS

614 adults were assessed an average of eight months post-infection. Participants were, on average, 47.6 y.o., who sought rehabilitation for neuropsychological problems. Patients were evaluated using the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS), Phonemic Verbal Fluency and Clock Drawing tests (NEUPSILIN) for executive functions, and the Hospital Anxiety and Depression Scale (HADS).

RESULTS

The BNIS score was significantly below reference values in all subscales, especially affect and memory. Verbal Fluency and Clock Drawing subtest results were also lower. Patients with PASC tested high for anxiety/depression, but there was no statistically significant relationship between HADS and BNIS scores. Neuropsychological evaluations showed no differences in cognitive or psychiatric profiles between hospitalized and non-hospitalized patients.

CONCLUSIONS

Neuropsychological results suggest executive function problems and high incidence of anxiety/depression, irrespective of acute-phase severity, underscoring a need for neurorehabilitation programs while providing data for public policy initiatives.

Association Between Citrus Flushing Cycles and Asian Citrus Psyllid Demography in Huanglongbing-Free Area in Brazil

Diaphorina citri Kuwayama (Hemiptera: Liviidae), named as Asian citrus psyllid (ACP), is the vector of the bacterium associated with huanglongbing (HLB), the most destructive citrus disease. The use of citrus flushing and ACP monitoring tools is essential for the knowledge of the occurrence pattern of cycles of both and for the improvement of the ACP management. During 3 years, 20 branches from 20 trees were evaluated for vegetative flushing, ACP abundance, and occupation in tree and branches in a Brazilian citrus area free for HLB. The obtained data was investigated through spectral and co-spectral analyses. Four to 12 flush shoot cycles occurred per year, which were similar to abundance and occupation cycles of ACP, with an apparent synchronization between these variables. In general, there was a difference from 14 to 19 days between flushing and ACP peaks, with an occurrence of the flushing peaks before the ACP peaks. Results will provide useful information to citrus growers and agricultural defense agencies to apply a suitable and targeted ACP management, which will avoid or delay the disease entrance into still free HLB areas. In addition, the modeling of occupation and abundance cycles of vectors as applied in this study may be useful for other pathosystems which insect vectors are associated or even in the intrusion monitoring programs.

Could polymorphisms in ABCB1 gene represent a genetic risk factor for the development of mammary tumors in dogs?

The ABCB1 gene encodes the P-glycoprotein (P-gp) which regulates distribution and bioavailability of many endogenous and exogenous substrates, acting as a cellular mechanism of protection against these substances. Some studies have shown evidence that P-gp is related to carcinogenesis. In this study, we performed PCR and direct sequencing of ABCB1 exons 9 and 26 in 47 tissue DNA samples from canine mammary tumors. A statistically significant correlation between distinct canine breeds and the frequency of ABCB1 polymorphisms (c.985T > A and c.3442A > G SNP in ABCB1exons 9 and 26, respectively) was observed (P = 0.0015). In contrast, the TNM clinical staging, age, histological type and grade, as well as other histopathological characteristics, did not present statistically significant difference in relation to one or both SNP found in exons 9 and 26. These findings raise questions about the role of the canine ABCB1 polymorphisms in the development of mammary tumors, since the Poodle breed, which is the most common dog breed affected by mammary tumors in Brazil, presented the highest frequency of these variants. Notwithstanding, additional studies comprising a number of samples expressing the ABCB1 gene from healthy dogs, with advanced age and from different breeds, will be necessary to confirm the association of ABCB1polymorphisms and the development of mammary tumors.

Antifungal treatment in allergic bronchopulmonary aspergillosis with and without cystic fibrosis: a systematic review

Allergic bronchopulmonary aspergillosis (ABPA) is a rare disease that affects patients with asthma or cystic fibrosis. Its debilitating course has led to the search for new treatments, including antifungals and monoclonal antibodies. To evaluate the efficacy and safety of antifungal treatments in patients with ABPA and either asthma or cystic fibrosis, we performed a systematic review of the literature on the effects of antifungal agents in ABPA using three biomedical databases. Quality assessment was performed using the GRADE methodology and, where appropriate, studies with comparable outcomes were pooled for meta-analysis. Thirty-eight studies - four randomized controlled trials and 34 observational studies - met the eligibility criteria. The antifungal interventions described were itraconazole, voriconazole, posaconazole, ketoconazole, natamycin, nystatin and amphotericin B. An improvement in symptoms, frequency of exacerbations and lung function was reported in most of the studies and was more common with oral azoles. Antifungals also had a positive impact on biomarkers and radiological pulmonary infiltrates, but adverse effects were also common. The quality of the evidence supporting these results was low or very low due to a shortage of controlled studies, heterogeneity between studies and potential bias. Antifungal interventions in ABPA improved patient and disease outcomes in both asthma and cystic fibrosis. However, the recommendation for their use is weak and clinicians should therefore weigh up desirable and undesirable effects on a case-by-case basis. More studies with a better methodology are needed, especially in cystic fibrosis, to increase confidence in the effects of antifungal treatments in ABPA.

Validation of otolith daily increments in early juveniles of shanny Lipophrys pholis

To assess the periodicity of micro-increment formation in otoliths of Lipophrys pholis, 90 early juveniles were immersed in alizarin red S or tetracycline hydrochloride for 24 h and sacrificed after 10, 20 and 30 days. The number of micro-increments viewed under light microscopy was significantly related to the duration of the experimental period, and the slopes of the linear regressions were not significantly different from 1. This study indicates that micro-increments in sagittae were deposited daily and can be used as reliable sources of age information for L. pholis.

Wakame and Nori in restructured meats included in cholesterol-enriched diets affect the antioxidant enzyme gene expressions and activities in Wistar rats

The effects of diets including restructured meats (RM) containing Wakame or Nori on total liver glutathione status, and several antioxidant enzyme gene expressions and activities were tested. Six groups of ten male growing Wistar rats each were fed a mix of 85% AIN-93 M diet and 15% freeze-dried RM for 35 days. The control group (C) consumed control RM, the Wakame (W) and the Nori (N) groups, RM with 5% Wakame and 5% Nori, respectively. Animals on added cholesterol diets (CC, CW, and CN) consumed their corresponding basal diets added with cholesterol (2%) and cholic acid (0.4%). Alga and dietary cholesterol significantly interact (P < 0.002) influencing all enzyme expressions but not activities. The cholesterol supplement decreased most enzyme expression and activity. W-RM vs. C-RM increased (P < 0.05) expression of GPx, GR, Mn-SOD, and Cu,Zn-SOD and decreased that of catalase. N-RM vs. C-RM increased (P < 0.05) expression of catalase and Mn-SOD. GR activity increased in W-RM rats while SOD activity increased, but that of Se-GPx decreased in N animals. W-RM increased total and reduced glutathione and decreased the redox index. CN diet induced significantly lower plasma cholesterol levels (P < 0.001) than the CW diet. In conclusion, Nori-RM is a hypocholesterolemic food while Wakame-RM is an antioxidant food. This should be taken into account when including this kind of RM as potential functional foods in human.

Polymorphism of the Human Immunodeficiency Virus Type 1 in Brazil: genetic characterization of the nef gene and implications for vaccine design

Most of the Brazilian HIV-1 samples have been characterized based on the structural genes (env, gag and pol) and no data concerning the variability of the accessory genes such as nef have been available so far. Considering the role of the nef on virus biology and the inclusion of this region in some HIV/AIDS vaccine products under testing, the purpose of this study was to document the genetic diversity of the nef gene in third-four HIV-1 Brazilian samples previously subtyped based on the env C2-V3 region. Although only few non-subtype B samples have already been analyzed so far, the cytotoxic Tlymphocyte epitopes encoded in this region were relatively conserved among the subtypes, with some amino acid signatures mainly in the subtype C samples. Considering the increasing of the non-B HIV-1 subtypes worldwide, in special the subtype C, more data should be generated concerning the genetic and antigenic variability of these subtypes, as well as the study of the impact of such polymorphism in HIV/AIDS vaccine design and testing.

Antiinflammatory activity of extracts and fractions from the leaves of Gochnatia polymorpha

The aqueous and ethanol extracts from the leaves of Gochnatia polymorpha and further fractions obtained from the latter extract using solvents with increasing polarity, including its aqueous residue and the amino acid, 4-hydroxy-N-methyl-proline were investigated by carrageenin-induced pedal oedema formation. It was shown that the aqueous and ethanol extracts and the ethyl acetate fraction demonstrated significant antiinflammatory activity. The chemical investigation of the latter fraction revealed the presence of caffeic acid, chlorogenic acid, 3-0-methylquercetin, hyperosid and rutin. The amino acid 4-hydroxy-N-methyl-proline, a nonprotein amino acid that has not been reported before in the Asteraceae was isolated as a major compound and identified by spectroscopic methods.

A model for analysis of the nurse-patient interactive process (MAIP)

A model for analysis of the nurse-patient interactive process (MAIP), based on the analysis of the content of that interaction, is proposed as a method for determining appropriate psychosocial nursing diagnoses for the patient. The model focuses on the qualitative aspects of the phenomenon of interaction. The MAIP permits a systematic analysis of the nurse-patient interaction, and in turn will provide guidance for the professional in their actions in the interactive process.

[Transition described by an adult woman. Assistance from the Schlossberg Human Adaptation Model]

The case study of a forty two years old woman expressed the transition and crisis experienced by an adult woman. The speech content is presented in this article according to the human adaptation model of SCHLOSSBERG and attempting to acquire informations about crisis and transitions. The authors assumed a position of non-normative interviewers applying a psychological model in nursing and used the content analysis technic. They verified that the adult woman crises were solved using her own personal resources.

[Historical retrospective of nursing education in Brazil and current tendencies]

This paper analyses the laws and resolutions that regulate Brazilian nursing education since 1923, emphasizing the circumstances that surrounded them and evidencing the major tendencies at the present time.

[Scientific production in nursing in northeastern Brazil (1988-1992)]

Descriptive exploratory study accomplished with the purpose of identifying nurses' scientific productions in the Northeast Region during the period of 1988-1992, checking the rind of papers presented, the predominating theme area and the divulgation used. We observe that there is a sensitive increase in these productions since 1990. Scientific articles and assistentcal area themes predominated, as did the divulgation through national events.

Visceral larva migrans: a seroepidemiological survey in five municipalities of São Paulo state, Brazil

An enzyme-linked immunosorbent assay (ELISA), employing antigens from Toxocara canis larvae and the absortion of suspected sera with Ascaris lumbricoides extracts was used in a seroepidemiological study performed in five municipalities of São Paulo State, Brazil (São Paulo, Campinas, Santos, Marília and Presidente Prudente) in order to determine the frequency of antibodies to Toxocara. In 2,025 blood samples collected, 806 proceeded from male subjects and 1,219 from females; 483 samples were collected from subjects under 15 years of age and the remaining 1,542 from subjects aged 15 years or over. Among the 2,025 sera investigated, 3.60% had antibodies to Toxocara at significant levels. A moderate predominance of infection with Toxocara among male subjects (3.72%) was observed, although the difference was not statistically significant when this rate was compared with that for female (3.28%). Related to age, a higher frequency of positive results was detected among subjects under 15 years (6.41%) against the older group (2.53%). A trend of more elevated rates of infection was observed in municipalities with high demographic densities (São Paulo, Campinas and Santos). Nevertheless, such findings only appeared to be statistically significant in subjects younger than 15 years.