COVID-19 neuropsychiatric repercussions: Current evidence on the subject

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the entire world, causing the coronavirus disease 2019 (COVID-19) pandemic since it was first discovered in Wuhan, China in December 2019. Among the clinical presentation of the disease, in addition to fever, fatigue, cough, dyspnea, diarrhea, nausea, vomiting, and abdominal pain, infected patients may also experience neurological and psychiatric repercussions during the course of the disease and as a post-COVID-19 sequelae. Thus, headache, dizziness, olfactory and gustatory dysfunction, cerebrovascular disorders, neuromuscular abnormalities, anxiety, depression, and post-traumatic stress disorder can occur both from the infection itself and from social distancing and quarantine. According to current evidence about this infection, the virus has the ability to infect the central nervous system (CNS) via angiotensin-converting enzyme 2 (ACE2) receptors on host cells. Several studies have shown the presence of ACE2 in nerve cells and nasal mucosa, as well as transmembrane serine protease 2, key points for interaction with the viral Spike glycoprotein and entry into the CNS, being olfactory tract and blood-brain barrier, through hematogenous dissemination, potential pathways. Thus, the presence of SARS-CoV-2 in the CNS supports the development of neuropsychiatric symptoms. The management of these manifestations seems more complex, given that the dense parenchyma and impermeability of brain tissue, despite protecting the brain from the infectious process, may hinder virus elimination. Still, some alternatives used in non-COVID-19 situations may lead to worse prognosis of acute respiratory syndrome, requiring caution. Therefore, the aim of this review is to bring more current points related to this infection in the CNS, as well as the repercussions of the isolation involved by the pandemic and to present perspectives on interventions in this scenario.

Effects of nutrients on immunomodulation in patients with severe COVID-19: Current knowledge

Recent research has demonstrated that critically ill patients with coronavirus disease 2019 (COVID-19) show significant immune system dysregulation. Due to that, some nutrients that influence immunomodulation have been suggested as a form of treatment against the infection. This review collected the information on the impact of vitamins on the prognosis of COVID-19, with the intention of facilitating treatment and prevention of the disease risk status in patients. The collected information was obtained using the PubMed electronic database by searching for articles that relate COVID-19 and the mechanisms/effects of the nutrients: Proteins, glucose, lipids, vitamin B12, vitamin D, calcium, iron, copper, zinc, and magnesium, including prospective, retrospective, and support articles. The findings reveal an optimal response related mainly to omega-3, eicosapentaenoic acid, docosahexaenoic acid, calcium, and iron that might represent benefits in the treatment of critically ill patients. However, nutrient supplementation should be done with caution due to the limited availability of randomized controlled studies.

Performance assessment of 11 commercial serological tests for SARS-CoV-2 on hospitalised COVID-19 patients

BACKGROUND

Commercial availability of serological tests to evaluate immunoglobulins (Ig) targeting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has grown exponentially since the start of the coronavirus disease 2019 (COVID-19) outbreak. Thorough validation of these tests is important before use as epidemiological tools to infer seroprevalence in specific populations and as diagnostic tools to complement molecular approaches (e.g., quantitative reverse transcription-polymerase chain reaction).

METHODS

Commercial serological tests from 11 suppliers were assayed side-by-side using 126 samples from SARS-CoV-2-infected inpatients and 36 from healthy and HIV-infected individuals.

RESULTS

The majority of the tests assayed have >95% specificity. For the sensitivity calculation, samples were stratified by days since symptoms onset; sensitivity peaks at 16-21 days for IgM and IgA (maximum 91.2%, Euroimmun) and, dependant on the test, at 16-21 or >21 days for IgG (maximum 94.1%, Snibe). Data from semiquantitative tests show that patients with a severe clinical presentation have lower levels of Ig targeting SARS-CoV-2 at <10 days since symptoms onset and higher levels at >21 days, compared to patients with a non-severe presentation.

CONCLUSIONS

This study highlights the heterogeneity of sensitivity and generally high specificity of the serological tests and establishes a basis for their usefulness to complement diagnostic techniques and population seroprevalence studies.

Chronic myeloid leukemia-from the Philadelphia chromosome to specific target drugs: A literature review

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm and was the first neoplastic disease associated with a well-defined genotypic anomaly - the presence of the Philadelphia chromosome. The advances in cytogenetic and molecular assays are of great importance to the diagnosis, prognosis, treatment, and monitoring of CML. The discovery of the breakpoint cluster region (BCR)-Abelson murine leukemia (ABL) 1 fusion oncogene has revolutionized the treatment of CML patients by allowing the development of targeted drugs that inhibit the tyrosine kinase activity of the BCR-ABL oncoprotein. Tyrosine kinase inhibitors (known as TKIs) are the standard therapy for CML and greatly increase the survival rates, despite adverse effects and the odds of residual disease after discontinuation of treatment. As therapeutic alternatives, the subsequent TKIs lead to faster and deeper molecular remissions; however, with the emergence of resistance to these drugs, immunotherapy appears as an alternative, which may have a cure potential in these patients. Against this background, this article aims at providing an overview on CML clinical management and a summary on the main targeted drugs available in that context.

Treatment of Helicobacter pylori infection in children: A systematic review

BACKGROUND

Helicobacter pylori (H. pylori) infection is predominantly acquired in childhood. When indicated, the most accepted treatment for H. pylori eradication in this age group is first-line triple therapy. However, the increasing resistance to clarithromycin and nitroimidazoles has been associated with treatment failure, and thus, alternative treatment regimens have been proposed.

AIM

To perform a systematic review of randomized controlled trials on treatment regimens for H. pylori infection in children.

METHODS

We surveyed relevant articles published in English from 2010 to April 2020 in the PubMed and MEDLINE databases. Keywords included “Helicobacter pylori”/”children or childhood”/”treatment or eradication.” The risk of bias was evaluated according to the Cochrane Handbook of Systematic Reviews for Interventions.

RESULTS

Among the 1144 records identified through the database, 20 articles were selected. Four studies compared the eradication rates of H. pylori infection between standard triple therapies, changing only the main antibiotic used. Seven studies evaluated the effectiveness of standard triple therapy with the addition of probiotics. One study investigated the relationship between the effectiveness in the eradication rates of standard triple therapy and vitamin E levels. Six studies analyzed the eradication rates of sequential therapy.

CONCLUSION

The findings suggest that although standard triple therapy is the most recommended regimen for children by the current guidelines, other therapeutic schemes have shown promising results and may also be recommended for clinical practice in the future.

Isolation and Characterization of Microsatellite Markers for Soybean Looper (Lepidoptera: Noctuidae)

We constructed 13 microsatellite markers for Chrysodeixis includens (Walker), a serious crop pest in the Americas. All SSR (Simple Sequence Repeat) markers were polymorphic, with no evidence of linkage disequilibrium between any loci in any population. The total number of alleles per locus ranged from 5 for L3, L9, and L11 to 26 for L6; the mean number of alleles per locus in three populations of C. includens ranged from 2.33 for L3 to 14.67 for L6. Hardy-Weinberg equilibrium (HWE) deviation was not observed in four loci for at least one population (L3, L5, L9, L10). Markers L6, L7, L8, L10, L11, L12, and L13 showed a frequency of null alleles > 0.2 for at least one population. STRUCTURE and F-statistics revealed low population structure among the populations (FST = 0.013) and a high degree of inbreeding (FIS = 0.658). The SSR markers developed here will be useful in future studies on the ecology, demography, host dynamics, and gene flow of C. includens. This information is essential to understand the recent status of C. includens as a key pest in South America.

Polymorphisms in the DGAT1 gene in buffaloes (Bubalus bubalis) in the Amazon

Water buffaloes (Bubalus bubalis) are quite well adapted to climatic conditions in the Amazon, and in this biome, they are noted for the considerable amount of meat and milk they produce and how hard they are able to work. Because of a lack of research dedicated to improving the rearing of buffaloes in the Amazon, the objective of this study was to genetically characterize the Murrah and Mediterranean breeds, as well as a mixed-breed population, based on polymorphisms in the diacylglycerol O-acyltransferase 1 gene (DGAT1), and associate the genotypes with milk production. By using the polymerase chain reaction-single-strand conformation polymorphism technique, the alleles A (0.79), B (0.20), and D (0.01) were found in the Murrah breed. In the Mediterranean and mixed-breed buffaloes, we found alleles A (0.69) and (0.77) and B (0.31) and (0.23), respectively. The Murrah breed had the genotypes AA (0.63), AB (0.29), BB (0.05), and AD (0.03), and the Mediterranean and mixed-breed buffaloes had the genotypes AA (0.44) and (0.61), AB (0.50) and (0.31), and BB (0.06) and (0.08), respectively. For the Murrah, Mediterranean, and mixed-breed buffaloes, respectively, the expected heterozygosity values were 0.34, 0.43, and 0.35, the inbreeding coefficients were 0.78, -0.15, and 0.17, and the Hardy-Weinberg probabilities were 0.70, 0.67, and 0.52. The genotypes evaluated did not have an effect on milk production; however, the single nucleotide polymorphisms can be used in studies on genetic variability.

CT findings of the main pathological conditions associated with horseshoe kidneys

Horseshoe kidney (HSK) is the most common renal fusion anomaly, with a prevalence of 0.25% among the general population. It consists of kidney fusion across the midline. HSK can be present as an isolated condition in 30%, but there is a wide variety of associated abnormalities. The most frequent include ureteropelvic obstruction, lithiasis and infections. There is also a higher risk of kidney lesions in trauma and an increased incidence of malignancies. Awareness of embryology and anatomy is essential to assess and understand the complications affecting HSK. CT is an excellent method for identification of its main findings.

Comparison of two models for evaluation histopathology of experimental renal ischemia

Renal ischemia/reperfusion (I/R) injury is one of the frequent causes of acute renal failure (ARF) due to the complex, interrelated sequence of events, that result in damage to and death of kidney cells. Cells of the proximal tubular epithelium are especially susceptible to I/R injury, leading to acute tubular necrosis, which plays a pivotal role in the pathogenesis of ARF. Several models have been explicated to assess morphological changes, including those of Jabonski et al. and Goujon et al. We compared the 2 models for histopathological evaluation of 30- or 120-minute periods of renal ischemia followed by 24-hour reperfusion in rats. Several changes were observed after application of the 2 models: proximal tubular cell necrosis, loss of brush border, vacuolization, denudation of tubular basement membrane as a consequence of flattening of basal cells, and presence of intratubular exfoliated cells in the lumen of proximal convoluted tubules at various stages of degeneration (karyorexis, kariopyknosis and karyolysis). Evaluating tubular lesions after 2 periods of experimental ischemia with light microscopy allowed us to conclude that the Goujon classification better characterized the main changes in cortical renal tubules after ischemia.

Evaluation of the effects of the parameters involved in the purification of clavulanic acid from fermentation broth by aqueous two-phase systems

The purification of clavulanic acid (CA), which is an important beta-lactam antibiotic produced by submerged cultivation of Streptomyces clavuligerus, was studied through the use of phosphate and polyethylene glycol-based aqueous two-phase systems. The parameters' effect on the yield and purification was evaluated through an experimental design and the preliminary results showed that the polyethylene molecular mass and tie-line length and phase volume ratio exerted the strongest effect on the yield and distribution coefficient in the range tested. In addition, the response surface methodology was used to optimize the distribution coefficient, yield, and purification factor. The optimal conditions of yield and purification factor are in the regions where polyethylene has a low molecular mass, pH close to the isoelectric point, and lower top phase volume. A 100% yield and a 1.5-fold purification factor are obtained when extracting CA by maximizing the conditions of an aqueous two-phase system.

Assessment of acute skin irritation in rabbits using electrical impedance model

This paper describes the use of an electrical impedance model to assess acute skin reactions to irritant over time. The applied method is noninvasive and quantitative and can detect the irritation before the visual signs. The results showed that the signs of acute irritation (oedema) were present until the second day after irritant application. The method is able to detect the initial phase of irritation and the assessment of regeneration time could be attained by a combination of more than one bioengineering methods.

Electrical impedance model for evaluation of skin irritation in rabbits and humans

BACKGROUND/AIM

The electrical impedance method has been used as a quantitative technique for evaluating changes in the skin during irritation within the invisible range. The purpose of this study was to apply an electrical model of skin to the interpretation of impedance data after the application of an irritant (SLS) in the skin of humans and rabbits.

METHODS

Investigations were performed on 12 humans and 15 albino rabbits. Responses were evaluated by measuring electrical impedance before irritant exposure and 24 h after its removal and also by visual inspection. Using the raw impedance parameter, a novel index was developed and its value was correlated with visual scoring.

RESULTS

The derived impedance index showed a significant correlation with visual scores and its value decreased (P<0.05) after irritant removal even without macroscopic signs of irritation.

CONCLUSION

The proposed electrical model of skin seems to be suitable for the detection and interpretation of changes in the impedance characteristics of skin induced by SLS in rabbits and humans.

Characterization of the gene expression related to the process of DNA damage tolerance in Schistosoma mansoni

In the course of its complex life cycle, the parasite Schistosoma mansoni need to adapt to distinct environments, and consequently is exposed to various DNA damaging agents. The Schistosoma genome sequencing initiative has uncovered sequences from genes and transcripts related to the process of DNA damage tolerance as the enzymes UBC13, MMS2, and RAD6. In the present work, we evaluate the importance of this process in different stages of the life cycle of this parasite. The importance is evidenced by expression and phylogenetic profiles, which show the conservation of this pathway from protozoa to mammalians on evolution.

Comparison of morning and afternoon exercise training for asthmatic children

Fitness improvement was used to compare morning with afternoon exercise periods for asthmatic children. Children with persistent moderate asthma (according to GINA criteria), 8 to 11 years old, were divided into 3 groups: morning training group (N = 23), afternoon training group (N = 23), and non-training group (N = 23). The program was based on twice a week 90-min sessions for 4 months. We measured the 9-min running distance, resting heart rate and abdominal muscle strength (sit-up number) before and after the training. All children took budesonide, 400 microg/day, and an on demand inhaled ss-agonist. The distance covered in 9 min increased (mean +/- SEM) from 1344 +/- 30 m by 248 +/- 30 m for the morning group, from 1327 +/- 30 m by 162 +/- 20 m for the afternoon group, and from 1310 +/- 20 m by 2 +/- 20 m for the control group (P < 0.05 for the comparison of morning and afternoon groups with the control group by ANOVA and P > 0.05 for morning with afternoon comparison). The reduction of resting heart rate from 83 +/- 1, 85 +/- 2 and 86 +/- 1 bpm was 5.1 +/- 0.8 bpm in the morning group, 4.4 +/- 0.8 bpm in the afternoon group, and -0.2 +/- 0.7 bpm in the control group (P > 0.05 for morning with afternoon comparison and P < 0.05 versus control). The number of sit-ups in the morning, afternoon and control groups increased from 22.0 +/- 1.7, 24.3 +/- 1.4 and 23 +/- 1.1 sit-ups by 9.8 +/- 0.9, 7.7 +/- 1.4, and 1.9 +/- 0.7 sit-ups, respectively (P > 0.05 for morning with afternoon comparison and P < 0.05 versus control). No statistically significant differences were detected between the morning and afternoon groups in terms of physical training of asthmatic children.

Extensive nodular cutaneous amyloidosis: an unusual presentation

Amyloidosis is characterized by the deposition of a group of unrelated proteins leading to changes in tissue architecture and function. The nodular variant is the rarest form of the cutaneous amyloidoses. We report a patient with localized nodular amyloidosis without systemic amyloid involvement or paraproteinaemia after 6 years of follow-up. The unusual aspects of our case were a plaque presentation rather than nodular, and the disseminated pattern observed.

Increased frequency of abnormal Papanicolaou smears in adolescents

Abnormal Papanicolaou smears has increased in adolescents. Our objective was to analyze the frequency of cervical intraepithelial neoplasia (CIN) in adolescents (< 20 years of age) over the last 12 years, comparing to adult (> or = 20 years of age). We studied 110,283 (10.85% of adolescents) reports from Papanicolaou smears between 1987 and 1999 in a public university hospital that has a screening program for cervical cancer prevention. The tests were divided into 3 periods (1987-1991, 1992-1995 and 1996-1999) for studying the evolution of frequencies. CIN I was more frequent among adolescents (1.73% vs. 0.99%) and CIN III and invasive cancer among adult women (0.62% vs. 0.05%, and 0.39% vs. 0.0083%, respectively). Between the periods 1987-1991 and 1996-1999 there was an increased in the frequency of CIN I among adolescents (from 0.78-2.17%) and adults (from 0.72-1.16%); CIN II decreased among adult patients (from 0.52-0.28%) and tripled among adolescents over recent years (from 0.15-0.47%), and CIN III increased in both group, although without statistical significance. One case of invasive carcinoma among adolescents occurred in the period from 1996-1999. We strongly recommend the inclusion of adolescent populations in the screening programs, from the time that they begin sexual activity.

Complete migration of retained surgical sponge into ileum without sign of open intestinal wall

A 24-year-old woman came to the emergency room with a history of diffuse abdominal pain in the form of colic, nausea, vomiting and intestinal constipation. Clinical and ultrasound findings suggested intestinal obstruction due to foreign body. She had been submitted to a cesarean section 4 months previously at another hospital. At laparotomy, a ileum loop was found to be distended by an inside large and hardened mass with another intestinal loops and omentum density adherent. An ileotomy was performed on the compromised segment with terminating anastomosis. When opened surgical specimen it was observed an intraluminal surgical sponge that had completely migrated into the interior of the ileum and stopped next to ileumcecal valve. No fistulas or open intestinal wall were observed.

Organochlorine pesticide levels in maternal adipose tissue, maternal blood serum, umbilical blood serum, and milk from inhabitants of Veracruz, Mexico

Organochlorine pesticides, due to their persistence, accumulate in food chains and cause elevated contamination in human beings. These residues bioconcentrate in lipid-rich tissues according to the equilibrium pattern of internal transport and lipid tissue content. The analyses of maternal adipose tissue, maternal blood serum, umbilical blood serum, colostrum, and mature milk indicate circulation of these compounds through all compartments of the maternal body, including their crossover of the placental barrier. The greatest residue levels found correspond to DDTs, with highest levels determined in colostrum (5.71 mg/kg of DDT total), followed by adipose tissue with 5.66 mg/kg and in mature milk with 4.70 mg/kg. Among DDTs, pp'DDE is the most predominant compound. The paired analyses of organochlorine pesticide residue levels between mother blood serum and umbilical blood serum demonstrate significant correlation and their transfer from mother to fetus through the placenta. The paired analyses of adipose tissue and colostrum and mature milk contamination levels indicate a high degree of coherence, principally of DDT, in the body and lactation as a decontamination means.

The metabolism of 1-acyl-PAF in rabbit platelets and its possible interaction with PAF

The metabolism of 1-acyl-2-acetyl-sn-glycero-3-phosphocholine (1-acyl-PAF), a naturally occurring analogue of platelet activating factor (PAF), was investigated in rabbit platelets. Our studies showed that 1-acyl-[3H]PAF (1-palmitoyl-2-acetyl-sn-glycero-3-phospho[N-methyl-3H]-choline) was converted by platelets into phosphatidyl-[3H]choline [( 3H]PC) in a time-dependent fashion. The formation of [3H]PC occurred at a rate similar to that observed when lyso-[3H]PC (palmitoyl-sn-glycero-3-phospho[N-methyl-3H]choline) was used as substrate. In addition, a time-dependent increase in the level of water-soluble radioactivity was observed during the incubation of platelets with either 1-acyl-[3H]PAF or lyso-[3H]PC. This increase was parallel to the formation of [3H]PC and was not observed in the presence of [14C]PAF (1-octadecyl-2-acetyl-sn-glycero-3-phospho[N methyl-14C]-choline). Analysis by thin-layer chromatography showed that the soluble radioactivity was mainly associated with glycerophosphocholine (GPC). On the other hand, the preincubation of platelets with phenylmethylsulfonyl fluoride, an inhibitor of the acetylhydrolase, reduced the hydrolysis of 1-acyl-[3H]PAF to [3H]GPC with a concomitant accumulation of radioactivity in 1-acyl-PAF. These findings suggest that 1-acyl-PAF is converted into PC through deacetylation-reacylation with lysoPC as an obligatory intermediate. The findings also indicate that the lysoPC resulting from 1-acyl-PAF is either reacylated to phosphatidylcholine (PC) or hydrolyzed to GPC by lysophospholipase. Finally, we showed that the stimulation of platelets with PAF led to a time- and concentration-dependent increase in the conversion of 1-acyl-[3H]PAF to [3H]PC.(ABSTRACT TRUNCATED AT 250 WORDS)