To describe the laboratory parameters and biomarkers of the cytokine storm syndrome associated with severe and fatal COVID-19 cases. A search with standardized descriptors and synonyms was performed ...on November 28.sup.th, 2020 of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, LILACS, and IBECS to identify studies of interest. Grey literature searches and snowballing techniques were additionally utilized to identify yet-unpublished works and related citations. Two review authors independently screened the retrieved titles and abstracts, selected eligible studies for inclusion, extracted data from the included studies, and then assessed the risk of bias using the Newcastle-Ottawa Scale. Eligible studies were those including laboratory parameters-including serum interleukin-6 levels-from mild, moderate, or severe COVID-19 cases. Laboratory parameters, such as interleukin-6, ferritin, hematology, C-Reactive Protein, procalcitonin, lactate dehydrogenase, aspartate aminotransferase, creatinine, and D-dimer, were extracted from the studies. Meta-analyses were conducted using the laboratory data to estimate mean differences with associated 95% confidence intervals. This review points to interleukin-6, ferritin, leukocytes, neutrophils, lymphocytes, platelets, C-Reactive Protein, procalcitonin, lactate dehydrogenase, aspartate aminotransferase, creatinine, and D-dimer as important biomarkers of cytokine storm syndrome. Elevated levels of interleukin-6 and hyperferritinemia should be considered as red flags of systemic inflammation and poor prognosis in COVID-19.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Diminished pulmonary function is associated with negative health outcomes and pulmonary impairment, and can be associated with frailty. The objectives of this study were to compare pulmonary function ...between frail, prefrail, and nonfrail older adults; to verify the association between pulmonary function and frailty syndrome; and to establish cut-off points for pulmonary function variables for predicting frailty.
A cross-sectional study was conducted with 379 community-dwelling older adults of both sexes. Spirometry was used to measure pulmonary function criteria (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV 1 ; and FEV 1 /FVC ratio). The presence of frailty was evaluated with Fried's frailty phenotype. Statistical analysis included a multinomial logistic regression model. Pulmonary function cut-off points for discriminating frailty syndrome were established through analysis of the receiver operating characteristic curves.
The study participants were a median of 69.0 (64.0-74.0) years old, and 12.4% presented frailty while 58% presented prefrailty. Frail and prefrail older adults presented significantly lower median FVC and FEV 1 values-FVC = 1.89 L (1.45-2.31) and FEV 1 = 1.60 L (1.24-1.91); FVC = 2.07 L (1.62-2.67) and FEV 1 = 1.66 L (1.32-2.09), respectively-than nonfrail participants-FVC = 2.53 L (1.96-3.16) and FEV 1 = 2.01 L (1.54-2.43). The adjusted analysis indicated that FEV 1 (odds ratio OR = 0.63; 95% confidence interval CI, 0.39-0.99) and the FVC (OR = 0.68; 95% CI, 0.48-0.96) were inversely associated with prefrailty and that FVC (OR = 0.52; 95% CI, 0.29-0.94) was associated with frailty. Cut-off points for prefrailty (FVC ≤2.3 L and FEV 1 ≤1.86 L) and frailty (FVC ≤2.07 L and FEV 1 ≤1.76 L) were established.
Pulmonary function was lower in frail and prefrail older adults than in their nonfrail peers. Frailty and prefrailty were inversely associated with pulmonary function. Cut-off points for FEV 1 and FVC for discriminating frailty were established and may allow pulmonary function to serve as an indicator of frailty in older adults.
The pandemic caused by SARS-CoV-2 that leads to COVID-19 has had an incalculable impact on society, services, and health professionals, including physiotherapists. The field of physiotherapy is ...currently facing ongoing challenges and pandemic-related repercussions, with Brazilian physiotherapists being especially affected. This article describes the current scenario in Brazil which has exposed the shortage of professionals and resources and reinforces the need for professional recognition, especially of those working in intensive care units. Barriers and challenges faced by Brazilian physiotherapists during the COVID-19 pandemic are described, followed by innovative solutions. Remote physiotherapy prior to the pandemic was merely one of many patient care options, but now has become a necessity, and several international organizations have provided guidelines for physiotherapists to follow, including guidelines on offering digital physiotherapy. Related demands, challenges, and perspectives of physiotherapy practice are likely to emerge amid the current uncertainties of the COVID-19 crisis, as well as during the post-pandemic period. The lessons learned by the Brazilian physiotherapy community may be of assistance to physiotherapists in other countries particularly those with comparable social and demographic characteristics.
Full text
Available for:
DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
No studies have previously analyzed the association between dynapenic abdominal obesity (DAO) and pulmonary function in older adults. The aim of this study was to analyze whether there is an ...association between pulmonary function and abdominal obesity, dynapenia, and DAO in community-dwelling older adults.
A cross-sectional study was conducted with community-dwelling older adults (n = 383) of Macapá, Amapá, Brazil. Pulmonary function variables were evaluated with spirometry; and DAO was evaluated with the combination of dynapenia and abdominal obesity. Cutoff points for handgrip strength, 26 kg force for men and 16 kg force for women, were used to detect dynapenia; and cutoff points of abdominal circumference of > 102 cm for men and > 88 cm for women were used to identify abdominal obesity.
Most of the studied pulmonary function variables (obtained values and obtained versus predicted values) were associated with abdominal obesity, dynapenia, and DAO. However, in the adjusted model, there was an association of FVC (β = - 0.163; p < 0.001), FEV
(β = - 0.119; p = 0.006), and PEF (β = - 0.110; p = 0.017) only with dynapenia.
Older adults with abdominal obesity, dynapenia, and DAO presented impaired pulmonary function when compared to those without these conditions. Most of the pulmonary function variables were associated with abdominal obesity, dynapenia, and DAO conditions. However, in the adjusted model, there was an association of reduced FVC, FEV
, and PEF values only with dynapenia.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
•Frail and pre-frail participants presented lower inspiratory and expiratory muscle strength.•Respiratory muscle strength was inversely associated with frailty and pre-frailty in the adjusted ...analysis.•Cut-off points for respiratory muscle strength may be useful for discriminating frailty.
To compare obtained and predicted inspiratory and expiratory muscle strength between frail, pre-frail, and non-frail older people; to examine the association between inspiratory and expiratory muscle strength and frailty in older people; and to determine cut-off points for inspiratory and expiratory muscle strength for discriminating frailty in older people.
A cross-sectional study was conducted with 379 community-dwelling older adults. Frailty was assessed using Fried’s phenotype, while inspiratory and expiratory muscle strength were measured with maximum inspiratory and maximum expiratory pressures. Inferential analyses were performed using paired Student t-tests, one-way analysis of variance (ANOVA) tests, and a multinomial logistic regression model. ROC curves were constructed to establish cut-off points of maximum inspiratory and expiratory pressures for discriminating frailty and pre-frailty.
Frail and pre-frail participants presented significantly lower mean inspiratory and expiratory pressures compared to non-frail participants; values were significantly lower than predicted. Inspiratory and expiratory muscle strength were inversely associated with frailty and pre-frailty. Cut-off points ≥-50cmH2O and ≤60cmH2O for maximum inspiratory and expiratory pressures, respectively, were established as optimal discriminators of frailty. The cut-off point ≤65cmH2O for maximum expiratory pressure was established as a discriminant for the presence of pre-frailty.
Inspiratory and expiratory muscle strength were lower in frail than in pre-frail older adults, and lower in pre-frail than in non-frail peers. Frailty and pre-frailty were inversely associated with inspiratory and expiratory muscle strength. Cut-off points for inspiratory and expiratory muscle strength may be useful in clinical practice for discriminating frailty and pre-frailty in older adults.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Highlights • The combinations of PZQ, EPI, and PPT are able to induce synergistic activity against Schistosoma mansoni. • The synergistic combinations of PZQ, EPI, and PPT induced surface alterations ...in the tegument of adult schistosomes after the treatments. • A decrease of cytotoxic effect of the synergistic combinations on mammalian cells was observed.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Candida tropicalis
is one the most relevant biofilm-forming fungal species increasingly associated with invasive mucosal candidiasis worldwide. The amplified antifungal resistance supports the ...necessity for more effective and less toxic treatment, including the use of plant-derived natural products. Scopoletin, a natural coumarin, has shown antifungal properties against plant yeast pathogens. However, the antifungal activity of this coumarin against clinically relevant fungal species such as
C. tropicalis
remains to be established. Here, we investigated the potential antifungal properties and mechanisms of action of scopoletin against a multidrug-resistant
C. tropicalis
strain (ATCC 28707). First, scopoletin was isolated by high-performance liquid chromatography from
Mitracarpus frigidus
, a plant species (family
Rubiaceae
) distributed throughout South America. Next, scopoletin was tested on
C. tropicalis
cultivated for 48h in both planktonic and biofilm forms. Fungal planktonic growth inhibition was analyzed by evaluating minimal inhibitory concentration (MIC), time-kill kinetics and cell density whereas the mechanisms of action were investigated with nucleotide leakage, efflux pumps and sorbitol and ergosterol bioassays. Finally, the scopoletin ability to affect
C. tropicalis
biofilms was evaluated through spectrophotometric and whole slide imaging approaches. In all procedures, fluconazole was used as a positive control. MIC values for scopoletin and fluconazole were 50 and 250 μg/L respectively, thus demonstrating a fungistatic activity for scopoletin. Scopoletin induced a significant decrease of
C. tropicalis
growth curves and cell density (91.7% reduction) compared to the growth control. Its action was related to the fungal cell wall, affecting plasma membrane sterols. When associated with fluconazole, scopoletin led to inhibition of efflux pumps at the plasma membrane. Moreover, scopoletin not only inhibited the growth rate of preformed biofilms (68.2% inhibition at MIC value) but also significantly decreased the extent of biofilms growing on the surface of coverslips, preventing the formation of elongated fungal forms. Our data demonstrate, for the first time, that scopoletin act as an effective antifungal phytocompound against a multidrug-resistant strain of
C. tropicalis
with properties that affect both planktonic and biofilm forms of this pathogen. Thus, the present findings support additional studies for antifungal drug development based on plant isolated-scopoletin to treat candidiasis caused by
C. tropicalis.
Over the last few years, there has been increasing interest in the use of amorphous carbon thin films with low secondary electron yield (SEY) to mitigate electron multipacting in particle ...accelerators and RF devices. Previous works found that the SEY increases with the amount of incorporated hydrogen and correlates with the Tauc gap. In this work, we analyse films produced by magnetron sputtering with different contents of hydrogen and deuterium incorporated via the target poisoning and sputtering of CxDy molecules. XPS was implemented to estimate the phase composition of the films. The maximal SEY was found to decrease linearly with the fraction of the graphitic phase in the films. These results are supported by Raman scattering and UPS measurements. The graphitic phase decreases almost linearly for hydrogen and deuterium concentrations between 12% and 46% (at.), but abruptly decreases when the concentration reaches 53%. This vanishing of the graphitic phase is accompanied by a strong increase of SEY and the Tauc gap. These results suggest that the SEY is not dictated directly by the concentration of H/D, but by the fraction of the graphitic phase in the film. The results are supported by an original model used to calculate the SEY of films consisting of a mixture of graphitic and polymeric phases.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Large observational studies have shown that small, dense LDL subfractions are related to atherosclerotic cardiovascular disease. This study assessed the effects of two highly effective lipid-lowering ...therapies in the atherogenic subclasses of lipoproteins in subjects with ST-segment elevation myocardial infarction (STEMI).
Patients of both sexes admitted with their first myocardial infarction and submitted to pharmacoinvasive strategy (N = 101) were included and randomized using a central computerized system to receive a daily dose of simvastatin 40 mg plus ezetimibe 10 mg or rosuvastatin 20 mg for 30 days. Intermediate-density lipoprotein (IDL) and low-density lipoprotein (LDL) subfractions were analysed by polyacrylamide gel electrophoresis (Lipoprint System) on the first (D1) and 30th days (D30) of lipid-lowering therapy. Changes in LDL and IDL subfractions between D1 and D30 were compared between the lipid-lowering therapies (Mann-Whitney U test).
The classic lipid profile was similar in both therapy arms at D1 and D30. At D30, the achievement of lipid goals was comparable between lipid-lowering therapies. Cholesterol content in atherogenic subclasses of LDL (p = 0.043) and IDL (p = 0.047) decreased more efficiently with simvastatin plus ezetimibe than with rosuvastatin.
Lipid-lowering therapy with simvastatin plus ezetimibe was associated with a better pattern of lipoprotein subfractions than rosuvastatin monotherapy. This finding was noted despite similar effects in the classic lipid profile and may contribute to residual cardiovascular risk.
ClinicalTrials.gov , NCT02428374, registered on 28/09/2014.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Spilanthol is a bioactive alkylamide from the native Amazon plant species, Acmella oleracea. However, antifungal activities of spilanthol and its application to the therapeutic treatment of ...candidiasis remain to be explored. This study sought to evaluate the in vitro and in vivo antifungal activity of spilanthol previously isolated from A. oleracea (spilanthol(AcO)) against Candida albicans ATCC® 10231™, a multidrug-resistant fungal strain. Microdilution methods were used to determine inhibitory and fungicidal concentrations of spilanthol(AcO). In planktonic cultures, the fungal growth kinetics, yeast cell metabolic activity, cell membrane permeability and cell wall integrity were investigated. The effect of spilanthol(AcO) on the proliferation and adhesion of fungal biofilms was evaluated by whole slide imaging and scanning electron microscopy. The biochemical composition of the biofilm matrix was also analyzed. In parallel, spilanthol(AcO) was tested in vivo in an experimental vulvovaginal candidiasis model. Our in vitro analyses in C. albicans planktonic cultures detected a significant inhibitory effect of spilanthol(AcO), which affects both yeast cell membrane and cell wall integrity, interfering with the fungus growth. C. albicans biofilm proliferation and adhesion, as well as, carbohydrates and DNA in biofilm matrix were reduced after spilanthol(AcO) treatment. Moreover, infected rats treated with spilanthol(AcO) showed consistent reduction of both fungal burden and inflammatory processes compared to the untreated animals. Altogether, our findings demonstrated that spilanthol(AcO) is an bioactive compound against planktonic and biofilm forms of a multidrug resistant C. albicans strain. Furthermore, spilanthol(AcO) can be potentially considered for therapeutical treatment of vulvovaginal candidiasis caused by C. albicans.
Lay summary
This study sought to evaluate the antifungal activity of spilanthol against Candida albicans ATCC® 10 231™, a multidrug-resistant fungal strain. Our findings demonstrated that spilanthol(AcO) can be potentially considered for therapeutical treatment of vulvovaginal candidiasis caused by C. albicans.
PDF
