Convalescent plasma therapy in COVID-19 patients: a non-randomized case-control study with concurrent control

Convalescent plasma therapy has shown controversial results in coronavirus disease-19 (COVID-19) patients. We performed a non-randomized case-control study with contemporaneous controls in a hospital in southern Brazil. Patients were selected for treatment with convalescent plasma by medical decision and compared with patients who did not receive plasma and were hospitalized due to COVID-19 at the same time. The outcomes of interest were intensive care unit (ICU) admission and in-hospital death. Patients that received convalescent plasma had lower in-hospital mortality than patients that did not receive plasma (relative risk (RR) 0.48; 95% confidence interval (CI) 0.29 to 0.79) and these results were consistent after changing the subset of control patients. There were no differences regarding ICU admission between groups (RR=0.80; 95%CI: 0.47 to 1.35). In this study, patients that received convalescent plasma for COVID-19 had lower in-hospital mortality, but this finding requires further confirmation given the retrospective nature of the study.

Why do men have worse COVID-19-related outcomes? A systematic review and meta-analysis with sex adjusted for age

We aimed to study the mechanism behind worse coronavirus disease-19 (COVID-19) outcomes in men and whether the differences between sexes regarding mortality as well as disease severity are influenced by sex hormones. To do so, we used age as a covariate in the meta-regression and subgroup analyses. This was a systematic search and meta-analysis of observational cohorts reporting COVID-19 outcomes. The PubMed (Medline) and Cochrane Library databases were searched. The primary outcome was COVID-19-associated mortality and the secondary outcome was COVID-19 severity. The study was registered at PROSPERO: 42020182924. For mortality, men had a relative risk of 1.36 (95%CI: 1.17 to 1.59; I2 63%, P for heterogeneity <0.01) compared to women. Age was not a significant covariate in meta-analysis heterogeneity (P=0.393) or subgroup analysis. For disease severity, being male was associated with a relative risk of 1.29 (95%CI: 1.19 to 1.40; I2 48%, P for heterogeneity <0.01) compared to the relative risk of women. Again, age did not influence the outcomes of the meta-regression (P=0.914) or subgroup analysis. Men had a higher risk of COVID-19 mortality and severity regardless of age, decreasing the odds of hormonal influences in the described outcomes.

Traditional knowledge and uses of the Caryocar brasiliense Cambess. (Pequi) by “quilombolas” of Minas Gerais, Brazil: subsidies for sustainable management / Conhecimento tradicional e usos de Caryocar brasiliense Cambess. (Pequi) por quilombolas de Minas Gerais, Brasil: subsídios para o manejo sustentável

Abstract Local knowledge of biodiversity has been applied in support of research focused on utilizing and management of natural resources and promotion of conservation. Among these resources, Pequi (Caryocar brasiliense Cambess.) is important as a source of income and food for communities living in the Cerrado biome. In Pontinha, a “quilombola” community, which is located in the central region of State of Minas Gerais, Brazil, an ethnoecological study about Pequi was conducted to support initiatives for generating income for this community. Data were collected through semi-structured interviews, participant observation, and crossing. The most relevant uses of Pequi were family food (97%), soap production (67%), oil production (37%), medical treatments (17%), and trade (3%). Bees were the floral visitors with the highest Salience Index (S=0.639). Among frugivores that feed on unfallen fruits, birds showed a higher Salience (S=0.359) and among frugivores who use fallen fruits insects were the most important (S=0.574). Borers (folivorous caterpillars) that attack trunks and roots were the most common pests cited. According to the respondents, young individuals of Pequi are the most affected by fire due to their smaller size and thinner bark. Recognition of the cultural and ecological importance of Pequi has mobilized the community, which has shown interest in incorporating this species as an alternative source of income.

Resumo O conhecimento local acerca da biodiversidade vem sendo utilizado em pesquisas voltadas ao uso e manejo de recursos naturais aliados à conservação. Entre estes recursos, destaca-se o Pequi (Caryocar brasiliense Cambess.) devido à sua importância econômica e alimentar para comunidades que vivem no Cerrado. No quilombo de Pontinha, localizado na região central do estado de Minas Gerais, um estudo etnoecológico sobre o Pequi foi desenvolvido, a fim de subsidiar iniciativas de geração de trabalho e renda para esta comunidade. Informações foram obtidas por meio de entrevistas semiestruturadas, observação participante e travessia. Alimentação familiar (97%), produção de sabão (67%), produção de óleo (37%), tratamento medicinal (17%) e comércio (3%) foram os principais usos do Pequi citados pelos comunitários. Abelhas foram os visitantes florais com maior Índice de Saliência (S=0,639). Dentre os frugívoros que se alimentam de frutos não caídos, as aves apresentaram maior Saliência (S=0,359) e os insetos foram os mais importantes frugívoros entre os que utilizam frutos caídos (S=0,574). Brocas, lagartas folívoras e que atacam troncos e raízes foram as pragas mais citadas. Os indivíduos jovens de Pequi são, segundo os entrevistados, os mais afetados pelo fogo devido ao menor porte e por ter a casca menos espessa. O reconhecimento da importância cultural e ecológica do Pequi tem mobilizado a comunidade, que demonstra interesse em fazer dessa espécie uma alternativa de renda.

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

The objective of the present cross-sectional study was to assess the prevalence and the clinical and laboratory features of hepatitis C virus (HCV)-positive patients with type 2 diabetes mellitus (DM) attending either an outpatient clinic or hemodialysis units. Serologic-HCV testing was performed in 489 type 2 DM patients (303 outpatients and 186 on dialysis). A structured assessment of clinical, laboratory and DM-related complications was performed and the patients were then compared according to HCV infection status. Mean patient age was 60 years; HCV positivity (HCV+) was observed in 39 of 303 (12.9 percent) outpatients and in 34 of 186 (18.7 percent) dialysis patients. Among HCV+ patients, 32 were men (43.8 percent). HCV+ patients had higher serum levels of aspartate aminotransferase (0.90 ± 0.83 vs 0.35 ± 0.13 µKat/L), alanine aminotransferase (0.88 ± 0.93 vs 0.38 ± 0.19 µKat/L), gamma-glutamyl transferase (1.57 ± 2.52 vs 0.62 ± 0.87 µKat/L; P < 0.001), and serum iron (17.65 ± 6.68 vs 14.96 ± 4.72 µM; P = 0.011), and lower leukocyte and platelet counts (P = 0.010 and P < 0.001, respectively) than HCV-negative (HCV-) patients. HCV+ dialysis patients had higher diastolic blood pressure than HCV- patients (87.5 ± 6.7 vs 81.5 ± 6.0 mmHg; P = 0.005) and a lower prevalence of diabetic retinopathy (75 vs 92.7 percent; P = 0.007). In conclusion, our study showed that HCV is common among subjects with type 2 DM but is not associated with a higher prevalence of chronic diabetic complications.

The prevalence of chronic diabetic complications and metabolic syndrome is not associated with maternal type 2 diabetes

The maternal history of type 2 diabetes mellitus (DM) has been reported more frequently in patients with type 2 DM than paternal history. The aim of the present study was to determine if there was an association between maternal history of DM and the presence of chronic complications or metabolic syndrome (MetS) in patients with type 2 DM. A cross-sectional study was conducted with 1455 patients with type 2 DM. All outpatients with type 2 diabetes attending the endocrine clinics who fulfilled the eligibility criteria were included. Familial history of DM was determined with a questionnaire. Diabetic complications were assessed using standard procedures. The definition of MetS used was that of the World Health Organization and the National Cholesterol Education Program's Adult Treatment Panel III report criteria. Maternal history of DM was present in 469 (32.3 percent), absent in 713 (49.1 percent) and unknown in 273 patients (18.7 percent). Paternal history of DM was positive in 255 (17.6 percent), negative in 927 (63.8 percent) and unknown in 235 patients (16.1 percent). The frequency of microvascular chronic complications in patients with and without a positive maternal history of DM was similar: diabetic nephropathy (51.5 vs 52.5 percent), diabetic retinopathy (46.0 vs 41.7 percent), and diabetic sensory neuropathy (31.0 vs 37.1 percent). The prevalence of macrovascular chronic complications and MetS was also similar. Patients with type 2 DM were more likely to have a maternal than a paternal history of DM, although maternal history of DM was not associated with an increased prevalence of chronic complications or MetS.