Physical condition and perceived fatigue in post-covid patients: An observational descriptive study

ABSTRACT BACKGROUND: Patients with severe coronavirus disease 2019 (COVID-19) often require hospital admission and experience sequelae such as chronic fatigue or low muscle mass. OBJECTIVE: To analyze the functional capacity of a cohort of patients with severe acute respiratory syndrome coronavirus 2 who required hospitalization. DESIGN AND SETTING: An observational descriptive study was conducted on post-COVID-19 patients referred to the Rehabilitation Department of Gregorio Marañón Hospital (Madrid, SPAIN). METHODS: Cardiorespiratory fitness, muscle strength, body composition, and perception of fatigue and dyspnea were analyzed. Furthermore, the existing correlations between clinical variables and physical conditions were analyzed. RESULTS: Forty-two patients who required hospital admission (80 ± 22.45 days) or intensive care unit (ICU) admission (58 ± 10.52 days) were analyzed. They presented with decreased strength, respiratory capacity, and moderate-to-severe perceived fatigue. Additionally, an inverse correlation was found between right-handgrip strength and days in the ICU, as well as the 6-minute walk test for women. Similarly, strength and fitness were negatively associated with perceived fatigue. CONCLUSIONS: Post-COVID-19 patients showed low muscle function and low levels of physical fitness associated with high perceived fatigue.

Infección con SARS-CoV2, antes y después de la vacunación, en funcionarios de un hospital de mediana y alta complejidad / Sars-CoV2 infection, before and after vaccination, in health care workers of a medium and high complexity hospital

Introducción: La pandemia de COVID-19 evidenció la importancia de los trabajadores esen-ciales de la salud. Objetivo: Estimar la ocurrencia de la infección por el virus Sars_CoV2 en funcionarios de un hospital, antes y después de implementación del programa de vacunación institucional y la fracción preventiva atribuible a la vacunación. Material y métodos: Estudio de cohorte histórica, teniendo como punto de inicio la fecha del primer funcionario diagnosticado con la Covid19 en el Hospital. Alrededor de mil traba-jadores fueron examinados, durante el periodo de estudio comprendido entre junio de 2020 y octubre 2021. Se utilizó el estadístico de Kaplan-Meier, para comparar la velocidad de infección y la fracción preventiva atribuible al programa de vacunación. Resultados. Hubo diferencias estadísticamente significativas en la reducción de casos según tipo de trabajo, los trabajadores asistenciales experimentaron una reducción del 58,1%, de 124 a 52 y la diferencia en la mediana de la velocidad de infección, antes y después, Log Rank = 127,4 gl = 1 p = 0,000; los administrativos 51,7% de 29 a 14, mediana log Rank = 34,4 gl = 1 p = 0,000, y los operativos 45,5% de 11 a 6, mediana Log Rank = 13,5 gl = 1 p = 0,000. La fracción atribuible preventiva entre los asistenciales fue 47,5% (37,4­54,9); 85,2% (77,7­88,9) en administrativos y una reducción no significativa de 43,6% (-20,7, 63,2) en operativos. Conclusiones: Los trabajadores asistenciales tienen un riesgo alto de contraer la infección por Sars_CoV2. Fue una acertada decisión vacunar a todos los trabajadores del hospital, el impacto es demostrable.

Introduction: The COVID-19 pandemic highlighted the importance of essential health care workers.Objective: To estimate the occurrence of Sars_CoV2 virus infection in hospital staff before and after implementation of the institutional vaccination program and the preventive fraction attributable to vaccination. Material and methods: Historical cohort study, having as starting point the date of the first employee diagnosed with Covid19 in the Hospital. About one thousand workers were exa-mined, during the study period from June 2020 to October 2021. The Kaplan-Meier statistic was used to compare the infection, rate and the preventive fraction attributable to the vac-cination program. Results: There were statistically significant differences in the reduction of cases according to type of work, with the assistential workers experiencing a reduction of 58.1%, from 124 to 52 and the difference in median infection rate, before and after, Log Rank = 127.4 gl = 1 p = 0.000; the administrative 51.7% from 29 to 14, median Log Rank = 34.4 gl = 1 p = 0.000, and the operatives 45.5% from 11 to 6, median Log Rank = 13.5 gl = 1 p = 0.000. The preventive attributable fraction among assistants was 47.5% (37.4-54.9); 85.2% (77.7-88.9) in adminis-trative and a non-significant reduction of 43.6% (-20.7, 63.2) in operatives.Conclusions: Healthcare workers are at high risk of contracting Sars_CoV2 infection. It was a wise decision to vaccinate all hospital workers, the impact is demonstrable.

CT features of inflammatory pseudotumor like follicular dendritic cell sarcoma of the spleen / 中华肝胆外科杂志

Objective:To explore the CT features of inflammatory pseudotumor like follicular dendritic cell sarcoma (FDCS) of the spleen.Methods:The clinical data of 12 patients with splenic inflammatory pseudotumor like FDCS admitted to 3 central hospitals including Yongjia People's Hospital in Zhejiang Province from January 2015 to December 2022 were retrospectively analyzed, including 4 males and 8 females, with a median age of 60 years old. The number, shape, size and CT features of the lesions were analyzed based on patient's CT image data.Results:CT scans of 12 patients showed 15 lesions, including 10 single lesions and 2 multiple lesions. The lesions were circular in 5 cases, elliptical in 4 cases, and irregular in 3 cases. The median maximum diameter of the mass is 6.5 cm. On plain scan, all 12 tumors showed low density or slightly low density. The CT value is (41.3±7.2) HU; 8 cases had uneven density and 4 cases had uniform density. There were 8 cases with clear tumor boundaries and 4 cases with unclear boundaries. There were 8 cases with tumor necrosis and cystic transformation, and 5 cases showed patchy bleeding lesions in the center of the tumor. Enhancement: the arterial phase shows small patches or flocculent enhancement at the edges or parenchymal parts of the tumor, with CT value of (56.0±3.8) HU. Among them, there were 7 cases of mild enhancement, 4 cases of moderate enhancement, and 1 case of significant enhancement. During the portal phase, there was mild to moderate persistent small patchy uneven enhancement, with CT value of (62.0±4.3) HU. Among them, there were 8 cases of mild enhancement and 4 cases of moderate enhancement. The delayed phase showed a slow withdrawal of enhancement, with CT value of (45.0±8.2) HU. All 12 cases underwent complete resection and were diagnosed with FDCS through pathological examination.Conclusion:FDCS plain scan shows circular or elliptical uneven low-density masses, with small patches or flocculent light to moderate uneven enhancement in the arterial phase, continuous enhancement in the portal phase, and slow withdrawal in the delayed phase as the main characteristics.

Structure‒tissue exposure/selectivity relationship (STR) correlates with clinical efficacy/safety

Drug optimization, which improves drug potency/specificity by structure‒activity relationship (SAR) and drug-like properties, is rigorously performed to select drug candidates for clinical trials. However, the current drug optimization may overlook the structure‒tissue exposure/selectivity-relationship (STR) in disease-targeted tissues vs. normal tissues, which may mislead the drug candidate selection and impact the balance of clinical efficacy/toxicity. In this study, we investigated the STR in correlation with observed clinical efficacy/toxicity using seven selective estrogen receptor modulators (SERMs) that have similar structures, same molecular target, and similar/different pharmacokinetics. The results showed that drug's plasma exposure was not correlated with drug's exposures in the target tissues (tumor, fat pad, bone, uterus), while tissue exposure/selectivity of SERMs was correlated with clinical efficacy/safety. Slight structure modifications of four SERMs did not change drug's plasma exposure but altered drug's tissue exposure/selectivity. Seven SERMs with high protein binding showed higher accumulation in tumors compared to surrounding normal tissues, which is likely due to tumor EPR effect of protein-bound drugs. These suggest that STR alters drug's tissue exposure/selectivity in disease-targeted tissues vs. normal tissues impacting clinical efficacy/toxicity. Drug optimization needs to balance the SAR and STR in selecting drug candidate for clinical trial to improve success of clinical drug development.

Ultrastructural changes in methicillin-resistant Staphylococcus aureus (MRSA) induced by a novel cyclic peptide ASP-1 from Bacillus subtilis: A scanning electron microscopy (SEM) study / Cambios ultraestructurales en Staphylococcusaureus resistente a meticilina (SARM) inducidos por un nuevo péptido cíclico ASP-1 de Bacillussubtilis: un estudio con microscopio electrónico de barrido (MEB)

ABSTRACT Increasing antimicrobial resistance amongStaphylococcus aureusnecessitates a new antimicrobial with a different site of action. We have isolated a novel cyclic peptide-1 (ASP-1) fromBacillussubtiliswith potent activity against methicillin-resistantS. aureus(MRSA) at a minimum inhibitory concentration (MIC) of 8-64μg/ml. Scanning electron micrographs demonstrated drastic changes in the cellular architecture of ASP-1 treated cells ofS. aureusATCC 29213 and an MRSA clinical isolate at MICs, with damages to the cell wall, membrane lysis and probable leakage of cytoplasmic contents at minimum bactericidal concentrations. The ultrastructure alterations induced by ASP-1 have also been compared with those of oxacillin-treated MRSA cells at its MIC using scanning electron microscopy.

RESUMEN El incremento de la resistencia antimicrobiana entre los tipos deS. aureusexige un nuevo agente antimicrobiano con un sitio de acción diferente. Aislamos un nuevo péptido cíclico (ASP-1) deBacillussubtiliscon potente actividad frente aS. aureusresistente a meticilina (SARM) en una concentración inhibitoria mínima (CIM) de 8-64μg/ml. Las micrografías obtenidas con microscopio electrónico de barrido mostraron cambios drásticos en la arquitectura celular de las células deS. aureusATCC 29213 tratadas con ASP-1, y un aislamiento clínico de SARM a la CIM, con daños a la pared celular, lisis de la membrana y probable fuga de contenido citoplasmático a concentraciones bactericidas mínimas. Comparamos también, las alteraciones de la ultraestructura inducidas por ASP-1 con las de células de SARM tratadas con oxacilina a su CIM, utilizando microscopio electrónico de barrido.

Research progress of sphingosine kinase 1 inhibitors / 中国药科大学学报

@#Sphingosine kinase 1 (SphK1) is an important protein that regulates the lipid microenvironment of cell membranes, and plays an important role in the dynamic equilibrium of ceramide, sphingosine and sphingosine-1-phosphate.The overexpression of SphK1 is closely related to the occurrence, development and migration of tumors as well as the generation of drug resistance.SphK1 inhibitors can induce apoptosis of various tumor cells and reverse drug resistance, which has a good prospect for drug development.In this article, the structural biology of SphK1, the structural types and structure-activity relationships of SphK1 inhibitors are reviewed.

La exitosa respuesta de los consolareños a la COVID-19 en la comunidad Camilo Cienfuegos / The successful response of Consolacion del Sur inhabitants to COVID-19 in Camilo Cienfuegos community

RESUMEN Introducción: la aparición de la pandemia de la COVID-19 trajo como resultado que más de 180 países estén afectados. Cuba no ha estado ajena a esta situación. El primer evento epidemiológico registrado en la comunidad Camilo Cienfuegos, municipio Consolación del Sur, provincia Pinar del Río, que puso a prueba la capacidad de movilización del personal médico, y de los sectores que de una u otra forma colaboraron en la puesta en cuarentena entre el 31 de marzo y el 1º de mayo, para evitar la propagación. Objetivo: caracterizar el comportamiento de la comunidad Camilo Cienfuegos durante la cuarentena por la COVID-19. Métodos: se utilizaron métodos empíricos, la observación, revisión documental, entrevistas a miembros del equipo médico y a dirigentes de la comunidad. Desarrollo: se logró una caracterización de la comunidad en el proceso de la cuarentena a partir de su indicación por el Consejo de Defensa Municipal, para el enfrentamiento y la prevención del surgimiento de nuevos casos de la enfermedad. Conclusiones: la caracterización histórica de la comunidad Camilo Cienfuegos permitió al Consejo de Defensa Municipal disponer de una herramienta testimonial sobre el tratamiento de la COVID-19, lo que facilitó su aplicación o consulta a posteriores situaciones episódicas de la enfermedad en la provincia y el país. Así como su importancia para la toma de decisiones en el enfrentamiento a la pandemia.

ABSTRACT Introduction: the emergence of Covid-19 pandemic resulted in more than 180 countries being affected today. Cuba has not been exempt from this situation and its first epidemiological event took place in Camilo Cienfuegos community, Consolacion del Sur municipality, Pinar del Río province, which tested the mobilization capacity of the medical personnel, and of the sectors that in one way or another collaborated in the period of quarantine between March 31 and May 1, in order to avoid the spread and the onset of new cases. Objective: to characterize the behavior of Camilo Cienfuegos community during Covid-19 period of quarantine. Methods: empirical methods such as observation, documentary review and interviews with members of the medical team and community leaders were applied. Development: a characterization of the community in the quarantine process was accomplished complying with the indications of the Municipal Defense Council to cope with and prevent the onset of Covid-19 new cases. Conclusions: the historical characterization of Camilo Cienfuegos community allowed the Municipal Defense Council to have a testimonial tool on the treatment of Covid-19, which facilitated the further requests or enquiries of posterior episodic situations of this disease in the province and the country, as well as its importance for decision making in coping with this pandemic.

The adaptation of SARS-CoV-2 to humans

The process of adaptation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to humans probably had started decades ago, when its ancestor diverged from the bat coronavirus. The adaptive process comprises strategies the virus uses to overcome the respiratory tract defense barriers and replicate and shed in the host cells. These strategies include the impairment of interferon production, hiding immunogenic motifs, avoiding viral RNA detection, manipulating cell autophagy, triggering host cell death, inducing lymphocyte exhaustion and depletion, and finally, mutation and escape from immunity. In addition, SARS-CoV-2 employs strategies to take advantage of host cell resources for its benefits, such as inhibiting the ubiquitin-proteasome system, hijacking mitochondria functions, and usage of enhancing antibodies. It may be anticipated that as the tradeoffs of adaptation progress, the virus destructive burden will gradually subside. Some evidence suggests that SARS-CoV-2 will become part of the human respiratory virome, as had occurred with other coronaviruses, and coevolve with its host.

Bronconeumonía por COVID-19 en un adolescente de 18 años / Bronchopneumonia due to COVID-19 in a 18 years adolescent

Se describe el caso clínico de un adolescente de 18 años de edad con antecedentes patológicos personales de hipertensión arterial crónica esencial y obesidad de grado II, que fue atendido en el Hospital Pediátrico Provincial José Martí Pérez de Sancti Spíritus por presentar tos húmeda ocasional, fiebre y falta de aire. Inicialmente se diagnosticó neumonía en la base del pulmón derecho, que luego evolucionó a bronconeumonía. Durante su hospitalización se recibió el resultado de la prueba de reacción en cadena de la polimerasa en tiempo real, que fue positivo en el coronavirus SARS-CoV-2. Se logró estabilizar el cuadro clínico del paciente, el cual tuvo una evolución favorable; se le dio el alta hospitalaria tras cumplir el periodo de vigilancia epidemiológica.

The case report of an 18 years teenager with a personal pathological history of chronic essencial hypertension and grade II obesity, who was assisted in José Martí Provincial Pediatric Hospital from Sancti Spiritus due to occasional humid cough, fever and lack of air. Initially pneumonia was diagnosed at the base of the right lung, which became a bronchopneumonia later. During his hospitalization, the result of the polymerase reaction test in real time was received, which was positive in the coronavirus SARS-CoV-2. It was possible to stabilize the patient clinical pattern, which had a favorable clinical course; he was discharged after fulfilling the surveillance period.

Manifestaciones oftalmológicas de la COVID-19 / Ophthalmological manifestations of COVID-19

RESUMEN La Organización Mundial de la Salud declaró el 11 de marzo del año 2020 pandemia por la COVID-19, enfermedad causada por el SAR-COV-2. Al no existir medicamentos efectivos disponibles para esta infección viral, muchos han sido los esfuerzos de las políticas de salud para lograr un control adecuado de la fuente de infección, la transmisión y la protección en poblaciones susceptible, mediante las cuarentenas obligatorias como medida oportuna de prevención. Hasta el momento la presencia de conjuntivitis viral y el riesgo de contagio por vía ocular son datos mencionados en la literatura internacional en el curso de diversas investigaciones. Se conoce que el virus puede aislarse en la lágrima y en la conjuntiva, y que su transmisibilidad por las secreciones oculares es posible. La actual pandemia del coronavirus es una emergencia sanitaria mundial y muchos países han sido actualmente afectados con miles de fallecidos. Se realizó una búsqueda de diversos artículos publicados, con el objetivo de conocer las manifestaciones oculares de la COVID-19 reportadas por diferentes investigadores. Se utilizó la plataforma Infomed, específicamente la Biblioteca Virtual de Salud(AU)

ABSTRACT COVID-19, a disease caused by SARS-CoV-2, was declared pandemic by the World Health Organization on 11 March 2020. In the absence of effective medications for this viral infection, many have been the efforts made by health policies to adequately control the source of infection and transmission, and to protect susceptible populations through compulsory quarantine as a timely prevention measure. Viral conjunctivitis and risk of contagion via the ocular route have been mentioned in a variety of international studies contained in the bibliography about the topic. It has been found that the virus may be isolated from tears and from the conjunctiva, and that it may be transmitted via ocular secretion. The current coronavirus pandemic is a world health emergency causing thousands of deaths in many countries. A search was conducted for published papers to identify the ocular manifestations of COVID-19 reported by researchers. Use was made of the platform Infomed, specifically the Virtual Health Library(AU)

Comparing RAS with and without biofloc: Transcriptional response of immune-related genes in Litopenaeus vannamei post-larvae / Comparación de SAR con y sin biofloc: Respuesta transcripcional de genes relacionados con el sistema inmune en postlarvas de Litopenaeus vannamei / Comparando o SAR com e sem biofloc: Resposta transcricional de genes relacionados ao sistema imune em pós-larvas de Litopenaeus vannamei

Abstract Background: Shrimp farming is evolving from semi-intensive to hyper-intensive systems with biofloc technology and water recirculation systems. Objective: To evaluate the transcriptional response promoted by biofloc on shrimp (Litopenaeus vannamei) under a recirculating aquaculture system (RAS). Methods: Quantitative real-time RT-PCR was used to monitor seven key genes related to the immune system in shrimp post-larvae, reared in a RAS with and without biofloc (BF and no- BF). In addition, we present for the first time nucleotide sequences of ADP-ribosylation factor 4 (LvArf4) from Litopenaeus vannamei. Results: Transcripts for penaeidin3 (Pen3), penaeidin4 (Pen4), crustin, and Toll receptor (LvToll) genes were up-regulated between 3 and 24 h in both systems, and tumor necrosis factor receptor-associated factor 6 (TRAF6) in no-BF as an early response. Regarding differential expression between treatments, 13 occurrences were encountered. Nine that were higher in BF than in no-BF and four higher in no-BF than in BF. In some sample times, expression of Pen3, crustin, LvToll, TRAF6, IMD, and LvArf4 was higher in BF than in no-BF and in others, expression of Pen3, Pen4, and TRAF6 was higher in no-BF than in BF. Conclusions: BF modulates the transcription of genes related to the immune response in shrimp as an early response. However, the RAS with no-BF promotes a similar response.

Resumen Antecedentes: Los cultivos de camarón están evolucionando de sistemas semi-intensivos a hiper-intensivos con biofloc y con recirculación. Objetivo: Evaluar la respuesta transcripcional promovida por el biofloc en un sistema acuícola con recirculación (SAR). Métodos: Monitoreamos mediante RT-PCR cuantitativo siete genes relacionados con el sistema inmune en postlarvas de camarón cultivadas en un SAR con y sin biofloc (BF y no-BF). Además, presentamos por primera vez la secuencia de nucleótidos del factor de ribosilación 4 de ADP (LvArf4) de Litopenaeus vannamei. Resultados: Los genes penaeidina3 (Pen3), penaeidina4 (Pen4), Crustina y Toll (LvToll) se sobre-expresaron entre las 3 y 24 h en ambos sistemas, y el factor 6 asociado al factor de necrosis tumoral (TRAF6) en BF como una respuesta temprana. Con respecto a la expresión diferencial entre los tratamientos, se presentaron 13 ocurrencias. Nueve donde el BF fue mayor que sin-BF y cuatro donde el no-BF fue mayor que el BF. La expresión fue más alta en BF que en no-BF en Pen3, Crustin, LvToll, TRAF6, IMD y LvArf4. En contraste, la expresión fue mayor en no-BF en Pen3, Pen4 y TRAF6. Conclusión: el BF modula la transcripción de los genes relacionados con la respuesta inmune en camarón como una respuesta temprana. Sin embargo, el SAR sin-BF promueve una respuesta similar.

Resumo Antecedentes: A criação de camarões está evoluindo de sistemas semi-intensivos para hiper-intensivos como tecnologia de bioflocos e sistemas de recirculação. Objetivo: Avaliar a resposta transcricional promovida pelo biofloco em um sistema de aquicultura recirculante (SAR). Métodos: Utilizamos RT-PCR quantitativo em tempo real para monitorar sete genes-chave relacionados ao sistema imune em pós-larvas de camarão, criados em SAR com e sem bioflocos (BF e no-BF). Além disso, apresentamos pela primeira vez sequências nucleotídicas do fator de ribosilação do ADP 4 (LvArf4) de Litopenaeus vannamei. Resultados: Os resultados mostraram que o Penaeidina3 (PEN3), Penaeidina4 (Pen4), Crustina e Toll genes (LvToll) foram sobre-expressos entre 3 e 24 h em ambos os sistemas, e o Factor de Necrose do Receptor 6 associado e protuberância (TRAF6) no BF como uma resposta precoce. Com relação à expressão diferencial entre tratamentos, 13 ocorrências foram apresentadas. Nove onde o BF foi maior do que os não-BF e quatro onde o não-BF foi maior do que o BF. A expressão foi maior do que em BF não-BF em Pen3, Crustin, LvToll, TRAF6, IMD e LvArf4. Em contraste, a expressão foi mais elevada no não-BF em Pen3, Pen4 e TRAF6. Conclusões: O BF modula a transcrição de resposta imune relacionada no camarão como um genes de resposta precoce. No entanto, o SAR não BF promove uma resposta semelhante.

Synthesis and biological evaluation of a series of 2-(((5-akly/aryl-1-pyrazol-3-yl)methyl)thio)-5-alkyl-6-(cyclohexylmethyl)-pyrimidin-4(3)-ones as potential HIV-1 inhibitors

A series of 2-(((5-akly/aryl-1-pyrazol-3-yl)methyl)thio)-5-alkyl-6-(cyclohexylmethyl)-pyrimidin-4(3)-ones were synthesized and their anti-HIV-1 activities were evaluated. Most of these compounds were highly active against wild-type (WT) HIV-1 strain (IIIB) with EC values in the range of 0.0038-0.4759 μmol/L. Among those compounds, had an EC value of 3.8 nmol/L and SI (selectivity index) of up to 25,468 indicating excellent activity against WT HIV-1. anti-HIV-1 activity and resistance profile studies suggested that compounds and displayed potential anti-HIV-1 activity against laboratory adapted strains and primary isolated strains including different subtypes and tropism strains (ECs range from 4.3 to 63.6 nmol/L and 18.9-219.3 nmol/L, respectively). On the other hand, it was observed that those two compounds were less effective with EC values of 2.77 and 4.87 μmol/L for HIV-1A (K103N + Y181C). The activity against reverse transcriptase (RT) was also evaluated for those compounds. Both and obtained sub-micromolar IC values showing their potential in RT inhibition. The pharmacokinetics examination in rats indicated that compound has acceptable pharmacokinetic properties and bioavailability. Preliminary structure-activity relationships and molecular modeling studies were also discussed.

The SAR Problem and Trouble Shooting Strategy / 中国医疗器械杂志

The modifications of slices, flip angle, SAR mode and TR time are required when the SAR exceeds the limits. The scan time and image quality are affected by those. This study analyzes the SAR from the basic side. With the principle diagram of SIEMENS 1.5 T AVANTO and 3.0 T VERIO MRIS, the trouble shooting procedure of SAR problem is reached both in application and problem sides.

Safety Study of Implant Wearers in MRI RF Field Environment / 中国医疗器械杂志

The complex electromagnetic field environments in magnetic resonance imaging system(MRI) can have a significant impact on patients carrying implants, the RF heating problems being particularly important. To ensure the safety of the patients, it is necessary to understand the distribution of tissue temperature in the MRI environment and its changes over time. Based on the analysis of tissue temperature rise in MRI, this paper constructs a bird cage coil for generating RF field in MRI system, and constructs ASTM standard/improved phantom and single-cavity pacemaker finite element models, use time-domain finite difference (FDTD) to simulate. Firstly, the correctness of the simulation software and simulation method was validated according to the method of ISO. Then the distribution of the electric field, SAR and temperature field and the temperature change with time were calculated in the environment of 64 MHz, 2 W/kg. The difference in temperature rise with blood heat exchange and no blood heat exchange (standard/improved phantom) was specifically compared. The simulation results show that there are electric field and SAR hotspots near the electrode tip, the wire tail and the case of pacemaker. There are high SAR values on both sides of the phantom, and the shorter the distance from the coil, the higher the SAR. The temperature field distribution is similar to the SAR distribution; the temperature is higher in the area around the end of the wire and the case of pacemaker because the heat accumulation is higher around this area. At the same time, blood heat exchange can reduce the temperature rise to a certain extent.

Comportamentos de proteção contra COVID-19 entre adultos e idosos brasileiros que vivem com multimorbidade: iniciativa ELSI-COVID-19 / Comportamientos de protección contra la COVID-19 entre adultos y ancianos brasileños que viven con multimorbilidad: la iniciativa ELSI-COVID-19 / Protective behaviors for COVID-19 among Brazilian adults and elderly living with multimorbidity: the ELSI-COVID-19 initiative

Objetivou-se medir a ocorrência de comportamentos de proteção contra a COVID-19 e fatores sociodemográficos segundo a ocorrência de multimorbidade na população brasileira com 50 anos ou mais de idade. Foram utilizados dados de inquérito telefônico entre participantes do ELSI-Brasil (Estudo Longitudinal da Saúde dos Idosos Brasileiros), conduzido entre maio e junho de 2020. Avaliou-se o uso de medidas de prevenção não farmacológica para COVID-19, motivos para sair de casa segundo a presença de multimorbidade e variáveis sociodemográficas. Participaram do estudo 6.149 pessoas. Multimorbidade foi mais frequente no sexo feminino, em casados, na faixa etária 50-59 anos de idade e em moradores da zona urbana. A maior parte da população saiu de casa entre uma e duas vezes na última semana, percentual que aumentou segundo o número de morbidades (22,3% sem morbidades e 38% com multimorbidade). Sair de casa todos os dias teve menor ocorrência entre indivíduos com multimorbidade (10,3%), e 9,3% saíram de casa na última semana para obter atendimento de saúde. Higienização de mãos (> 98%) e sempre usar máscara ao sair de casa (> 96%) foram hábitos quase universais. Observou-se maior adesão ao isolamento social entre as mulheres com multimorbidade quando comparadas com os homens (RP = 1,49; IC95%: 1,23-1,79); esta adesão aumentou proporcionalmente com a idade e inversamente ao nível de escolaridade. O comportamento de proteção em pessoas com multimorbidade parece ser maior em relação aos demais, embora questões relacionadas ao isolamento social e cuidado em saúde mereçam ser destacadas. Esses achados podem ser úteis na customização de estratégias de enfrentamento atual da pandemia.

El objetivo fue medir la ocurrencia de comportamientos de protección contra la COVID-19 y factores sociodemográficos, según la ocurrencia de multimorbilidad, en la población brasileña con 50 años o más de edad. Se utilizaron datos de la encuesta telefónica entre participantes del ELSI-Brasil (Estudio Brasileño Longitudinal del Envejecimiento), realizado entre mayo y junio de 2020. Se evaluó el uso de medidas de prevención no farmacológica para la COVID-19, motivos para salir de casa, según la presencia de multimorbilidad y variables sociodemográficas. Participaron del estudio 6.149 personas. La multimorbilidad fue más frecuente en el sexo femenino, en casados, en la franja de edad 50-59 años de edad y en residentes de la zona urbana. La mayor parte de la población salió de casa entre una y dos veces en la última semana, porcentaje que aumentó según el número de morbilidades (22,3% sin morbilidades y 38% con multimorbilidad). Salir de casa todos los días tuvo una menor ocurrencia entre individuos con multimorbilidad (10,3%), y 9,3% salieron de casa en la última semana para obtener atención en salud. La higienización de manos (> 98%) y siempre usar mascarilla al salir de casa (> 96%) fueron hábitos casi universales. Se observó una mayor adhesión al aislamiento social entre las mujeres con multimorbilidad cuando se compararon con los hombres (RP = 1,49; IC95%: 1,23-1,79); esta adhesión aumentó proporcionalmente con la edad y fue inversamente proporcional al nivel de escolaridad. El comportamiento de protección en personas con multimorbilidad parece ser mayor respecto a los demás, a pesar de que las cuestiones relacionadas con el aislamiento social y cuidado en salud merezcan ser destacadas. Estos resultados pueden ser útiles en la personalización de estrategias de combate a la actual pandemia.

To measure the occurrence of protective behaviors for COVID-19 and sociodemographic factors according to the occurrence of multimorbidity in the Brazilian population aged 50 or over was the objective of this study. We used data from telephone surveys among participants of ELSI-Brazil (Brazilian Longitudinal Study of Aging), conducted between May and June 2020. The use of non-pharmacological prevention measures for COVID-19, reasons for leaving home according to the presence of multimorbidity and sociodemographic variables were evaluated. among 6,149 individuals. Multimorbidity was more frequent in females, married, aged 50-59 years and residents of the urban area. Most of the population left home between once and twice in the last week, increasing according to the number of morbidities (22.3% no morbidities and 38% with multimorbidity). Leaving home every day was less common among individuals with multimorbidity (10.3%) and 9.3% left home in the last week to access health care. Hand hygiene (> 98%) and always wearing a mask when leaving home (> 96%) were almost universal habits. Greater adherence to social isolation was observed among women with multimorbidity when compared to men (PR = 1.49, 95%CI: 1.23-1.79). This adherence increased proportionally with age and inversely with the level of education. The protective behavior in people with multimorbidity seems to be greater in relation to the others, although issues related to social isolation and health care deserve to be highlighted. These findings can be useful in customizing strategies for coping with the current pandemic.

Dengue, COVID-19 y gota, una asociación infrecuente / Dengue, COVID-19 and gout, an uncommon association

El panorama médico mundial actual está enfocado en el control de la COVID-19. La enfermedad afecta con mayor frecuencia a pacientes con enfermedades crónicas y puede concomitar con otras enfermedades virales; situación que incrementa el riesgo de complicaciones graves en los pacientes. El propósito de este estudio es dar a conocer las manifestaciones clínicas presentes en un paciente con gota en el cual concomitaron el dengue y la COVID-19. Se presenta a un paciente masculino de 50 años de edad con diagnóstico de artropatía gotosa de 5 años de evolución que comenzó con un cuadro inflamatorio atípico para esta enfermedad, acompañado de otras manifestaciones clínicas como decaimiento marcado, lesiones hemorragíparas en la piel, hematuria y disnea progresiva. Se realizó el diagnóstico de dengue y COVID-19 mediante estudios serológicos. Se aplicó el protocolo de tratamiento para ambas enfermedades, y el paciente evolucionó favorablemente hasta que fue dado de alta hospitalaria 26 días después sin que se presentaran complicaciones de la artropatía gotosa, el dengue o la COVID-19. Es importante conocer el patrón articular en el curso de las enfermedades reumáticas, pues esto, unido a las características epidemiológicas imperantes, facilita el diagnóstico de asociación de distintas enfermedades como ocurrió en el caso presentado. Se requiere crear protocolos y guías de actuación que establezcan el esquema terapéutico ante pacientes con estos diagnósticos(AU)

The current world medical panorama is focused on the control of COVID-19. The disease occurs more frequently in patients with chronic diseases and can be associated with other viral diseases; in this situation, the risk of serious complications in patient's increases. To present the clinical manifestations present in a patient with gout in whom dengue and COVID-19 coexist. A 50-year-old male patient is presented with a diagnosis of gouty arthropathy of 5 years of evolution that begins with an atypical inflammatory picture for this disease, accompanied by other clinical manifestations such as marked decay, hemorrhagic skin lesions, hematuria and progressive dyspnea. Dengue and COVID-19 diagnosis is made through serological studies. It is important to know the joint pattern in the course of rheumatic diseases, this, together with the prevailing epidemiological characteristics, facilitates the diagnosis of association of different diseases as occurred in the case presented(AU)

Aspectos clínico-epidemiológicos en 36 niños cubanos con COVID-19

Introducción: La COVID-19 es una enfermedad infecciosa de alta transmisibilidad. Objetivo: Caracterizar la casuística pediátrica que posibilite disponer de conocimientos para el enfrentamiento a la pandemia en Cuba. Métodos: Estudio descriptivo, observacional y transversal en pacientes con COVID-19, ingresados en el Hospital Pediátrico San Miguel del Padrón: abril-junio de 2020. Se analizó: edad, sexo, estado nutricional, enfermedad previa, área de residencia, sintomatología al ingreso, resultados de complementarios, y condición al egreso. Resultados: Se identificaron 36 niños con COVID-19. La proporción según sexo no mostró diferencias. Hubo predominio del grupo de edad entre 10-14 años, piel mestiza y presentación asintomática en 72,2 %. Las comorbilidades más observadas fueron el asma bronquial leve y la anemia ligera. Prevalecieron los residentes del Este de la capital, sobre todo, en la semana estadística 21 y 25. En el grupo de enfermos sintomáticos predominaron las manifestaciones respiratorias y la fiebre. Los complementarios revelaron linfocitosis (63,9 %), anemia (13,9 %) e infiltrados pulmonares (8,3 %). El 100 % de los pacientes tuvo evolución favorable y PCR negativo tras concluir tratamiento. Conclusiones: La COVID-19 tuvo mayor incidencia en niños de 10 años o más. No hubo variaciones en cuanto al sexo. Predominó el color de piel mestizo. Los pacientes tuvieron espectro clínico variable, y evolución de PCR condicionada por la presencia de factores de riesgo individual y social. La recuperación clínica y la regresión de alteraciones hematológicas y radiológicas se logró en todos los pacientes entre 2-3 semanas.

Introduction: COVID-19 is an infectious disease with high transmissibility. Objective: To characterize the pediatrics casuistry that allows having the relevant knowledge to fight COVID-19 pandemic in Cuba. Methods: Descriptive, observational and cross-sectional study in patients with COVID-19 admitted in San Miguel del Padrón municipality's Pediatric Hospital from April to June, 2020. There were analyzed as variables: age, sex, nutritional state, previous diseases, living area, sintomatology in the moment of admission, results of complementary tests, and state in the moment of discharge. Results: 36 children were identified with COVID-19. Proportion according to sex had no differences. There was a predominance of the group age among 10 to 14 years, mixed race patients and the asymptomatic forms in 72,2% of them. The most frequent comorbidities were slight bronchial asthma and slight anemia. There was predominance of patients living in the Eastern area of the capital, mainly in the statistic weeks #21 and #25. In the group of symptomatic patients prevailed the respiratory manifestations and the fever. The complementary tests showed lymphocytes (63,9%), anemia (13,9) and pulmonary infiltrates (8,3%). 100% of the patients had favorable evolution and negative PCR after finishing the treatment. Conclusions: COVID-19 had a higher incidence in 10 or more year's children. There were not variations regarding sex. Mixed race patients predominated. Patients had a variable clinical spectrum, and an evolution of the PCR conditioned by the presence of individual and social risk factors. Clinical recovery and regression of hematologic and radiologic alterations was achieved in all the patients among 2 to 3 weeks.

Similitudes y diferencias entre el síndrome respiratorio agudo severo causado por SARS-CoV y la COVID-19

Introducción: De manera epidémica, en los años 2003, 2012 y 2019, han ocurrido eventos caracterizados por tener una elevada morbilidad y mortalidad poblacional y ser originados por tres nuevos Beta-CoV denominados: SARS-CoV, MERS-CoV y SARS-CoV-2 (este último comparte una identidad de 82 % en su secuencia génica con el SARS-CoV), causantes del síndrome respiratorio agudo severo, el síndrome respiratorio del Medio Oriente y la COVID -19, respectivamente. Objetivo: Examinar las principales similitudes y diferencias entre el síndrome respiratorio agudo severo causado por el SARS-CoV y la COVID-19. Métodos: Se realizó la búsqueda en las bases de datos Medline, Scielo y Google académico. Se seleccionaron artículos en inglés y en español y las palabras clave: utilizadas fueron: infecciones por coronavirus, COVID-19, SARS-CoV, SARS-CoV-2. Resultados: Una similitud importante entre ambas afecciones es que tienen igual vía de transmisión y periodo de incubación; sin embargo, la letalidad en el SRAS duplicó la de la COVID-19. Existen diferencias estructurales entre el SARS-CoV y el SARS-CoV-2 pero ambos se fijan al receptor de la enzima convertidora de angiotensina 2. Las manifestaciones clínicas y exámenes complementarios son similares, pero existen diferencias relacionadas con el inicio de los síntomas respiratorio, su frecuencia y orden de aparición. Consideraciones finales: Existen similitudes entre las enfermedades causadas por el SARS-CoV y el SARS-CoV 2; pero también existen diferencias en sus características epidemiológicas, clínicas y de laboratorio que nos podrían permitir hacer un diagnóstico diferencial y garantizar un tratamiento y seguimiento adecuado en situaciones específicas.

Introduction: In the years 2003, 2012 and 2019 have happened epidemic events characterized with a high population morbidity and mortality and originated by three new Beta-CoV called: SARS-CoV, MERS-CoV and SARS-CoV-2 (this last one shares with SARS-CoV an identity of 82% in its gene sequence) which cause the severe acute respiratory syndrome, the Middle East respiratory syndrome and COVID-19, respectively. Objective: To assess the main similarities and differences among COVID-19 and the severe acute respiratory syndrome caused by SARS-CoV. Methods: It was carried out the search in Medline, Scielo and Google Scholar databases. The requirements used were that the articles were in English or Spanish language and the keywords were: infections by coronavirus, COVID-19, SARS-CoV, SARS-CoV-2. Results: An important similarity among both conditions is that they have the same transmission way and incubation period; however, lethality in the SARS doubled the COVID-19 one. There are structural differences among SARS-CoV and SARS-CoV-2 but both are fixed to the recipient of the angiostensina 2 converter´s enzyme. Clinical manifestations and complementary exams are similar but there are differences related to the onset of respiratory symptoms, their frequence and the order of appareance. Final considerations: There are similarities among the diseases caused by SARS-CoV and SARS-CoV-2; but also there are differences in their epidemiological, clinical and laboratory characteristics that can allow to do a differencial diagnosis and to guarantee an adequate treatment and follow-up in specific situations.

Synthesis and cytotoxic activity evaluation of 8-substituted quercetin derivatives / 国际药学研究杂志

Objective: To synthesize 8-substituted quercetin derivatives and test their cytotoxicity on human cancer cell lines, so as to find out hit or lead compounds via structure activity relationship(SAR)analysis. Methods: Using rutin as the raw material, quercetin was obtained by the acid hydrolysis of rutin, and the 8-substituted quercetin derivatives, 3a-3h, were synthesized via the whole hydroxyl protection of quercetin and then halogenation, followed by the Suzuki coupling or heck coupling reaction. The in vitro inhibitory activity of these derivatives was assayed by the MTT method using human cancer HepG2, HT-29 and K562 cell lines. Results and Conclusion: Eight new target compounds, 3a-3h, were synthesized, and their structures were confirmed by the 1H NMR, 13C NMR and MS data. The inhibitory effect of 3b-3h on HepG2 cell line, 3b and 3d on HT-29 cell line, and 3b-3d and 3f-3h on K562 cell line has remarkably and significantly enhanced than that of quercetin, and the present research results provide a suggestive preliminary SAR.

Research Progress of Immune Checkpoint Inhibitor Therapy for BRAF Mutation in Non-small Cell Lung Cancer / 中国肺癌杂志

BRAF gene mutation is found in about 2%-4% of the patients with non-small cell lung cancer (NSCLC). This type of NSCLC is characterized by high malignancy, low efficacy of chemotherapy and poor prognosis. Although the combination treatment of BRAF inhibitor and MEK inhibitor has achieved remarkable results in advanced NSCLC patients with BRAF V600E mutation, which has been written into the National Comprehensive Cancer Network (NCCN) guidelines, severe side effects of the combination therapy are frequently observed. There isn't effective treatment strategy after drug resistance, and targeted therapy for non-V600E mutation patients is still lacking. In this paper, we summarized the researches on expression of immune markers in NSCLC patients with mutant BRAF and analyzed the studies on efficacy of immune checkpoint inhibitor (ICI), so as to provide more options for prolonging survival of the patients.
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