ABSTRACT
Introduction: Long-term pulmonary dysfunction (L-TPD) is one of the most critical manifestations of long-COVID. This lung affection has been associated with disease severity during the acute phase and the presence of previous comorbidities, however, the clinical manifestations, the concomitant consequences and the molecular pathways supporting this clinical condition remain unknown. The aim of this study was to identify and characterize L-TPD in patients with long-COVID and elucidate the main pathways and long-term consequences attributed to this condition by analyzing clinical parameters and functional tests supported by machine learning and serum proteome profiling. Methods: Patients with L-TPD were classified according to the results of their computer-tomography (CT) scan and diffusing capacity of the lungs for carbon monoxide adjusted for hemoglobin (DLCOc) tests at 4 and 12-months post-infection. Results: Regarding the acute phase, our data showed that L-TPD was favored in elderly patients with hypertension or insulin resistance, supported by pathways associated with vascular inflammation and chemotaxis of phagocytes, according to computer proteomics. Then, at 4-months post-infection, clinical and functional tests revealed that L-TPD patients exhibited a restrictive lung condition, impaired aerobic capacity and reduced muscular strength. At this time point, high circulating levels of platelets and CXCL9, and an inhibited FCgamma-receptor-mediated-phagocytosis due to reduced FcγRIII (CD16) expression in CD14+ monocytes was observed in patients with L-TPD. Finally, 1-year post infection, patients with L-TPD worsened metabolic syndrome and augmented body mass index in comparison with other patient groups. Discussion: Overall, our data demonstrated that CT scan and DLCOc identified patients with L-TPD after COVID-19. This condition was associated with vascular inflammation and impair phagocytosis of virus-antibody immune complexes by reduced FcγRIII expression. In addition, we conclude that COVID-19 survivors required a personalized follow-up and adequate intervention to reduce long-term sequelae and the appearance of further metabolic diseases.
ABSTRACT
AIM: This study evaluated the immune bioactivity of testing media (TM) obtained from different calcium silicate-based sealers and cements on monocyte morphology, activation, differentiation and cytokine secretion. METHODS: Blood-derived CD14+ monocytes were isolated and cultured for 5 days with 25% TM from the following calcium silicate-based materials: TotalFill BC RRM Fast-Set Putty, Biodentine, TotalFill BC Sealer and BioRoot-Root-Canal-Sealer (RCS). A resin-based endodontic cement was used as a control. The expression of surface markers such as CD86, HLA-DR, CD16, CD309 and CD209, and cytokine secretion were analysed by flow cytometry. Data were analysed using the one-way repeated measures analysis of variance (anova) multiple comparison test and a Holm-Sidak multiple comparison post-hoc test (p < .05). RESULTS: This comparative analysis revealed that monocytes co-cultured with calcium silicate-based materials showed a spindle-shaped morphology compared with the round shape observed in the control. Regarding activation markers, BioRoot-RCS and Biodentine significantly increased CD86 expression compared with the control sample, whereas no significant differences (p > .05) were observed in HLA-DR expression. In addition, no differences were observed among the differentiation markers. When the inflammatory cytokines were analysed, BioRoot-RCS increased the secretion of IL-1ß, IL-6, IL-10 and TNF-α, whereas BioRoot-RCS and Biodentine significantly decreased IL-8 production (p < .05). CONCLUSIONS: These data showed that the calcium silicate-based materials tested changed the morphology of CD14+ monocytes; however, only BioRoot-RCS and Biodentine significantly upregulated CD86. In addition, BioRoot-RCS was the sealer with the highest immunomodulatory properties for cytokine production which means that it can contribute with the in vivo healing process and regeneration of periapical lesions.
Subject(s)
HLA-DR Antigens , Monocytes , CytokinesABSTRACT
Objective: To determine the association between Obstructive Sleep Apnea (OSA) with long-term symptoms and inflammatory cytokines, exploring the changes between 4-months and 1-year after COVID-19 infection. Methods: We conducted an observational, prospective cohort study, including patients ≥18 years old with confirmed diagnosis of COVID-19 between April to July 2020. All participants underwent two clinical follow-up visits, the first at 4-months (Visit 1) and the second at 1 year, after SARS-CoV-2 infection (Visit 2). Plasma glucose, total cholesterol, HDL, and triglycerides. Regarding pulmonary function, spirometry and lung diffusion capacity tests were assessed. For mental and neurocognitive evaluation, a short-form (SF-12), Beck depression and Hospital-Anxiety depression questionnaires were conducted at both time-points, whereas the Montreal Cognitive assessment was conducted during the second follow-up. Regarding to sleep evaluation, Epworth Sleepiness Scale, Insomnia Severity index and STOP-BANG questionnaire were conducted. Additionally, a home sleep apnea test and 7-day wrist actigraphy were performed in all participants. Inflammatory cytokines were measured using an inflammatory cytokine bead array kit. p-values < 0.05 were considered statistically significant and statistical analyses were performed using R software. Results: A total of 60 patients were included in the first follow-up, from which 57 completed the second follow-up. The mean age was 46.4 years-old (SD ± 13.1) and 53.3% were male. 30% of cases reported mild COVID-19 infection, 28.3% with moderate illness, and 41.6% with severe illness. Moreover, 56.6% of them were admitted to the ICU. Regarding to metabolic values, the OSA group showed higher values of insulin resistance (IR) (27%), systolic blood pressure (SBP) 135.2 (±19.1), dyslipidemia (67.5%), total cholesterol 202.1 (±60.5), triglycerides 176.1 (±119.0) and HOMA-IR 9.0 (±18.8) in comparison with the non-OSA group. 1 year after COVID-19 infection, DLCO test remains abnormal in OSA patients (25% OSA vs. 3.6% non-OSA, p = 0.02). Finally, those participants with OSA who develop ARDS reported an adjusted OR 20.4 (95%-CI, 1.04-504) risk of neurocognitive impairment. Discussion: Among patients with previous COVID-19, OSA impact the development of incident glycemic, neurocognitive impairment, and abnormal functional pulmonary changes that persist up to 1 year since acute phase.
ABSTRACT
Resumen Introducción Esta investigación indaga la influencia del sistema binario de género en la construcción del sujeto trans desde la perspectiva del Hacer y las potencialidades de Llegar a Ser, en el contexto sociocultural y político chileno, centrándose en las experiencias de los participantes mediante el rescate de la historia ocupacional. Objetivos Analizar la construcción del sujeto trans a través del hacer, ser y llegar a ser en base a sus narrativas y en relación a la estructura social chilena en la cual se desenvuelven, visualizando la influencia en sus estados de salud. Metodo Desde una perspectiva cualitativa con enfoque de conocimientos situados, se utiliza la metodología de producciones narrativas y técnicas discontinuas a múltiples voces. La información fue recolectada mediante entrevistas individuales y un grupo focal. Resultados El proceso de tránsito se presenta como un continuo ocupacional, identificando la performatividad del género mediante la ocupación, así como las transformaciones corporales en la construcción de subjetividad. Además se identifica un contexto sociocultural y político que vulnera derechos, lo cual impacta en la salud y el involucramiento en ocupaciones colectivas. Conclusiones La ocupación se presenta como un elemento reproductor del sistema binario de sexo-género, no obstante, también puede ser entendida como una herramienta de emancipación en la medida que permite transgredirla. En este sentido, se interpela a la Terapia Ocupacional a promover ocupaciones colectivas que potencien la capacidad de agencia de sujetos abyectos, determinando estados de salud favorables.
Resumo Introdução Esta pesquisa investiga a influência do sistema binário de gênero na construção do sujeito trans desde a perspectiva do fazer e as potencialidades do tornar-se a ser, no contexto sociocultural e político chileno, enfocando as experiências dos participantes através do resgate de História Ocupacional. Objetivos Analisar a construção do sujeito trans através do fazer, ser e tornar-se, com base em suas narrativas e em relação à estrutura social chilena em que atuam, visualizando a influência em seus estados de saúde. Método Em uma perspectiva qualitativa, com foco no conhecimento situado, foi utilizada a metodologia de produção de narrativa e técnicas descontínuas com múltiplas vozes. As informações foram coletadas por meio de entrevistas individuais e um grupo focal. Resultados O processo de trânsito é apresentado como um continuum ocupacional, identificando a performatividade de gênero através da ocupação, bem como transformações corporais na construção da subjetividade. Além disso, é identificado um contexto sociocultural e político que viola os direitos, com impacto na saúde e no envolvimento em ocupações coletivas. Conclusões A ocupação é apresentada como um elemento reprodutor do sistema binário sexo-gênero, no entanto, também pode ser entendida como uma ferramenta de emancipação, na medida em que permite transgredi-la. Nesse sentido, interpela-se a Terapia Ocupacional a promover ocupações coletivas que aumentem a capacidade de agência de sujeitos abjetos, determinando estados de saúde favoráveis.
Abstract Introduction This research inquires the influence of the binary gender system on the construction of the trans subject from the perspective of Doing and the potential of becoming, in the Chilean socio-cultural and political context, focusing on the experiences of the participants through the rescue of history occupational. Objectives Analyze the construction of the trans subject through doing, being and becoming based on their narratives, the Chilean social structure in which they develop, visualizing the influence on their health states. Method From a qualitative perspective with focus on situated knowledge, the methodology of narrative productions and discontinuous techniques is used to multiple voices. The information was collected through individual interviews and a focus group. Results The transit process is presented as an occupational continuum, identifying the performativization of gender through occupation, such as bodily transformations, in the construction of subjectivity. In addition, a sociocultural and political context that violates rights is identified, which impacts on health and participation in collective occupations. Conclusions Occupation is presented as a reproductive element of the binary sex-gender system, however, it can also be understood as a tool of emancipation insofar as it transgresses it. In this sense, Occupational Therapy is called upon to promote collective occupations that enhance the capacity of agency of abject subjects, determining favorable health states.
