Clinical Presentation of COVID19 in Dementia Patients.

OBJECTIVE: No studies analyzing the role of dementia as a risk factor for mortality in patients affected by COVID-19. We assessed the prevalence, clinical presentation and outcomes of dementia among subjects hospitalized for COVID19 infection. DESIGN: Retrospective study. SETTING: COVID wards in Acute Hospital in Brescia province, Northern Italy. PARTICIPANTS: We used data from 627 subjects admitted to Acute Medical wards with COVID 19 pneumonia. MEASUREMENTS: Clinical records of each patients admitted to the hospital with a diagnosis of COVID19 infection were retrospectively analyzed. Diagnosis of dementia, modalities of onset of the COVID-19 infection, symptoms of presentation at the hospital and outcomes were recorded. RESULTS: Dementia was diagnosed in 82 patients (13.1%). The mortality rate was 62.2% (51/82) among patients affected by dementia compared to 26.2% (143/545) in subjects without dementia (p<0.001, Chi-Squared test). In a logistic regression model age, and the diagnosis of dementia resulted independently associated with a higher mortality, and patients diagnosed with dementia presented an OR of 1.84 (95% CI: 1.09-3.13, p<0.05). Among patients diagnosed with dementia the most frequent symptoms of onset were delirium, especially in the hypoactive form, and worsening of the functional status. CONCLUSION: The diagnosis of dementia, especially in the most advanced stages, represents an important risk factor for mortality in COVID-19 patients. The clinical presentation of COVID-19 in subjects with dementia is atypical, reducing early recognition of symptoms and hospitalization.

Characterization of a pepper collection (Capsicum frutescens L.) from Brazil.

Germplasm banks are essential as sources of genetic variability for plant breeding programs. To characterize a Brazilian Capsicum frutescens collection, 21 malagueta and 5 Tabasco hot pepper accessions were evaluated under field and greenhouse conditions regarding morphological and molecular traits, as well as resistance to viruses. Morphological characterization was performed using 53 IPGRI (International Plant Genetic Resources Institute) descriptors, 15 vegetative, 13 inflorescence, 22 fruit, and 3 seed. Molecular characterization was carried out with 60 polymorphic markers from 29 RAPD primers. The incidence of major viruses infecting Capsicum spp, Tomato spotted wilt virus (TSWV), Groundnut ringspot virus (GRSV), Potato virus Y (PVY), Pepper yellow mosaic virus (PepYMV), Pepper mild mottle virus (PMMoV), and Cucumber mosaic virus (CMV) was evaluated by ELISA. Based on the average genetic distance among genotypes, six groups were defined for the 53 IPGRI descriptors. When considering only 11 quantitative traits (five vegetative and six fruit), six groups were also determined, and the traits plant canopy width (56.05%) and days to fruiting (25.07%) most explained the genetic diversity among genotypes. Molecular analysis defined five groups of accessions with partial correspondence to the morphological characterization data. The incidence of viruses in field-grown plants varied among genotypes and according to virus species, from 5.6% (GRSV; CNPH 3286) to 100% (PMMoV; CNPH2871), and indicated some accessions as potential sources of virus resistance. These results demonstrate the genetic variability within the group of 26 hot pepper accessions, as well as virus-resistant genotypes that can be used in breeding programs.

Genetic variability of a Brazilian Capsicum frutescens germplasm collection using morphological characteristics and SSR markers.

Characterization studies provide essential information for the conservation and use of germplasm in plant breeding programs. In this study, 103 Capsicum frutescens L. accessions from the Active Germplasm Bank of Embrapa Hortaliças, representative of all five Brazilian geographic regions, were characterized based on morphological characteristics and microsatellite (or simple sequence repeat - SSR) molecular markers. Morphological characterization was carried out using 57 descriptors, and molecular characterization was based on 239 alleles from 24 microsatellite loci. From the estimates of genetic distances among accessions, based on molecular characterization, a cluster analysis was carried out, and a dendrogram was established. Correlations between morphological and molecular variables were also estimated. Twelve morphological descriptors were monomorphic for the set of C. frutescens accessions, and those with the highest degree of polymorphism were stem length (14.0 to 62.0 cm), stem diameter (1.0 to 4.2 cm), days to flowering (90 to 129), days to fruiting (100 to 140), fruit weight (0.1 to 1.4 g), fruit length (0.6 to 4.6 cm), and fruit wall thickness (0.25 to 1.5 mm). The polymorphism information content for the SSR loci varied from 0.36 (EPMS 417) to 0.75 (CA49), with an overall mean of 0.57. The correlation value between morphological and molecular characterization data was 0.6604, which was statistically significant. Fourteen accessions were described as belonging to the morphological type tabasco, 85 were described as malagueta, and four were malaguetinha, a morphological type confirmed in this study. The typical morphological pattern of malagueta was described. Six similarity groups were established for C. frutescens based on the dendrogram and are discussed individually. The genetic variability analyzed in the study highlights the importance of characterizing genetic resources available for the development of new C. frutescens cultivars with the potential for various niche markets.

Morphological and genetic relationships between wild and domesticated forms of peppers (Capsicum frutescens L. and C. chinense Jacquin).

Capsicum chinense and C. frutescens peppers are part of the Brazilian biodiversity, and the Amazon basin is the area of greatest diversity for them, especially for that former species. Nevertheless, little is known about their evolutionary history. Aiming to identify genotypes with wild and domesticated characteristics, 30 accessions of the germplasm bank of Embrapa were characterized using morphological descriptors and ISSR molecular markers. Of the 72 primers tested, 42% showed amplification and produced 136 amplicons with some of the primers, namely i7Pv and i57Zm, allowing the identification of each species. ISSR also revealed polymorphisms within a species, especially between domesticated and wild forms. Four wild accessions collected in the Amazon region (CNPH 4315, CNPH 4372, CNPH 4337 and CNPH 4325B) popularly known as "olho-de-peixe" or "olho-de periquito" were molecularly classified as C. chinense and showed fruit with similar characteristics as the wild species: upright position, rounded to campanulate shape, small size (1.0 cm long and 0.8 cm wide), average weight of 0.2 g, dark-red color when ripe, easy detachment of calyx and presence of calyx annular constriction (discriminative of C. chinense). The wild form CNPH 4353 known as "malaguetinha" was morphologically and molecularly classified as C. frutescens, demonstrating a more preserved morphology in C. frutescens than in C. chinense. A significant correlation was found between morphological and molecular characterization, and the combination of the two analyses was effective in identifying and classifying the wild forms and contributing to evolutionary studies in the genus.

The C-C motif chemokine ligands CCL5, CCL11, and CCL24 induce the migration of circulating fibrocytes from patients with severe asthma.

The C-C motif chemokine ligand 5 (CCL5), CCL11, and CCL24 are involved in the pathogenesis of asthma, and their function is mainly associated with the airway recruitment of eosinophils. This study tested their ability to induce the migration of circulating fibrocytes, which may contribute to the development of irreversible airflow obstruction in severe asthma. The sputum fluid phase (SFP) from patients with severe/treatment-refractory asthma (PwSA) contained elevated concentrations of CCL5, CCL11, and CCL24 in comparison with the SFP from patients with non-severe/treatment-responsive asthma (PwNSA). The circulating fibrocytes from PwSA expressed the receptors for these chemokines at increased levels and migrated in response to recombinant CCL5, CCL11, and CCL24. The SFP from PwSA induced the migration of autologous fibrocytes, and its activity was significantly attenuated by neutralization of endogenous CCL5, CCL11, and CCL24. These findings suggest that CCL5, CCL11, and CCL24 may contribute to the airway recruitment of fibrocytes in severe asthma.

Interleukin (IL)-4, IL-13, and IL-17A differentially affect the profibrotic and proinflammatory functions of fibrocytes from asthmatic patients.

Fibrocytes contribute to the fibrotic changes most frequently observed in forms of asthma where inflammation is driven by T helper type 2 (Th2) cells. The mechanisms that regulate the profibrotic function of asthmatic fibrocytes are largely unknown. We isolated circulating fibrocytes from patients with allergen-exacerbated asthma, who showed the presence of fibrocytes, together with elevated concentrations of interleukin (IL)-4 and IL-13 and slightly increased concentrations of the Th17 cell-derived IL-17A, in induced sputum. Fibrocytes stimulated with IL-4 and IL-13 produced high levels of collagenous and non-collagenous matrix components and low levels of proinflammatory cytokines. Conversely, fibrocytes stimulated with IL-17A proliferated and released proinflammatory factors that may promote neutrophil recruitment and airway hyperresponsiveness. IL-17A also indirectly increased α-smooth muscle actin but not collagen expression in fibrocytes. Thus, fibrocytes may proliferate and express a predominant profibrotic or proinflammatory phenotype in asthmatic airways depending on the local concentrations of Th2- and Th17-derived cytokines.

[The clinical use of levosulpiride in retinal fluorangiography]. / Considerazione sull'uso clinico della levo-sulpiride nella fluorangiografia retinica.

The value of administering 25 mg of levosulpiride per os approximately one hour before the sodium fluorescein bolus used in fluorangiography is assessed in order to avoid to the onset of nausea and/or vomiting during and after the test. The study was performed in 35 patients. No nausea and/or vomiting was observed in over 90% of cases treated.

Adrenergic activity and aldosterone regulation: no evidence for an alpha-1 adrenoceptor-mediated influence in normal subjects.

In normal man the sympathetic nervous system could exert an inhibitory influence on aldosterone responsiveness to angiotensin II. The possible role of alpha-1 adrenoceptors in the modulation of aldosterone response was assessed by studying the changes of plasma aldosterone during infusion of angiotensin II at the doses of 1, 2, 5 and 10 ng/kg.min or after corticotrophin injection, 0.25 mg, in 9 normal subjects before and after treatment with the selective alpha-1 adrenoceptor antagonist, prazosin. Prazosin, given during 3 weeks, did not modify supine arterial pressure, heart rate and the plasma levels of angiotensin II, renin, aldosterone or adrenaline but caused a significant (P less than 0.05) increase of plasma noradrenaline. The correlation relating plasma aldosterone to plasma angiotensin II levels before and during angiotensin II infusion and the response of plasma aldosterone to corticotrophin was not modified by prazosin. These findings suggest that in normal man there is no inhibitory influence of the noradrenergic system on aldosterone responsiveness to angiotensin II mediated by an alpha-1 dependent mechanism.

[Drug therapy of so-called postherpetic neuralgia, the only valid alternative. Clinical experience in 43 treated cases]. / La terapia farmacologica della cosiddetta nevralgia post-erpetica unica valida alternativa. Esperienza clinica di 43 casi trattati.

The efficacy of tricyclic antidepressants in association with neuroleptics having been demonstrated in patients suffering from so-called tardive post-herpetic neuralgia, 43 patients were given this treatment either alone or in association with transcutaneous nerve stimulation (TENS). Of the 33 patients given drug treatment alone, 25 found relief from pain in 3-18 months, 5 produced a partial result and in 3 the treatment failed. The results obtained suggest that this is the most effective treatment as long as it is continuous and given for at least 3-6 months. The use of TENS produced no benefit.

[So-called post-herpetic neuralgia and phantom limb pain: therapeutic concepts needing review]. / La cosidetta nevralgia posterpetica e l' arto fantasma doloroso: concetti terapeutici da rivedere.

After a brief review of the most recent findings on peripheral nerve nociception and deafferentation, the advisability of considering two so-called neuralgias - postherpetic neuralgia and phantom limb pain - in the more complex framework of deafferentation syndromes is examined together with the consequent need for a basic review of the therapeutic approaches pursued up to the present in the antalgic treatment of these two syndromes.

[Clinical and echo-phonomechanocardiographic study of the mitral valve prolapse (author's transl)]. / Studio clinico e strumentale del prolasso della valvola mitrale

The results of a study of 32 patients with the clinical and auscultatory suspect of M.V.P., confirmed echo-cardiographically, are reported. Part of the pathogenetic cause of the symptomatology and ECgraphic alterations are attributed to the hypomagnesiemia. The relation between exercise test positivity and gravity of the symptomatology is confirmed. The phonomechanocardiographic tracings were studied and the morphological features from C.P. and apexcardiogram are described and shown, with particular attention given to the clicks and systolic murmurs. The authors describe three types of prolapse, early, "U"-and "double U"--shaped pansystolic, and, relating echo-to-phonomechanocardiographic results, point out features which seem typical of the M.V.P. Echo-phono mechanocardiography is confirmed as a technique which is useful and sufficiently safe and reliable in diagnosing, detecting and following the disease in its not yet perfectly acknowledged evolution. It avoids the use of invasive tools which could become extremely dangerous.