Neuropsychological manifestations of long COVID in hospitalized and non-hospitalized Brazilian Patients.

BACKGROUND: There has been a significant increase in number of patients seeking neuropsychological rehabilitation months after the acute phase of COVID-19 infection. OBJECTIVE: Identify the cognitive and psychiatric disorders in patients with long COVID or Post-Acute Sequelae of COVID (PASC) and explore the association between disease severity during the acute phase and persistent neuropsychological manifestations. METHODS: 614 adults were assessed an average of eight months post-infection. Participants were, on average, 47.6 y.o., who sought rehabilitation for neuropsychological problems. Patients were evaluated using the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS), Phonemic Verbal Fluency and Clock Drawing tests (NEUPSILIN) for executive functions, and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The BNIS score was significantly below reference values in all subscales, especially affect and memory. Verbal Fluency and Clock Drawing subtest results were also lower. Patients with PASC tested high for anxiety/depression, but there was no statistically significant relationship between HADS and BNIS scores. Neuropsychological evaluations showed no differences in cognitive or psychiatric profiles between hospitalized and non-hospitalized patients. CONCLUSIONS: Neuropsychological results suggest executive function problems and high incidence of anxiety/depression, irrespective of acute-phase severity, underscoring a need for neurorehabilitation programs while providing data for public policy initiatives.

Collection of semen in a dog with partial penectomy followed by successful artificial insemination: case report / [Coleta de sêmen em um cão parcialmente penectomizado seguida de inseminação artificial bem sucedida: relato de caso]

This study describes a case of a dog with a lacerated penile tear treated with partial penectomy followed by successful semen collections for artificial insemination. A 1.5-year-old Jack Russel Terrier with normal libido, genital organs and semen, had a penile laceration after copulation. The dog underwent a partial penectomy without orchiectomy, thus preserving the possibility of semen collection. Semen was successfully collected at 45 and 53 days after surgery, and it was used for artificial insemination of two bitches, one of which became pregnant. Therefore, this report demonstrated that semen may be collected from dogs with partial penectomy for artificial insemination, this technique has the potential to preserve fertility of dogs with penile lesions that require penectomy.(AU)

Este estudo descreve o caso de um cão que teve laceração peniana tratada por penectomia parcial seguida de coleta de sêmen para inseminação artificial bem sucedida. Um cão Jack Russel Terrier de 1,5 anos, com libido, órgãos genitais e sêmen normais, teve laceração peniana após cópula. O cão foi parcialmente penectomizado sem orquiectomia, preservando a possibilidade de coleta de sêmen. A coleta de sêmen foi bem sucedida 45 e 53 dias após a cirurgia, sendo utilizado para inseminação artificial de duas cadelas, uma delas se tornando gestante. Portanto, sêmen para inseminação artificial pode ser coletado em cães parcialmente penectomizados, esta técnica revelando ser uma potencial forma de preservação da fertilidade de cães com lesões penianas que necessitem penectomia.(AU)

Chlorinated metronidazole as a promising alternative for treating trichomoniasis.

Trichomoniasis is the most common non-viral, sexually transmitted infection affecting humans worldwide. The main treatment for trichomoniasis is metronidazole (MTZ). However, adverse effects and reports of resistance have stimulated the development of therapeutic alternatives. The ease of manipulation of the side chains of MTZ coupled with its safety makes this molecule attractive for the development of new drugs. In this context, we evaluated the activity of the chlorinated MTZ derivative, MTZ-Cl, on sensitive and resistant strains of Trichomonas vaginalis. MTZ-Cl presented a remarkable activity against both sensitive and resistant strains. In vitro and in vivo toxicity assays indicated that the new molecule is safe for future clinical trials. Furthermore, we noticed different rates of free radical production between the sensitive and resistant strains. MTZ-Cl induced a higher release of nitric oxide (NO, ~ 9000 a.u.) by both sensitive and resistant strains. However, the sensitive strain produced a greater amount of H2O2 (~ 1,800,000 a.u.) and superoxide radicals (~ 350,000 a.u.) in the presence of MTZ. In the resistant strain, production of these radicals was more prominent when MTZ-Cl was used. Collectively, these results suggest that NO is an important molecule in the trichomonacidal activity against resistant and sensitive strains, suggesting an alternative pathway for MTZ-Cl activation. We highlight the high trichomonacidal potential of MTZ-Cl, improving the effectiveness of treatment and reducing side effects. In addition, MTZ-Cl is derived from a well-established drug on the world market that presents low toxicity to human cells, suggesting its safety to proceed with future clinical trials.

High embryonic recovery rates with in vivo and ex vivo techniques in the bitch.

The embryonic collection techniques in dogs present a vast methodological variation and low recovery rates. The objectives were to compare and describe two techniques as to the recovery of canine embryos, on the 12th day after the first mating or artificial insemination. Embryos were recovered through uterine horn flushing in vivo, before performing the ovariohysterectomy (OHE) (Group 1; n = 9) or ex vivo, immediately after the OHE (Group 2; n = 9). In total, 43 and 47 embryonic structures were recovered in Groups 1 and 2, respectively. There was no significant difference (p > 0.05) between groups on recovery rates (72.8% and 81.0%, respectively). We inferred that both in vivo and ex vivo techniques allow a high rate of embryonic recovery; in the collection technique prior to the OHE, it is essential to carefully handle the reproductive system during the trans-surgical period and that the 12th day (D12) after the first mating/artificial insemination is an efficient option for the high recovery rate of morulae and blastocysts.

Lack of reduction in body fat after treatment with insulin-like growth factor-I in two children with growth hormone gene deletions.

Two patients with growth hormone (GH) gene deletions were treated with recombinant insulin-like growth factor-I (IGF-I) (80-240 (microg/kg/day) and the effects on bone mass and body composition were compared to administration of GH (0.075 U/kg/day) to 8 patients with idiopathic GH deficiency. Bone mass and body composition were measured by dual photon X-ray absorptiometry (DEXA ) before and 3 and 6 months after treatment with GH or IGF-I. Similar increases in growth velocities were observed after GH and IGF-I treatment. Treatment with GH resulted in prompt and significant reduction in body fat percentage (basal, 3 and 6 months: 22+/-10, 17+/-9, and 16+/-9%) whereas body fat percentage remained unchanged after IGF-I therapy (basal, 3 and 6 months: 49, 52 and 48% in patient 1 and 45, 42 and 43% in patient 2, respectively). Fat percentage remained elevated after 18 months of IGF-I treatment in patients 1 (51%) and 2 (44%), respectively. Lean mass and bone mineral content increased with GH and IGF-I therapies. We conclude that reduction of body fat measured by DEXA, observed after administration of GH but not after IGF-I treatment in these children with GH deficiency, suggests that the GH effect on body fat mass is not mediated by circulating IGF-I.

Insulin-like growth factor-I treatment in two children with growth hormone gene deletions.

Two unrelated Brazilian patients had homozygous 6.7 kb deletions in the GH-1 gene (girl and boy, 1.8 and 3.3 yr, heights -7.9 and -6.0 SDS, respectively). Desensitization using small amounts of exogenous GH (0.033 IU/kg body weight/week, divided into daily s.c. injections) was attempted, but anti-GH antibodies appeared. Replacement with usual doses of hGH induced only transient increase in growth. IGF-I therapy with increasing doses resulted in catch-up growth without side-effects. Growth velocity was 7.5 cm/yr in the first year and 8.4 cm/yr in the next 6 months in patient 1, and 6.7 cm/yr in the first year, 5.9 cm/yr in the second year and 7.9 cm/yr in the third year of IGF-I treatment in patient 2, when the daily dose of 240 micrograms/kg was divided into three injections. IGFBP-3 levels were low (0.55 and 0.40 mg/I) and did not increase after IGF-I treatment, suggesting that this GH effect is not mediated by IGF-I, and injected IGF-I had a rapid disappearance rate. We conclude that IGF-I promotes growth by endocrine mechanisms and constitutes an effective treatment for patients with GH insensitivity secondary to GH antibodies.

Clinical and molecular characterization of Brazilian patients with growth hormone gene deletions.

Genomic DNA from 23 patients with isolated growth hormone (GH) deficiency (12 males and 11 females: heights -4.9 +/- 1.4 SDS) was screened for GH gene deletions by restriction endonuclease analysis of polymerase chain reaction amplification products. Three unrelated patients had typical features of severe GH deficiency and deletions (6.7 kb in two and 7.6 kb in one) of the GH gene. The two patients with 6.7-kb deletions developed growth-attenuating anti-GH antibodies whereas the patient with the 7.6-kb deletion continued to grow with GH replacement therapy. Our finding that 3/23 (approximately 13%) Brazilian subjects had GH gene deletions agrees with previous studies of severe isolated GH deficiency subjects in other populations. Two of three subjects (67%) with deletions developed blocking antibodies despite administration of exogenous GH at low doses. Interestingly, only 1/10 of cases with affected relatives or parental consanguinity had GH-1 gene deletions.

Changes in growth hormone-binding protein in girls with central precocious puberty treated with a depot preparation of luteinizing hormone-releasing hormone analogue.

Growth hormone-binding protein (GHBP) was studied in 11 girls with true precocious puberty, aged 7.3 +/- 0.2 years (mean +/- SE), before and after the first 6 months of treatment with luteinizing hormone-releasing hormone analogue D-Trp6-LHRH. The 125I-human GH was incubated with 150 microliters of serum, bound and free GH were separated by gel filtration. The levels of GHBP increased significantly from 24.2 +/- 1.3 to 28.1 +/- 1.9% (p < 0.002, paired t test), more than expected for the normal age-dependent increase. The efficiency of LHRH-A therapy was confirmed by a decrease in growth rate and normalization of clinical and biological parameters. Our data agree with the hypothesis that the pubertal spurt is mediated by a sex-steroid-induced rise in GH concentration, and they suggest that the levels of GHBP may be related to the GH secretion and its variation with treatment.

Effect of granulocyte inhibitory factor on granuloma formation in mice infected with Schistosoma mansoni.

Mononuclear cells from patients infected with Schistosoma mansoni were able to produce a soluble material that inhibited the granulocyte cytotoxicity against schistosomula in a complement-dependent killing assay. This granulocyte inhibitory factor (GIF) appears to exist preformed in the mononuclear cells of patients, but it can also be released in the supernatant after antigenic stimulation (lymphokine-like). Only T lymphocytes were able to mediate the inhibition of granulocyte cytotoxicity against schistosomula in vitro. The treatment of S. mansoni-infected mice with GIF induced a significant decrease in the liver granuloma size.

Indicadores de risco gravidico no Piaui. / Indicators of pregnancy risk in Piaui

O presente trabalho traduz estudo prospectivo sobre indicadores de risco gravidico no Piaui. Para tanto, foi elaborada ficha contendo indicadores socio-economicos e medico-cirurgicos, aos quais foram dados valores arbitrarios de 0 a 8. Considerou-se alto risco quando a soma de pontos foi maior ou igual 8, medio risco de 4 a 7 e baixo risco menor 4. Os dados foram obtidos na primeira consulta de gestantes assistidas nos servicos pre-natal da Maternidade Dona Evangelina Rosa (capital do Estado), do bairro Dirceu Arcoverde (periferico da capital) e zona rural da cidade de Barras, que dista 120Km da capital. Esses grupos populacionais apresentaram em comum o fato de pertencerem a classes sociais com limitados recursos financeiros e, por isso, dependentes, quase exclusivamente, da assistencia medica gratuita oferecida pelo Estado. Os resultados demonstraram que os problemas socio-economicos repercutem na aceitacao da gravidez e interferem negativamente na assistencia prenatal. Dentre os problemas medicos destacam-se a sifilis, os estados de hipertensao arterial, as lesoes pre-malignas e malignas do colo uterino e as infeccoes urinarias. Dos tres grupos em estudo, o que apresentou indice mais elevado de gravidez de alto risco foi o da zona rural de Barras, seguido daquele assistido no pre-natal da Maternidade Dona Evangelina Rosa

Condroblastoma benigno.Relato de tres casos - estudo clinico e anatomo-patologico. / Benign chondroblastoma.Report of 3 cases - clinical and pathological study

Tres casos de condroblastoma benigno do osso sao relatados. Uma revisao critica da literatura, com comentarios sobre nomenclatura, achados clinicos e radiologicos, patologia, diagnostico diferencial e tratamento, e apresentada. Nos tres casos descritos, ha 2 pontos poucos usuais e dignos de nota: a idade elevada de uma senhora de 40 anos e a localizacao pouco comum no calcaneo, em outro caso. Os casos sao analisados clinicamente e a anatomia patologica e revista. Todos os casos tratados com curetagem e enxerto osseo

Lipoma intra-osseo da tibia. Relato de um caso e revisao da literatura. / Intraosseous lipoma of the tibia. A case report and review of the literature

Um caso de lipoma intra-osseo da tibia e apresentado com uma pequena revisao da literatura. A imagem radiologica apresenta-se como lesao osteolitica bem delimitada na porcao proximal da tibia, sem destruicao cortical, com reacao periosteal. O aspecto macroscopico revelou presenca de tecido adiposo com espiculas osseas esparsas. Foi encontrado aspecto histologico tipico de tecido adiposo maduro, com trabeculas osseas degeneradas. O tratamento foi feito a base de curetagem e enxerto osseo autogeno. Este tumor e muito raro e ate o momento menos de 50 casos foram publicados