Are hemoglobin-derived peptides involved in the neuropsychiatric symptoms caused by SARS-CoV-2 infection?

Follow-up of patients affected by COVID-19 has unveiled remarkable findings. Among the several sequelae caused by SARS-CoV-2 viral infection, it is particularly noteworthy that patients are prone to developing depression, anxiety, cognitive disorders, and dementia as part of the post-COVID-19 syndrome. The multisystem aspects of this disease suggest that multiple mechanisms may converge towards post-infection clinical manifestations. The literature provides mechanistic hypotheses related to changes in classical neurotransmission evoked by SARS-CoV-2 infection; nonetheless, the interaction of peripherally originated classical and non-canonic peptidergic systems may play a putative role in this neuropathology. A wealth of robust findings shows that hemoglobin-derived peptides are able to control cognition, memory, anxiety, and depression through different mechanisms. Early erythrocytic death is found during COVID-19, which would cause excess production of hemoglobin-derived peptides. Following from this premise, the present review sheds light on a possible involvement of hemoglobin-derived molecules in the COVID-19 pathophysiology by fostering neuroscientific evidence that supports the contribution of this non-canonic peptidergic pathway. This rationale may broaden knowledge beyond the currently available data, motivating further studies in the field and paving ways for novel laboratory tests and clinical approaches.

Are hemoglobin-derived peptides involved in the neuropsychiatric symptoms caused by SARS-CoV-2 infection?

Follow-up of patients affected by COVID-19 has unveiled remarkable findings. Among the several sequelae caused by SARS-CoV-2 viral infection, it is particularly noteworthy that patients are prone to developing depression, anxiety, cognitive disorders, and dementia as part of the post-COVID-19 syndrome. The multisystem aspects of this disease suggest that multiple mechanisms may converge towards post-infection clinical manifestations. The literature provides mechanistic hypotheses related to changes in classical neurotransmission evoked by SARS-CoV-2 infection; nonetheless, the interaction of peripherally originated classical and non-canonic peptidergic systems may play a putative role in this neuropathology. A wealth of robust findings shows that hemoglobin-derived peptides are able to control cognition, memory, anxiety, and depression through different mechanisms. Early erythrocytic death is found during COVID-19, which would cause excess production of hemoglobin-derived peptides. Following from this premise, the present review sheds light on a possible involvement of hemoglobin-derived molecules in the COVID-19 pathophysiology by fostering neuroscientific evidence that supports the contribution of this non-canonic peptidergic pathway. This rationale may broaden knowledge beyond the currently available data, motivating further studies in the field and paving ways for novel laboratory tests and clinical approaches.

Considerações sobre a ejaculação precoce / Premature ejaculation considerations

Este artigo versa sobre ejaculação precoce. De forma breve, aborda situações que podem ser vivenciadas pelos homens, entre elas: a presença de sintomas de ansiedade e de depressão, a dificuldade com a parceira geradora de estresse no relacionamento amoroso. As opções de tratamento dos modelos multimodal e tridimensional são apresentadas como forma de tratamento para ajudar o homem a recuperar a condição que tinha antes da disfunção sexual. Em geral, há relatos de vergonha e de dificuldade em satisfazer a parceira sexualmente. Recomenda-se avaliar o grau de sintomas de depressão e de ansiedade nos homens em decorrência do impacto na função sexual e na resposta sexual. A depressão é um fator de risco às disfunções sexuais masculinas, evidenciando desde a baixa do desejo sexual à perda de satisfação que pode, nesses casos, estar associada às alterações cognitivas e comportamentais. A ansiedade está presente em diferentes graus nos pacientes com ejaculação precoce em relação ao padrão de evitação do intercurso sexual com penetração vaginal. Interfere na capacidade do homem de manter a excitação física e/ou psíquica presente na sensação premonitória do orgasmo durante o coito. A psicoterapia enfoca o pensamento desadaptativo cujo temor da atividade sexual com penetração vaginal está presente, diminuindo a capacidade de enfrentar a situação e aprender novas maneiras de lidar com a sexualidade e o intercurso sexual com penetração vaginal. PALAVRAS-CHAVE: Ejaculação precoce, sexualidade, ansiedade, depressão, psicoterapia

Pre- and Post-Conditioning of the Heart: An Overview of Cardioprotective Signaling Pathways.

Since the discovery of ischemic pre- and post-conditioning, more than 30 years ago, the knowledge about the mechanisms and signaling pathways involved in these processes has significantly increased. In clinical practice, on the other hand, such advancement has yet to be seen. This article provides an overview of ischemic pre-, post-, remote, and pharmacological conditioning related to the heart. In addition, we reviewed the cardioprotective signaling pathways and therapeutic agents involved in the above-mentioned processes, aiming to provide a comprehensive evaluation of the advancements in the field. The advancements made over the last decades cannot be ignored and with the exponential growth in techniques and applications. The future of pre- and post-conditioning is promising.

Considerações sobre a ejaculação precoce: o modelo multimodal e o modelo tridimensional de compreensão da disfunção sexual / Considerations on the premature ejaculation: the model multimodal and the model three-dimensional understanding of sexual dysfunction Abrir no Google Tradutor •

A ejaculação precoce é uma disfunção sexual sem etiologia descrita na literatura, apesar de os primeiros relatos clínicos serem de 1890. Ao longo dos anos, foi utilizada a definição da Internacional Society for Medicine Sexual para compreensão da ejaculação precoce e dos seus critérios diagnósticos. Muitos homens acreditam que a resposta sexual é automática e nata, no entanto, o medo de falhar e a perda do mundo erótico associados à angústia, frustração e evitação da intimidade sexual são aspectos subjetivos relacionados à dificuldade de controle ejaculatório. O homem cuja parceira apresenta postura ativa e envolvimento no intercurso sexual tem o seu processo de aprendizagem facilitado, controlando, assim, a excitação e mantendo a ereção. Essa parceira, em geral, tem maior qualidade de comunicação sexual, construto associado de forma positiva à função sexual masculina (por exemplo, ao aumento da excitação e ao controle ejaculatório); diminuindo a vulnerabilidade e a predisposição ao desenvolvimento de disfunção sexual. O presente artigo versa, também, sobre a proposta de tratamento do modelo multimodal e tridimensional para a ejaculação precoce. O primeiro modelo apresenta a resposta excitatória na ejaculação por meio de um sistema de software, sistema psicológico (variável conforme o contexto e com base na experiência sexual); e um hardware, sistema biológico (com pouca variação intrínseca e determinante genética), combina farmacoterapia e psicoterapia; o segundo, tridimensional, apresenta coordenadas cartesianas para corroborar aspectos subjetivos e relacionais da ejaculação precoce, apresentando uma baixa de serotonina na fenda sináptica, impactando a sensação de controle e reflexo ejaculatório.

Impact of mother-infant interaction on development during the first year of life: A systematic review.

The objectives of this project were to systematically review the impact of mother-infant interaction on the development of infants 12 months or younger and determine factors that mediate this relationship and early development. We systematically reviewed the literature and identified 21 papers which fulfilled inclusion and exclusion criteria. The majority of the studies found significant association between mother-infant interaction and language, cognition, motor, and social development during the first year of life. Only seven studies assessed motor development and four studies found significant relationship between motor development and mother-infant interaction. Prematurity, infant age, multiples births, maternal anxiety, maternal opioid exposure, history of foster care, and criminal record were the only factors found to mediate the relationship between mother-infant interaction and social, cognitive, and language development. The quality of the interactions between a mother and infant can both positively and negatively influence cognitive, language, and social outcomes during the first year of life. Additional research is needed to determine the influence of mother-infant interaction on motor development. Future research is needed on the efficacy of interventions designed to alter mother-infant interaction with the ultimate goal of achieving positive developmental outcomes during the first year of life.

Effects of virtual reality in body oscillation and motor performance of children with cerebral palsy: A preliminary randomized controlled clinical trial.

BACKGROUND AND PURPOSE: Virtual reality is an adjuvant technique to rehabilitation of children with cerebral palsy (CP). It has been gaining prominence in this field because of its accessibility and great levels of motivation it promotes in treatment. However, there is a lack of studies addressing the effects of virtual reality-based therapy on activity levels regarding postural stability, especially considering the level of evidence presented by studies addressing this issue. Therefore, we aim to evaluate the effects of intervention in body sway and gross motor function of children with CP using an active video game. MATERIALS AND METHODS: In this blind randomized controlled trial, fifteen children with CP, Gross Motor Function Classification System (GMFCS) I-II, regularly attending conventional physical therapy programs, were randomly assigned to an intervention (IG:n = 7) or to a control group (CG:n = 8). In both groups, children remained attending conventional therapy. In addition, IG underwent intervention using an active video game twice a week for 45 min and eight weeks. Standing body sway was assessed using a force plate, and Gross Motor Function Measure (GMFM) dimensions D (Standing) and E (Walking, Running and Jumping) were tested. RESULTS: Following the virtual reality-based intervention, the IG only showed significant improvements in the GMFM dimensions D (p = 0.021) and E (p = 0.008). Improvements were clinically significant (D = 10.8%; E = 14.0%). For the CG, no variable analyzed showed differences after eight weeks. CONCLUSIONS: Intervention using an active video game is a promising tool that can improve the gross motor function of children with CP, GMFCS I-II.

Microcephaly and Zika virus: Neuroradiological aspects, clinical findings and a proposed framework for early evaluation of child development.

BACKGROUND AND AIMS: As the recent outbreak of microcephaly cases caused by Zika virus has been declared a global health emergency, providing assessment guidelines for multidisciplinary teams providing early developmental screening and stimulation to infants with microcephaly is much needed. Thus, the aim of this manuscript is to provide an overview on what is known about neuroradiological aspects and clinical findings in infants with microcephaly caused by Zika virus and to propose a framework for early evaluation of child development. METHODS: The keywords "Zika virus" and "microcephaly" were searched in PubMed database for articles published from incept to May 2017. These texts were reviewed, and the ones addressing neuroradiological and clinical findings in infants were selected. Recommendations for early assessment were made based on the International Classification of Functionality Disability and Health (ICF) model. OUTCOMES AND RESULTS: The database search yielded 599 publications and 36 were selected. The studies detected microcephaly with diffuse brain malformations and calcifications, ventriculomegaly, optic nerve hypoplasia, macular atrophy, cataracts, impaired visual and hearing function, arthrogryposis, spasticity, hyperreflexia, irritability, tremors, and seizures, but very little is known about early development. Early assessments were described based on the ICF domains (Body Function and Structures, Activities and Participation and Contextual factors). CONCLUSION AND IMPLICATIONS: Studies published showed abnormal brain, optic, neurologic and orthopedic findings, but very little is known about other aspects of functioning in infants with microcephaly caused by Zika virus. The biopsychosocial model based on the ICF paradigm provides an adequate framework to describe the condition of the infant with microcephaly receiving rehabilitative efforts to minimize disability. Efforts towards early identification of developmental delays should be taken within the first six months of life.

MortalitY in caRdIAc surgery (MYRIAD): A randomizeD controlled trial of volatile anesthetics. Rationale and design.

OBJECTIVE: There is initial evidence that the use of volatile anesthetics can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization following coronary artery bypass graft (CABG) surgery. Nevertheless, small randomized controlled trials have failed to demonstrate a survival advantage. Thus, whether volatile anesthetics improve the postoperative outcome of cardiac surgical patients remains uncertain. An adequately powered randomized controlled trial appears desirable. DESIGN: Single blinded, international, multicenter randomized controlled trial with 1:1 allocation ratio. SETTING: Tertiary and University hospitals. INTERVENTIONS: Patients (n=10,600) undergoing coronary artery bypass graft will be randomized to receive either volatile anesthetic as part of the anesthetic plan, or total intravenous anesthesia. MEASUREMENTS AND MAIN RESULTS: The primary end point of the study will be one-year mortality (any cause). Secondary endpoints will be 30-day mortality; 30-day death or non-fatal myocardial infarction (composite endpoint); cardiac mortality at 30day and at one year; incidence of hospital re-admission during the one year follow-up period and duration of intensive care unit, and hospital stay. The sample size is based on the hypothesis that volatile anesthetics will reduce 1-year unadjusted mortality from 3% to 2%, using a two-sided alpha error of 0.05, and a power of 0.9. CONCLUSIONS: The trial will determine whether the simple intervention of adding a volatile anesthetic, an intervention that can be implemented by all anesthesiologists, can improve one-year survival in patients undergoing coronary artery bypass graft surgery.

Hepatic inflammatory biomarkers and its link with obesity and chronic diseases.

INTRODUCTION: The low-grade inflammation and insulin resistance are two events that could be present in varying degrees, on obesity and chronic diseases. The degree of subclinical inflammation can be gauged by measuring the concentrations of some inflammatory biomarkers, including the hepatic origin ones. Some of those biomarkers are sialic acid, α1-antitrypsin and the C-terminal fragment of alpha1-antitrypsin, ceruloplasmin, fibrinogen, haptoglobin, homocystein and plasminogen activator inhibitor-1. OBJECTIVES: To approach the relation between adiposity and hepatic inflammatory markers, and to assess the possible associations between hepatic inflammatory biomarkers and obesity, as well as their capacity of predicting chronic diseases such as type 2 diabetes and atherotrombotic cardiovascular diseases. METHODS: We used electronic scientific databases to select articles without restricting publication year. RESULTS: The sialic acid predicts the chance increase to become type 2 diabetic independently of BMI. Moreover, the α1-antitripsin, ceruloplasmin, fibrinogen and haptoglobulin biomarkers, seem predict the chance increase to become type 2 diabetic, dependently, of BMI. So, this process could be aggravated by obesity. The concentrations of fibrinogen, homocystein and PAI-1 increase proportionally to insulin resistance, showing its relation with metabolic syndrome (insulin resistance state) and with type 2 diabetes. In relation to cardiovascular diseases, every biomarkers reported in this review seem to increase the risk, becoming useful in add important prognostic. CONCLUSION: This review integrates the knowledge concerning the possible interactions of inflammatory mediators, in isolation or in conjunction, with obesity and chronic diseases, since these biomarkers play different functions and follow diverse biochemical routes in human body metabolism.

Introdución: El bajo grado de inflamación y la resistencia a la insulina son dos eventos que podrían estar presentes en mayor o menor grado, en la obesidad y las enfermedades crónicas. El grado de inflamación subclínica se puede evaluar por medición de las concentraciones de algunos biomarcadores inflamatorios, incluyendo los de origen hepático. Algunos de estos biomarcadores son el ácido siálico, 1-antitripsina y el fragmento C-terminal de la alfa 1-antitripsina, ceruloplasmina, fibrinógeno, haptoglobina, la homocisteína y el inhibidor-1 del activador del plasminógeno. Objetivos: Evaluar la relación entre la obesidad y los marcadores de inflamación hepática, y las posibles asociaciones entre los biomarcadores inflamatorios hepáticos y la obesidad, así como su capacidad de predicción de las enfermedades crónicas como la diabetes tipo 2 y enfermedades cardiovasculares aterotromboticas. Métodos: Se utilizaron bases científicas electrónicas para selección de artículos, sin límite de año de publicación. Resultados: El ácido siálico predice el aumento de convertirse en diabéticos tipo 2 independientemente del IMC. Por otra parte, los biomarcadores 1-antitripsina, ceruloplasmina, fibrinógeno y haptoglobulina, parecen predecir el aumento de convertirse en diabético tipo 2, dependiente, de IMC. Por lo tanto, este proceso podría verse agravada por la obesidad. Las concentraciones de fibrinógeno, homocisteína y PAI-1 incrementam proporcionalmente a la insulinoresisténcia, mostrando su relación con el síndrome metabólico (estado de resistencia insulínica) y con la diabetes tipo 2. En relación con las enfermedades cardiovasculares, cada biomarcador informado en esta revisión parece aumentar el riesgo, llegando a ser muy útil en el complemento pronóstico. CONCLUSION: Esta revisión se integra el conocimiento acerca de las posibles interacciones de los mediadores inflamatorios, en forma aislada o en combinación, con la obesidad y las enfermedades crónicas, ya que estos biomarcadores desempeñan funciones diferentes y siguen diversas rutas bioquímicas en el metabolismo del cuerpo humano.

[Acceptance of handmade products containing nuts and fructooligosaccharides]. / Aceptación de productos artesanales formulados con nueces y fructooligosacáridos.

INTRODUCTION: Prebiotic and food with functional properties are beneficial for consumers through prevention of many diseases. AIM: Verify the acceptance of handmade product (chocolate bar, soy sweet and sweet bread) formulated based on oil seeds (flaxseed, peanut and Brazil nut) and or fructooligosaccharides (FOS). METHODS: Four samples of each handmade product were prepared adding different concentrations of oil seed and FOS. The sensory evaluation was performed by a sample of 373 consumers; 126, 121 and 126 tasters of chocolate bar, soy sweet and sweet bread, respectively, using a hedonic scale of nine points. The results were submitted to analysis of variance (ANOVA) and Tukey's test. RESULTS AND DISCUSSION: Observing the trials averages, we inferred that samples of sweet bread with Brazil nut and/or FOS had the greater acceptance. However, all the samples are good market alternatives because they had presented averages between 6 and 9 points, and conferred accretion of omega-3 and omega-6 fatty acids, protein, fiber, antioxidant vitamins and minerals, as well as, phytochemicals, which plays an important role in health promotion. CONCLUSION: The handmade products formulated based on oil seeds and FOS had good acceptance and can improve the consumer dietary patterns. But, in order to prove the functionality of these products, new studies should be performed.

Introducción: Los prebióticos y alimentos con propiedades funcionales proporcionan beneficios para la salud de los consumidores a través de la prevención de muchas enfermedades. Objetivo: Verificar la aceptación de productos artesanales (chocolate en barra, dulce de soja y pan dulce) formulados con nueces (linaza, maní y nueces de Brasil) y, o fructooligosacáridos (FOS). Métodos: Cuatro muestras de cada producto fueron preparados con adición de diferentes concentraciones de nueces y FOS. La evaluación sensorial se realizó mediante una muestra de 373 consumidores, con 126, 121 y 126 probadores para muestras de chocolate en barra, dulce de soja y pan dulce, respectivamente, utilizándose la escala hedónica de nueve puntos. Los resultados fueron sometidos a Análisis de Varianza (ANOVA) y el test de Tukey. Resultados y Discusión: Observándose las medias de los juzgamientos, se infiere que las muestras con mayor aceptación han sido de pan dulce con nueces de Brasil y, o FOS. Sin embargo, todas las muestras son buenas alternativas de mercado y se lo mostró un promedio de entre 6 y 9 puntos, más un aumento de ácidos grasos omega 3 y 6, proteínas, fibras, vitaminas, antioxidantes y minerales, así como fitoquímicos, los cuales desempeñan un papel importante en la promoción de la salud. Conclusión: Los productos artesanales formulados con oleaginosas y, o FOS tuvieron una buena aceptabilidad y pueden mejorar los hábitos alimentarios de los consumidores. Pero para probar la funcionalidad de estos productos, se necesitan nuevos estudios.

Heterogeneity of silica and glycan-epitope distribution in epidermal idioblast cell walls in Adiantum raddianum laminae.

Laminae of Adiantum raddianum Presl., a fern belonging to the family Pteridaceae, are characterised by the presence of epidermal fibre-like cells under the vascular bundles. These cells were thought to contain silica bodies, but their thickened walls leave no space for intracellular silica suggesting it may actually be deposited within their walls. Using advanced electron microscopy in conjunction with energy dispersive X-ray microanalysis we showed the presence of silica in the cell walls of the fibre-like idioblasts. However, it was specifically localised to the outer layers of the periclinal wall facing the leaf surface, with the thick secondary wall being devoid of silica. Immunocytochemical experiments were performed to ascertain the respective localisation of silica deposition and glycan polymers. Epitopes characteristic for pectic homogalacturonan and the hemicelluloses xyloglucan and mannan were detected in most epidermal walls, including the silica-rich cell wall layers. The monoclonal antibody, LM6, raised against pectic arabinan, labelled the silica-rich primary wall of the epidermal fibre-like cells and the guard cell walls, which were also shown to contain silica. We hypothesise that the silicified outer wall layers of the epidermal fibre-like cells support the lamina during cell expansion prior to secondary wall formation. This implies that silicification does not impede cell elongation. Although our results suggest that pectic arabinan may be implicated in silica deposition, further detailed analyses are needed to confirm this. The combinatorial approach presented here, which allows correlative screening and in situ localisation of silicon and cell wall polysaccharide distribution, shows great potential for future studies.

Variability in the levels of postural control in 0-4-month-old infants.

This prospective cross-sectional study aimed to characterize variability in the levels of postural control in supine and prone positions in typical 0-4-month-old infants by using the Chailey Levels of Abilities Scale. Forty infants were divided into five groups of eight infants, according to their age. In supine, the levels varied between 1 and 2 in 0-month group, and between 2 and 3 in 2-month group. In prone, the levels varied between 1 and 2 in both 0- and 1-month groups. There was no variability in 1-month group in supine or in 2-month group in prone. In 3-month and 4-month groups, no variability was found in any of the positions. Variability in the levels of postural control among infants at the same age may be interpreted as normal as long as infants are in the initial process of acquiring postural control, that is, within the age range of 0-2 months.