Validation of a SARS-CoV-2 Surrogate Neutralization Test Detecting Neutralizing Antibodies against the Major Variants of Concern.

SARS-CoV-2 infection and/or vaccination elicit a broad range of neutralizing antibody responses against the different variants of concern (VOC). We established a new variant-adapted surrogate virus neutralization test (sVNT) and assessed the neutralization activity against the ancestral B.1 (WT) and VOC Delta, Omicron BA.1, BA.2, and BA.5. Analytical performances were compared against the respective VOC to the reference virus neutralization test (VNT) and two CE-IVD labeled kits using three different cohorts collected during the COVID-19 waves. Correlation analyses showed moderate to strong correlation for Omicron sub-variants (Spearman's r = 0.7081 for BA.1, r = 0.7205 for BA.2, and r = 0.6042 for BA.5), and for WT (r = 0.8458) and Delta-sVNT (r = 0.8158), respectively. Comparison of the WT-sVNT performance with two CE-IVD kits, the "Icosagen SARS-CoV-2 Neutralizing Antibody ELISA kit" and the "Genscript cPass, kit" revealed an overall good correlation ranging from 0.8673 to -0.8773 and a midway profile between both commercial kits with 87.76% sensitivity and 90.48% clinical specificity. The BA.2-sVNT performance was similar to the BA.2 Genscript test. Finally, a correlation analysis revealed a strong association (r = 0.8583) between BA.5-sVNT and VNT sVNT using a double-vaccinated cohort (n = 100) and an Omicron-breakthrough infection cohort (n = 91). In conclusion, the sVNT allows for the efficient prediction of immune protection against the various VOCs.

Microtubules and viral infection.

Microtubules (MTs) form rapidly adaptable, complex intracellular networks of filaments that not only provide structural support, but also form the tracks along which motors traffic macromolecular cargos to specific sub-cellular sites. These dynamic arrays play a central role in regulating various cellular processes including cell shape and motility as well as cell division and polarization. Given their complex organization and functional importance, MT arrays are carefully controlled by many highly specialized proteins that regulate the nucleation of MT filaments at distinct sites, their dynamic growth and stability, and their engagement with other subcellular structures and cargoes destined for transport. This review focuses on recent advances in our understanding of how MTs and their regulatory proteins function, including their active targeting and exploitation, during infection by viruses that utilize a wide variety of replication strategies that occur within different cellular sub-compartments or regions of the cell.

Segurança do paciente cirúrgico pediátrico: uma revisão integrativa / Pediatric surgical patient safety: an integrative review / Seguridad del paciente quirúrgico pediátrico: una revisión integradora

No cuidado de enfermagem ao paciente cirúrgico pediátrico o checklist de cirurgia segura deve ser empregado, contribuindo para que as etapas do preparo e promoção de cirurgia segura sejam realizadas. O objetivo deste estudo foi conhecer a produção científica nacional de enfermagem sobre cirurgia segura do paciente pediátrico. Trata-se de uma revisão integrativa. A coleta de dados ocorreu nos meses de agosto e setembro de 2022, por meio da Biblioteca Virtual em Saúde e da base de dados Scientific Electronic Library Online (SciELO). É crescente a publicação sobre o tema. Pesquisas sobre a elaboração e validação de lista de verificação predominaram na amostra selecionada. O estudo revela que a implementação do checklist em cirurgias pediátricas merece destaque nas instituições de saúde que prestam atendimento ao paciente perioperatório. Este instrumento proporciona a verificação dos pontos críticos da assistência durante o processo cirúrgico, incorporando as boas práticas na rotina da equipe multidisciplinar.

In nursing care for pediatric surgical patients, the safe surgery checklist should be used, contributing to the steps of safe surgery preparation and promotion. The objective of this study was to know the national scientific nursing production on safe surgery for pediatric patients. This is an integrative review. Data collection took place in August and September 2022, through the Virtual Health Library and the Scientific Electronic Library Online (SciELO) database. There is a growing number of publications on the subject. Research on the creation and validation of checklists predominated in the selected sample. The study reveals that the implementation of the checklist in pediatric surgeries should be highlighted in health institutions providing perioperative patient care. This instrument provides verification of the critical points of assistance during the surgical process, incorporating good practices into the routine of the multidisciplinary team.

En el cuidado de enfermería al paciente quirúrgico pediátrico, se debe utilizar la lista de verificación de cirugía segura, que contribuye a los pasos de preparación y promoción para que se realice la cirugía segura. El objetivo fue conocer la producción científica nacional de enfermería sobre cirugía segura para pacientes pediátricos. Es una revisión integradora. La recolección de datos ocurrió en agosto y septiembre de 2022, a través de la Biblioteca Virtual en Salud y la base de datos Scientific Electronic Library Online. Es creciente el número de publicaciones sobre el tema. En la muestra predominó la investigación sobre la creación y validación de listas de cotejo. La implementación de la lista de verificación en las cirugías pediátricas merece ser destacada en las instituciones de salud que brindan atención al paciente. Lo que permite revisar puntos críticos de asistencia durante el proceso quirúrgico, incorporando las buenas prácticas a la rutina del equipo multidisciplinario.

Aleitamento materno de prematuros internados em Unidade de Terapia Intensiva neonatal: coorte prospectiva / Breastfeeding of premature infants hospitalized in a neonatal Intensive Care Unit: a prospective cohort / Lactancia materna de bebés prematuros hospitalizados en la Unidad de Cuidados Intensivos neonatales: cohorte prospectiva

Identificar variáveis com potencial de intervenção que estejam associadas ao volume de leite esgotado das mães de recém-nascidos prematuros. Trata-se de um estudo de coorte, descritivo e exploratório. A coleta de dados ocorreu em um hospital materno-infantil do Sul do Brasil no período de julho de 2021 a janeiro de 2022, por meio de entrevistas a 20 mães de recém-nascidos prematuros. Verificou-se que, em relação ao número de vezes ao dia que foi realizado o esgotamento hospitalar e domiciliar, a mediana foi de 4 vezes. A maioria das mães utilizou dois métodos de esgotamento das mamas (manual e com bomba de sucção). O estudo identificou que o volume de leite esgotado foi abaixo do esperado pelo Ministério da Saúde. Destaca-se a falta de procura do banco de leite para o esgotamento, problemas relacionados à mama, como exemplo o método utilizado para esgotamento.

To identify variables with intervention potential that are associated with the volume of depleted milk from mothers of premature newborns. This is a cohort, descriptive, and exploratory study. Data collection occurred in a maternal-infant hospital in southern Brazil from July 2021 to January 2022, through interviews with 20 mothers of premature newborns. It was verified that, in relation to the number of times per day that hospital and home milk expression was performed, the median was 4 times. Most mothers used two methods of breast milk expression (manual and with suction pump). The study found that the volume of expressed milk was lower than expected by the Ministry of Health. We highlight the lack of demand of the milk bank for expression, problems related to the breast, as an example of the method used for expression.

Identificar variables con potencial de intervención que se asocian al volumen de leche agotada de madres de recién nacidos prematuros. Se trata de un estudio de cohortes, descriptivo y exploratorio. La recolección de datos ocurrió en un hospital materno-infantil en el sur de Brasil de julio de 2021 a enero de 2022, a través de entrevistas con 20 madres de recién nacidos prematuros. Se verificó que, en relación al número de veces por día que se realizaba el agotamiento hospitalario y domiciliario, la media fue de 4 veces. La mayoría de las madres utilizaron dos métodos de depleción mamaria (manual y con succión apretada). El estudio identificó que el volumen de leche empobrecida fue menor de que lo esperado por el Ministerio de Salud. Destacamos la falta de demanda del banco de leche por agotamiento, problemas relacionados con la mama, como ejemplo del método utilizado para el agotamiento.

Vaccine- and Breakthrough Infection-Elicited Pre-Omicron Immunity More Effectively Neutralizes Omicron BA.1, BA.2, BA.4 and BA.5 Than Pre-Omicron Infection Alone.

Since the emergence of SARS-CoV-2 Omicron BA.1 and BA.2, several Omicron sublineages have emerged, supplanting their predecessors. Here we compared the neutralization of Omicron sublineages BA.1, BA.2, BA.4 and BA.5 by human sera collected from individuals who were infected with the ancestral B.1 (D614G) strain, who were vaccinated (3 doses) or with breakthrough infection with pre-Omicron strains (Gamma or Delta). All Omicron sublineages exhibited extensive escape from all sera when compared to the ancestral B.1 strain and to Delta, albeit to different levels depending on the origin of the sera. Convalescent sera were unable to neutralize BA.1, and partly neutralized BA.2, BA.4 and BA.5. Vaccinee sera partly neutralized BA.2, but BA.1, BA.4 and BA.5 evaded neutralizing antibodies (NAb). Some breakthrough infections (BTI) sera were non-neutralizing. Neutralizing BTI sera had similar neutralizing ability against all Omicron sublineages. Despite similar levels of anti-Spike and anti-Receptor Binding Domain (RBD) antibodies in all groups, BTI sera had the highest cross-neutralizing ability against all Omicron sublineages and convalescent sera were the least neutralizing. Antibody avidity inferred from the NT50:antibody titer ratio was highest in sera from BTI patients, underscoring qualitative differences in antibodies elicited by infection or vaccination. Together, these findings highlight the importance of vaccination to trigger highly cross-reactive antibodies that neutralize phylogenetically and antigenically distant strains, and suggest that immune imprinting by first generation vaccines may restrict, but not abolish, cross-neutralization.

A infodemia COVID-19 à luz da teoria da complexidade de Edgar Morin: um estudo de reflexão

Objetivo: Refletir sobre a infodemia da COVID-19 sob a luz da Teoria da Complexidade de Edgar Morin e seus três principais principios, a saber o princípio dialógico, da recursão organizacional e hologramático. Metodologia: Trata-se de ensaio teórico de caráter reflexivo da literatura acerca da infodemia de COVID-19 sob a luz da Teoria da Complexidade de Edgar Morin. Resultados: Interrelacionando o princípio dialógico com a infodemia, pode-se refletir sobre a relação da ambivalência complexa entre a desinformação e informações validadas cientificamente e dos diversos conteúdos dissipados nos meios de comunicação. Ressalta-se que é necessário realizar uma síntese coerente e confiável sobre os conteúdos abordados e amplamente difundidos. A infodemia de COVID-19 submerge de uma intenção que ocorre nas entrelinhas dos meios de comunicação, e nessa intencionalidade há participação direta da sociedade. Compreende-se que a desinformação se amplia na medida em que a produção de conteúdo aumenta, nesse sentido, a desinformação produz a infodemia que, consequentemente, é produzida também pela desinformação. É possível refletir sobre a infodemia através da noção de que está pode influenciar e ser influenciada pelo todo, envolvendo assim, questões que atravessam a saúde pública, a economia, a política, ao mesmo tempo que é fomentada e influenciada por esses eixos específicos. Considerações finais: Os princípios do pensamento complexo, constituem-se como elementos que auxiliam a compreensão do fenômeno infodemia sua influência no contexto informacional. Espera-se que este estudo reflexivo possa contribuir para que sejam mitigadas as repercussões da infodemia no cotidiano dos usuários das redes de informação.

Objective: To reflect on the COVID-19 infodemic in the light of Edgar Morin's Complexity Theory and its three main principles, namely the dialogic principle, organizational and hologrammatic recursion. Methodology: This is a theoretical essay with a reflective character of the literature on the COVID-19 infodemic in the light of Edgar Morin's Complexity Theory. Result: Interrelating the dialogic principle with the infodemic, one can reflect on the relationship of the complex ambivalence between disinformation and scientifically validated information and the various contents dissipated in the media. It is noteworthy that it is necessary to carry out a coherent and reliable synthesis of the contents covered and widely disseminated. The COVID-19 infodemic is submerged in an intention that occurs between the lines of the media, and in this intention, there is direct participation by society. It is understood that disinformation increases as the production of content increases, in this sense, disinformation produces the infodemic which, consequently, is also produced by disinformation. It is possible to reflect on the infodemic through the notion that it can influence and be influenced by the whole, thus involving issues that cross public health, the economy, politics, at the same time that it is fostered and influenced by these specific axes. Final considerations: the principles of complex thinking are elements that help the understanding of the infodemic phenomenon and its influence in the informational context. It is hoped that this reflective study can contribute to mitigate the repercussions of the infodemic in the daily lives of users of information networks.

Objetivo: Reflexionar sobre la infodemia de la COVID-19 a la luz de la Teoría de la Complejidad de Edgar Morin y sus tres principios fundamentales, a saber, el principio dialógico, el organizativo y el hologramático de la recursividad. Metodología: Se trata de un ensayo teórico con carácter reflexivo de la literatura sobre la infodemia del COVID-19 a la luz de la Teoría de la Complejidad de Edgar Morin. Resultados: Interrelacionando el principio dialógico con la infodemia, se puede reflexionar sobre la relación de la compleja ambivalencia entre la desinformación y la información científicamente validada y los diversos contenidos disipados en los medios. Cabe destacar que es necesario realizar una síntesis coherente y confiable de los contenidos abordados y ampliamente difundidos. La infodemia del COVID-19 está sumergida en una intención que se da entre líneas mediáticas y en esa intención hay una participación directa de la sociedad. Se entiende que la desinformación se expande a medida que aumenta la producción de contenidos. En ese sentido, la desinformación produce la infodemia que, en consecuencia, también es producida por la desinformación. Es posible reflexionar sobre la infodemia a partir de la noción de que puede influir y ser influenciada por el conjunto, involucrando así cuestiones que cruzan la salud pública, la economía, la política, al tiempo que es fomentada e influenciada por estos ejes específicos. Consideraciones finales: Los principios del pensamiento complejo son elementos que ayudan a la comprensión del fenómeno infodémico y su influencia en el contexto informacional. Se espera que este estudio reflexivo pueda contribuir a mitigar las repercusiones de la infodemia en la cotidianidad de los usuarios de las redes de información.

A saúde mental dos profissionais de enfermagem frente à pandemia do COVID-19: Revisão de literatura / La salud mental de los profesionales de enfermería frente a la pandemia del COVID-19: Revisión de la literatura / The mental health of nursing professionals against the COVID-19 pandemic: Literature review

Objetivo:analisar a saúde mental dos profissionais de enfermagem frente à pandemia do COVID-19. Método:trata-se de uma revisão integrativa, realizadaem 2021,através da questão norteadora: "Qual o impacto da pandemia da Covid-19 na saúde mental dos profissionais de enfermagem?". Para a coleta de dados, foram utilizados bases de dados como LILACS, MEDLINE, SCIELO e BDENF, com auxilio dos Descritores em Ciências da Saúde (DeCS), obedecendo alguns critérios de inclusão para a seleção dos estudos, sendoas buscas realizadas entre os meses de maio a agosto de 2021, com intervalo de revisão de 2019 a 2021. Resultado:elaborou-se uma matriz de síntese dos artigos selecionados, para análise dos dados.Conclusão: destaca-se que esses profissionais estão mais suceptivéis a desenvolverem transtornos mentais, visto que a todo tempo lidam com situações causadoras de um alto nível de estresse e ansiedade, além da necessidade de tomada de decisão de maneira rápida(AU)

Objective: to analyze the mental health of nursing professionals in the face of the COVID-19 pandemic. Method: this is an integrative review, carried out in 2021, through the guiding question: "What is the impact of the Covid-19 pandemic on the mental health of nursing professionals?". For data collection, databases such as LILACS, MEDLINE, SCIELO and BDENF were used, with the help of the Health Sciences Descriptors (DeCS), following some inclusion criteria for the selection of studies, and the searches were carried out between the months from May to August 2021, with a review interval from 2019 to 2021. Result: a synthesis matrix of selected articles was prepared for data analysis. Conclusion: it is noteworthy that these professionals are more susceptible to developing mental disorders, as they constantly deal with situations that cause a high level of stress and anxiety, in addition to the need for quick decision-making.(AU)

Objetivo: analizar la salud mental de los profesionales de enfermería frente a la pandemia de COVID-19. Método: tratar- a partir de una revisión integradora, realizada en 2021, a través de la pregunta orientadora: "Cuál es el impacto de la pandemia del Covid-19 en la salud mental de los profesionales de enfermería?". Para la recolección de datos se utilizan bases de datos como LILACS, MEDLINE, SCIELO y BDENF, con ayuda de los Descriptores de Ciencias de la Salud (DeCS), obedeciendo a unos criterios de inclusión para la selección de estudios, realizándose las búsquedas entre los meses de mayo a agosto de 2021, con un intervalo de revisión de 2019 a 2021. Resultado: se elaboró ​​una matriz resumen de los artículos seleccionados para el análisis de datos que estos profesionales son más propensos a desarrollar trastornos mentales, ya que se ocupan de situaciones que provocan un alto nivel de estrés y ansiedad, además de la necesidad de una rápida toma de decisiones.(AU)

Pre-Omicron Vaccine Breakthrough Infection Induces Superior Cross-Neutralization against SARS-CoV-2 Omicron BA.1 Compared to Infection Alone.

SARS-CoV-2 variants raise concern because of their high transmissibility and their ability to evade neutralizing antibodies elicited by prior infection or by vaccination. Here, we compared the neutralizing abilities of sera from 70 unvaccinated COVID-19 patients infected before the emergence of variants of concern (VOCs) and of 16 vaccine breakthrough infection (BTI) cases infected with Gamma or Delta against the ancestral B.1 strain, the Gamma, Delta and Omicron BA.1 VOCs using live virus. We further determined antibody levels against the Nucleocapsid (N) and full Spike proteins, the receptor-binding domain (RBD) and the N-terminal domain (NTD) of the Spike protein. Convalescent sera featured considerable variability in the neutralization of B.1 and in the cross-neutralization of different strains. Their neutralizing capacity moderately correlated with antibody levels against the Spike protein and the RBD. All but one convalescent serum failed to neutralize Omicron BA.1. Overall, convalescent sera from patients with moderate disease had higher antibody levels and displayed a higher neutralizing ability against all strains than patients with mild or severe forms of the disease. The sera from BTI cases fell into one of two categories: half the sera had a high neutralizing activity against the ancestral B.1 strain as well as against the infecting strain, while the other half had no or a very low neutralizing activity against all strains. Although antibody levels against the spike protein and the RBD were lower in BTI sera than in unvaccinated convalescent sera, most neutralizing sera also retained partial neutralizing activity against Omicron BA.1, suggestive of a better cross-neutralization and higher affinity of vaccine-elicited antibodies over virus-induced antibodies. Accordingly, the IC50: antibody level ratios were comparable for BTI and convalescent sera, but remained lower in the neutralizing convalescent sera from patients with moderate disease than in BTI sera. The neutralizing activity of BTI sera was strongly correlated with antibodies against the Spike protein and the RBD. Together, these findings highlight qualitative differences in antibody responses elicited by infection in vaccinated and unvaccinated individuals. They further indicate that breakthrough infection with a pre-Omicron variant boosts immunity and induces cross-neutralizing antibodies against different strains, including Omicron BA.1.

Pleomorphic hyalinizing angiectatic tumor of the vulva: literature review based on a rare presentation.

Pleomorphic hyalinizing angiectatic tumor (PHAT) of soft tissues is a rare, non-metastatic tumor of unknown etiology and uncertain behavior, which may recur locally. There are few reports on this condition, and due to the rarity of the disease, its lineage has not yet been fully elucidated. The present study aims to report the case of an unusual entity observed for the first time in vulval topography. A female patient, 83 years old, presented with a tumor in the vulvar region that had evolved for approximately 4 months. Magnetic resonance imaging showed an expansive perineal formation of 8.5 × 3.5 cm, and a hemivulvectomy with a flap rotation was performed. The review of the slides revealed a mesenchymal lesion without significant atypia, which was richly vascularized. In the areas of interest, the immunohistochemical (IHC) study demonstrated positivity for CD34, estrogen, and progesterone receptors; it was negative for the other tested markers. Morphological findings associated with the IHC staining panel supported the diagnosis of PHAT. The main morphological features of PHAT are clusters of ectatic vessels of different sizes that show deposits of subendothelial and intraluminal fibrin. Fusiform and pleomorphic cells randomly arranged in leaves or long fascicles intermingle these vessels. It is essential to recognize this entity and consider it among the differential diagnoses of a mesenchymal lesion, given the wide variety of entities that comprise this group of lesions.

Accuracy of fine-needle aspiration of lymph nodes: A cancer center's experience.

INTRODUCTION: Lymph node fine needle aspiration (LN-FNA) is a minimally invasive method of evaluating lymphadenopathy. Nonetheless, its use is not widely accepted due to the lack of guidelines and a cytopathological categorisation that directly relates to management. We report our experience with LN FNA at a large Cancer Center in Latin America. METHODS: We retrospectively collected cytological cases of lymph node FNA from the department of pathology at AC Camargo Cancer Center performed over a 2-year period. Data extracted included LN location, age, sex and final cytological diagnosis. Patients that had undergone neoadjuvant chemotherapy and/or cases for which the surgery specimen location was not clearly reported were excluded. For those cases with surgical reports, risk of malignancy was calculated for each diagnostic category, along with overall performance of cytology. False positive cases were reviewed to assess any possible misinterpretation or sampling errors. RESULTS: A total of 1730 LN-FNA were distributed as follows: 62 (3.5%) non-diagnostic (ND); 1123 (64.9%) negative (NEG), 19 (1.1%) atypical (ATY), 53 (3.1%) suspicious for malignancy (SUS), and 473 (27.3%) positive (POS). Surgical reports were available for 560 cases (32.4%). Risk of malignancy (ROM) for each category was 33.3% for ND, 29.9% for NEG, 25% for ATY, 74.2% for SUS and 99.6% for POS. Overall sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were 78.5%, 99.4%, 70.2% and 99.6%, respectively. CONCLUSION: Lymph node FNA is a very specific and accurate exam, which is reliable in the detection of lymph node metastasis and other causes of lymphadenopathy.

Photobiomodulation therapy prevents dysgeusia chemotherapy induced in breast cancer women treated with doxorubicin plus cyclophosphamide: a triple-blinded, randomized, placebo-controlled clinical trial.

PURPOSE: To evaluate the effectiveness of photobiomodulation (PBMT) in preventing dysgeusia in breast cancer patients treated with doxorubicin-cyclophosphamide (AC). METHODS: This is a phase II, randomized, triple-blind, placebo-controlled clinical trial involving 112 breast cancer patients treated with AC. The patients were divided equally into two groups: a test group treated with 2 J red laser and 3 J infrared laser on 21 points that were symmetrically distributed on the tongue on day 0 of four cycles of AC, and an equal placebo group treated with simulated PBMT to blind the patient, evaluator, and statistician. The clinicopathological and sociodemographic data, results of taste test, and subjective taste analysis, and the QoL, ECOG performance status, body mass index, and other side effects were recorded. The data were analyzed using ANOVA-RM/Bonferroni, Friedman/Dunn, and chi-square/Fisher's exact tests. RESULTS: PBMT patients showed less objective and subjective taste loss (p<0.05). On the other hand, the placebo group showed a higher ECOG status (p=0.037) and more significant weight loss (p<0.001) after four cycles of AC. The QoL was significantly higher in the PBMT group (p<0.05) at all assessment periods, and PBMT treatment also reduced the incidence of cachexia (p=0.020), anorexia (p<0.001), diarrhea (p=0.040), oral mucositis (p=0.020), and vomiting (p=0.008). CONCLUSION: PBMT reduced the taste loss and improved the overall health status and QoL of patients with breast cancer treated with AC. TRIAL REGISTRATION: Brazilian Clinical Trials Registry ( www.ensaiosclinicos.gov.br ) approval number RBR-9qnm34y, registered on 01/05/2021.

Repercussões da infodemia associada ao COVID-19 na saúde mental do idoso no Brasil / Repercusiones de la infodemia asociada al COVID-19 en la salud mental de los ancianos en Brasil / Repercussions of infodemia associated with COVID-19 on the mental health of the elderly in Brazil

O fenômeno denominado infodemia refere-se ao aumento do volume informacional sobre um tema em específico, que se multiplica rapidamente em um curto período de tempo, e tem-se destacado frente ao contexto da crise sanitária desencadeada pela pandemia de COVID-19. O excesso de informações pode suscitar sentimentos de medo, ansiedade, estresse e outras condições de sofrimento mental. O estudo tem como objetivo descrever o perfil de exposição a informações sobre COVID-19 e suas repercussões na saúde mental de idosos brasileiros. Trata-se de um estudo transversal realizado com 1924 idosos brasileiros. Coletaram-se dados por meio de web-based survey enviada aos idosos por redes sociais e e-mail, no período de julho a outubro de 2020. Os resultados da análise descritiva dos dados demonstram que a maioria dos idosos apresentou idade entre 60 e 69 anos (69,02por cento), é do sexo feminino (71,26por cento), casados (53,79 por cento) e de cor branca (75,57por cento). Cerca de 21,67por cento (n = 417) concluíram a graduação, 19,75por cento (380) concluíram especialização e 16,63por cento (320) concluíram mestrado ou doutorado. Foram reportados como fontes frequentes de exposição às notícias ou informações sobre a COVID-19, a televisão 862 (44,80por cento) e as redes sociais 651 (33,84por cento). Os participantes assinalaram que a televisão (46,47por cento; n = 872), as redes sociais (30,81por cento; n = 575) e o rádio (14,48por cento; 251) os afetavam psicológica e/ou fisicamente. Receber notícias falsas sobre a COVID-19 pela televisão (n = 482; 19,8por cento) e pelas redes sociais (n = 415; 21,5por cento) repercutiu, principalmente, estresse e medo. As informações disseminadas contribuem para conscientização, mas, também, afetam física e/ou psicologicamente muitos idosos, principalmente gerando medo e estresse(AU)

El fenómeno denominado infodemia hace referencia al aumento del volumen de información sobre un tema específico, que se multiplica rápidamente en un corto período, y ha destacado en el contexto de la crisis sanitaria desencadenada por la pandemia de la COVID-19. Demasiada información puede desencadenar sentimientos de miedo, ansiedad, estrés y otras condiciones de angustia mental. El estudio tiene como objetivo describir el perfil de exposición a la información sobre la COVID-19 y sus repercusiones en la salud mental de los ancianos brasileños. Se trata de un estudio transversal realizado con 1924 ancianos brasileños. Los datos fueron recolectados a través de una encuesta web enviada a los ancianos a través de redes sociales y correo electrónico, de julio a octubre de 2020. Los resultados del análisis descriptivo de los datos muestran que la mayoría de los ancianos tenían entre 60 y 69 años (69,02 por ciento), mujer (71,26 por ciento), casada (53,79 por ciento) y blanca (75,57 por ciento). El 21,67 por ciento (n = 417) concluyó su graduación, el 19,75 por ciento (380) concluyó especialización y el 16,63 por ciento (320) concluyó maestría o doctorado. La televisión 862 (44,80 por ciento) y las redes sociales 651 (33,84 por ciento) se reportaron como fuentes frecuentes de exposición a noticias o información sobre el COVID-19. Los participantes indicaron que la televisión (46,47 por ciento; n = 872), las redes sociales (30,81 por ciento; n = 575) y la radio (14,48 por ciento; 251) les afectaban psicológica y/o físicamente. Recibir noticias falsas sobre el COVID-19 en la televisión (n = 482; 19,8 por ciento) y en las redes sociales (n = 415; 21,5 por ciento) resultó principalmente en estrés y miedo. La información difundida contribuye a la sensibilización, pero también afecta física y/o psicológicamente a muchas personas mayores, generando principalmente miedo y estrés(AU)

The phenomenon called infodemia refers to the increase in the volume of information on a specific topic, which multiplies rapidly in a short period of time, and has stood out in the context of the health crisis triggered by the COVID-19 pandemic. Too much information can trigger feelings of fear, anxiety, stress, and other conditions of mental distress. The study aims to describe the profile of exposure to information about COVID-19 and its repercussions on the mental health of elderly Brazilians. This is a cross-sectional study carried out with 1924 elderly Brazilians. Data were collected through a web-based survey sent to the elderly via social networks and email, from July to October 2020. The results of the descriptive analysis of the data show that most of the elderly were aged between 60 and 69 years (69.02percent), female (71.26percent), married (53.79percent) and white (75.57percent). About 21.67percent (n = 417) concluded their graduation, 19.75percent (380) concluded their specialization and 16.63percent (320) concluded their master's or doctoral degrees. Television 862 (44.80percent) and social networks 651 (33.84percent) were reported as frequent sources of exposure to news or information about COVID-19. Participants indicated that television (46.47percent; n = 872), social networks (30.81percent; n = 575) and radio (14.48percent; 251) affected them psychologically and/or physically. Receiving fake news about COVID-19 on television (n = 482; 19.8percent) and on social media (n = 415; 21.5percent) mainly resulted in stress and fear. The disseminated information contributes to awareness, but also affects physically and/or psychologically many elderly people, mainly generating fear and stress(AU)

Pleomorphic hyalinizing angiectatic tumor of the vulva: literature review based on a rare presentation

Pleomorphic hyalinizing angiectatic tumor (PHAT) of soft tissues is a rare, non-metastatic tumor of unknown etiology and uncertain behavior, which may recur locally. There are few reports on this condition, and due to the rarity of the disease, its lineage has not yet been fully elucidated. The present study aims to report the case of an unusual entity observed for the first time in vulval topography. A female patient, 83 years old, presented with a tumor in the vulvar region that had evolved for approximately 4 months. Magnetic resonance imaging showed an expansive perineal formation of 8.5 × 3.5 cm, and a hemivulvectomy with a flap rotation was performed. The review of the slides revealed a mesenchymal lesion without significant atypia, which was richly vascularized. In the areas of interest, the immunohistochemical (IHC) study demonstrated positivity for CD34, estrogen, and progesterone receptors; it was negative for the other tested markers. Morphological findings associated with the IHC staining panel supported the diagnosis of PHAT. The main morphological features of PHAT are clusters of ectatic vessels of different sizes that show deposits of subendothelial and intraluminal fibrin. Fusiform and pleomorphic cells randomly arranged in leaves or long fascicles intermingle these vessels. It is essential to recognize this entity and consider it among the differential diagnoses of a mesenchymal lesion, given the wide variety of entities that comprise this group of lesions.

Dementia in Southeast Asia: influence of onset-type, education, and cerebrovascular disease.

BACKGROUND: Southeast Asia represents 10% of the global population, yet little is known about regional clinical characteristics of dementia and risk factors for dementia progression. This study aims to describe the clinico-demographic profiles of dementia in Southeast Asia and investigate the association of onset-type, education, and cerebrovascular disease (CVD) on dementia progression in a real-world clinic setting. METHODS: In this longitudinal study, participants were consecutive series of 1606 patients with dementia from 2010 to 2019 from a tertiary memory clinic from Singapore. The frequency of dementia subtypes stratified into young-onset (YOD; <65 years age-at-onset) and late-onset dementia (LOD; ≥65 years age-at-onset) was studied. Association of onset-type (YOD or LOD), years of lifespan education, and CVD on the trajectory of cognition was evaluated using linear mixed models. The time to significant cognitive decline was investigated using Kaplan-Meier analysis. RESULTS: Dementia of the Alzheimer's type (DAT) was the most common diagnosis (59.8%), followed by vascular dementia (14.9%) and frontotemporal dementia (11.1%). YOD patients accounted for 28.5% of all dementia patients. Patients with higher lifespan education had a steeper decline in global cognition (p<0.001), with this finding being more pronounced in YOD (p=0.0006). Older patients with a moderate-to-severe burden of CVD demonstrated a trend for a faster decline in global cognition compared to those with a mild burden. CONCLUSIONS: There is a high frequency of YOD with DAT being most common in our Southeast Asian memory clinic cohort. YOD patients with higher lifespan education and LOD patients with moderate-to-severe CVD experience a steep decline in cognition.

COVID-19 infodemic and adult and elderly mental health: a scoping review.

OBJECTIVE: to map scientific knowledge about the repercussions of the infodemic on adult and elderly mental health in the context of the COVID-19 pandemic. METHOD: this is a scoping review, developed using the Joanna Briggs Institute (JBI) methodology, which included 33 articles. These articles were analyzed according to average age, gender and education level; place and period of the studies; exposure time to COVID-19 information; main signs and symptoms related to mental health; main sources of information; suggestions for mitigating the effects of the infodemic; and knowledge gaps. RESULTS: the most present repercussions of the infodemic on the adult and elderly mental health were anxiety, depression and stress, and the most affected group was young adults and females. CONCLUSION: future studies with more robust designs are needed to investigate the repercussions of the infodemic on people's mental health in the medium and long term, as well as to assess the effects, feasibility, cost-benefit and meaning of interventions in population groups, especially in the elderly population.

Dynactin 1 negatively regulates HIV-1 infection by sequestering the host cofactor CLIP170.

Many viruses directly engage and require the dynein-dynactin motor-adaptor complex in order to transport along microtubules (MTs) to the nucleus and initiate infection. HIV type 1 (HIV-1) exploits dynein, the dynein adaptor BICD2, and core dynactin subunits but unlike several other viruses, does not require dynactin-1 (DCTN1). The underlying reason for HIV-1's variant dynein engagement strategy and independence from DCTN1 remains unknown. Here, we reveal that DCTN1 actually inhibits early HIV-1 infection by interfering with the ability of viral cores to interact with critical host cofactors. Specifically, DCTN1 competes for binding to HIV-1 particles with cytoplasmic linker protein 170 (CLIP170), one of several MT plus-end tracking proteins (+TIPs) that regulate the stability of viral cores after entry into the cell. Outside of its function as a dynactin subunit, DCTN1 also functions as a +TIP that we find sequesters CLIP170 from incoming particles. Deletion of the Zinc knuckle (Zn) domain in CLIP170 that mediates its interactions with several proteins, including DCTN1, increased CLIP170 binding to virus particles but failed to promote infection, further suggesting that DCTN1 blocks a critical proviral function of CLIP170 mediated by its Zn domain. Our findings suggest that the unique manner in which HIV-1 binds and exploits +TIPs to regulate particle stability leaves them vulnerable to the negative effects of DCTN1 on +TIP availability and function, which may in turn have driven HIV-1 to evolve away from DCTN1 in favor of BICD2-based engagement of dynein during early infection.

Giant lactating adenoma.

Lactating adenoma is a rare benign breast lesion that most often presents as a small (up to 3 cm), solid, well-circumscribed, solitary, painless, mobile, lobulated mass. The highest incidence occurs in primiparous women (20 to 40 years old) during the third trimester of pregnancy. However, in the rare case presented herein, in addition to its giant size (more than 10 centimeters on palpation), this lactating adenoma is distinctive due to the presence of multiple nodules, poorly defined ultrasonographic margins, worrisome radiologic features, growth since early pregnancy, presence of infarction and association with chronic mastitis. From the clinical-radiologic perspective, the differential diagnoses included abscess associated with puerperal mastitis, phyllodes tumor, and galactocele. Biopsy was performed, and pathologic examination revealed the classic characteristics of lactating adenoma with multiple infarcted areas, leading to an unexpected confirmed case of giant lactating adenoma.

The Efficacy of Transdermal Rivastigmine in Mild to Moderate Alzheimer's Disease with Concomitant Small Vessel Cerebrovascular Disease: Findings from an Open-Label Study.

BACKGROUND: Rivastigmine is used to treat cognitive impairment in Alzheimer's disease (AD); however, the efficacy of Rivastigmine in patients with AD and concomitant small vessel cerebrovascular disease (svCVD) remains unclear. We investigated the effectiveness of Rivastigmine Patch in patients with AD and svCVD. METHODS: In this open-label study, 100 patients with AD and MRI confirmed svCVD received 9.5mg/24 hours Rivastigmine transdermal treatment for 24 weeks. The primary outcome was global cognition indexed using the ADAS-Cog. Secondary outcomes included clinical-rated impression of change (indexed using (ADCS-CGIC), activities of daily living (indexed using ADCS-ADL) and side effects. RESULTS: Overall, performance on the ADAS-Cog after 24 weeks deteriorated by 1.78 (SD = 5.29) points. Fifty-two percent of the sample demonstrated improvement or remained stable, while 48% demonstrated worsening of ADAS-Cog scores. Of the 52%, significant improvement (2 or more-point decline) on the ADAS-Cog was observed in 25% of the sample, with a mean change of -5.08 (SD = 3.11). A decline on the ADAS-Cog was observed in 48% of the sample, with a mean change of 6 (SD = 2.98) points. Cognitive outcome did not interact with severity of svCVD. ADCS-ADL scores remained stable from baseline to week 24 and ADCS-CGIC reports indicated that 81% of the patients remained stable after treatment. Side effects were reported by 16% of the patients, with contact dermatitis being the most common. CONCLUSION: Our findings suggest that Rivastigmine may have a role in the management of patients having AD and concomitant mild-severe svCVD, with minimal side effects.

COVID-19 infodemic and adult and elderly mental health: a scoping review / Infodemia de COVID-19 y salud mental de adultos y ancianos: una revisión de alcance / Infodemia de COVID-19 e saúde mental de adultos e idosos: uma revisão de escopo

Abstract Objective: to map scientific knowledge about the repercussions of the infodemic on adult and elderly mental health in the context of the COVID-19 pandemic. Method: this is a scoping review, developed using the Joanna Briggs Institute (JBI) methodology, which included 33 articles. These articles were analyzed according to average age, gender and education level; place and period of the studies; exposure time to COVID-19 information; main signs and symptoms related to mental health; main sources of information; suggestions for mitigating the effects of the infodemic; and knowledge gaps. Results: the most present repercussions of the infodemic on the adult and elderly mental health were anxiety, depression and stress, and the most affected group was young adults and females. Conclusion: future studies with more robust designs are needed to investigate the repercussions of the infodemic on people's mental health in the medium and long term, as well as to assess the effects, feasibility, cost-benefit and meaning of interventions in population groups, especially in the elderly population.

RESUMEN Objetivo: mapear el conocimiento científico sobre las repercusiones de la infodemia en la salud mental de adultos y ancianos en el contexto de la pandemia de COVID-19. Método: se trata de una revisión de alcance, desarrollada utilizando la metodología del Instituto Joanna Briggs (JBI), que incluyó 33 artículos. Estos artículos fueron analizados según edad promedio, género y nivel educativo; lugar y período de los estudios; tiempo de exposición a la información de COVID-19; principales signos y síntomas relacionados con la salud mental; principales fuentes de información; sugerencias para mitigar los efectos de la infodemia; y las lagunas de conocimiento. Resultados: las repercusiones más presentes de la infodemia en la salud mental de adultos y ancianos fueron la ansiedad, la depresión y el estrés, y el grupo más afectado fue el de adultos jóvenes y mujeres. Conclusión: se necesitan estudios futuros con diseños más robustos para investigar las repercusiones de la infodemia en la salud mental de las personas a mediano y largo plazo, así como evaluar los efectos, factibilidad, costo-beneficio e importancia de las intervenciones en grupos poblacionales. especialmente en la población anciana.

Objetivo: mapear o conhecimento científico sobre as repercussões da infodemia na saúde mental de adultos e idosos no contexto da pandemia de COVID-19. Método: trata-se de uma revisão de escopo, desenvolvida na metodologia do Joanna Briggs Institute (JBI), que incluiu 33 artigos. Esses artigos foram analisados segundo média de faixa etária, sexo e nível de escolaridade; local e período de realização dos estudos; tempo de exposição a informações sobre COVID-19; principais sinais e sintomas relacionados à saúde mental; principais fontes de informação; sugestões para mitigar os efeitos da infodemia; e lacunas de conhecimento. Resultados: as repercussões da infodemia na saúde mental de adultos e idosos mais presentes foram ansiedade, depressão e estresse, e o grupo mais afetado foi o de jovens adultos e do sexo feminino. Conclusão: são necessários estudos futuros com desenhos mais robustos para investigar as repercussões da infodemia na saúde mental das pessoas a médio e longo prazos, assim como para avaliar efeitos, viabilidade, custo-benefício e significado de intervenções em grupos populacionais, especialmente na população idosa.

Giant lactating adenoma

Lactating adenoma is a rare benign breast lesion that most often presents as a small (up to 3 cm), solid, well-circumscribed, solitary, painless, mobile, lobulated mass. The highest incidence occurs in primiparous women (20 to 40 years old) during the third trimester of pregnancy. However, in the rare case presented herein, in addition to its giant size (more than 10 centimeters on palpation), this lactating adenoma is distinctive due to the presence of multiple nodules, poorly defined ultrasonographic margins, worrisome radiologic features, growth since early pregnancy, presence of infarction and association with chronic mastitis. From the clinical-radiologic perspective, the differential diagnoses included abscess associated with puerperal mastitis, phyllodes tumor, and galactocele. Biopsy was performed, and pathologic examination revealed the classic characteristics of lactating adenoma with multiple infarcted areas, leading to an unexpected confirmed case of giant lactating adenoma.