Critically ill patients with COVID-19-associated acute kidney injury treated with kidney replacement therapy: Comparison between the first and second pandemic waves in São Paulo, Brazil

INTRODUCTION: This study aimed to compare the characteristics and outcomes of critically ill patients with COVID-19-associated acute kidney injury (AKI) who were treated with kidney replacement therapy (KRT) in the first and second waves of the pandemic in the megalopolis of Sao Paulo, Brazil. METHODS: A multicenter retrospective study was conducted in 10 intensive care units (ICUs). Patients aged ≥18 years, and treated with KRT due to COVID-19-associated AKI were included. We compared demographic, laboratory and clinical data, KRT parameters and patient outcomes in the first and second COVID-19 waves. RESULTS: We assessed 656 patients (327 in the first wave and 329 in the second one). Second-wave patients were admitted later (7.1±5.0 vs. 5.6±3.9 days after the onset of symptoms, p<0.001), were younger (61.4±13.7 vs. 63.8±13.6 years, p = 0.023), had a lower frequency of diabetes (37.1% vs. 47.1%, p = 0.009) and obesity (29.5% vs. 40.0%, p = 0.007), had a greater need for vasopressors (93.3% vs. 84.6%, p<0.001) and mechanical ventilation (95.7% vs. 87.8%, p<0.001), and had higher lethality (84.8% vs. 72.7%, p<0.001) than first-wave patients. KRT quality markers were independently associated with a reduction in the OR for death in both pandemic waves. CONCLUSIONS: In the Sao Paulo megalopolis, the lethality of critically ill patients with COVID-19-associated AKI treated with KRT was higher in the second wave of the pandemic, despite these patients being younger and having fewer comorbidities. Potential factors related to this poor outcome were difficulties in health care access, lack of intra-hospital resources, delay vaccination and virus variants.

Could formaldehyde induce mutagenic and cytotoxic effects in buccal epithelial cells during anatomy classes?

BACKGROUND: Due to increased formaldehyde exposure, carcinogenic to humans, several researches have been studying the potential toxicity and the safe levels for human beings. The aim of this study was to investigate mutagenicity and cytotoxicity in buccal epithelial exfoliated cells (BEC) of students subjected to formaldehyde (FA) during anatomy classes. MATERIAL AND METHODS: BEC were collected periodically from 17 volunteers of undergraduate programs, who had participated in practical anatomy classes, before and after FA exposure. Cells were stained according to Feulgen method and then micronucleus test was applied. A total of 1,500 cells were assessed per individual in this study for the micronucleus frequency and other parameters of cytotoxicity. RESULTS: There was statistically significant increase in number of micronucleated BEC after FA exposure (after 1 month p=.034 and after 3.5 months p=.017). However, FA exposure caused no significant increase in other nuclear alterations closely related to cytotoxicity (p≥.05). CONCLUSIONS: FA induced mutagenicity during anatomy classes. Cell death increased, but it was not statistically significant. Efforts have to be made to improve air quality and reduce exposures during anatomy classes.

Efeito da ingestão de taurina no desempenho físico: uma revisão sistemática / Effect of taurine intake on physical performance: a systematic review

Objetivo. Presentar los efectos de la taurina (Tau) en la capacidad aeróbica y anaeróbica, además de describir sus mecanismos de acción. Método. Se ha realizado una revisión sistemática de la literatura en las bases de datos PubMed/Medline y SportDiscus, teniendo como criterios de inclusión estudios con humanos, publicados en lengua inglesa, entre el 1 de enero de 2000 hasta el 1 de septiembre de 2011. La manera de consumo de Tau fue: Tau aislada o como ingrediente de bebidas energéticas evaluada con un suplemento placebo. La calidad de los estudios seleccionados fue valorada por la escala de PEDro siendo considerados los artículos con puntuaciones por encima de 5. Resultados. Fueron seleccionados 14 estudios, siendo 11 los que obtuvieron cambios en la capacidad física aeróbica y 3 en la anaeróbica. Se observaron mejoras significativas en las actividades aeróbicas (8 de los 11 artículos) de igual manera que en las anaeróbicas (2 de los 3 estudios) tras ingesta de Tau frente a placebo. Conclusión. El consumo agudo de apenas 1 g de Tau, independiente del tiempo previo de ingesta presentó un efecto positivo frente la capacidad física aeróbica y anaeróbica. El principal efecto ergogénico que se observó en el componente aerobio fue aumentar la capacidad temporal para realizar un ejercicio, sin embargo en la actividad anaerobia proporcionó una mejora en la respuesta de los iones de calcio durante la contracción muscular(AU)

Objective. Describe the effects of taurine (Tau) on aerobic and anaerobic physical performance as well as its mechanisms of action. Method. A systematic literature review on PubMed/Medline and SPORTDiscus was performed, including studies on humans which were published in English between January 1st, 2000 and September 1st, 2011.The forms of Tau intake were as the isolated compound (Tau) or as an ingredient in energy drinks analyzed with a placebo supplement. The quality of the selected articles was assessed using the PEDro scale and included articles with at least 5 points. Results. After the filtering process, 14 studies were selected from which 11 presented changes in aerobic physical performance and 3 in anaerobic physical performance. Significant improvements were observed in aerobic activities (8 out of 11 articles) and in anaerobic activities (2 out of 3 studies) after intake of Tau, compared to the placebo. Conclusion. The consumption of only 1 g of Tau, regardless of the time prior to intake, showed a beneficial effect on aerobic and anaerobic physical performance. The main ergogenic effect observed in the aerobic component was an increase on the temporal capacity of performing an exercise, whereas for the anaerobic activity there was a better response of calcium ions during muscle contraction(AU)

Avaliação da temperatura da pele durante o exercício através da termografia infravermelha: uma revisão sistemática / Evaluation of skin temperature during exercise by infrared thermography: a systematic review

Objetivo. Describir los cambios en la temperatura de la piel (Tp) durante el ejercicio registrado por medio de termografía infrarroja. Método. Se realizó una revisión sistemática de la literatura utilizando los términos ejercicio y termografía en las bases de datos de MEDLINE/PubMed, IEEEXplore y SciELO teniendo como principales factores de inclusión, estudios con humanos sin ningún tipo de problema físico o metabólico. Resultados. Tras el proceso de exclusión, fueron seleccionados ocho artículos. La Tp tiende a disminuir al inicio del ejercicio, de manera que su magnitud depende de la duración e intensidad de la actividad propuesta. En ejercicios con carga progresiva se observa una continua reducción de la Tp en comparación con los valores de reposo. Sin embargo, en ejercicios prolongados, la Tp puede variar según la región corporal evaluada con reducción, mantenimiento o incluso un aumento térmico, como sucede en las principales regiones musculares involucradas en el ejercicio. La Tp presenta respuestas específicas durante el ejercicio en función de la región corporal y la necesidad de pérdida de calor. Conclusión. La Tp disminuye en la fase inicial del ejercicio. La manera de realizar el ejercicio de perfil máximo o submáximo determina la respuesta de la Tp. No existe una respuesta homogénea en la Tp entre las diferentes regiones corporales, demostrando así la extremada complejidad del proceso de control de la temperatura central. Consecuentemente, la termografía infrarroja puede ser un valioso instrumento para hacer un seguimiento tanto de la respuesta térmica local como de la general(AU)

Objective. To describe the changes on Skin Temperature (Tsk) during exercise through Infrared Thermography. Method. A systematic review of the current literature was made, using the keywords "exercise" and "thermography" on the database MEDLINE/PubMed, IEEEXplore and SciELO. The research was made including the articles done with healthy humans without any physical or metabolic impairment. Results. After the exclusion process eight articles were selected. Tsk was has the tendency to decrease at the beginning of the exercise, depending on the duration and intensity of the task. In graded exercises a continuous reduction on Tsk was observed. Nevertheless, a bigger duration could lead to different thermal responses depending on the body area: reduction, maintenance or even an increase on the main regions involved on the exercise. Tsk has specific thermal responses depending on the body region and the heat loss necessities. Conclusion. Tsk decreases during the early stages of exercise. The thermal response will depend on the way of doing the maximal or submaximal exercise. There is a heterogeneous thermal response of Tsk between the different body regions, showing the extremely complexity of body temperature control. Therefore, Infrared Thermography could be a valuable tool in order to monitor both the local or the main thermal responses(AU)