Relationship between clinical-epidemiological parameters and outcomes of patients with COVID-19 admitted to the intensive care unit: a report from a Brazilian hospital.

Background: People in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death. Materials and methods: We conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021. Results: The use of bladder catheters (OR 79.30; p < 0.0001) and central venous catheters (OR, 45.12; p < 0.0001) were the main factors associated with death in ICU COVID-19 patients. Additionally, the number of non-survivors increased with age (p < 0.0001) and prolonged ICU stay (p < 0.0001). Besides, SAPS3 presents a higher sensibility (77.9%) and specificity (63.1%) to discriminate between survivors and non-survivor with an AUC of 0.79 (p < 0.0001). Conclusion: We suggest that multi-laboratory parameters can predict patient prognosis and guide healthcare teams toward more assertive clinical management, better resource allocation, and improved survival of COVID-19 patients admitted to the ICU.

Antimicrobial activity of coconut oil-in-water emulsion on Staphylococcus epidermidis and Escherichia coli EPEC associated to Candida kefyr.

Candida kefyr has been considered both a food-spoiling agent and a type of yeast with fermentation properties. In this study, the authors have evaluated the antimicrobial activity of a coconut oil-in-water emulsion associated to the presence of C. kefyr. Fresh coconut kernels were used to obtain the coconut oil-in-water emulsion, the sterile coconut oil-in-water emulsion by decantation, and the coconut oil by means of a heating process. Commercial virgin coconut oil was also used. Agar diffusion, minimal inhibitory concentration and minimal bactericidal concentration (MIC/MBC) techniques were employed to evaluate antimicrobial activity against E. coli and S. epidermidis. The C. kefyr isolate was identified and confirmed. Coconut milk-derived fatty acids were characterized by acid index and thin layer chromatography. Scanning electronic microscopy was performed to evaluate the morphology of the microorganisms. Lipase activity of C. kefyr isolate was also detected. Coconut oil-in-water emulsion associated to C. kefyr was active against both bacteria. Thin layer chromatography confirmed the presence of triglycerides and free fatty acids. The acid index showed higher acidity potential for the coconut oil-in-water emulsion. The microscopic images showed antibacterial action through the formation of membrane holes' and demonstrated yeast shape. All the above show new potentials for C. kefyr and coconut oil-in-water emulsion in food technology.

Biological activities of extracts from Chenopodium ambrosioides Lineu and Kielmeyera neglecta Saddi.

BACKGROUND: Chenopodium ambrosioides and Kielmeyera neglecta are plants traditionally used in Brazil to treat various infectious diseases. The study of the biological activities of these plants is of great importance for the detection of biologically active compounds. METHODS: Extracts from these plants were extracted with hexane (Hex), dichloromethane (DCM), ethyl acetate (EtOAc) and ethanol (EtOH) and assessed for their antimicrobial properties, bioactivity against Artemia salina Leach and antifungal action on the cell wall of Neurospora crassa. RESULTS: Extracts from C. ambrosioides (Hex, DCM and EtOH) and K. neglecta (EtOAc and EtOH) showed high bioactivity against A. salina (LD50 < 1000 µg/mL), which might be associated with cytotoxic activity against cancer cells. C. ambrosioides Hex and DCM showed specific activity against yeasts, highlighting the activity of hexanic extract against Candida krusei (MIC = 100 µg/mL). By comparing the inhibitory concentration of 50% growth (IC 50%) with the growth control, extracts from K. neglecta EtOAc and EtOH have shown activities against multidrug-resistant bacteria (Enterococcus faecalis ATCC 51299 and Staphylococcus aureus ATCC 43300), with IC 50% of 12.5 µg/mL The assay carried out on N. crassa allowed defining that extracts with antifungal activity do not have action through inhibition of cell wall synthesis. CONCLUSIONS: Generally speaking, extracts from C. ambrosioides and K. neglecta showed biological activities that have made the search for bioactive substances in these plants more attractive, illustrating the success of their use in the Brazilian folk medicine.

Genipa americana (Rubiaceae) fruit extract affects mitogen-activated protein kinase cell pathways in human trophoblast-derived BeWo cells: implications for placental development.

Genipa americana L. (Rubiaceae) is a fruit tree and a traditional medicine used to treat anemia, icterus, asthma, and liver and spleen problems. The aim of the present study was to verify the effect of G. americana fruit ethanolic extract on the mechanism for proliferation and differentiation of trophoblast-like cells. Qualitative analysis of G. americana fruit extract was performed, and BeWo cells, a well-established placental choriocarcinoma cell line that can undergo differentiation, were used to analyze cell viability and proliferation. Methods consisted of cytotoxic and proliferation measurement, detection of release of human chorionic gonadotrophins, cell fusion observation, and evaluation of cell-signaling pathways (production of cyclic adenosine monophosphate and phosphorylation of mitogen-activated protein kinases [MAPKs]). A stock solution of the extract was diluted in Ham's F-12 medium with 10% fetal bovine serum at concentrations ranging from 50 to 1000 µg/mL. Cells treated with dimethylsulfoxide, forskoline, and MAPK inhibitors (PD98059 or SB203580) were used as a control. Forskoline was used to induce the differentiation state in BeWo cells. Phytoanalysis indicated the presence of steroids only. Results showed that the G. americana fruit extract did not cause any cytotoxicity or interference in cell differentiation. However, a significant antiproliferative state related to inhibition and reactivation of ERK1/2 and p38 MAPK in BeWo cells was seen. These results suggest that steroids from G. americana may affect placental cell regulation.

Effect of St. John's Wort standardized extract and hypericin on in vitro placental calcium transport.

Hypericum perforatum L., known as St. John's wort (SJW), is widely used in human therapeutics for wound healing and to treat depression; however, its recommendation during pregnancy is controversial. Hypericin, a polycyclic quinone isolated from this plant, has been studied and used to standardize the plant extracts. The objective of the present study was to examine the effect of SJW and hypericin on in vitro placental Ca(2+) transport. Cell viability, human chorionic gonadotrophin (hCG) production, Ca(2+) uptake, and Ca(2+) transport proteins expression analysis were conducted using the JEG-3 cell line. Toxicity of SJW was seen at high concentrations (>or=150 microg/mL), but no effect on hCG production was observed using SJW (25 microg/mL) or hypericin (7.5 and 75 ng/mL). The results showed that cells treated with both SJW and hypericin exhibited increased intracellular Ca(2+) concentration after long-term (24-hour) but not short-term (10-minute) period incubation. A significant decrease in translationally controlled tumor protein Ca(2+) handling protein was seen only with SJW-treated cells. Hypericin increased the protein expression of the transient receptor potential vanilloid 6 Ca(2+) channel and 28-kDa calcium-binding protein and decreased that of plasma membrane Ca(2+)-ATPase 1/4. In conclusion, SJW and hypericin can increase the trophoblast internal Ca(2+) concentration through regulating the protein expression of the Ca(2+) transport system, and their intake during pregnancy is still a point of concern.