Fattening Pigs with Tannin-Rich Source (Ceratonia siliqua L.) and High Doses of Vitamin E: Effects on Growth Performance, Economics, Digestibility, Physiology, and Behaviour.

This study aimed to assess the impact on growth, economic results, apparent nutrient digestibility (CTTAD), physiological variables, and animal behaviour when 214 fattening pigs (78 ± 8.5 kg of initial body weight and 130 ± 4.5 days of age) of both sexes (gilts and boars) were fed two levels of carob pulp (Cp, 0 vs. 20%) and two doses of vitamin E (Vit E, 30 vs. 300 IU/kg) for 40 days. No interaction effects between factors studied (Cp, Vit E, and sex) were observed on the variables. Most productive traits were unaffected by Cp or Vit E inclusion. However, the Cp increased the feed conversion ratio during the first 20 days. The Cp group showed a higher CTTAD of ether extract and hemicellulose but lower CTTAD of crude protein. Pigs fed Cp had a lower plasmatic urea content than the control group. The high Vit E doses increased the CTTAD of every nutrient and the plasmatic α-tocopherol content. The pigs fed Cp tended to spend more time eating in the early morning, likely to mitigate tannins' astringent effects. Dietary inclusion of 20% Cp in finishing high-conformation pigs is possible without affecting overall performance though it reduces nutrient CTTAD and increases feeding cost. Supra-nutritional doses of Vit E do not affect pig performance but increase the α-tocopherol deposition with potential antioxidant effects.

Attaching Metal-Containing Moieties to ß-Lactam Antibiotics: The Case of Penicillin and Cephalosporin.

Procedures for the preparation of transition metal complexes having intact bicyclic cepham or penam systems as ligands have been developed. Starting from readily available 4-azido-2-azetidinones, a synthetic approach has been tuned using a copper-catalyzed azide-alkyne cycloaddition between 3-azido-2-azetinones and alkynes, followed by methylation and transmetalation to Au(I) and Ir(III) complexes from the mesoionic carbene Ag(I) complexes. This methodology was applied to 6-azido penam and 7-azido cepham derivatives to build 6-(1,2,3-triazolyl)penam and 7-(1,2,3-triazolyl)cepham proligands, which upon methylation and metalation with Au(I) and Ir(III) complexes yielded products derived from the coordination of the metal to the penam C6 and cepham C7 positions, preserving intact the bicyclic structure of the penicillin and cephalosporin scaffolds. The crystal structure of complex 28b, which has an Ir atom directly bonded to the intact penicillin bicycle, was determined by X-ray diffraction. This is the first structural report of a penicillin-transition-metal complex having the bicyclic system of these antibiotics intact. The selectivity of the coordination processes was interpreted using DFT calculations.

Ethnic disparities in cancer mortality in the capital and northeast of the State of São Paulo, Brazil 2001-17.

PURPOSE: There is a paucity of studies investigating cancer disparities in groups defined by ethnicity in transitioning economies. We examined the influence of ethnicity on mortality for the leading cancer types in São Paulo, Brazil, comparing patterns in the capital and the northeast of the state. METHODS: Cancer deaths were obtained from a Brazilian public government database for the Barretos region (2003-2017) and the municipality of São Paulo (2001-2015). Age-standardized rates (ASR) per 100,000 persons-years, by cancer type and sex, for five self-declared racial classifications (white, black, eastern origin (Asian), mixed ethnicity (pardo), and indigenous Brazilians), were calculated using the world standard population. RESULTS: Black Brazilians had higher mortality rates for most common cancer types in Barretos, whereas in São Paulo, white Brazilians had higher rates of mortality from breast, colorectal, and lung cancer. In both regions, lung cancer was the leading cause of cancer death among white, black, and pardo Brazilians, with colorectal cancer deaths leading among Asian Brazilians. Black and pardo Brazilians had higher cervical cancer mortality rates than white Brazilians. CONCLUSION: There are substantial disparities in mortality from different cancers in São Paulo according to ethnicity, pointing to inequities in access to health care services.

A Machine Learning Approach Investigating Consumers' Familiarity with and Involvement in the Just Noticeable Color Difference and Cured Color Characterization Scale.

The aim of this study was to elucidate the relations between the visual color perception and the instrumental color of dry-cured ham, with a specific focus on determining the Just Noticeable Color Difference (JNCD). Additionally, we studied the influence of consumer involvement and familiarity on color-related associations and JNCD. Slices of ham were examined to determine their instrumental color and photos were taken. Consumers were surveyed about color scoring and matching of the pictures; they were also asked about their involvement in food, familiarity with cured ham, and sociodemographic characteristics. Consumers were clustered according to their level of involvement and the JNCD was calculated for the clusters. An interpretable machine learning algorithm was used to relate the visual appraisal to the instrumental color. A JNCD of ΔEab* = 6.2 was established, although it was lower for younger people. ΔEab* was also influenced by the involvement of consumers. The machine-learning algorithm results were better than those obtained via multiple linear regressions when consumers' psychographic characteristics were included. The most important color variables of the algorithm were L* and hab. The findings of this research underscore the impact of consumers' involvement and familiarity with dry-cured ham on their perception of color.

Comparison of Easy-to-Use Bronchiolitis Scores in the Post-COVID-19 Era-An Observational Study.

In the post-restrictions COVID-19 period, the incidence of bronchiolitis in infants has increased considerably. Several scores determine the degree of severity of the bronchiolitis episode, but few are clinician-friendly. The main aim of this research was to find the easy-to-use score that most accurately estimated the severity of patients' infections according to their clinical situations and most accurately predicted the need for hospital admission. An observational cross-sectional study was performed in a reference pediatric hospital during the post-restrictions period of the COVID-19 pandemic (2021 and 2022). A comparison was made between the severity estimate provided by five international acute bronchiolitis scales and the clinical severity of the acute bronchiolitis episode. Three hundred and seventy-seven patients participated in the investigation, with a mean age of 5.68 months; 68.7% of the participants had a mild episode of bronchiolitis, 24.5% had a moderate episode, and 6.9% had a severe episode. The severity estimated by the Tal scale modified by McCallum showed a statistically significant correlation with the clinical severity established by clinical criteria (0.836; p < 0.001). It showed a high correlation with other international scores, such as the Wang score (0.820; p < 0.05) and the Wood-Downes-Ferrés score (0.936; p < 0.001). In the multivariate analysis, the constituent variables of the modified Tal score appeared in the final model that predicts the need for hospital admission. In the context of increased incidence after COVID-19, the Tal score modified by McCallum is an easy-to-use measuring instrument that presents an excellent concordance with the clinical severity estimated at first care contact. It also offers a more significant prediction of the need for hospital admission.

Colour Stability, Fatty Acid Profile, and Lipid Oxidation in Meat Stored in Modified Atmosphere Packaging from Light Lambs Fed with Concentrate with Carob Pulp (Ceratonia siliqua L.).

There is a growing interest in using by-products rich in polyphenols, such as carob pulp (Cp, Ceratonia siliqua L.), as a dietary source of antioxidants for animals. This study assesses the effects of including Cp in lambs' diet and meat display time (0, 7, 9, and 11 days) in modified atmosphere packaging on meat colour, fatty acid (FA) composition, tocopherol levels, and lipid oxidation values in the Semimembranosus muscle of 40 light lambs. The lambs were fed with concentrates supplemented with increasing Cp levels (0, 150, and 300 g/kg) for 45 days before slaughter. Metmyoglobin (MMb) and malondialdehyde (MDA) contents increased linearly with display time (p < 0.05), regardless of diet (p > 0.05). At 11 days of display, MMb (28 ± 0.8%) and MDA (0.6 ± 0.1 mg MDA/kg of meat) contents remained within the acceptable limits. The α-tocopherol content was lower in the 30% Cp group and meat (p < 0.05). Total saturated and monounsaturated FA contents (934 ± 64 and 823 ± 65 mg/100 g of meat, respectively) did not differ significantly among the groups. However, the meat from lambs fed with 30% Cp showed reduced levels of branched-chain FAs, while polyunsaturated FAs increased (p < 0.05) compared to the control lambs. The inclusion of Cp in the lamb's diet, up to 30%, did not lead to meat deterioration and improved certain quality parameters, including a healthier FA profile. These findings highlight Cp's potential as an alternative antioxidant source in animal diets.

Thyroid Cancer Incidence and Mortality by Socioeconomic Level in the State of São Paulo, Brazil 2001-2017.

OBJECTIVE: Thyroid cancer is rising largely due to greater detection of indolent or slow-growing tumors; we sought to compare the incidence and mortality profiles of thyroid cancer in the State of São Paulo by socioeconomic status (SES). METHODS: Data on thyroid cancer cases diagnosed from 2003 to 2017 in the Barretos Region and from 2001 to 2015 in the municipality of São Paulo were obtained from the respective cancer registries. Corresponding death data were obtained from a Brazilian public government database. Age-standardized rates were calculated and presented as thematic maps. The rates were also calculated by SES and spatial autocorrelation was assessed by global and local indices. RESULTS: There were 419 cases of thyroid cancer and 21 deaths in Barretos, contrasting with the highly populated São Paulo, with 30 489 cases and 673 deaths. The overall incidence rates in São Paulo (15.9) were three times higher than in Barretos (5.7), while incidence rates in women were close to five times higher in Barretos and four times higher in São Paulo than in men. Mortality rates were, in relative terms, very low in both regions. A clear stepwise gradient of increasing thyroid cancer incidence with increasing SES was observed in São Paulo, with rates in very high SES districts four times those of low SES (31.6 vs 8.1). In contrast, the incidence rates in Barretos presented little variation across SES levels. CONCLUSION: Thyroid cancer incidence varied markedly by SES in São Paulo, with incidence rates rising with increasing socioeconomic index. Overdiagnosis is likely to account for a large proportion of the thyroid cancer burden in the capital.

Survival inequalities in head and neck cancers: A hospital-based cohort study.

BACKGROUND: We investigated whether the socioeconomic status (SES) influenced survival rates in oropharynx cancers (OPC), oral cavity cancers (OCC), and larynx cancers (LC) in Brazilian patients. METHODS: This hospital-based cohort study assessed the age-standardized 5-year relative survival (RS) using the Pohar Perme estimator. RESULTS: Overall, we identified 37 191 cases, and 5-year RS were 24.4%, 34.1%, and 44.9% in OPC, OCC, and LC, respectively. In multiple Cox regression, the highest risk of death occurred in the most vulnerable social strata for all subsites-that is, illiterates or patients relying on publicly funded healthcare services. Disparities increased over time by 34.9% in OPC due to the rising of survival rates in the highest SES, whereas they reduced by 10.2% and 29.6% in OCC and LC. CONCLUSIONS: The potential inequities were more significant for OPC than for OCC and LC. It is urgent to tackle social disparities to improve prognoses in highly unequal countries.

Geographic variations in cancer incidence and mortality in the State of São Paulo, Brazil 2001-17.

BACKGROUND: Cancer is a leading cause of morbidity and mortality in Brazil and the burden is rising. To better inform tailored cancer actions, we compare incidence and mortality profiles according to small areas in the capital and northeast region of the State of São Paulo for the leading cancer types. METHODS: New cancer cases were obtained from cancer registries covering the department of Barretos (2003-2017) and the municipality of São Paulo (2001-2015). Cancer deaths for the same period were obtained from a Brazilian public government database. Age-standardized rates per 100,000 persons-years by cancer and sex are presented as thematic maps, by municipality for Barretos region, and by district for São Paulo. RESULTS: Prostate and breast cancer were the leading forms of cancer incidence in Barretos, with lung cancer leading in terms of cancer mortality in both regions. The highest incidence and mortality rates were seen in municipalities from the northeast of Barretos region in both sexes, while elevated incidence rates were mainly found in São Paulo districts with high and very high socioeconomic status (SES), with mortality rates more dispersed. Breast cancer incidence rates in São Paulo were 30 % higher than Barretos, notably in high and very high SES districts, while corresponding rates of cervical cancer conveyed the opposite profile, with elevated rates in low and medium SES districts. CONCLUSIONS: There is substantial diversity in the cancer profiles in the two regions, by cancer type and sex, with a clear relation between the cancer incidence and mortality patterns observed at the district level and corresponding SES in the capital.

Cancer inequalities in incidence and mortality in the State of São Paulo, Brazil 2001-17.

BACKGROUND: Cancer disparities exist between and within countries; we sought to compare cancer-specific incidence and mortality according to area-level socioeconomic status (SES) in the State of São Paulo, Brazil. METHODS: Cancer cases diagnosed 2003-2017 in the Barretos region and 2001-2015 in the municipality of São Paulo were obtained from the respective cancer registries. Corresponding cancer deaths were obtained from a Brazilian public government database. Age-standardized rates for all cancer combined and the six most common cancers were calculated by SES quartiles. RESULTS: There were 14,628 cancer cases and 7513 cancer deaths in Barretos, and 472,712 corresponding cases and 194,705 deaths in São Paulo. A clear SES-cancer gradient was seen in São Paulo, with rates varying from 188.4 to 333.1 in low to high SES areas, respectively. There was a lesser social gradient for mortality, with rates in low to high SES areas ranging from 86.4 to 98.0 in Barretos, and from 99.2 to 100.1 in São Paulo. The magnitude of the incidence rates rose markedly with increasing SES in São Paulo city for colorectal, lung, female breast, and prostate cancer. Conversely, both cervical cancer incidence and mortality rose with lower levels of SES in both regions. CONCLUSIONS: A clear SES association was seen for cancers of the prostate, female breast, colorectum, and lung for São Paulo. This study offers a better understanding of the cancer incidence and mortality profile according to SES within a highly populated Brazilian state.

Ganglionated plexi ablation in the right atrium for the treatment of cardioinhibitory syncope.

Neurocardiogenic syncope, also called vasovagal syncope, represents one of the clinical manifestations of neurally mediated syncopal syndrome. Generally, the prognosis of the cardioinhibitory form of neurocardiogenic syncope is good, but quality of life is seriously compromised in patients who experience severe forms. Drug therapy has not achieved good clinical results and very heterogeneous data come from studies regarding permanent cardiac pacing. In this scenario, the ganglionated plexi ablation has been proposed as an effective and safe method in patients with cardioinhibitory neurocardiogenic syncope, especially in young patients in order to avoid or prolong, as much as possible, the timing of definitive cardiac pacing. Certainly, making this procedure less extensive and limiting the ablation in the right atrium (avoiding the potential complications of a left atrial approach) and at level of anatomical regions of the most important ganglionated plexy, considered 'gateway' of the sino-atrial and atrio-ventricular node function (through the recognition of specific endocardial potentials), could be very advantageous in this clinical scenario. Finally, randomized, multicentre, clinical trials on a large population are needed to better understand which is the best ablation treatment (right-only or bi-atrial) and provide evidence for syncope guidelines.

Worldwide research trends on bronchiolitis in pediatrics.

BACKGROUND: The COVID-19 pandemic has led to a significant increase in cases of bronchiolitis among children. As a result, there has been a corresponding increase in the number of publications on this topic. It is essential to examine the main areas of focus within the scientific literature to understand the current trends in research on pediatric bronchiolitis. This research aims to analyze the types of scientific advances related to pediatric bronchiolitis, the research trends being pursued, and the countries and research institutions leading these efforts. By understanding these aspects of bronchiolitis research, we can better understand the current state of knowledge and identify areas where further research is needed. METHODS: To conduct a bibliometric analysis of the scientific literature on pediatric bronchiolitis, all relevant publications were retrieved from the Scopus database. The Scopus API and the SW VosViewer software with optimized modularity functions were used. This analysis was intended to provide a comprehensive overview of the current state of research on this topic, including the types of scientific advances being developed, the research trends being pursued, and the countries and research institutions leading these efforts. RESULTS: A total of 3810 publications were reviewed. We observed an increasing number of publications, particularly in recent years. Of these, 73.7% were articles, 95% were written in English, and 29.4% were from the United States. The main keywords used in these publications included: human, bronchiolitis, child, preschool, preschool child, major clinical study, controlled study, pneumonia, asthma, adolescent, hospitalization, infant, and newborn. These keywords were grouped into six clusters: outpatient management, long-term consequences, etiology, intensive care management, diagnostic methods, and the main cluster, which focused on hospital treatment and clinical studies. CONCLUSIONS: The bibliometric analysis of bronchiolitis research in pediatrics reveals that there has been a significant increase in the number of publications on this topic, particularly in recent years. Most of these publications are articles written in English and published in the United States. The main keywords used in these studies relate to various aspects of bronchiolitis, including diagnosis, treatment, and long-term consequences. The results of this analysis suggest that bronchiolitis is a topic of significant interest and concern for researchers and practitioners in the field of pediatrics and that further research is needed to improve our understanding and management of this condition.

Evaluation of completeness and timeliness of data in the National Information System for Notifiable Diseases for spotted fever in the state of São Paulo, Brazil, 2007-2017 / Evaluación de la integridad and oportunidad de datos en el Sistema de Información sobre Enfermedades de Notificación Obligatoria por fiebre manchada en el estado de São Paulo, Brasil, 2007-2017 / Avaliação da completitude e oportunidade dos dados no Sistema de Informação de Agravos de Notificação (Sinan) para febre maculosa no estado de São Paulo, 2007-2017

Objective: To evaluate the completeness and timeliness of notifications of cases of spotted fever (SF) in the National System of Information on Notifiable Diseases (Sinan) in the state of São Paulo, from 2007 to 2017. Methods: This is a descriptive and ecological study of confirmed human cases of SF for completeness and timeliness of ten form fields (good if ≥ 90% for most variables). Linear regression was performed to analyze trends in the time series. Results: Among essential fields, only "Discharge date" showed low completeness (68.5%). "Investigation" and "Closure" had good timeliness; other intervals were not adequate. Conclusion: In the state of São Paulo, data completeness was good for most variables, but not adequate in terms of timeliness, except for "Closing" and "Investigation", pointing to the need for health education and communication actions on SF.

Objetivo: Evaluar la integridad y oportunidad de las notificaciones de casos de fiebre maculosa (SF) en el Sistema Nacional de Información sobre Enfermedades de Declaración Obligatoria (Sinan) en el estado de São Paulo, de 2007 a 2017. Métodos: Se trata de un estudio descriptivo y ecológico. estudio de casos humanos confirmados de SF para la integridad y puntualidad de diez campos de formulario (bueno si ≥ 90% para la mayoría de las variables). Se realizó una regresión lineal para analizar las tendencias en la serie temporal. Resultados: Entre los campos esenciales, solo "Fecha de alta" mostró baja completitud (68,5%). "Investigación" y "Cierre" tuvieron buena oportunidad; otros intervalos no fueron adecuados. Conclusión: En São Paulo, la completitud fue buena para la mayoría de las variables, pero no adecuada en cuanto a la oportunidad, excepto para "Cierre" e "Investigación", lo que apunta a la necesidad de acciones de educación y comunicación en salud sobre SF.

Objetivo: avaliar completitude e oportunidade das notificações de casos de febre maculosa (FM) no Sistema de Informação de Agravos de Notificação (Sinan), no estado de São Paulo, Brasil, no período de 2007 a 2017. Métodos: estudo descritivo e ecológico dos casos humanos confirmados de FM, mediante análise dos atributos "completitude" e "oportunidade" de dez campos da ficha de notificação (boas quando ≥ 90% para a maioria das variáveis); realizou-se análise de regressão linear para avaliar as tendências das séries temporais. Resultados: foram analisados 736 registros; dos campos essenciais, apenas "Data da alta" demonstrou baixa completitude (68,5%); "Investigação" e "Encerramento" tiveram boa oportunidade; demais intervalos não foram adequados. Conclusão: no estado de São Paulo, a completitude dos dados foi boa na maioria das variáveis, porém não adequada quanto à oportunidade (exceto para "Encerramento" e "Investigação"), apontando para a necessidade de ações de educação e comunicação em saúde sobre FM.

Researching with Qualitative Methodologies in the Time of Coronavirus: Clues and Challenges.

In late 2020 and the first semester of 2021, in Santiago de Chile, five women researchers who work with qualitative methodologies, based on their reflections on how the context of the COVID-19 pandemic has impacted on their doctoral research or their role as thesis advisors, conducted a reflective exploration of the conditions and challenges for qualitative research amid a global crisis. In this context, they convene once per week to explore how other researchers conduct and document their research processes, based on a purposive and thorough bibliographic exploration of qualitative studies on the pandemic and remote methods published in qualitative research journals. During these meetings, they reflect on and analyze the impacts and challenges of research in today's world, identifying possibilities and challenges in the methodological and ethical domains. Thus, they organize the present paper around two axes: one on the effects of the pandemic on academic and research practices, in general terms, and another on the specific methodological challenges facing qualitative research during the pandemic. These challenges are largely caused by difficulties in accessing and recruiting participants; the conditions of participation, influenced by vulnerabilities or barriers that constitute factors of inequality; the data production strategies and methodologies used in virtual contexts; ethical considerations; and the effects of the pandemic context on quality and rigor criteria. The article concludes with reflections and questions on the meanings, underlying logic, and practices of qualitative research, which are interrogated and re-signified in light of the COVID-19 pandemic while also illuminating research in post-pandemic settings.

Impact of gilt immunocastration on weight losses and instrumental and chemical characteristics of Teruel dry-cured ham.

A total of 32 fresh hams intended for the Spanish Protected Designation of Origin "Teruel ham" were used to evaluate the impact of gilt immunocastration (vs. entire gilts) on weight losses during the dry-curing process. After processing, 20 dry-cured hams (10 of each group) were chosen at random to assess instrumental and chemical characteristics. Hams from immunocastrated gilts tended (P = 0.057) to present lower weight losses, they were fattier (P < 0.05) at both subcutaneous and intramuscular levels and had lower (P < 0.05) water activity and volatile compounds that provide unpleasant odors than those from entire gilts. However, immunocastration increased (P < 0.05) slightly sodium chloride and sodium nitrite contents, being normal levels. Fatty acid profile was not significantly affected (P > 0.05). It can be concluded that, in general, immunocastration could be a good strategy in gilts to improve the quality of Teruel dry-cured ham.

Profile of neurological manifestations in patients with COVID-19: Review of the literature published during the first six months of the pandemic

Introduction: Several studies describing different neurological manifestations in patients with COVID-19 were published during the first six months of the pandemic. Objective: To collect and synthesize the scientific evidence published within the first six months after COVID-19 was declared a pandemic on neurological manifestations in patients infected with SARS-CoV-2, as well as their prevalence and variations in specific populations. Materials and methods: A literature search was conducted in PubMed/MEDLINE using the following search strategy: types of study: any study describing neurological manifestations in COVID-19 patients; publication period: March 11-August 31, 2020; publication language: English; search terms and search equation: (("COVID-19") AND "Neurologic Manifestations"). Results: The initial search yielded 388 records, of which 79 met the eligibility criteria and were included for full analysis. Most studies were case reports (50.63% individual case reports and 18.99% case series), while only 30.38% were analytical studies, with cross-sectional studies being the most common (n=25). The most frequently described neurological manifestation was smell and/or taste disorder (43.04%), followed by peripheral neuropathy (20.25%), seizures (8.86%), encephalitis (7.59%), and delirium (5.06%). Other manifestations reported to a lesser extent included headache, myositis, stroke, and transverse myelitis. Conclusion: Most neurological manifestations reported have a favorable progress, occur in young patients without any comorbidity, and are unrelated to the severity of the disease. Other manifestations such as delirium and epileptic seizures occur more frequently in people with a history of dementia or epilepsy, respectively. Finally, some manifestations such as Guillain-Barré syndrome and stroke may cause several sequelae.

Introducción. Durante los primeros seis meses de la pandemia por COVID-19 se publicaron varios estudios que describen diferentes manifestaciones neurológicas en pacientes con esta enfermedad. Objetivo. Recopilar y sintetizar evidencia científica publicada en los seis meses posteriores a la declaración de la pandemia por COVID-19 sobre manifestaciones neurológicas en pacientes infectados con SARS-CoV-2, así como sus variaciones y frecuencia en poblaciones específicas. Materiales y métodos. Se realizó una búsqueda de la literatura en PubMed/Medline mediante la siguiente estrategia de búsqueda: tipos de estudio: cualquier estudio que describiera manifestaciones neurológicas en pacientes con COVID-19; periodo de publicación: marzo 11 a agosto 31, 2020; idioma de publicación: inglés; términos y ecuación de búsqueda: (("COVID-19") AND "Neurologic Manifestations"). Resultados. La búsqueda inicial arrojó 388 registros, de los cuales 79 cumplieron los criterios de elegibilidad. La mayoría de los estudios fueron reportes de caso (50.63% fueron reportes individuales de caso y 18.99%, series de casos), mientras que solo 30.38% fueron estudios analíticos, siendo los estudios transversales los más frecuentes (n=20). La manifestación neurológica descrita más frecuentemente fue la alteración de olfato y/o gusto (43.04%), seguida de neuropatía periférica (20.25%), convulsiones (8.86%), encefalitis (7.59%) y delirium (5.06%). Otras manifestaciones reportadas en menor proporción fueron cefalea, miositis, accidente cerebrovascular (ACV) y mielitis transversa. Conclusión. La mayoría de las manifestaciones neurológicas de la COVID-19 reportadas tienen una evolución favorable, ocurren en pacientes jóvenes sin comorbilidades y no tienen relación con la severidad de la enfermedad. Otras manifestaciones, como delirium y crisis epilépticas, se presentan con mayor frecuencia en población con antecedente de demencia o epilepsia, respectivamente. Por último, algunas manifestaciones como el síndrome de Guillain-Barré y los ACV pueden causar secuelas.

Production of biofilm by Staphylococcus aureus: Association with infective endocarditis?

OBJECTIVES: Staphylococcus aureus is a well-known biofilm-producing pathogen that is capable of causing chronic infections owing to its ability to resist antibiotic treatment and obstruct the immune response. However, the possible association between high biofilm production and infective endocarditis (IE) has not been assessed. Our objective was to compare production of biofilm by S. aureus strains isolated from patients with bacteremia and IE, catheter-related bloodstream infection (C-RBSI), or non-device associated bacteremia. METHODS: We isolated 260 S. aureus strains from the blood of patients with bacteremia who were diagnosed during hospital admission between 2012 and 2015. Patients were divided into 3 groups according to whether they had IE, C-RBSI, or non-device associated bacteremia. Biofilm production was measured in terms of biomass and metabolic activity using the crystal violet and XTT assays, respectively. High biomass and metabolic activity rates (based on tertile ranks classification) were compared between the 3 groups. RESULTS: The high biomass and metabolic activity rates of each group were 41.9% and 37.2% for IE, 32.5% and 35.0%, for C-RBSI, and 29.0% and 33.3% for non-device associated bacteremia (p=0.325 and p=0.885, respectively). CONCLUSIONS: High biomass and metabolic activity levels for S. aureus isolates from IE were similar to those of S. aureus isolates from C-RBSI or non-device associated bacteremia.

Production of biofilm by Staphylococcus aureus: Association with infective endocarditis? / Producción de biofilm en Staphylococcus aureus: ¿Asociación con endocarditis infecciosa?

Objectives: Staphylococcus aureus is a well-known biofilm-producing pathogen that is capable of causing chronic infections owing to its ability to resist antibiotic treatment and obstruct the immune response. However, the possible association between high biofilm production and infective endocarditis (IE) has not been assessed. Our objective was to compare production of biofilm by S. aureus strains isolated from patients with bacteremia and IE, catheter-related bloodstream infection (C-RBSI), or non-device associated bacteremia. Methods: We isolated 260 S. aureus strains from the blood of patients with bacteremia who were diagnosed during hospital admission between 2012 and 2015. Patients were divided into 3 groups according to whether they had IE, C-RBSI, or non-device associated bacteremia. Biofilm production was measured in terms of biomass and metabolic activity using the crystal violet and XTT assays, respectively. High biomass and metabolic activity rates (based on tertile ranks classification) were compared between the 3 groups. Results: The high biomass and metabolic activity rates of each group were 41.9% and 37.2% for IE, 32.5% and 35.0%, for C-RBSI, and 29.0% and 33.3% for non-device associated bacteremia (p=0.325 and p=0.885, respectively). Conclusions: High biomass and metabolic activity levels for S. aureus isolates from IE were similar to those of S. aureus isolates from C-RBSI or non-device associated bacteremia.(AU)

Objetivos: Staphylococcus aureus es un conocido microorganismo productor de biofilm, capaz de causar infecciones crónicas debido a su capacidad de resistir el tratamiento antibiótico y dificultar la respuesta inmunitaria. Sin embargo, no se ha evaluado la posible asociación entre una elevada producción de biofilm y la endocarditis infecciosa (EI). Nuestro objetivo fue comparar la producción de biofilm por parte de cepas de S.aureus aisladas de pacientes con bacteriemia y EI, bacteriemia relacionada con el catéter (BRC) o bacteriemia no asociada a dispositivos. Métodos: Se aislaron 260 cepas de S.aureus de sangre de pacientes con bacteriemia que fueron diagnosticados durante su ingreso hospitalario entre 2012 y 2015. Los pacientes se dividieron en tres grupos según tuvieran EI, BRC o bacteriemia no asociada a dispositivos. La producción de biofilm se midió en términos de biomasa y de actividad metabólica utilizando los ensayos de cristal violeta y XTT, respectivamente. Se compararon los índices de alta biomasa y actividad metabólica (basadas en clasificación por terciles) entre los tres grupos. Resultados: Los índices altos de biomasa y actividad metabólica de cada grupo fueron del 41,9 y del 37,2% para EI, del 32,5 y del 35,0% para BRC, y del 29,0 y del 33,3% para bacteriemia no asociada a dispositivos (p=0,325 y p=0,885, respectivamente). Conclusiones: Los niveles altos de biomasa y actividad metabólica de los aislados de S.aureus procedentes de EI fueron similares a los de los aislados de BRC o de bacteriemia no asociada a dispositivos.(AU)

Religiosity as a potential mediator for violence in childhood and adulthood: results from a Brazilian nationally representative survey.

OBJECTIVES: Although previous studies have investigated the role of religiosity in violence outcomes, there is a lack of studies including this aspect as a mediator for violence in childhood and adulthood. This study aimed to investigate the relationship between religiosity and violence in childhood, as well as the possible mediating role of religiosity between suffering violence in childhood and suffering and/or perpetrating violence in adulthood. DESIGN: Cross-sectional population-based study carried out from November 2011 to March 2012. SETTING: Face-to-face surveys (at participants' homes) were performed in a Brazilian nationally representative sample. PARTICIPANTS: A total of 3378 adults (aged 19 years and above) were included. PRIMARY AND SECONDARY OUTCOMES MEASURES: The association between suffering violence in childhood and religiosity, and the mediating role of religiosity between childhood and adulthood violence were analysed using logistic regression models. RESULTS: Religiosity was associated with childhood violence, showing that those who suffered less violence in childhood were more religious in adulthood and considered religion more important in their lives. However, while there was a significant association between suffering violence during childhood and suffering and/or perpetrating violence in adulthood, religiosity did not mediate this relationship. CONCLUSIONS: Although religious individuals self-reported less violence suffered in childhood, religiosity did not show evidence of being a potential mediator for childhood and adulthood violence (experienced and/or perpetrated). These results could help researchers explore this phenomenon, and aid health professionals and managers when proposing future interventions.

Working conditions are associated with the occurrence of sleepiness of nursing professionals: a case-control study.

Objectives: To identify the factors associated with the occurrence of sleepiness among nursing professionals. Material and Methods: A case-control study nested in a cross-sectional one, conducted with 364 controls and 121 cases. Data on demographic and occupational characteristics were collected, as well as about lifestyle, physical and psychosocial work environment and somnolence. A multiple logistic regression analysis was performed. Results: The independent factors associated with the presence of sleepiness were as follows: imbalance between efforts and rewards (ORa=3.81; p<0.001), high overcommitment (ORa=3.20; p<0.001), workload equal to or greater than 45 hours a week (ORa=2.30; p=0.001), situations that can generate pain/injury with moderate or high exposure (ORa=1.85; p=0.037), and night work (ORa=1.71; p=0.038). The model was adjusted by gender and age group. Conclusion: Individual and historical-occupational characteristics and, mainly, those related to the physical and psychosocial work environment, were associated with the occurrence of sleepiness. Public and institutional preventive policies must include improvements in the conditions of the physical and psychosocial work environment, as well as strengthening of the individual resources.