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Background: Long COVID is an emerging global public health issue. Socially vulnerable communities in low- and-middle-income countries were severely impacted by the pandemic and are underrepresented in research. This prospective study aimed to determine the prevalence of long COVID, its impact on health, and associated risk factors in one such community in Rio de Janeiro, Brazil. Methods: A total of 710 individuals aged 18 and older, with confirmed SARS-CoV-2 infection at least three months prior, were enrolled between November 25, 2021, and May 5, 2022. Participants were assessed via telephone or in person using a standardized questionnaire to evaluate their perception of recovery, symptoms, quality of life, and functional status. Findings: Twenty percent of participants did not feel fully recovered, 22% experienced new or persistent symptoms, 26% had worsened functional status, 18% had increased dyspnoea, and 32% reported a worse quality of life. Persistent symptoms included headache, cough, fatigue, muscle pain, and shortness of breath. Dyspnoea during the acute phase was the strongest independent predictor of worsening outcomes. Females and individuals with comorbidities were more likely to report worse recovery, functioning, dyspnoea, and quality of life. Interpretation: Our findings reveal a high burden of severe and persistent physical and mental health sequelae in a socially vulnerable community following COVID-19. Funding: UK Foreign, Commonwealth and Development Office and Wellcome Trust Grant (222048/Z/20/Z), Fundação Oswaldo Cruz (FIOCRUZ), Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), and the Centers for Disease Control and Prevention (CDC).
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PURPOSE: Evaluate the differences between surgical techniques in the modifications of body composition and the interference in skeletal muscle health, risk of sarcopenia, and reduced physical performance. MATERIALS AND METHODS: This is a cross-sectional prospective study. A total of 71 patients, who underwent sleeve gastrectomy (SG) or underwent Roux-en-Y gastric bypass (RYGB). Both groups underwent anthropometric, laboratory analysis, body composition assessment, presence of sarcopenia, and physical performance tests. RESULTS: The study found a higher percentage of weight loss and lower BMI in RYGB compared to SG. The other assessments of sarcopenia and physical performance showed similarity between the surgical models. Baumgartner index (7.9 kg/m2 vs. 7.3 kg/m2), FNIH (9.0 vs. 3.0), handgrip strength (27.3 kg vs. 25.2 kg), and SPPB (9.5 vs. 9.3). Leptin in the general SG group was higher than in RYGB (14.2 ng/ml vs. 8.0 ng/ml). CONCLUSION: RYGB and SG have a similar presence of sarcopenia and physical performance. However, SG allows greater preservation of bone and muscle mass and is associated with higher values of leptin, which may represent protection from long-term postoperative complications.
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Cirurgia Bariátrica , Derivação Gástrica , Obesidade Mórbida , Sarcopenia , Humanos , Derivação Gástrica/métodos , Leptina , Obesidade Mórbida/cirurgia , Estudos Transversais , Força da Mão , Estudos Prospectivos , Gastrectomia/métodos , Composição Corporal , Desempenho Físico Funcional , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Mast cells, known as pro-inflammatory effector cells, are immunocytes present in the meninges and may be involved in the pathophysiology of migraine. This study aims to evaluate the histomorphometric parameters of mast cells located in the convexity of the human intracranial dura mater. For this, samples of intracranial dura mater from eight human fresh cadavers were collected between 8- and 24-h post-mortem. The whole samples were fixed and, subsequently, two fragments of 1.5 cm² each were cut from four different areas of the dura mater convexity, containing a segment of the middle meningeal artery, totaling 64 fragments. After histological processing, the fragments were submitted to microtomy (5 and 10 µm), stained with toluidine blue (0.1%), or immunohistochemically labeled for tryptase, and analyzed using optical microscopy. The following histomorphometric parameters were evaluated: distance from mast cells to vessels, the density of mast cells, and percentage of mast cells with degranulation. Histomorphometric analyzes showed a higher density of mast cells in the vicinity of blood vessels (arterial and venous), with distances around 0-150 µm. A greater number of mast cells was detected near venous vessels in the periosteal layer (17.0 ± 10.1 cells/mm²) than in the meningeal layer (14.1 ± 7.0 cells/mm²) (p < 0.05). Mast cells from the region close to the superior sagittal sinus were found in greater quantity close to the venous vessels (16.7 ± 10.1 cells/mm²) than to the arterial vessels (11.2 ± 7.5 cells/mm²) (p < 0.05). In short, in the convexity of the human intracranial dura mater, mast cells are located close to blood vessels, with a greater number of cells next to the venous vessels of the periosteal layer and in the proximal region of the superior sagittal sinus.
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Dura-Máter , Mastócitos , Encéfalo , Cadáver , Contagem de Células , HumanosRESUMO
Our study aimed to explore the influence of bariatric surgery (BS) on heart rate (HR) variability (HRV) through a systematic review. Manuscripts were selected based on electronic searches of the MEDLINE, EMBASE, and CINAHL databases from the inception of each database up to year 2020, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Searching of these studies was systematized using the Population Intervention Comparison Outcome Study Design strategy. We selected randomized and nonrandomized controlled trials and cohorts from prospective studies that reported the influence of BS on HRV. We assessed the quality rating using the Black and Downs questionnaire. Following the screening and eligibility stages, 14 studies were included in the review. All studies agreed that BS promotes an increase in parasympathetic HR control and HRV and a decrease in HR. Yet the literature does not provide evidence that these outcomes are directly caused by the surgical procedure. There is limited evidence to support that patients with type 2 diabetes have greater improvement in HRV as an interim measure, to individuals without. The decrease in insulin resistance was correlated with the increase in HRV in some studies, but, other studies are unsupportive of this outcome. Improvements in 2 metabolic parameters (e.g., leptin, N-terminal pro B-type natriuretic peptide) were connected with superior increases in HRV. This review demonstrated that BS promotes an increase in HRV, indicating improved autonomic control of HR.
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Cirurgia Bariátrica , Diabetes Mellitus Tipo 2 , Sistema Nervoso Autônomo , Frequência Cardíaca , Humanos , Estudos ProspectivosRESUMO
OBJECTIVE: We assessed the acute effect of beetroot extract intake on cardiovascular and autonomic recovery subsequent to strength exercise. METHODS: This is a crossover, randomized, double-blind and placebo-controlled trial. We assessed 16 subjects but only 12 healthy male adults completed the two protocols in two randomized days: Beetroot extract (600 mg in capsule) and placebo (600 mg starch in capsule). Beetroot extract or placebo was ingested, the subjects endured 120 minutes seated at rest, followed by a 75% 1RM strength exercise and then remained seated for 60 minutes at rest. Cardiorespiratory parameters, heart rate (HR) variability (HRV) (SDNN, rMSSD, pNN50, SD1, SD2 HF [ms2]) were estimated before, during exercise and during recovery from exercise. RESULTS: ingestion of beetroot extract before exercise: accelerates the recovery of SBP following physical effort; improves HR recovery to baseline resting levels (beetroot protocol: change in â¼62% vs. placebo protocol: change in â¼80%), and intensifies the return of vagal HR control during recovery after exercise. CONCLUSIONS: Beetroot extract acutely improved cardiovascular and autonomic recovery after exercise.
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Beta vulgaris , Adulto , Estudos Cross-Over , Método Duplo-Cego , Frequência Cardíaca , Humanos , Projetos Piloto , Extratos Vegetais/farmacologiaRESUMO
During the early periods of development, i.e., gestation and lactation, the influences of stimulus such as undernutrition can lead to several behavioural and morphofunctional damages to organs and systems in general, including pathways and structures that control energy balance and feeding behaviour. Although a large body of evidences have shown the effects of this stimulus on structures such as hypothalamus, only few studies have directed their attention to the long-term effects of undernutrition on the nucleus of the solitary tract (NTS). The aim of this study was to investigate the effects of early undernutrition on the NTS and control of food intake in adulthood. Male Wistar rats were divided into two groups according to the diet offered to the dams during gestation and lactation: control group (C, diet containing 17% casein) or isocaloric low-protein group (LP, diet containing 8% casein). On 35 or 180 days, we evaluated the rats' body weight, food intake, behavioural satiety sequence and c-Fos protein expression in the NTS in response to food stimulus. Based on these assessments, it was found that perinatal undernutrition promoted an increase in food intake and the number of activated cells in rostral and, mainly, medial NTS in response to food stimulation in adulthood. These results indicated that the NTS is a structure particularly vulnerable to the influences of nutritional manipulation in the early stages of development with effects on food control in adulthood.
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Ingestão de Alimentos/fisiologia , Comportamento Alimentar/fisiologia , Desnutrição/patologia , Desnutrição/fisiopatologia , Neurônios/fisiologia , Núcleo Solitário/patologia , Fatores Etários , Animais , Animais Recém-Nascidos , Peso Corporal/fisiologia , Feminino , Regulação da Expressão Gênica/fisiologia , Masculino , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos , Ratos Wistar , Resposta de Saciedade/fisiologiaRESUMO
This study examined the ingestive and behavioral effects of NMDA- and AMPA/kainate glutamatergic receptor blockade in the lateral hypothalamic area (LHy) of free-feeding pigeons (Columba livia). Injections of MK-801 (NMDA receptor antagonist; 6 nmol) or CNQX (AMPA/kainate receptor antagonist; 25.8 nmol) into the LHy of free-feeding pigeons induced significant increases in food intake and in feeding duration, as well as reductions in the latency to start feeding. Duration, latency and volume of water intake, as well as duration of sleep-like behavior, alert immobility, locomotion and preening were not changed by these treatments in the LHy. These results indicate that glutamatergic inputs to cells containing NMDA and/or AMPA receptors located in the LHy could modify both the beginning of a feeding bout (or the end of a period of satiety) and its duration (satiation). Our data also suggest that these inhibitory glutamatergic influences on feeding behavior are tonically active in the LHy.
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Columbidae/metabolismo , Comportamento Alimentar/fisiologia , Ácido Glutâmico/metabolismo , Região Hipotalâmica Lateral/metabolismo , Neurônios/metabolismo , Receptores de Glutamato/metabolismo , 6-Ciano-7-nitroquinoxalina-2,3-diona/farmacologia , Animais , Regulação do Apetite/efeitos dos fármacos , Regulação do Apetite/fisiologia , Columbidae/anatomia & histologia , Maleato de Dizocilpina/farmacologia , Antagonistas de Aminoácidos Excitatórios/farmacologia , Comportamento Alimentar/efeitos dos fármacos , Região Hipotalâmica Lateral/anatomia & histologia , Região Hipotalâmica Lateral/efeitos dos fármacos , Masculino , Microinjeções/métodos , Inibição Neural/efeitos dos fármacos , Inibição Neural/fisiologia , Vias Neurais/anatomia & histologia , Vias Neurais/efeitos dos fármacos , Vias Neurais/metabolismo , Neurônios/efeitos dos fármacos , Terminações Pré-Sinápticas/efeitos dos fármacos , Terminações Pré-Sinápticas/metabolismo , Receptores de AMPA/antagonistas & inibidores , Receptores de AMPA/metabolismo , Receptores de Glutamato/efeitos dos fármacos , Receptores de N-Metil-D-Aspartato/antagonistas & inibidores , Receptores de N-Metil-D-Aspartato/metabolismo , Resposta de Saciedade/efeitos dos fármacos , Resposta de Saciedade/fisiologia , Especificidade da Espécie , Transmissão Sináptica/efeitos dos fármacos , Transmissão Sináptica/fisiologiaRESUMO
The participation of glutamatergic circuits of the ventral basal ganglia in feeding-related regulatory mechanisms has been extensively indicated in primate and rodent species. In avian species, it has been shown that ICV injections of MK-801 or of CNQX increase food intake and reduce the latency of feeding initiation in free-feeding pigeons. In the present study, the effects of local injections of MK-801 (6 nmol), CNQX (160 nmol) or vehicle (0.2 microl) into a number of ventral striatopallidal nuclei on feeding, drinking and non-ingestive (sleep, preening) spontaneous behaviors were investigated in free-feeding pigeons (Columba livia). Intense feeding responses associated with an increased duration of feeding behavior were consistently recorded after injections of MK-801 or CNQX into the medial two-thirds of the tuberculum olfactorium (TO), the ventral aspect of lobus parolfactorium (LPOv), or the ventral pallidum (VP). In contrast, the latency of feeding initiation was unaffected by these treatments. No changes in drinking, preening or sleep responses were observed after drug injections into the TO/LPOv/VP area. These data indicate that glutamate-mediated circuits in the TO/LPOv/VP area can play an inhibitory role in feeding behavior in this species, contributing to the conclusion of a feeding bout, thus delaying satiation processes, and that these effects may be mediated by AMPA and NMDA receptors. Additionally, our data support the notion that a region functionally and anatomically comparable to the mammalian accumbens shell may be present in the TO/LPOv/VP region of the pigeon, and that the existence of a glutamatergic circuit in the ventral striatum controlling feeding-related phenomena may represent a highly conserved attribute throughout the amniote's evolution.