"COVID toes": A meta-analysis of case and observational studies on clinical, histopathological, and laboratory findings.

BACKGROUND: Coronavirus disease (COVID-19) is related to several extrapulmonary disorders; however, little is known about the clinical, laboratory, and histopathological characteristics of pernio-like skin lesions associated with COVID-19 infection. OBJECTIVE: To evaluate and summarize the clinical, laboratory, and histopathological characteristics of pernio-like lesions reported in the literature. METHODS: We conducted a search of the PubMed, SciELO, and ScienceDirect databases for articles published between January 1, 2020 and November 30, 2020, following the PRISMA recommendations (PROSPERO registration ID: CRD42020225055). The target population was individuals with suspected or laboratory-confirmed COVID-19 with pernio-like lesions. Observational studies, research letters, and case/series reports were all eligible for inclusion. Observational studies were evaluated using a random-effects model to calculate the weighted mean prevalence, overall mean, and 95% confidence interval. We evaluated case studies using the chi-square test for dichotomous variables and the Mann-Whitney test for continuous variables. RESULTS: A total of 187 patients from case reports and 715 patients from 18 observational studies were included. The mean age of patients was 16.6 years (range 14.5-18.8). Feet were affected in 91.4% (87.0-94.4%) of patients in observational studies. The proportion of patients with a positive RT-PCR test was less than 15%. Lesion topography and morphology were associated with age. CONCLUSION: Lesions mostly occurred in pediatric patients, and the morphological characteristics tended to differ between pediatric and non-pediatric populations. There is a possible multifactorial component in lesion pathophysiology. The non-positivity of laboratory tests does not exclude an association with COVID-19. Pernio-like lesions may be a late manifestation of COVID-19.

Conhecimento geral, atitude psicológica e sua associação com a concentração de HbA1C em pacientes portadores de Diabetes Mellitus tipo 2 / General knowledge, psychological attitude and its association with the concentration of HbA1C in patients with Type 2 Diabetes Mellitus

Objetivo: Diabetes mellitus (DM) é uma doença relacionada a várias complicações e alta morbimortalidade, com comprometimento significativo da qualidade de vida do paciente, afetando sua saúde física e mental, bem como sua motivação ao autocuidado. Este estudo objetivou avaliar o conhecimento geral e a atitude psicológica para o DM, correlacionando a concentração de hemoglobina glicada (HbA1C) com escores do DKN-A e ATT-19 de pacientes portadores de DM tipo 2 (DM2). Métodos: Estudo observacional transversal com amostra de 65 participantes, 24,6% homens e 75,4% mulheres, com idade média de 57±12, avaliados entre novembro/2016 e fevereiro/2017. A avaliação do conhecimento geral e da atitude psicológica para o DM foi realizada pela aplicação do Diabetes Knowledge Questionnaire (DKN-A) e do Diabetes Attitude Questionnaire (ATT-19). O SPSS 20.0 foi utilizado para as análises estatísticas. Resultados: Para os escores de conhecimento (r=0,005; p=0,966) e de atitude (r=0,034; p=0,790) não houve correlação significante com a HbA1C, sendo que (94%) dos pacientes não atingiram o ponto de corte do ATT-19. Considerando o grupo com pontuação >8 para o escore de conhecimento, foi observada diferença negativa e significativa entre este escore e o de atitude (r=-0,444; p=0,0018). Conclusão: O conhecimento em relação à doença não traduziu em melhor controle da glicemia na população estudada, sugerindo que o controle eficiente da HbA1C não depende exclusivamente do conhecimento sobre a doença, mas sim de diversos outros fatores, que também precisam ser considerados na conduta do DM2.

Objective: Diabetes mellitus (DM) is a disease related to several complications and high morbidity and mortality, with significant impairment of the patient's quality of life, affecting his physical and mental health, as well as his motivation to self-care. The aim of this study was to evaluate the knowledge and attitude about type 2 DM (DM2) in its patients, correlating Diabetes Knowledge Questionnaire (DKN-A) and Diabetes Attitudes Questionnaire (ATT-19) scores with the concentration of glycated hemoglobin (HbA1c). Methods: Cross-sectional observational study with a sample of 65 participants, 24.6% male and 75.4% female, with a mean age of 57 ± 12, with low schooling, between November / 2016 and February / 2017. The evaluation of the knowledge and attitude about DM was carried out by the application of the DKN-A and ATT-19. SPSS 20.0 was used for statistical analysis. Results: There were no statistically significant correlations with HbA1c (r = 0.005, p = 0.966) and attitude (r = 0.034, p = 0.790), and 61 patients (94%) did not reach the cutoff point of ATT-19. Considering the group with scores higher than 8 points for the knowledge score, a negative and significant correlation was observed between this score and the attitude score (r = -0.444; p = 0.0018). Conclusion: Knowledge and attitude towards the disease did not translate into better glycemic control in the study population. The efficient control of HbA1c is multifactorial, involving genetic, comorbid, behavioral, drugs, health services, among others, that should be considered in the conduct.

Hormone receptor expression, clinical and histopathological analysis in feline injection site sarcomas.

Feline injection site sarcomas (FISS) are aggressive, with high recurrence and rarely metastasising. The objective of this study was to evaluate, by immunohistochemistry, the expression of oestrogen (ER) and progesterone (PR) receptors in FISS and correlate them with clinical and histopathological aspects. This was a retrospective study with 51 cases of FISS. Immunohistochemistry was performed to detect vimentin, ER, PR and Ki67 expression. Clinical, histopathological and immunohistochemical characteristics were predictor variables and the expression of ER and PR were the dependent ones. Twenty-eight (55%) of the 51 FISS cases were female and 23 (45%) male with 10.7 ± 4.2 years and median tumour size of 3 cm (2.0-5.4). The trunk was the most affected site, with 38 cases (84%). Histological grade III was observed in 57% of the cases, considering differentiation score, necrosis and mitotic index. ER expression, positive in 64% of cases, was associated with the mitotic index (P = .05) and degree of pleomorphism (P = .04). PR was not associated with the variables and 63% of cases were negative for this receptor. Thus, ER expression can affect tumour growth. The knowledge on the FISS hormonal expression is important to clarify the pathophysiological mechanisms. Further studies are needed to predict the value of ER expression in the prognosis of FISS.

Capacidade funcional e risco de quedas em idosos com síndrome metabólica / Functional capacity and risk of falls in the elderly with metabolic syndrome / Capacidad funcional y riesgo de caídas en ancianos con síndrome metabólico

Introdução: A síndrome metabólica (SM) é a anormalidade metabólica mais comum na população que predispõe a eventos cardiovasculares e pode estar relacionada à baixa aptidão física e baixa capacidade funcional em idosos. O objetivo deste estudo foi avaliar a interferência das alterações metabólicas na capacidade funcional e no risco de quedas em idosos. Métodos: Trata-se de um estudo transversal realizado com 126 idosos, sendo 58 com síndrome metabólica e 68 sem síndrome metabólica, segundo os critérios da International Diabetes Federation. Os índices de Katz, Tinetti, Timed Up e Go e Berg Scale foram aplicados para avaliar a capacidade funcional. A Escala de Eficácia das Quedas-Escala Internacional (FES-I-Brasil) foi utilizada para avaliar o medo de cair. Para análise estatística, foram utilizados os testes de correlação de Mann-Whitney, Qui-quadrado e Spearman. Resultados: Houve associação dos grupos MetS e non-MetS em relação com os estratos de risco do índice TUG [p=0,02; OR=0,38; IC95% (0,16-0,91)]. Entre esses dois grupos, houve diferença significativa na média dos seguintes marcadores: escala de Berg (p=0,03); TUG (p=0,03); FES-I-Brazil (p=0,02). O índice de Kats e IPAQ não apresentaram associação significativa. Conclusões: Os idosos com SM apresentaram maior risco e medo de quedas quando comparados aos pacientes sem SM. No entanto, não houve variação na capacidade de caminhar ou no equilíbrio.

Introduction: Metabolic syndrome (MetS) is the most common metabolic abnormality in the population that predisposes to cardiovascular events and may be related to poor physical fitness and low functional capacity in the elderly. The objective of this study was to evaluate the interference of metabolic changes in functional capacity and risk of falls in the elderly. Methods: A cross-sectional study was carried out with 126 elderly subjects, 58 presented MetS and 68 without MetS, according to the criteria of the International Diabetes Federation. Katz Index, Tinetti Index, Timed Up and Go test and Berg Scale were applied to evaluate the functional capacity. Falls Efficacy Scale-International scale (FES-I-Brazil) was used to evaluate the fear of falling. For statistical analysis, the Mann-Whitney, Chi-square and Spearman correlation tests were used. Results: There was an association between the MetS and non-MetS groups in relation to the risk strata of the TUG index [p=0.02; OR=0.38; 95%CI (0.16-0.91)]. Between these two groups, there was a significant difference in the mean of the following markers: Berg scale (p=0.03); TUG (p=0.03); FES-I-Brazil (p=0.02). The Kats and IPAQ index did not show any significant association. Conclusions: Elderly patients with MetS presented higher risk and fear of falls when compared to patients without MetS. However, there was no variation in walking ability or balance.

Introducción: El síndrome metabólico (MetS) es la anormalidad metabólica más común en la población que predispone a eventos cardiovasculares y puede estar relacionado con un mal estado físico y una baja capacidad funcional en los ancianos. El objetivo de este estudio fue evaluar la interferencia de los cambios metabólicos en la capacidad funcional y el riesgo de caídas en los ancianos. Método: Se realizó un estudio transversal con 126 sujetos de edad avanzada, 58 presentaron MetS y 68 sin MetS, según los criterios de la Federación Internacional de Diabetes. Se aplicaron los índices Katz, Tinetti, Timed Up and Go y Berg Scale para evaluar la capacidad funcional. La Escala de Eficacia de las Caídas - Escala internacional (FES-I-Brasil) se utilizó para evaluar el miedo a las caídas. Para el análisis estadístico, se utilizaron las pruebas de correlación de Mann-Whitney, Chi-cuadrado y Spearman. Resultados: Hubo una asociación entre los grupos MetS y no MetS en relación con los estratos de riesgo del índice TUG [p=0.02; OR=0,38; IC 95% (0.16-0.91)]. Entre estos dos grupos, hubo una diferencia significativa en la media de los siguientes marcadores: escala de Berg (p=0.03); TUG (p=0.03); FES-I-Brasil (p=0.02). El índice de Kats e IPAQ no mostró ninguna asociación significativa. Conclusiones:Los pacientes de edad avanzada con síndrome metabólico presentaron mayor riesgo y miedo a las caídas en comparación con los pacientes sin síndrome metabólico. Sin embargo, no hubo variación en la capacidad para caminar o el equilibrio.

3D Topology Preserving Flows for Viewpoint-Based Cortical Unfolding.

We present a variational method for unfolding of the cortex based on a user-chosen point of view as an alternative to more traditional global flattening methods, which incur more distortion around the region of interest. Our approach involves three novel contributions. The first is an energy function and its corresponding gradient flow to measure the average visibility of a region of interest of a surface with respect to a given viewpoint. The second is an additional energy function and flow designed to preserve the 3D topology of the evolving surface. The third is a method that dramatically improves the computational speed of the 3D topology preservation approach by creating a tree structure of the 3D surface and using a recursion technique. Experiments results show that the proposed approach can successfully unfold highly convoluted surfaces such as the cortex while preserving their topology.

A hybrid Eulerian-Lagrangian approach for thickness, correspondence, and gridding of annular tissues.

We present a novel approach to efficiently compute thickness, correspondence, and gridding of tissues between two simply connected boundaries. The solution of Laplace's equation within the tissue region provides a harmonic function whose gradient flow determines the correspondence trajectories going from one boundary to the other. The proposed method uses and expands upon two recently introduced techniques in order to compute thickness and correspondences based on these trajectories. Pairs of partial differential equations are efficiently computed within an Eulerian framework and combined with a Lagrangian approach so that correspondences trajectories are partially constructed when necessary. Examples are presented in order to compare the performance of this method with those of the pure Lagrangian and pure Eulerian approaches. Results show that the proposed technique takes advantage of both the speed of the Eulerian approach and the accuracy of the Lagrangian approach.