Depression and anxiety symptoms remained elevated after 10 months of the COVID-19 pandemic in southern Brazil: findings from the PAMPA cohort.

OBJECTIVES: This study aimed to examine the changes in depression and anxiety symptoms among Brazilian adults over 10 months of the COVID-19 pandemic. STUDY DESIGN/METHODS: The present study used data from wave 1 (June/July 2020) and wave 2 (December 2020/January 2021) of the Prospective Study About Mental and Physical Health (PAMPA) Cohort, a state-level, ambispective longitudinal study with adults from southern Brazil. The frequency of anxiety and depressive symptoms was assessed using the Hospital Anxiety and Depression Scale. Anxiety and depressive symptoms before social distancing were retrospectively assessed during wave 1. RESULTS: Most of the 674 participants were classified as non-symptomatic for depressive (85.0%) and anxiety symptoms (73.2%) before the COVID-19 pandemic. At wave 1, there were increases in symptoms of depression (7.6% [95% confidence interval [CI]: 7.2%, 8.1%]) and anxiety (9.1% [95% CI: 8.6%, 9.5%]). These decreased at wave 2 (depression: 6.9% [95% CI: 6.5%, 7.2%]; anxiety: 7.4% [95% CI: 7.1%, 7.8%]) although they were still elevated compared with pre-COVID (depression: 4.5% [95% CI: 4.2%, 4.8%]; anxiety: 5.8% [95% CI: 5.5%, 6.1%]). Adults living alone (b = 0.44 [95% CI: 0.07, 0.82]) had a faster trajectory in anxiety symptoms than their counterparts. Cohort members who were living alone (b = 0.24 [95% CI: 0.06, 0.42]) and with diagnosed chronic disease (0.32 [95% CI: 0.18, 0.46]) had a faster increase in depressive symptoms than their respective counterparts. Participants aged ≥60 years showed a slower trajectory of depressive (b = -0.46 [95% CI: -0.73, -0.18]) and anxiety (b = -0.61 [95% CI: -1.20, -0.02) symptoms. CONCLUSIONS: During 10 months of COVID-19, anxiety and depression symptoms improved but were still higher than before COVID-19.

Association between specific types of physical activity during the COVID-19 pandemic and the risk of subjective memory decline: findings from the PAMPA Cohort.

OBJECTIVES: This study aimed to identify the effects of different physical activities practised during the time period when COVID-19 social distancing measures were in place on the risk of subjective memory decline in adults. STUDY DESIGN: Retrospective cohort study. METHODS: Data from the Prospective Study about Mental and Physical Health (PAMPA), a state-level (Rio Grande do Sul, Brazil), online-based cohort study, were analysed. Respondents were asked to rate their memory before COVID-19 social distancing measures were implemented (retrospectively) and on the day that the survey was completed. Subjective memory decline was defined as a perceived worsening of memory function during COVID-19 social distancing compared with the pre-pandemic period. The types of physical activity practised before and during COVID-19 social distancing measures were assessed. RESULTS: Data from 2319 adults were included. Out-of-home endurance, muscle strengthening, combined endurance and muscle strengthening, and stretching activities reduced the risk of subjective memory decline during the pandemic. In terms of physical activities practised at home, only muscle strengthening did not protect against subjective memory decline. Participants who sustained any type of physical activity at home during the COVID-19 pandemic showed a reduced risk for subjective memory decline. CONCLUSIONS: Physical activity, regardless of the type of activity and location performed, during the time period when COVID-19 social distancing measures were in place can mitigate the effects of the pandemic on subjective memory decline.

Reduced oxygen stress promotes propagation of murine postnatal enteric neural progenitors in vitro.

BACKGROUND: Neural stem and progenitor cells of the Enteric Nervous System (ENS) are regarded as a novel cell source for applications in regenerative medicine. However, improvements to the current ENS cell culture protocols will be necessary to generate clinically useful cell numbers under defined culture conditions. Beneficial effects of physiologically low oxygen concentrations and/or the addition of anti-oxidants on propagation of various types of stem cells have previously been demonstrated. In this study, we tested the effects of such culture conditions on ENS stem and progenitor cell behavior. METHODS: Enteric neural progenitor cells were isolated from postnatal day 3 mouse intestine and propagated either as monolayers or neurosphere-like bodies. The influence of hypoxic culture conditions and/or anti-oxidants on enteric cell propagation were studied systematically using proliferation, differentiation and apoptosis assays, whereas effects on gene expression were determined by qRT-PCR, western blot, and immunocytochemistry. KEY RESULTS: Both hypoxic culture conditions and anti-oxidants supported a significantly improved enteric cell propagation and the generation of differentiated neural cell types. Enteric neural progenitors were shown to be specifically vulnerable to persistent oxidative stress. CONCLUSIONS & INFERENCES: Our findings are consistent with previous reports of improved maintenance of brain stem cells cultured under reduced oxygen stress conditions and may therefore be applied to future cell culture protocols in ENS stem cell research.

Safety of various dosage regimens during induction of sublingual immunotherapy. A preliminary study.

BACKGROUND: Sublingual immunotherapy (SLIT) has been demonstrated to be a viable alternative to injection immunotherapy. Administration of high doses of allergens to ensure efficacy has been shown to be well tolerated. The aim of the present study was the first step to address the issue of fast-induction regimens using various induction SLIT regimens in paediatric and adult patients. METHODS: Sixty-four patients (age range 5-46 years) with grass pollen rhinoconjunctivitis were enrolled in an 8-month double-blind, placebo-controlled trial of SLIT. Sixty-three patients were randomized to four groups and evaluated at the end of the study. One group received placebo (n = 16) and the other three groups (n = 47) received five grass pollen extracts according to three different induction regimens: regimen 1 starting with 3 IR tablets (n = 15), regimen 2 starting with 10 IR (n = 16) and regimen 3 starting with 30 IR (n = 16). The maintenance phase was made with sublingual-swallow drops at the same concentration of 300 IR/ml for all the patients. Adverse events were recorded on diary cards. RESULTS: During induction phase, 25/47 patients in the SLIT groups had adverse reactions in comparison to 2/16 patients in the placebo group (p < 0.05). The rate of adverse reactions was 33.3% (11.8-61.6) (95% CI) for regimen 1, 31.3% (11.0-58.7) for regimen 2, 43.8% (19.8-70.1) for regimen 3 and 12.5% (1.6-38.3) for placebo. Fifty-seven reactions were local reactions involving the oral region (54 SLIT, 3 placebo) and 13 were systemic reactions (all in the SLIT groups). 11/13 reactions were mild (gastrointestinal disorders, rhinoconjunctivitis), 1/13 consisted of moderate asthma and 1/13 consisted of severe abdominal pain. No urticaria, angioedema or life-threatening events were observed. CONCLUSIONS: These preliminary data showed that various induction regimens for SLIT are generally well tolerated and could allow a fast build-up phase of SLIT.

Therapeutic application of T cell receptor mimic peptides or cDNA in the treatment of T cell-mediated skin diseases.

An 8-amino acid peptide encoding a sequence of the transmembrane region of the T cell receptor alpha chain (TCR-alpha) was shown to inhibit T cell function by preventing functional assembly of the T cell receptor (mimic peptide). To avoid systemic immunosuppression by peptide application in vivo, we used a topical application of the peptide. In the system of murine contact sensitivity, topical application of the peptide inhibited the elicitation of contact sensitivity following application of a contact allergen in sensitized animals. Alternatively, when naked DNA encoding the peptide sequence was injected into skin before application of a contact allergen to sensitized animals, local immunosuppression was also observed. To investigate the effects of this peptide in humans, patients with psoriasis, atopic eczema, lichen planus, or contact dermatitis were treated topically with mimic peptide or control peptide. All patients except for one reported a marked improvement or cure of their skin disease following application of the TCR-alpha peptide, but not controls. These data indicate that TCR-alpha peptide or cDNA treatment might be a proper treatment for human T cell-mediated dermatoses substituting for corticosteroids.

Hemodynamic and hormonal effects of quinaprilat in patients with congestive heart failure.

OBJECTIVE: To assess the pharmacodynamic activity and safety of rising single and multiple doses of intravenous quinaprilat compared with placebo in patients with New York Heart Association (NYHA) class III and IV congestive heart failure who were receiving digitalis or diuretic therapy or both. METHODS: Patients were randomly assigned to three treatment groups to receive low (0.5 to 1.0 mg), medium (1.0 and 2.5 mg), or high (5.0 and 10.0 mg) single intravenous doses of quinaprilat or placebo on day 1. On the basis of responses observed on day 1, the three treatment groups received stable multiple intravenous doses of either quinaprilat or placebo every 6 hours on days 2 and 3. Hemodynamic measurements, hormonal assessments, and safety were evaluated before and at specified intervals during the study. RESULTS: Compared with placebo, single and multiple doses of quinaprilat increased cardiac index and reduced pulmonary capillary wedge pressure, mean arterial pressure, systemic vascular resistance, and right atrial pressure in a dose-related manner. No clinically important change in heart rate was observed. Hemodynamic changes after multiple-dose quinaprilat administration were similar to those observed after single doses and were generally sustained during the 6-hour dosing interval. Relative to placebo, quinaprilat reduced plasma angiotensin converting enzyme (ACE) activity, angiotensin II concentration, and aldosterone concentration and increased plasma renin activity; no prominent changes in plasma catecholamine and atrial natriuretic peptide concentrations were observed. There were no clinically important drug-related changes in the safety parameters. CONCLUSIONS: Single and multiple intravenous doses of 0.5 to 10 mg quinaprilat are well-tolerated and produce favorable dose-dependent hemodynamic effects and hormonal changes consistent with those expected of an ACE inhibitor in patients with NYHA class III and IV congestive heart failure.

Chronic fatigue syndrome.

A 36-yr-old white female presented with severe fatigue and symptoms consistent with immune deficiency, but was later found to be suffering from chronic fatigue syndrome. This article discusses the diagnostic criteria for this condition. Chiropractic manipulation afforded relief of some symptoms for this patient.

Calcium channel blockers for kidney protection.

Acute postischemic renal failure (ARF) is a major complication in surgery and in particular in renal transplantation. Calcium channel blockers (CCBs) are able to prevent or ameliorate ARF in different experimental models when given before ischemic injury. Because ARF, which is observed in 20-60% of graft recipients, carries the risk of undetected rejections and nephrotoxic injury and is also expensive, we tested the hypothesis, suggested by animal experiments, that there is also a beneficial effect of CCBs when given after ischemic injury. A total of 134 recipients of first or second cadaver grafts were randomly assigned to a diltiazem pretreatment (DZ) or control (C) group. Kidney grafts were pretreated immediately prior to transplantation by reperfusion with 500 ml Euro-Collins (preservation fluid), with or without DZ. The DZ patients also received a 74-h infusion of DZ (0.12 mg/kg/h), starting 2 h prior to surgery. DZ was continued (90 mg b.i.d. p.o.) until day 30. Immunosuppression consisted of low-dose steroids and cyclosporine A (CSA) (10 mg/kg p.o.). CSA was instituted 6 h after surgery and later adjusted to achieve whole-blood trough levels of 300-600 ng/ml [by polyclonal radioimmunoassay (RIA)]. A total of 129 patients were available for efficacy analysis. There were no significant differences concerning donor demographics, human lymphocyte antigen (HLA) match, or ischemic times. ARF was defined as a need for dialysis in the first week. Our data show a significant reduction in ARF in grafts pretreated with DZ.(ABSTRACT TRUNCATED AT 250 WORDS)

[Value of prealbumin in the 1st and after the 12th day of life]. / Valeur de la préalbumine au premier et après le douzième jour de la vie.

From a series of 129 neonates, well defined with regard to weight and gestational age, the authors established that serum concentration of prealbumin (PA) in an aseptic neonate depends on its gestational age on the first day of extrauterine life (p less than 0.001). Serum concentrations of PA are significantly different in appropriate for gestational age (AGA) and small for gestational age (SGA) neonates; this may be the consequence of insufficient materno-foetal transfers in the majority of SGA children. The study of the ratio maternal PA/neonatal PA at the time of delivery helps to establish the cause of SGA. On and after the 12th day of life, serum concentrations of PA are closely correlated with the usual data of anthropometry (weight, height, skull circumference) (p less than 0.001), when correlation is less close with gestational age at the time of sample taking: it may be used as a marker of the appropriateness of gestational age rather than of maturity. However, the ratio PA/weight varies from one child to another and from one week to another for a same child, giving PA a value different from ordinary anthropometry for the evaluation of the appropriateness of gestational size in neonates.

[Neonatal bacterial infections. Kinetic study of C-reactive protein and orosomucoid]. / Infections bactériennes néo-natales. Etude cinétique de la C réactive protéine et de l'orosomucoïde.

Changes in serum concentrations versus time of C reactive protein and orosomucoid were investigated in 134 neonates with either materno-foetal infection (group A, n = 111) or nosocomial infection (group B, n = 23). Both proteins were significantly elevated in group A neonates, with mean +/- S.E.M. values of 0.029 +/- 0,003 g/l for C reactive protein (n = 111) and 0.56 +/- 0.003 g/l for orosomucoid (n = 37). In cases with superinfection serum levels of both proteins rose before clinical symptoms developed. Changes in orosomucoid concentrations occurred a few hours after changes in C reactive protein concentrations. Monitoring C reactive protein and orosomucoid levels, in an excellent means of assessing the effectiveness of treatment and of deciding on its withdrawal when both proteins return to normal values.

[Alveolar hypoventilation during sleep in pharyngeal obstruction caused by lymphoid hypertrophy in children]. / Hypoventilation alvéolaire du sommeil au cours de l'obstruction pharyngée par hypertrophie lymphoïde chez l'enfant.

Twenty-four children suspected of having apnea induced by lymphoid pharyngeal obstruction were studied by nocturnal polygraphy. The data recorded were: instantaneous cardiac frequency, thoracic movements, naso-oral flux, transcutaneous PO2 and PCO2. Episodes of hypoxemia and of hypercapnia related to obstructive apneas were found in 19 children; the mean of the lowest values of PtcO2 during sleep was 58.4 mmHg versus 85 mmHg during wakefulness. The mean od the highest values of PtcCO2 was 50 mmHg during sleep versus 40 mmHg during wakefulness. Six children presented with marked hypoxemia (PtcO2 less than or equal to 50 mmHg). Transcutaneous blood gas monitoring is indicated in all children presenting with sleep disorders due to pharyngeal obstruction. The finding of a marked hypoxemia should suggest removal of the obstacle concerned.

C-reactive protein measurement: a reliable method of diagnosing and monitoring the infected newborn for the assessment of a mezlocillin therapeutic trial.

Clinical and bacteriological efficacy of mezlocillin was evaluated in 41 neonates (including 12 premature babies) with clinical and laboratory evidence of bacterial infection, as shown by elevated C-reactive protein serum concentrations. They received intravenous mezlocillin (80 to 100 mg/kg/dose) every 8 h for 10.4 days. The mean serum concentration (+/- S.E.M.) of mezlocillin in full-term neonates was 214 +/- 19.8 mg/l 1 h after the infusion and 52.0 +/- 9.3 mg/l prior to the next infusion. In premature neonates these mean concentrations were respectively 167 +/- 23.4 mg/l and 40.7 +/- 6.7 mg/l. The efficacy of mezlocillin was documented by the decrease in C-reactive protein serum concentrations and by improvement in clinical condition. Therapy with mezlocillin alone proved to be safe and effective when used for non-nosocomial infections during the neonatal period.

[Prevention of iatrogenic effects of artificial ventilation with transcutaneous monitoring of PO2 and PCO2 in the newborn infant]. / Prévention des effets iatrogénes de la ventilation artificielle grâce au monitorage transcutané de la PO2 et de la PCO2 (Tc PO2 et Tc PCO2) chez le nouveau-né.

The authors have monitored Tc PCO2, Tc PO2 and mean airway pressure in 25 ventilated newborns, during 68 days. They show that the best blood gases values are not even obtained with the most aggressive artificial ventilation (A.V.). Tc PCO2 and Tc PO2 transcutaneous monitoring and mean airway pressure measurement allow an "à la carte" adaptation of the A.V. to bring in each case the most efficient and the least aggressive A.V. This method may decrease the iatrogenic complications of the A.V.

[Value of C-reactive protein in neonatal bacterial infections]. / Intérêt de la C réactive protéine dans les infections bactériennes néonatales.

C reactive protein (CRP) levels were measured in the serum of 2 groups of neonates before and after the 12th hour of life. One group consisted of controls, the other of children with neonatal sepsis. The means (+/- standard error) for CRP serum level were 6 +/- 0.7 mg/l and 7.7 +/- 0.8 mg/l respectively before and after 12 hours of life in controls (n = 100); they were 19.7 +/- 3.4 mg/l and 67.5 +/- 6.6 mg/l in the group of infected neonates (n = 54). For both times of sampling, levels were significantly higher (p less than 0.001) in infected neonates. The low percentage of false-positives and false-negatives suggests that this dosage is almost specific for neonatal sepsis.