Skeletal muscle mass increases after viral eradication with direct-acting antivirals in patients with chronic hepatitis C: A longitudinal study.

BACKGROUND: Results of studies evaluating the effect of viral eradication following direct-acting antiviral (DDA) therapy on skeletal muscle mass of patients with chronic hepatitis C (CHC) are scarce. AIM: To assess the components of sarcopenia (low muscle mass, low muscle strength and low physical performance) in a cohort of CHC individuals before and after DAA therapy. METHODS: We performed a longitudinal study of patients with CHC who underwent body composition assessment before (T0), and at 12 (T1) and 48 (T2) weeks after DDA therapy. Bioelectrical Impedance Analysis was used to assess skeletal mass muscle (SM) and phase angle (PhA). SM index (SMI) was calculated by dividing the SM by squared height. Muscle function was evaluated by hand grip strength (HGS) and timed up-and-go (TUG) test. Mixed-effects linear regression models were fitted to SMI, HGS and physical performance and were used to test the effect of HCV eradication by DAA. RESULTS: 62 outpatients (mean age, 58.6 ± 10.8 years; 58% with compensated cirrhosis) were included. Significant decreases in liver fibrosis markers and an increase of 0.20 and 0.22 kg/m2 in the SMI were observed at T1 and T2. Following DAA therapy, an increase of one unit of PhA was associated with a reduction of 0.38 min in TUG. CONCLUSION: HCV eradication with DAA therapy was associated with a dynamic reduction of non-invasive markers of liver fibrosis and increased muscle mass in 62 patients with CHC who had an undetectable HCV load at 12 weeks after completion of antiviral treatment.

Renal Involvement in Pediatric Patients with COVID-19: An Up-to-date Review.

BACKGROUND: In pediatric patients, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has been mostly associated with mild symptoms. However, as in adults, renal involvement has been reported in children and adolescents with Coronavirus Disease 2019 (COVID-19). OBJECTIVE: This review aimed to report data about renal involvement in pediatric COVID-19 patients. The focuses were on the pathophysiology of acute kidney injury in Pediatric Inflammatory Multisystem Syndrome Temporally Associated (PIMS-TS) with SARS-CoV-2 and the possible impact of SARS-CoV-2 infection upon kidney function, as well as data concerning patients with previous kidney diseases, including Nephrotic Syndrome and Chronic Renal Disease. The implications for COVID-19 outcomes in pediatric patients were also discussed. METHODS: This integrative review searched for articles on renal involvement in pediatric COVID-19 patients. The databases evaluated were PubMed and Scopus. RESULTS: The emergence of PIMS-TS with SARS-CoV-2 has shown that pediatric patients are at risk of severe COVID-19, with multi-organ involvement and dysfunction. In addition to intense inflammation, several systems are affected in this syndrome, collectively creating a combination of factors that results in acute kidney injury. Several studies have proposed that kidney cells, including the podocytes, might be at risk of direct infection by SARS-CoV-2, as high levels of ACE2, the virus receptor, are expressed on the membrane of such cells. Some cases of glomerular diseases triggered by SARS-CoV-2 infection and relapses of previous renal diseases have been reported. CONCLUSION: Further studies are necessary to establish risk factors for renal involvement in pediatric COVID-19 and to predict disease outcomes.

Prevalência, perfil e fatores associados à automedicação em adolescentes e servidores de uma escola pública profissionalizante / Prevalence, profile and factors associated with self-medication in adolescents and employees of a professionalizing public school

Resumo Objetivos Avaliar a prevalência, o perfil e fatores associados à automedicação na população do Instituto Federal Minas Gerais/Ouro Preto, constituída principalmente por adolescentes. Método Trata-se de um estudo transversal, no qual foi aplicado um questionário aos alunos e servidores da Instituição abordando questões sobre nível socioeconômico, características gerais, condição de saúde autorreferida, medicamento utilizado nos últimos 15 dias, uso de medicamento com e sem receita médica e questões relativas à automedicação. A regressão de Poisson foi empregada para avaliar os fatores associados à automedicação. Resultados Foram entrevistadas 270 pessoas, sendo 231 alunos e 39 servidores. A prevalência de automedicação foi de 69,3% (IC95% 63,6-74,6), sendo os analgésicos a principal classe farmacológica utilizada. Os fatores associados à automedicação foram: utilizar medicamento influenciado por propaganda (RP=1,2 IC95%=1,1-1,4); a prática de indicar medicamento (RP=1,4 IC95%=1,1-1,6); estado de saúde autorreferido muito bom/bom (RP=0,8 IC95%=0,6-0,9) e ter realizado a última consulta médica há mais de um mês (RP=1,5 IC95%=1,1-2,1). Conclusão Estes fatores reforçam a importância do acesso a consultas médicas e de ações de conscientização sobre o uso racional de medicamentos.

Abstract Objectives To evaluate the prevalence, profile and factors associated with self-medication in the population of the Federal Institute of Minas Gerais (Instituto Federal de Minas Gerais) - Ouro Preto. Method This is a cross-sectional study, in which a questionnaire was applied to students and staff of the Institution addressing issues such as socioeconomic status, general characteristics, self-reported health condition, medication used in the previous 15 days, use of prescription and over-the-counter medication. Poisson regression was used to evaluate the factors associated with self-medication. Results 270 individuals were interviewed, 231 students and 39 employees. The prevalence of self-medication was 69.3% (95%CI 63.6-74.6), analgesics being the main pharmacological class used. The factors associated with self-medication were: to use medicine influenced by advertising (PR = 1.2; 95%CI = 1.1-1.4); the practice of indicating medication (PR = 1.4; 95%CI = 1.1-1.6); self-reported health status very good/good (PR = 0.8; 95%CI = 0.6-0.9), and having the last medical appointment for more than a month (RP = 1.5; 95%CI= 1.1-2.1). Conclusion These factors reinforce the importance of access to medical consultations and awareness actions of the rational use of medicines.