Retinal findings in hospitalised patients with severe COVID-19.

AIM: To identify retinal findings using dilated eye examination, which are possibly related to SARS-CoV-2 infection in hospitalised patients with confirmed severe COVID-19. METHODS: In this cross-sectional study, hospitalised patients with confirmed severe COVID-19 in a single referral centre for the treatment of COVID-19, in Santo André, São Paulo Metropolitan Area, Brazil, underwent dilated eye examination of both eyes performed by a retina specialist. Findings were recorded using a portable digital fundus camera. Retinographies were analysed by two retina specialists. Medical records were reviewed for assessment of patient demographics, baseline comorbidities and clinical data. RESULTS: There were a total of 18 patients, nine (50%) male, median IQR age of 62.5 (12) years. Ten of the 18 patients (55.6%; 95% CI 33.7 to 75.4) had abnormalities on dilated eye examination. The main findings were flame-shaped haemorrhages (N=4; 22.2%; 95% CI 9.0 to 45.2) and ischaemic pattern lesions (cotton wool spots and retinal sectorial pallor) (N=4; 22.2%; 95% CI 9.0 to 45.2), with one patient having both cotton wool spots and flame-shaped haemorrhages. CONCLUSION: These findings suggest that patients with severe COVID-19 have acute vascular lesions of the inner retina including flame-shaped haemorrhages and cotton wool spots. Further studies controlling for confounding factors are necessary to properly assess these findings so as to increase the understanding of COVID-19 pathophysiology and to identify new therapies.

Effects of resistance training on kidney morphology of aged ovariectomized rats.

With the advancing age, there is an increase of the incidence of chronic renal diseases. However, it is suggested that exercise, as resistance training, is a key factor in positively modulate the kidney structure and function. Thus, this study aimed to analyze the effects of estrogen deprivation and a moderate resistance protocol on the right kidney structure of rats. A total of 32 animals were randomly divided in four groups (n = 8/per group): control group (CG); resistance trained animals (RT); control ovariectomized animals (OvxC); and trained ovariectomized animals (OvxT). Sections of the right kidney were stained with hematoxylin and eosin for morphometry and blood was collected for biochemical analysis. Our results showed that the group submitted to both ovariectomy and resistance training had significant impact on renal corpuscle components (Bowman's space, renal corpuscle area, and visceral layer), and proximal and distal tubules. Additionally, resistance training, with or without estrogen deprivation, increases creatine phosphokinase and decreases ultrasensitive C-reactive protein. In summary, we suggested that moderate resistance training may be a key factor to maintain the kidney structure and function across age. However, future studies are need to corroborate with our findings.

Effects of moderate aerobic exercise on thoracic aortic remodeling of female LDL-receptor knockout ovariectomized mice.

Menopause is a major factor involved in dyslipidemia increasing the risk of atherosclerosis which may be reversed by a routine of aerobic physical activity. Thus, this study aimed to analyze the effects of aerobic training on the thoracic aorta of female LDL-receptor knockout mice submitted to estrogen deprivation. Fifteen genetically modified female mice, knockout for the low-density lipoprotein receptor (LDL-Knockout group) were used as experimental groups and fifteen wild female mice (C57BL/6 J) were used as control groups. Animals were divided as (n = 5/per group): sedentary control (SC); sedentary control ovariectomized (SCO); trained control ovariectomized (TCO); LDL-Knockout sedentary (KS); LDL-Knockout sedentary ovariectomized (KOS); and LDL-Knockout trained ovariectomized (KOT). Immunohistochemical techniques for TIMP-1 and metalloproteinases 2 and 9 were used to evaluate thoracic aorta remodeling. Picrosirius stain was used to highlight the collagen fibers. Verhoff-Van Gienson was used for the quantitative analyses of elastic lamellae. Our results demonstrate a positive remodeling promoted by physical exercise in ovariectomized and dyslipidemic animals. However, further studies are needed including the evaluation of inflammatory markers present in dyslipidemia.

Pancreatic insufficiency in HIV: is it possible?

Pancreatic involvement in AIDS is very important and common, but there are few studies in the literature concerning the pancreas in AIDS. Therefore, our research involves an important issue in the pancreatic field. The objective of the study was to evaluate the profile of HIV-infected patients with probable exocrine pancreatic insufficiency and its relation to the degree of human immunodeficiency virus (HIV) infection. This is a cross-sectional study carried out at Faculdade de Medicina do ABC in partnership with the basic health care unit Vila Guiomar in Santo André. We selected 118 individuals divided into four groups (a control group and three other groups composed of AIDS patients, separated according to CD4 levels); participants had an interview, completed a questionnaire, and had laboratory and imaging tests. The only clinical variables with significant differences among the studied groups were the use of highly active antiretroviral therapy (HAART), the incidence of opportunistic infections, the administration of chemoprophylaxis, and weight loss. There were no differences in the amylase, lipase, and steatocrit dosages among the groups. Levels of fecal elastase 1 were lower in the HIV patient groups (2, 3, and 4) when compared with the control group, although all of them showed average levels that were much higher than the cutoff point (200 µg/g). Only nonalcoholic individuals showed a relationship between diarrhea and alterations in elastase levels. A relationship between the use of HAART and exocrine pancreatic insufficiency in different phases of HIV infection could not be verified.

Fatores Socioeconômicos Associados à Obesidade Infantil em Escolares do Município de Carapicuíba (SP, Brasil) / Socioeconomic factors associated with obesity in schoolchildren from Carapicuíba, SP, Brazil

Objetivo: o objetivo deste estudo foi avaliar a relação entre fatores socioeconômicos e o excesso de peso em escolares da rede pública do município de Carapicuíba (SP, Brasil). Material e Métodos: Foram incluídas 355 crianças (176 de cinco anos e 179 de 12 anos), selecionadas por amostragem aleatória simples, para a coleta das variáveis em estudo: sexo, escolaridade dos pais, renda familiar bruta, número de cômodos da casa e número de pessoas que habitavam o domicílio. O exame físico envolveu as medidas de peso, estatura e cálculo do índice de massa corporal (IMC) para a classificação das crianças em magreza severa, magreza, eutrofia, sobrepeso e obesidade (OMS, 2007). Os dados foram analisados por estatística descritiva, testes Quiquadrado, Kruskal-Wallis e correlação de Spearman. Resultados: Foram observados índices de excesso de peso e obesidade de 26,7% e 10,8% aos cinco anos, e 21,8% e 8,9% aos 12 anos, respectivamente. Os índices observados no grupo de cinco anos foram inferiores, enquanto os observados no grupo de 12 anos foram superiores aos índices nacionais. No grupo de cinco anos, o número de cômodos dos lares de crianças com obesidade foi significativamente maior que o de crianças que apresentavam eutrofia (p=0,016); já no grupo de 12 anos, o IMC correlacionou-se positivamente com a escolaridade materna (r=0,163; p=0,040). Conclusão: Os fatores socioeconômicos relacionaram-se com a presença de excesso de peso em escolares do município de Carapicuíba (SP, Brasil), devendo esta condição ser avaliada e abordada por meio de políticas e estratégias públicas de saúde em suas múltiplas dimensões. (AU)

Objective: To evaluate the relationship between socioeconomic factors and overweight in children attending public schools in Carapicuíba, SP, Brazil. Material and Methods:The sample comprised 355 children (176 subjects 5years old, and 179 subjects 12years old), and the following variables were evaluated: sex, parental education, family income, number of rooms inthe household, and the number of people living in the household. Physical examination involved measurements of weight, height, and determination of the body mass index (BMI) to classify children into groups: severe underweight, underweight, normalweight, overweight and obesity. Data collected were analyzed using descriptive statistics, chi-square test, Kruskal-Wallis and Spearman correlation tests. Results:A prevalence of overweight and obesity of 26.7% and 10.8% in 5-year-old children, and 21.8% and 8.9% in 12-year-old children, respectively, was observed. The prevalence rates observed in 5-year-old children were lower than those of national surveys, whilethe rates observed among 12-year oldswerehigher. In the group of 5-year olds, the number of householdrooms of children with obesity was significantly higher than that of normalweight (p=0.016) subjects. In the group of 12-year olds, BMI was positively correlated with maternal education (r=0.163, p=0.040).Conclusion: It is therefore concluded that socioeconomic factors were related with overweight and obesity in schoolchildren from Carapicuíba, SP, Brazil. This condition should be evaluated and addressed through public health policies and strategies in its multiple dimensions. (AU)