Out of sight is not out of mind: Associations between perceived maternal attachment and self-representations of youth in residential care moderated by sex and age.

The present study aimed to explore the associations between perceived maternal attachment and self-representations of youth in residential care (RC), considering the potential moderator role of youth's sex and age and the potential concurrent effect of frequency and type of family visits and length of time in RC. To this end, a sample of 659 youth aged 11-18 (M = 15.65, SD = 1.72) from RC settings filled out self-report questionnaires to evaluate their perceptions of maternal attachment and self-representations. Results indicated that lower perceived maternal attachment was associated with higher levels of global negative self-representations. Moreover, compared to young men, young women with lower levels of perceived maternal attachment perceived themselves as having more negative self-representations. No moderating effects of age were found. This study contributes to the literature in the field of RC with evidence regarding the association of perceived maternal attachment with self-representations and the moderating role of youth's sex, which informs the development of interventions with this vulnerable population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Liver and Inflammatory Biomarkers Are Related to High Mortality in Hospitalized Patients with COVID-19 in Brazilian Amazon Region.

COVID-19 is a multisystem disease with many clinical manifestations, including liver damage and inflammation. The objective of this study is to analyze inflammation biomarkers in relation to the clinical outcome and respiratory symptoms of COVID-19. This is a retrospective cohort of patients with COVID-19 admitted to the Hospital Regional do Baixo Amazonas from 2020 to 2022. Data were collected from electronic medical records from admission to the 30th day of hospitalization and soon after hospital discharge. A total of 397 patients were included in the study. In the longitudinal follow-up of liver markers, a significant difference was found for AST on day 14, with a higher median in the death group. Among the hematological markers, lymphopenia was observed throughout the follow-up, with the death group having the most altered values. When comparing the evolution of biomarkers in the Non-Invasive Ventilation (NIV) and Invasive Mechanical Ventilation (IMV) groups, AST showed a significant difference only on day 14 and GGT on day 1, being greater in the IMV group, and indirect bilirubin on day 7 being more altered in the NIV group. In conclusion, death during hospitalization or a more severe form of COVID-19 was related to significant changes in liver and inflammatory biomarkers.

Island hitchhikers: pathogen agents of Madeira and Azores ticks.

Ticks are blood-sucking arthropods that can transmit pathogens to their host. As insular ecosystems can enhance tick-host interactions, this study aimed to understand tick diversity, pathogen presence, and their respective associations in the Azores and Madeira archipelagos. Unfed or partially engorged ticks (n = 120) were collected from 58 cats and dogs in the Azores (n = 41 specimens) and Madeira (n = 79 specimens) from November 2018 to March 2019. Vector identification was based on morphology and molecular criteria. For pathogen sequencing, 18S gene fragment for Babesia/Hepatozoon and gltA for Rickettsia were performed. Sequence data was explored using BLAST and BLAST and phylogenetic inference tools. In the Azores, Ixodes hexagonus, I. ventalloi, and Rhipicephalus sanguineus (n = 6; 14.6%, n = 6; 14.6%, and n = 29; 70.7% respectively) were found and in Madeira I. ricinus and R. sanguineus (n = 78, 98.7%; and n = 1, 1.3%; respectively) were identified. Tick COI markers confirmed species highlighting confirmation of R. sanguineus s.s. and genotype A of I. ventalloi. In the Azores Islands, the detected Rickettsia massiliae was linked to R. sanguineus (dogs and cats) and I. hexagonus (dogs), and in Madeira Island, R. monacensis (dogs) and Hepatozoon silvestris (cats) were found associated with I. ricinus. Further, I. ventalloi presence in the Azores expands west its known range, and Hepatozoon silvestris in Madeira may suggest that I. ricinus could have a role as a potential vector. Finally, as R. massiliae and R. monacensis presence underlines public health risks, surveillance by health authorities is crucial as pathogen-tick interactions may drive disease spread, therefore monitoring remains pivotal for disease prevention.

Equal Maintenance of Anti-SARS-CoV-2 Antibody Levels Induced by Heterologous and Homologous Regimens of the BNT162b2, ChAdOx1, CoronaVac and Ad26.COV2.S Vaccines: A Longitudinal Study Up to the 4th Dose of Booster.

Several technological approaches have been used to develop vaccines against COVID-19, including those based on inactivated viruses, viral vectors, and mRNA. This study aimed to monitor the maintenance of anti-SARS-CoV-2 antibodies in individuals from Brazil according to the primary vaccination regimen, as follows: BNT162b2 (group 1; 22) and ChAdOx1 (group 2; 18). Everyone received BNT162b2 in the first booster while in the second booster CoronaVac, Ad26.COV2.S, or BNT162b2. Blood samples were collected from 2021 to 2023 to analyze specific RBD (ELISA) and neutralizing antibodies (PRNT50). We observed a progressive increase in anti-RBD and neutralizing antibodies in each subsequent dose, remaining at high titers until the end of follow-up. Group 1 had higher anti-RBD antibody titers than group 2 after beginning the primary regimen, with significant differences after the 2nd and 3rd doses. Group 2 showed a more expressive increase after the first booster with BNT162B2 (heterologous booster). Group 2 also presented high levels of neutralizing antibodies against the Gamma and Delta variants until five months after the second booster. In conclusion, the circulating levels of anti-RBD and neutralizing antibodies against the two variants of SARS-CoV-2 were durable even five months after the 4th dose, suggesting that periodic booster vaccinations (homologous or heterologous) induced long-lasting immunity.

Estratégias adotadas pelos profissionais de enfermagem a partir da violência sofrida na urgência e emergência / Strategies adopted by nursing professionals based on the violence suffered in urgency and emergency / Estrategias adoptadas por los profesionales de enfermería basadas en la violencia sufrida en urgencia y emergencia

Objetivo: identificar os significados e estratégias adotadas pelos profissionais de enfermagem em situações de violência em uma unidade de urgência e emergência. Método: estudo descritivo, qualitativo, tendo como suporte teórico-conceitual o interacionismo simbólico, que utilizou um grupo focal de oito profissionais da equipe de enfermagem de um serviço de urgência e emergência hospitalar. Resultados: os significados foram complexos e as estratégias adotadas foram tolerância à violência para manter o controle no ambiente de trabalho, gerenciamento de conflito, tentando aplacar a situação de violência, buscar a segurança de terceiros e adotar um posicionamento de afastamento do atendimento ao paciente/acompanhante agressor. Conclusão: a violência significou diversas concepções frequentemente negativas, e as estratégias adotadas pelos profissionais de enfermagem evidenciam a tentativa de evitar o sofrimento perpetuado pelos pacientes no serviço de urgência e emergência hospitalar. Os diversos atores sociais devem sinergicamente propiciar meios para a proteção dos profissionais.

Objective: To identify the strategies adopted and meanings constructed by nursing professionals exposed to violence in an urgency and emergency unit. Method:A descriptive, qualitative study based on symbolic interactionism was conducted with eight nursing professionals from a hospital urgency and emergency service by means of a focus group. Results: The meanings were complex and the strategies adopted were tolerance towards violence to maintain control in the workplace, conflict management seeking to placate the situation, seek the safety of third parties and withdrawal from caring for the offending patient/companion. Conclusion: Violence was often conceptualized negatively and the strategies adopted by nursing professionals show an attempt to avoid the harm perpetrated by emergency patients. The various social actors implicated should synergistically provide means for protecting professionals

Objetivo: identificar los significados y estrategias adoptadas por los profesionales de enfermería en situación de violencia en una unidad de urgencia y emergencia. Método:estudio descriptivo, cualitativo, con interaccionismo simbólico como marco teórico y conceptual, que utilizó un grupo focal formado por ocho profesionales del equipo de enfermería de un servicio de urgencia y emergencia hospitalaria. Resultados: los significados fueron complejos, y las estrategias adoptadas se centraron en la tolerancia a la violencia para mantener el control en el ambiente de trabajo, el manejo de conflictos buscando aplacar la situación de violencia, la búsqueda de seguridad de terceros y la adopción de una posición de retiro de la atención al paciente/acompañante infractor. Conclusión: la violencia significó varias concepciones que muchas veces son negativas, y las estrategias adoptadas por los profesionales de enfermería muestran el intento de evitar el sufrimiento perpetuado por los pacientes en el servicio de emergencia hospitalaria. Los diversos actores sociales deben proporcionar sinérgicamente medios para la protección de los profesionales

Microelimination of Hepatitis C in Patients with Substance Use and Dual Disorders - a Portuguese Study.

Chronic hepatitis C (CHC) is a serious condition of public health importance. In Portugal, the prevalence of detectable hepatitis C virus (HCV) antibodies is approximately 0.54%, with a higher prevalence in high-risk groups. Compared with the general population, the prevalence of HCV infection is higher in individuals with psychiatric disorders. As no studies have reported the prevalence of HCV antibodies in Portuguese patients with psychiatric conditions and substance use disorders, we conducted an observational, prospective study of patients followed in the Dual Pathology Outpatient and Inpatient Unit of Coimbra Hospital and University Center (CHUC), Patients were tested for HCV antibodies. Of the 149 patients, 17.4% were positive for HCV antibodies and 7.4% had detectable HCV RNA indicating CHC. Most patients with confirmed CHC were male inpatients, aged 50 to 59 years, and reported unprotected sex with more than one concurrent partner in the past 6 months. Their most common psychiatric diagnosis was "Disorders due to use of multiple specified psychoactive substances, including medications." The prevalence of HCV antibodies and confirmed CHC were higher in patients followed in the Dual Pathology Outpatient and Inpatient Unit than in the general Portuguese population.

Sodium alginate-based multifunctional sandwich-like system for treating wound infections.

Microbial colonization and development of infections in wounds is a sign of chronicity. The prevailing approach to manage and treat these wounds involves dressings. However, these often fail in effectively addressing infections, as they struggle to both absorb exudates and maintain optimal local moisture. The system here presented was conceptualized with a three-layer design: the outer layer made of a fibrous polycaprolactone (PCL) film, to act as a barrier for preventing microorganisms and impurities from reaching the wound; the intermediate layer formed of a sodium alginate (SA) hydrogel loaded with ampicillin (Amp) for fighting infections; and the inner layer comprised of a fibrous film of PCL and polyethylene glycol (PEG) for facilitating cell recognition and preventing wound adhesion. Thermal evaluations, degradation, wettability and release behavior testing confirmed the system resistance overtime. The sandwich demonstrated the capability for absorbing exudates (≈70 %) and exhibited a controlled release of Amp for up to 24 h. Antimicrobial testing was performed against Staphylococcus aureus and Escherichia coli, as representatives of Gram-positive and Gram-negative bacteria: >99 % elimination of bacteria. Cell cytotoxicity assessments showed high cytocompatibility levels, confirming the safety of the proposed sandwich system. Adhesion assays confirmed the system ease of detaching without mechanical effort (0.37 N). Data established the efficiency of the sandwich-like system, suggesting promising applications in infected wound care.

Development and Evaluation of Nutritional and Quality Standard of Beef Burger Supplemented with Pumpkin (Cucurbita moschata) Seed Flour.

The composition of pumpkin seeds includes bioactive compounds, proteins, polyunsaturated fatty acids, and dietary fibers. Thus, the objective of this research was to develop and evaluate the nutritional and quality standard of beef burgers supplemented with pumpkin seeds (Cucurbita moschata) added in different proportions. To process the pumpkin seed flour (PSF), the seeds were sanitized, dried in an oven, crushed, and sieved. Through such means, three formulations of beef burgers were prepared, named S (without the addition of PSF), F5 (with the addition of 5% (w/w) of PSF), and F10 (with the addition of 10% (w/w) of PSF). The respective results for burgers P, F5, and F10 were as follows (w/w): proteins 17.61%, 18.04%, 19.86%; lipids 12.19%, 12.42%, 14.55%; ash 1.77%, 1.86%, 1.94%; fibers 0%, 0.88%, 1.76%; phenolic compounds 39.55, 82.93, 90.30 (mg/g); and total antioxidant capacity 11.09%, 18.48%, 24.45%. Regarding the sensory analysis attributes, tasters gave sample F10 scores lower than 7. However, the standard and F5 samples showed results higher than 7 for all parameters. For the determination of shelf life, an expiration date of 30 days was established. It was observed that adding PSF to industrialized products adds nutritional value with the inclusion of polyunsaturated fats, phenolic compounds, and dietary fibers.

Sensitivity of Salmonella Typhimurium to nisin in vitro and in orange juice under refrigeration.

The influence of environmental factors on Salmonella sensitivity to nisin in vitro and in refrigerated orange juice were investigated. Nisin activity was observed in the different conditions, but the highest efficiency was achieved at lower pH (4.0) and with higher bacteriocin concentration (174 µM). Moreover, the bactericidal action was directly proportional to the incubation period. When tested in orange juice, nisin caused a reduction of up to 4.05 logarithm cycles in the Salmonella population. So, environmental factors such as low pH and low temperature favored the sensitization of Salmonella cells to the bactericidal action of nisin. Therefore, this may represent an alternative to control Salmonella in refrigerated foods.

Hydroxyapatite/alginate/gellan gum inks with osteoconduction and osteogenic potential for bioprinting bone tissue analogues.

There is a growing demand for engineered bone tissues custom-designed to match the patient-specific defect size and in vitro models for studying bone diseases and/or drug screening. Herein, we propose a bioprinted bone tissue construct using SaOs-2 cells within alginate/gellan gum/hydroxyapatite inks. Different ink formulations were developed with varying hydroxyapatite content and then evaluated for viscoelasticity, printability, biomineralization properties, post-printing viability, proliferation, metabolic activity, and osteogenic phenotype of SaOs-2-encapsulated cells. Results indicate that ink formulations exhibit non-Newtonian shear-thinning behaviour, maintaining shape integrity and structural stability post-printing. Ink mineralization rates increase with the hydroxyapatite content, rendering them suitable for bone defect strategies. Post-printed cells in the developed constructs remain live, spreading, and metabolically active but do not proliferate. Osteogenic gene and protein expression, both early and late, show upregulation at day 7 relative to day 1, followed by downregulation at day 14. Lower hydroxyapatite content inks demonstrate up to fourfold upregulation in genes and proteins at most time points. Additionally, these constructs release calcium and phosphate at levels conducive to mineralization. Overall, the tissue-engineered miniaturized constructs not only meet the criteria for early-stage bone defect/fracture regeneration but also serve as a promising platform for drug screening and evaluating potential therapeutic treatments.

Environmental Comfort in Promoting Sleep in Critically Ill Patients: A Scoping Review.

INTRODUCTION: It is important to understand the concept of comfort as a whole to build an assistance intervention plan that meets the person's needs. Therefore, it is necessary to monitor and assess the person's sleep by considering the surrounding environment, to provide a comfortable environment that is quiet and provides privacy, especially in contexts of difficult management of environmental factors in the approach to the person in critical condition. OBJECTIVES: The aims of this study were to map the nursing interventions that promote sleep-promoting environmental comfort in critically ill people and identify the instruments to assess sleep in critically ill people. METHODS: This is a scoping review based on the methodological strategy of the Joanna Briggs Institute for Scoping Reviews. The search was conducted on February 17 and 18, 2022, in the databases CINAHL, Cochrane Library Plus, PubMed, JBI Evidence Synthesis, SciELO, DANS Easy Archive, RCAAP, and DART-Europe using the Boolean phrase search strategy: "Hospital Emergency Service" OR "Critical Care" AND "Sleep" NOT "Children" AND Nurs*. We included all studies, conducted in any contextual setting, in Portuguese, English, or Spanish, on adult patients with acute and/or critical illness in intensive care and/or emergency units, which addressed nursing interventions that contribute to environmental comfort and promote sleep. Studies on pregnant or puerperal women, persons with psychiatric disorders, and those at the end of life or in palliative care were excluded. RESULTS: Twenty-one articles were included in this scoping review. Three categories of nursing interventions emerged: person centered (14 interventions), environment centered (37 interventions), and nurse role centered (45 interventions). Three categories of instruments for sleep assessment emerged, in particular: quality of sleep (12 instruments), environmental effects on a night's sleep (2 instruments), and influence on sleep practices in the intensive care unit (1 instrument). DISCUSSION: The use of instruments to monitor comfort and sleep allows for an accurate assessment of the impact of nurses' intervention focusing on sleep-promoting interventions aimed at comfort, for an improvement of sleep in critically ill patients. CONCLUSION: The interpretation of the content makes it clear that how critically ill patients in different contexts experience the environmental context positively or negatively conditions their comfort. In this sense, it is essential to reflect on these measures as a team so that everyone can apply them.

Listening Effort, An Overview of App Validation and Testing by the Audiology 4 all Project.

OBJECTIVE: To describe an application's development and validation process that aims to track hearing difficulties in adverse environments (a listening effort application). DESIGN: 71 subjects were evaluated, divided into two groups: 30 subjects aged between 18 and 30, and 41 subjects aged between 40 and 65. All subjects had European Portuguese as their native language; the Montreal Cognitive Assessment (MOCA) scored above 24, and all could read and write. All subjects performed the intelligibility test in noise and the test of listening effort. The two tests were randomly applied in the free field in the audiometric cabin and the application. RESULTS: There were no statistically significant differences between the results of the two methods (p>0.05). For the group aged between 40 and 65 years old, the ROC curve showed that intelligibility inferior to 68.5% and the number of correct answers lower than 1,5 in the listening effort test are the optimal cut-off for referral to further management. Both tests showed low sensitivity and specificity regarding individuals between 18 and 30 years old, indicating that the application is inappropriate for this age group. CONCLUSIONS: The application is valid and can contribute to the screening and self-awareness of listening difficulties in middle age, with a reduction in the prevalence of dementia soon.

Use of CompEx in eosinophilic patients with severe, uncontrolled asthma on benralizumab.

Background: CompEx Asthma, a composite end-point for asthma exacerbations, captures clinically relevant, diary-based acute worsening events (AWEs) (defined as deterioration in daily peak expiratory flow concurrent with deterioration in asthma symptoms and/or rescue therapy use) and severe exacerbations (SevEx) (defined by American Thoracic Society/European Respiratory Society guidelines). We hypothesised that CompEx and SevEx would show similar benralizumab treatment effects and correlations to blood eosinophil counts in patients with severe asthma. Methods: This post hoc analysis of pooled 12-month data from two phase 3 studies included patients aged ≥16 years with severe, uncontrolled asthma who were randomised to benralizumab 30 mg or placebo. Annualised event rates were analysed using a negative binomial model. The impact of blood eosinophil count on treatment effect was assessed. Results: Among patients with a blood eosinophil count ≥300 cells·µL-1 (n=913), benralizumab reduced the annualised event rate versus placebo for CompEx (1.57 versus 2.57; risk ratio 0.61, 95% CI 0.53-0.70, p<0.001), SevEx (0.94 versus 1.55; risk ratio 0.60, 95% CI 0.52-0.70, p<0.001) and AWE (0.92 versus 1.57; risk ratio 0.59, 95% CI 0.48-0.72, p<0.001), with greater treatment effects observed for higher blood eosinophil counts. In patients with blood eosinophil count ≥300 cells·µL-1, benralizumab was associated with shorter median event duration (CompEx: 10.5 days versus 17.0 days; SevEx: 10.0 days versus 15.0 days; AWE: 5.0 days versus 6.0 days). Conclusions: Benralizumab reduced the risk of CompEx events with treatment effects similar to those for SevEx and AWEs across a range of blood eosinophil counts. Use of CompEx supports the evaluation of benralizumab and other novel drugs in clinical studies.

Haemodialysis machine designation for patients with chronic Hepatitis B virus: A practice and attitudes survey of Australian renal healthcare workers.

BACKGROUND: To reduce the risk of viral transmission, guidelines recommend the use of designated haemodialysis machines and patient isolation for patients with chronic hepatitis B virus (HBV). These practices are without a strong evidence base, and may no longer be necessary in the setting of heat disinfection programs and standard precautions. METHODS: An online cross-sectional survey was developed for renal clinicians across Australia and New Zealand to explore infection prevention policy concerning patients with chronic HBV in haemodialysis units. We sought to determine whether psychosocial and cultural impacts might result from the mandatory use of machine designation and patient isolation practices, as perceived by multidisciplinary healthcare workers with experience working with this patient population. RESULTS: Sixty-seven responses from 27 health districts across all states of Australia and one New Zealand district were received. Most respondents were from urban areas (65%), and were nurses (87%). 50% of health districts reported using designated machines, while 32% isolate patients. Lack of necessary resources limited the use of designated machines (57%), and patient isolation (78%). Respondents not routinely using these precautions were more likely to express concerns regarding patient psychosocial wellbeing and cultural appropriateness. Overall, 30% of respondents expressed concerns regarding the cultural appropriateness of these recommendations. CONCLUSION: We demonstrate wide variation in haemodialysis infection prevention and control policy and practice with regards to managing patients with chronic HBV. While use of standard precautions and machine disinfection are consistently applied, resource availability and concerns for patient psychosocial wellbeing limit adherence to international guidelines.

Leishmanicidal and immunomodulatory activity of Terminalia catappa in Leishmania amazonensisin vitro infection.

Leishmaniases are infectious-parasitic diseases that impact public health around the world. Antileishmanial drugs presented toxicity and increase in parasitic resistance. Studies with natural products show an alternative to this effect, and several metabolites have demonstrated potential in the treatment of various diseases. Terminalia catappa is a plant species with promising pharmaceutical properties. The objective of this work was to evaluate the therapeutic potential of extracts and fractions of T. catappa on Leishmania amazonensis and investigate the immunomodulatory mechanisms associated with its action. In anti-Leishmania assays, the ethyl acetate fraction exhibited activity against promastigotes (IC50 86.07 ± 1.09 µg/mL) and low cytotoxicity (CC50 517.70 ± 1.68 µg/mL). The ethyl acetate fraction also inhibited the intracellular parasite (IC50 25.74 ± 1.08 µg/mL) with a selectivity index of 20.11. Treatment with T. catappa ethyl acetate fraction did not alter nitrite production by peritoneal macrophages stimulated with L. amazonensis, although there was a decrease in unstimulated macrophages treated at 50 µg/mL (p = 0.0048). The T. catappa ethyl acetate fraction at 100 µg/mL increased TNF-α levels (p = 0.0238) and downregulated HO-1 (p = 0.0030) and ferritin (p = 0.0002) gene expression in L. amazonensis-stimulated macrophages. Additionally, the total flavonoid and ellagic acid content for ethyl acetate fraction was 13.41 ± 1.86 mg QE/g and 79.25 mg/g, respectively. In conclusion, the T. catappa ethyl acetate fraction showed leishmanicidal activity against different forms of L. amazonensis and displayed immunomodulatory mechanisms, including TNF-α production and expression of pro and antioxidant genes.

Quality of life and level of satisfaction with pharmacotherapeutic follow-up in a transgender health center in Brazil.

Trans people face numerous barriers to access and permanence in health services, which makes it difficult, among other things, to know about their quality of life and satisfaction with health services related to these users. Thus, the objective was to describle the quality of life and satisfaction with pharmacotherapeutic follow-up in transgender people. A cross-sectional, descriptive, and quantitative study was conducted between January and September 2022 at a specialized outpatient clinic for transgender individuals. The following aspects were describle: sociodemographic and medication profiles; quality of Life, which was measured using the WHOQOL-BREF questionnaire; and levels of satisfaction with Pharmacotherapeutic Monitoring, assessed through the Pharmacy Services Satisfaction Questionnaire (QSSF). Descriptive analyses employed measures of central tendency, absolute and relative frequencies, while inferential analyses used the Student's t test. A total of 101 transgender individuals participated in the study, with a mean age of 25 years, the majority being single (79.2%/80), having more than 11 years of education (47.5%/n = 48), and comprising 48.5% (n = 49) transgender women. Hormone use was reported by 59.4% (n = 60) of the participants, with 18.3% (n = 11) of self-medication. Testosterone cypionate was the most common hormone used by transgender men (84%), while cyproterone acetate and estradiol represented 60.4% of hormone use among transgender women. Additionally, 36 transgender individuals were taking other drugs (n = 60), mainly antidepressives (28%). The WHOQOL-BREF showed higher scores in the domains of self-rated Quality of Life, and physical, and psychological well-being among transgender women compared to transgender men, but without statistical differences. Income revealed a statistically significant association with psychological domains and overall quality of life. The results of the QSSF indicated that the overall mean and average scores per question were higher than 4, suggesting that 100% of the sample was satisfied with the provided service. No statistically significant differences were observed in the Quality of Life between transgender men and women, but income was associated with the psychological domain and overall Quality of Life. All participants reported satisfaction with the Pharmacotherapeutic Monitoring service; however, there is a need to expand service offerings, such as medication dispensing.

Puerperal women's social interactions related to their sexual health after childbirth.

OBJECTIVE: To analyze puerperal women's experiences of sexual health after childbirth from the perspective of symbolic interactionism. METHOD: Descriptive, qualitative study. Twenty semi-structured interviews were conducted by videoconference with women in the remote puerperium, captured by snowball technique and searched for "seeds" on Instagram®. Bardin's content analysis and Symbolic Interactionism were used as references. RESULTS: The puerperal women signify sexual health from a perspective of comprehensive healthcare. However, due to the duality between "being a woman" and "being a mother", they recognize fear, bodily transformations and changes in focus from the love relationship to caring for the baby as factors that interfere with sexual health. And they choose to put themselves aside, prioritizing caring for others. They re-signify sexual health by recognizing the importance of taking care of themselves in biopsychosocial aspects and try to recover self-care for a healthy sexual experience. CONCLUSION: Despite the meanings attributed, women's social interactions with the puerperium interfere negatively with sexual health. Professionals should be sensitized to the inclusion of actions that promote changes in the social action of these women towards self-care.

Ethanol binge drinking exposure during adolescence displays long-lasting motor dysfunction related to cerebellar neurostructural damage even after long-term withdrawal in female Wistar rats.

Ethanol is one of the psychoactive substances most used by young individuals, usually in an intermittent and episodic manner, also called binge drinking. In the adolescent period, brain structures undergo neuromaturation, which increases the vulnerability to psychotropic substances. Our previous studies have revealed that ethanol binge drinking during adolescence elicits neurobehavioral alterations associated with brain damage. Thus, we explored the persistence of motor function impairment and cerebellum damage in the context of ethanol withdrawal periods (emerging adulthood and adult life) in adolescent female rats. Female Wistar rats (35 days old) received orally 4 cycles of ethanol (3.0 g/kg/day) or distilled water in 3 days on-4 days off paradigm (35th until 58th day of life). Motor behavioral tests (open field, grip strength, beam walking, and rotarod tests) and histological assays (Purkinje's cell density and NeuN-positive cells) were assessed on the 1-, 30-, and 60-days of binge alcohol exposure withdrawal. Our findings demonstrate that the adolescent binge drinking exposure paradigm induced cerebellar cell loss in all stages evaluated, measured through the reduction of Purkinje's cell density and granular layer neurons. The cerebellar tissue alterations were accompanied by behavioral impairments. In the early withdrawal, the reduction of spontaneous movement, incoordination, and unbalance was seen. However, the grip strength reduction was found at long-term withdrawal (60 days of abstinence). The cerebellum morphological changes and the motor alterations persisted until adulthood. These data suggest that binge drinking exposure during adolescence causes motor function impairment associated with cerebellum damage, even following a prolonged withdrawal, in adult life.

Severe COVID-19 and long COVID are associated with high expression of STING, cGAS and IFN-α.

The cGAS-STING pathway appears to contribute to dysregulated inflammation during coronavirus disease 2019 (COVID-19); however, inflammatory factors related to long COVID are still being investigated. In the present study, we evaluated the association of cGAS and STING gene expression levels and plasma IFN-α, TNF-α and IL-6 levels with COVID-19 severity in acute infection and long COVID, based on analysis of blood samples from 148 individuals, 87 with acute COVID-19 and 61 in the post-COVID-19 period. Quantification of gene expression was performed by real-time PCR, and cytokine levels were quantified by ELISA and flow cytometry. In acute COVID-19, cGAS, STING, IFN-α, TNF-α, and IL-6 levels were higher in patients with severe disease than in those with nonsevere manifestations (p < 0.05). Long COVID was associated with elevated cGAS, STING and IFN-α levels (p < 0.05). Activation of the cGAS-STING pathway may contribute to an intense systemic inflammatory state in severe COVID-19 and, after infection resolution, induce an autoinflammatory disease in some tissues, resulting in long COVID.

Clinical characteristics and outcomes of COVID-19 patients with preexisting dementia: a large multicenter propensity-matched Brazilian cohort study.

BACKGROUND: Although dementia has emerged as an important risk factor for severe SARS-CoV-2 infection, results on COVID-19-related complications and mortality are not consistent. We examined the clinical presentations and outcomes of COVID-19 in a multicentre cohort of in-hospital patients, comparing those with and without dementia. METHODS: This retrospective observational study comprises COVID-19 laboratory-confirmed patients aged ≥ 60 years admitted to 38 hospitals from 19 cities in Brazil. Data were obtained from electronic hospital records. A propensity score analysis was used to match patients with and without dementia (up to 3:1) according to age, sex, comorbidities, year, and hospital of admission. Our primary outcome was in-hospital mortality. We also assessed admission to the intensive care unit (ICU), invasive mechanical ventilation (IMV), kidney replacement therapy (KRT), sepsis, nosocomial infection, and thromboembolic events. RESULTS: Among 1,556 patients included in the study, 405 (4.5%) had a diagnosis of dementia and 1,151 were matched controls. When compared to matched controls, patients with dementia had a lower frequency of dyspnoea, cough, myalgia, headache, ageusia, and anosmia; and higher frequency of fever and delirium. They also had a lower frequency of ICU admission (32.7% vs. 47.1%, p < 0.001) and shorter ICU length of stay (7 vs. 9 days, p < 0.026), and a lower frequency of sepsis (17% vs. 24%, p = 0.005), KRT (6.4% vs. 13%, p < 0.001), and IVM (4.6% vs. 9.8%, p = 0.002). There were no differences in hospital mortality between groups. CONCLUSION: Clinical manifestations of COVID-19 differ between older inpatients with and without dementia. We observed that dementia alone could not explain the higher short-term mortality following severe COVID-19. Therefore, clinicians should consider other risk factors such as acute morbidity severity and baseline frailty when evaluating the prognosis of older adults with dementia hospitalised with COVID-19.