Lithium salts as a treatment for COVID-19: Pre-clinical outcomes.

INTRODUCTION: Identifying effective drugs for Coronavirus disease 2019 (COVID-19) is urgently needed. An efficient approach is to evaluate whether existing approved drugs have anti-SARS-CoV-2 effects. The antiviral properties of lithium salts have been studied for many years. Their anti-inflammatory and immune-potentiating effects result from the inhibition of glycogen synthase kinase-3. AIMS: To obtain pre-clinical evidence on the safety and therapeutic effects of lithium salts in the treatment of COVID-19. RESULTS: Six different concentrations of lithium, ranging 2-12 mmol/L, were evaluated. Lithium inhibited the replication of SARS-CoV-2 virus in a dose-dependent manner with an IC50 value of 4 mmol/L. Lithium-treated wells showed a significantly higher percentage of monolayer conservation than viral control, particularly at concentrations higher than 6 mmol/L, verified through microscopic observation, the neutral red assay, and the determination of N protein in the supernatants of treated wells. Hamsters treated with lithium showed less intense disease with fewer signs. No lithium-related mortality or overt signs of toxicity were observed during the experiment. A trend of decreasing viral load in nasopharyngeal swabs and lungs was observed in treated hamsters compared to controls. CONCLUSIONS: These results provide pre-clinical evidence of the antiviral and immunotherapeutic effects of lithium against SARS-CoV-2, which supports an advance to clinical trials on COVID-19's patients.

Self-efficacy and organizational commitment among Spanish nurses: the role of work engagement.

AIM: The objective of this study was to verify the mediating role of work engagement between self-efficacy and affective organizational commitment on the basis of the Job Demands-Resources Model in a sample of Spanish nursing staff. BACKGROUND: Affective organizational commitment is a key element, both for the permanence of nursing staff and for the provision of an excellent quality of care of health organizations. However, the relationships between self-efficacy, work engagement and affective commitment to the organization have been little explored within the nursing context. METHODS: A total of 527 nursing professionals from Spanish public hospitals in Andalusia were surveyed, obtaining a convenience sample of 324 participants (52.96% nurses, 47.04% nursing assistants). The mediating role of work engagement was examined using structural equation modelling and the bootstrapping method. RESULTS: The results showed that affective organizational commitment was positively predicted by self-efficacy and work engagement. Work engagement had a direct effect on affective organizational commitment, while the effect of self-efficacy on affective commitment was totally mediated by work engagement. CONCLUSIONS: The results give empirical support to the Job Demands-Resources Model, which raises the mediating role of work engagement between self-efficacy (personal resource) and affective organizational commitment (organizational result). IMPLICATIONS FOR NURSING PRACTICE: Health organizations should be aware that a greater perception of efficacy beliefs and work engagement strengthens the affective bond with the organization, thus improving the corporate image of the health institution. IMPLICATIONS FOR NURSING POLICY: Policy changes are necessary to create work environments that enhance the self-efficacy of nursing staff and generate high levels of work engagement, such as flexible training plans and informal support groups.

Cognitive performance of people with traumatic spinal cord injury: a cross-sectional study comparing people with subacute and chronic injuries.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To assess the impact of spinal cord injury (SCI) on cognitive function in individuals with subacute and chronic SCI. SETTING: National Hospital for SCI patients (Spain). METHODS: The present investigation was designed to determine the nature, pattern, and extent of cognitive deficits in a group of participants with subacute (n = 32) and chronic (n = 34) SCI, using a comprehensive battery of reliable and validated neuropsychological assessments to study a broad range of cognitive functions. Twenty-seven able-bodied subjects matched to the groups with SCI for age and educational level formed the control group. RESULTS: The neuropsychological assessment showed alterations in the domain of attention, processing speed, memory and learning, executive functions, and in recognition in participants with SCI. The prevalence of cognitive dysfunction in the chronic stage was also confirmed at the individual level. The comparison of the neuropsychological assessment between the groups with subacute and chronic SCI showed a worsening of cognitive functions in those with chronic SCI compared to the group with subacute SCI. CONCLUSIONS: In participants with SCI, cognitive dysfunctions are present in the subacute stage and worsen over time. From a clinical point of view, we confirmed the presence of cognitive dysfunction that may interfere with the first stage of rehabilitation which is the most intense and important. Moreover, cognitive dysfunction may be important beyond the end of the first stage of rehabilitation as it can affect an individual's quality of life and possible integration to society.

Safety Study of Transcranial Static Magnetic Field Stimulation (tSMS) of the Human Cortex.

BACKGROUND: Transcranial static magnetic field stimulation (tSMS) in humans reduces cortical excitability. OBJECTIVE: The objective of this study was to determine if prolonged tSMS (2 h) could be delivered safely in humans. Safety limits for this technique have not been described. METHODS: tSMS was applied for 2 h with a cylindric magnet on the occiput of 17 healthy subjects. We assessed tSMS-related safety aspects at tissue level by measuring levels of neuron-specific enolase (NSE, a marker of neuronal damage) and S100 (a marker of glial reactivity and damage). We also included an evaluation of cognitive side effects by using a battery of visuomotor and cognitive tests. RESULTS: tSMS did not induce any significant increase in NSE or S100. No cognitive alteration was detected. CONCLUSIONS: Our data indicate that the application of tSMS is safe in healthy human subjects, at least within these parameters.

Studying plasticity of sensory function: insight from pregnancy.

Plasticity of sensory function has become an object of study because of its proposed role in the recovery of function after central nervous system damage. Normal pregnancy may provide a useful in vivo model to study the effects of progressive reduction in the abdominal skin receptor density. As such changes are confined to abdominal skin, other parts of the body are only moderately affected by pregnancy and therefore can provide a control for other changes during pregnancy. The two-point discrimination test (TPDT) of the skin is a simple test of the sensory function. We conducted the TPDT in a pregnant population longitudinally studied at different pregnancy stages and in different skin regions. In this pregnant population, we found a reduction in sensory sensibility that was not skin region specific. In particular, the increase in abdominal circumference did not produce different effects of TPDT on the belly compared to the dorsum or the hand. This suggests that the sensory system is able to compensate for the reduction in peripheral information flow through central nervous system plasticity.

Effects of baclofen on temperature perception in humans.

The aim of this study was to evaluate the effect of chronic consumption of the GABAB agonist baclofen on temperature perception in humans. We investigated temperature perception thresholds to detect warm and cold stimuli in a group of 21 patients with spinal cord injury, who were chronically consuming oral baclofen at different daily doses to treat spasticity. Temperature perception thresholds were assessed above the level of the lesion, using a psychophysical approach based on the ability of the subjects to perceive precisely quantified sensory stimuli (quantitative sensory testing, QST). The data were compared with a control group of healthy subjects, not receiving baclofen. We found that chronic baclofen consumption increased temperature perception thresholds for both cold and warm stimuli in a dose-dependent manner. Temperature perception thresholds did not depend on the level of the lesion nor on the duration of baclofen treatment, suggesting that our finding represent normal GABAB-mediated modulation in spared nervous structures. We conclude that GABAB therefore plays a role in temperature perception in humans.