Potential predictors of depressive symptoms during the initial stage of the COVID-19 outbreak among Brazilian adults.

BACKGROUND: In early 2020, Sars-Cov-2 was identified in China as a new coronavirus. Due to its transmission, Sars-Cov-2 has spread rapidly across the world. In the early stage of the disease outbreak, psychiatric symptoms have been reported, including depressive symptoms. In this study, we assessed the prevalence of depressive symptoms in quarantine and its association with sociodemographic variables and known protective factors for depression, such as spirituality, social support, resilience, and quality of life. METHODS: A cross-sectional web-based questionnaire was distributed via social media. The instruments consisted of the 8-item EUROHIS-QOL, PHQ-9, Social Support Questionnaire, WHOQoL-SRPB, and CD-RISC. RESULTS: A total of 3,274 participants were included in this study. 23.67% of the participants met the criteria for a depressive episode. Higher age, spirituality, social support, resiliency, and quality of life were associated with less depressive symptoms. Quarantine length; mental health treatment; chronic disease; age; sex; lower levels of spirituality, social support, resilience, quality of life, physical exercise, and education; and unpaid occupation were found to be predictors of depressive symptoms during COVID-19 quarantine. LIMITATIONS: The data are limited to the pandemic initial period, the sample isn't random and the use of self-reported questionnaires are some limitations of our study. CONCLUSIONS: During the initial phase of the COVID-19 outbreak in Brazil, quarantine time, treatment for mental health, chronic illness, lower levels of education, and unpaid occupation were positively associated with depressive symptoms. Age, sex, spirituality, social support, resilience, quality of life, and physical exercise showed a negative relationship with depressive symptoms.

Thrombolytics in VAD management - A single-center experience.

BACKGROUND: With continued increase in the use of mechanical circulatory support, the incidence of device thrombus remains a challenge. This study is a retrospective analysis of data at a single center to assess the safety and efficacy of thrombolytic use in durable mechanical assist devices. METHODS: Data was analyzed retrospectively from 154 patients who underwent left ventricular assist device (LVAD) implantation from 1/1/2005 to 6/30/2014. The HMII device was implanted in 131 patients while 23 received the HVAD. LVAD thrombus was diagnosed when lactate dehydrogenase levels exceeded 1000 units/l accompanied by clinical signs of hemolysis and heart failure, echocardiographic data and surges in pump power. TPA (tissue plasminogen activator) protocol consisted of a 5 mg intravenous bolus followed by 3 mg/h infusion in normal saline for 10 h. If symptoms persisted another cycle of TPA at 1 mg/h was continued up to 48 h. RESULTS: The TPA group had a 70% success rate. Success was defined as complete resolution of hemolysis and clinical symptoms with no requirement for LVAD exchange at 30 days. 95% survival was noted at 30 days and 90% were free of a hemorrhagic stroke in the TPA group. The rates of hemorrhagic strokes in the TPA group and the control group were not different (OR = 0.92). CONCLUSION: The TPA protocol described here was successful consistently. Though this study is limited by its size and retrospective nature it leads the way for larger studies to generate more robust comparisons between different types of mechanical assist devices as well as the tailored use of thrombolytics in this patient population.

Modulation of Wnt/ß-catenin signaling and proliferation by a ferrous iron chelator with therapeutic efficacy in genetically engineered mouse models of cancer.

Using a screen for Wnt/ß-catenin inhibitors, a family of 8-hydroxyquinolone derivatives with in vivo anti-cancer properties was identified. Analysis of microarray data for the lead compound N-((8-hydroxy-7-quinolinyl) (4-methylphenyl)methyl)benzamide (HQBA) using the Connectivity Map database suggested that it is an iron chelator that mimics the hypoxic response. HQBA chelates Fe(2+) with a dissociation constant of ∼10(-19) M, with much weaker binding to Fe(3+) and other transition metals. HQBA inhibited proliferation of multiple cell lines in culture, and blocked the progression of established spontaneous cancers in two distinct genetically engineered mouse models of mammary cancer, MMTV-Wnt1 and MMTV-PyMT mice, without overt toxicity. HQBA may inhibit an iron-dependent factor that regulates cell-type-specific ß-catenin-driven transcription. It inhibits cancer cell proliferation independently of its effect on ß-catenin signaling, as it works equally well in MMTV-PyMT tumors and diverse ß-catenin-independent cell lines. HQBA is a promising specific intracellular Fe(2+) chelator with activity against spontaneous mouse mammary cancers.