Effectiveness of Drug Repurposing and Natural Products Against SARS-CoV-2: A Comprehensive Review.

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a betacoronavirus responsible for the COVID-19 pandemic, causing respiratory disorders, and even death in some individuals, if not appropriately treated in time. To face the pandemic, preventive measures have been taken against contagions and the application of vaccines to prevent severe disease and death cases. For the COVID-19 treatment, antiviral, antiparasitic, anticoagulant and other drugs have been reused due to limited specific medicaments for the disease. Drug repurposing is an emerging strategy with therapies that have already tested safe in humans. One promising alternative for systematic experimental screening of a vast pool of compounds is computational drug repurposing (in silico assay). Using these tools, new uses for approved drugs such as chloroquine, hydroxychloroquine, ivermectin, zidovudine, ribavirin, lamivudine, remdesivir, lopinavir and tenofovir/emtricitabine have been conducted, showing effectiveness in vitro and in silico against SARS-CoV-2 and some of these, also in clinical trials. Additionally, therapeutic options have been sought in natural products (terpenoids, alkaloids, saponins and phenolics) with promising in vitro and in silico results for use in COVID-19 disease. Among these, the most studied are resveratrol, quercetin, hesperidin, curcumin, myricetin and betulinic acid, which were proposed as SARS-CoV-2 inhibitors. Among the drugs reused to control the SARS-CoV2, better results have been observed for remdesivir in hospitalized patients and outpatients. Regarding natural products, resveratrol, curcumin, and quercetin have demonstrated in vitro antiviral activity against SARS-CoV-2 and in vivo, a nebulized formulation has demonstrated to alleviate the respiratory symptoms of COVID-19. This review shows the evidence of drug repurposing efficacy and the potential use of natural products as a treatment for COVID-19. For this, a search was carried out in PubMed, SciELO and ScienceDirect databases for articles about drugs approved or under study and natural compounds recognized for their antiviral activity against SARS-CoV-2.

Placenta accreta spectrum: intraoperatory analysis for immediate tele-help.

INTRODUCTION: Placenta accreta spectrum (PAS) is a potentially fatal disease. A quarter of PAS cases are not detected during prenatal evaluations, so obstetricians without experience with this disease may encounter complex cases without having the necessary resources. We report a series of PAS intraoperative finding (IOF) cases and analyze useful strategies to improve patient outcomes. CASE SERIES: Four cases of PAS IOF are reported. These patients were women with previous pregnancies terminated by cesarean section, with placenta previa/anterior, and whose prenatal ultrasound did not detect PAS. Three patients were candidates for the postponement of cesarean section and/or hysterectomy. One case had active vaginal bleeding, so it was not feasible to delay surgery. Patients who benefited from delaying surgery or seeking additional help through telesupport had better clinical outcomes. CONCLUSION: Decisions about which interventions to conduct and which to delay in cases of PAS intraoperative finding can determine the clinical outcome.

Hypoxia during embryonic development increases energy metabolism in normoxic juvenile chicks.

Environmental changes during perinatal development can affect the postnatal life. In this sense, chicken embryos that experience low levels of O2 over a specific phase of incubation can have their tissue growth reduced and the ventilatory response to hypoxia blunted, at least until hatching. Additionally, exposure to low level of O2 after birth reduces the thermogenesis as well. In the present study, we tested the hypothesis that hypoxia over the third week of incubation affects the thermoregulation of juvenile chicks at an age when thermogenesis is already expected to be well-developed. To this end, we measured body temperature (Tb) and oxygen consumption (V̇02) under acute hypoxia or different ambient temperatures (Ta) of 1 and 10day-old chicks that have been exposed to 21% O2 for entire incubation (Nx) or to 15% O2 in the last week of incubation (Hx). We also assessed the thermal preference under normoxia or acute hypoxia of the older chicks from both incubation groups in a thermocline. Hypoxia over incubation reduced growth but did not affect the cold-induced thermogenesis in hatchlings. Regarding the juvenile Hx, present data indicate a catch up growth with higher resting V̇02, a thermal preference for warmer Tas and a possible higher thermal conductance. In conclusion, our results show that hypoxia over the third week of incubation can affect the thermoregulation at least until 10days after hatch in chickens.

Significado que construye el personal de enfermería sobre los cuidadores familiares de personas hospitalizadas / The Meaning of Family Caregivers of Inpatients Constructed by Nursing Personnel / Significado construído pelo pessoal de enfermagem sobre os cuidadores familiares de pessoas hospitalizadas

Objetivo: Conocer el significado que construye el personal de enfermería sobre los cuidadores familiares de personas hospitalizadas. Método: Cualitativo con enfoque etnográfico. Se realizaron 13 entrevistas y 50 horas de observación participante. Los participantes fueron el personal de enfermería que labora en salas de medicina interna en dos instituciones de la ciudad de Medellín, Colombia. El análisis se hizo a partir de la lectura de relatos, observaciones y notas de campo; se extractaron códigos que se agruparon en categorías y se procedió a la interpretación de los hallazgos. Resultados: Para el personal de enfermería el cuidador es importante en el ámbito hospitalario en la medida que está pendiente, colabora, facilita el cuidado y se interesa en aprender. En contraposición, es un obstáculo, porque no participa en las actividades de cuidado al paciente en el hospital, ya sea por miedo o falta de conocimientos. El contexto hospitalario no condiciona el significado que construye el personal de enfermería acerca del cuidador familiar, pues si bien el modelo de cuidado en ambas instituciones está centrado en el paciente y la familia, el cuidador familiar se utiliza como recurso alternativo de cuidado, sin considerar sus necesidades y vulnerabilidad en el ambiente hospitalario. Conclusiones: El personal de enfermería construye el significado acerca del cuidador familiar en el hospital de acuerdo con su utilidad o no en el apoyo que este realiza para las actividades de cuidado.

Objective: Learning about the meaning of family caregivers of inpatients constructed by nursing personnel. Method: Qualitative with an ethnographic focus. Thirteen (13) interviews and fifty (50) hours of participant observation were carried out. The participants were members of the nursing personnel working in the internal medicine rooms in two institutions of Medellin, Colombia. The analysis was performed based on the reading of stories, observations, and field notes. A series of codes were extracted and grouped in categories, followed by the interpretation of the findings. Results: For the nursing personnel, the caregiver is important in the hospital environment to the extent he is alert, cooperates, facilitates care, and shows willingness to learn. On the other hand, he is regarded as an obstacle as he does not take part in the hospital care activities, either because of fear or a lack of knowledge. The hospital context does not condition the meaning constructed by the nursing personnel regarding the family caregiver since, although the care model in both institutions is centered around the patient and the family, the family caregiver is used as an alternative mean for care, with no consideration for his needs and vulnerabilities in the hospital environment. Conclusions: The nursing personnel constructs a meaning around family caregivers according to their contributions, or lack thereof, to care activities.

Objetivo: Conhecer o significado construído pelo pessoal de enfermagem sobre os cuidadores familiares de pessoas hospitalizadas. Método: Qualitativa com enfoque etnográfico. Realizaram-se 13 entrevistas e 50 horas de observação participante. Os participantes foram o pessoal de enfermagem que trabalha em salas de medicina interna em duas instituições da cidade de Medellín, Colômbia. A análise foi feita a partir da leitura de relatos, observações e notas de campo; extrataram-se códigos que foram agrupados em categorias e procedeu-se à interpretação dos achados. Resultados: Para o pessoal de enfermagem o cuidador é importante no âmbito hospitalar na medida em que está atento, colabora, facilita o cuidado e se interessa por aprender. Na contraposição, é obstáculo porque não participa nas atividades de cuidado do paciente no hospital, bem por medo ou falta de conhecimento. O contexto hospitalar não condiciona o significado que constrói a equipe de enfermagem acerca do cuidador familiar, embora que o modelo de cuidado em ambas as instituições esteja focado no paciente e a família, o cuidador familiar é utilizado como recurso alternativo de cuidado, sem considerar suas necessidades e vulnerabilidade no ambiente hospitalar. Conclusões: O pessoal de enfermagem constrói o significado acerca do cuidador familiar no hospital segundo sua utilidade ou não no suporte que aquele realiza nas atividades de cuidado.

Interacción del personal de enfermería con el cuidador familiar en el ámbito hospitalario / Interaction of nursing staff with family caregivers in a hospital environment

Objetivo: describir cómo interactúa el personal de enfermería con el cuidador familiar del paciente hospitalizado con enfermedad crónica. Metodología: estudio cualitativo con enfoque etnográfico. Resultados: la comunicación entre el personal de enfermería y el cuidador familiar fue unidireccional, encaminada a promover acciones que permitieran aliviar la carga laboral, es decir, una interacción cuyo fin era meramente instrumental. La relación con el cuidador era positiva si este aprendía lo enseñado, colaboraba y participaba en las actividades de cuidado de su paciente. Conclusiones: la interacción personal de enfermería – cuidador familiar del paciente crónico hospitalizado, se construye a partir de una comunicación limitada a la entrega de información por parte del personal para instruirlo o entrenarlo en el cuidado tanto en el hospital como en la casa, desconociendo sus necesidades, saberes y sentimientos.

Objective: to describe how nursing staff interact with the family caregivers of hospitalized patients with chronic disease.Methodology: qualitative study with ethnographic approach.Results: communication between nursing staff and family caregivers was unidirectional, aimed at promoting actions that allow the reduce the workload, ie, an interaction whose purpose was purely instrumental. The relationship with the caregiver was positive if this was learning what is taught, collaborated and participated in the activities of patient care. Conclusions: the interaction of the nursing staff - family caregivers of chronic hospitalized patient, is constructed from a limited communication to the release of information by the staff to instruct or training them in the care, both in hospital as same as in home, ignoring their needs, knowledge and feelings.

Objetivo: descrever a interação do pessoal de enfermagem com o cuidador familiar do paciente hospitalizado com doença crônica. Metodologia: estudo qualitativo com enfoque etnográfico. Resultados: a comunicação entre o pessoal de enfermagem e o cuidador familiar foi de mão única, encaminhada a promover ações que permitissem aliviar a carga de trabalho, ou seja, uma interação cujo fim era meramente instrumental. A relação com o cuidador era positiva se este aprendia o ensinado, colaborava e participava nas atividades do cuidado do seu paciente. Conclusões: a interação pessoal de enfermagem – cuidador familiar de paciente crónico hospitalizado constrói-se a partir de uma comunicação limitada à entrega de informação por parte do pessoal para instruí-lo ou treiná-lo no cuidado tanto no hospital como em casa, desconhecendo as suas necessidades, saberes e sentimentos.

Chicken hatchlings prefer ambient temperatures lower than their thermoneutral zone.

We investigated whether or not the preferred ambient temperature (Tapref) of the 1-day old chicken hatchling, a precocial neonate with excellent locomotory capacity, clearly identifiable thermogenesis and independence from maternal care, coincides with the lower critical temperature (LCT) of thermoneutrality and minimal oxygen consumption (V̇(O(2))). Tapref of single chicks measured in a thermocline (N=16) averaged 33.5±0.3 °C (mode, 33.3±0.4 °C). The same value was obtained in hatchlings studied in pairs. LCT was computed from the ambient temperature (Ta)-V̇(O(2)) relationship, constructed by slowly decreasing the Ta of a respirometer from 38 to 29 °C over 2.5h, while continuously measuring V̇(O(2)) by an open-flow methodology; LCT averaged 36.4 °C±0.3 or 36.8 °C±0.4, depending on the method of computation. In all hatchlings Tapref was lower than LCT (P<0.001), by a magnitude that depended on the method of computation of the two variables, 2.8 °C±0.3 (P<0.001) or 3.9 °C±0.5. The Tapref-LCT difference implied that, at Tapref, V̇(O(2)) was higher than at thermoneutrality. We conclude that in the chicken hatchling thermal preference does not coincide with thermoneutrality, probably because during development what seems optimal from a thermoregulatory viewpoint may not necessarily be so for other regulatory functions.

Palynological composition of a Lower Cretaceous South American tropical sequence: climatic implications and diversity comparisons with other latitudes.

PREMISE OF THE STUDY: Reconstruction of floristic patterns during the early diversification of angiosperms is impeded by the scarce fossil record, especially in tropical latitudes. Here we collected quantitative palynological data from a stratigraphic sequence in tropical South America to provide floristic and climatic insights into such tropical environments during the Early Cretaceous. METHODS: We reconstructed the floristic composition of an Aptian-Albian tropical sequence from central Colombia using quantitative palynology (rarefied species richness and abundance) and used it to infer its predominant climatic conditions. Additionally, we compared our results with available quantitative data from three other sequences encompassing 70 floristic assemblages to determine latitudinal diversity patterns. KEY RESULTS: Abundance of humidity indicators was higher than that of aridity indicators (61% vs. 10%). Additionally, we found an angiosperm latitudinal diversity gradient (LDG) for the Aptian, but not for the Albian, and an inverted LDG of the overall diversity for the Albian. Angiosperm species turnover during the Albian, however, was higher in humid tropics. CONCLUSIONS: There were humid climates in northwestern South America during the Aptian-Albian interval contrary to the widespread aridity expected for the tropical belt. The Albian inverted overall LDG is produced by a faster increase in per-sample angiosperm and pteridophyte diversity in temperate latitudes. However, humid tropical sequences had higher rates of floristic turnover suggesting a higher degree of morphological variation than in temperate regions.

Diferentes procedimentos na determinação de indicadores internos para estimativa de produção fecal e fluxo duodenal de matéria seca em bovinos / Different procedures for internal markers determination in fecal production and duodenal flow of dry matter estimate in cattle

Avaliou-se tempos de incubação in situ (144 e 288h) dos indicadores internos FDAi e FDNi e o efeito do procedimento (lavagem ou não dos sacos de náilon durante a incubação) em amostras da dieta, digesta duodenal e fezes bovina. O fluxo duodenal de matéria seca e a produção fecal utilizando esses indicadores internos em comparação ao indicador externo óxido crômico também foram estimados. Os animais receberam dietas compostas de silagem de híbridos de sorgo, concentrado ou uréia durante o experimento. O delineamento experimental adotado foi o quadrado latino 4x4 duplicado, sendo os tratamentos distribuídos em esquema fatorial (dois tempos de incubaçao x dois procedimentos de lavagem). Não houve efeito do tempo de incubação ou procedimento na concentração dos indicadores internos FDNi e FDAi sendo a incubação in situ por 144h indicada para reproduzir a fração indigestível dos indicadores nas amostras incubadas. Na estimativa da produção fecal o indicador externo óxido crômico apresentou resultado (1,26 kg dia-1) mais próximo ao da coleta total de fezes (1,49 kg dia-1). Para o fluxo duodenal de matéria seca, ambos indicadores internos superestimaram os resultados quando comparados ao indicador externo óxido crômico.

Times of in situ incubation (144 and 288h) for determination of internal markers IADF and INDF and the effects of differents procedures (wash or not the nylon bag every 72h incubation) was evaluated in samples of diet, duodenal digesta and cattle feces. The duodenal flow dry matter and fecal production utilizing the internal markers to compare with the external marker chromium oxide there was estimated. The animals were fed with sorgum silage, concentrate or urea. In this experiment, a latin square design was used, in a factorial scheme (two times of incubation x two processing nylon bag). No was observed effect of the incubation time or processing in the internal markers INDF and IADF concentration and the in situ incubation after 144h is adequate to reproduce the indigestible markers fraction in samples. For fecal production estimation, the external marker chromium oxide presented similar result (1.26 kg day-1) as the total fecal collection (1.49 kg day-1). Both the internal markers overestimate the duodenal flow dry matter when compared with the external marker chromium oxide.

Diferentes procedimentos na determinação de indicadores internos para estimativa de produção fecal e fluxo duodenal de matéria seca em bovinos / Different procedures for internal markers determination in fecal production and duodenal flow of dry matter estimate in cattle

Avaliou-se tempos de incubação in situ (144 e 288h) dos indicadores internos FDAi e FDNi e o efeito do procedimento (lavagem ou não dos sacos de náilon durante a incubação) em amostras da dieta, digesta duodenal e fezes bovina. O fluxo duodenal de matéria seca e a produção fecal utilizando esses indicadores internos em comparação ao indicador externo óxido crômico também foram estimados. Os animais receberam dietas compostas de silagem de híbridos de sorgo, concentrado ou uréia durante o experimento. O delineamento experimental adotado foi o quadrado latino 4x4 duplicado, sendo os tratamentos distribuídos em esquema fatorial (dois tempos de incubaçao x dois procedimentos de lavagem). Não houve efeito do tempo de incubação ou procedimento na concentração dos indicadores internos FDNi e FDAi sendo a incubação in situ por 144h indicada para reproduzir a fração indigestível dos indicadores nas amostras incubadas. Na estimativa da produção fecal o indicador externo óxido crômico apresentou resultado (1,26 kg dia-1) mais próximo ao da coleta total de fezes (1,49 kg dia-1). Para o fluxo duodenal de matéria seca, ambos indicadores internos superestimaram os resultados quando comparados ao indicador externo óxido crômico.(AU)

Times of in situ incubation (144 and 288h) for determination of internal markers IADF and INDF and the effects of differents procedures (wash or not the nylon bag every 72h incubation) was evaluated in samples of diet, duodenal digesta and cattle feces. The duodenal flow dry matter and fecal production utilizing the internal markers to compare with the external marker chromium oxide there was estimated. The animals were fed with sorgum silage, concentrate or urea. In this experiment, a latin square design was used, in a factorial scheme (two times of incubation x two processing nylon bag). No was observed effect of the incubation time or processing in the internal markers INDF and IADF concentration and the in situ incubation after 144h is adequate to reproduce the indigestible markers fraction in samples. For fecal production estimation, the external marker chromium oxide presented similar result (1.26 kg day-1) as the total fecal collection (1.49 kg day-1). Both the internal markers overestimate the duodenal flow dry matter when compared with the external marker chromium oxide.(AU)