"H" is not for hydroxychloroquine-"H" is for heparin: lack of efficacy of hydroxychloroquine and the role of heparin in COVID-19-preliminary data of a prospective and interventional study from Brazil.

BACKGROUND: COVID-19 pandemic is the major public health problem in the world actually. It's associated with high morbidity and mortality. To date, no therapeutic measure has a curative potential. Hydroxychloroquine (HCQ) is a drug with immunomodulatory properties that has demonstrated antiviral efficacy in in vitro experiments, with conflicting results in in vivo studies. METHODS: A single-center, prospective and interventional study, that evaluates the impact on mortality of the HCQ use in 154 patients hospitalized with COVID-19 in a Brazilian public hospital. The study also aims to determine prognostic factors that predict mortality, ICU admission and endotracheal intubation in this population. RESULTS: 154 patients diagnosed with COVID-19 confirmed by RT-PCR and hospitalized were included. There was a male predominance (87/154, 56.5%), median age 60 years and 88% (136/154) had comorbidities. Among these, 76% (117/154) were admitted to the ICU and 29.2% (45/154) experienced EOT. The OMR was 51.3% (79/154). There was no difference in mortality between patients treated with HCQ (N = 95) and non-HCQ (N = 59) (44.1% × 55.8%, p = 0.758). In univariate analysis, age ≥ 60 years (HR 3.62, p < 0.001), need for mechanical ventilation (HR 2.17, p = 0.001), ≥ 2 comorbidities (HR 1.83, p = 0.049), SAH (HR: 1.56, p = 0.054) were predictors of mortality, as well as no use of prophylactic or therapeutic heparin (HR 3.60, p = 0.02). Multivariate analysis identified admission to the ICU (HR 8.98, p = 0.002) and advanced age (HR 3.37, p < 0.01) as independent predictors of mortality, although, use of heparin (HR 0.25, p = 0.001) was independently associated with a favorable outcome. CONCLUSION: This study confirmed the absence of a benefit associated with the use of HCQ in Brazilian patients hospitalized with COVID-19. However, prophylactic or therapeutic heparin was an independent predictor for reducing mortality in this population.

High-Throughput Genomic Data Reveal Complex Phylogenetic Relationships in Stylosanthes Sw (Leguminosae).

Allopolyploidy is widely present across plant lineages. Though estimating the correct phylogenetic relationships and origin of allopolyploids may sometimes become a hard task. In the genus Stylosanthes Sw. (Leguminosae), an important legume crop, allopolyploidy is a key speciation force. This makes difficult adequate species recognition and breeding efforts on the genus. Based on comparative analysis of nine high-throughput sequencing (HTS) samples, including three allopolyploids (S. capitata Vogel cv. "Campo Grande," S. capitata "RS024" and S. scabra Vogel) and six diploids (S. hamata Taub, S. viscosa (L.) Sw., S. macrocephala M. B. Ferreira and Sousa Costa, S. guianensis (Aubl.) Sw., S. pilosa M. B. Ferreira and Sousa Costa and S. seabrana B. L. Maass & 't Mannetje) we provide a working pipeline to identify organelle and nuclear genome signatures that allowed us to trace the origin and parental genome recognition of allopolyploids. First, organelle genomes were de novo assembled and used to identify maternal genome donors by alignment-based phylogenies and synteny analysis. Second, nuclear-derived reads were subjected to repetitive DNA identification with RepeatExplorer2. Identified repeats were compared based on abundance and presence on diploids in relation to allopolyploids by comparative repeat analysis. Third, reads were extracted and grouped based on the following groups: chloroplast, mitochondrial, satellite DNA, ribosomal DNA, repeat clustered- and total genomic reads. These sets of reads were then subjected to alignment and assembly free phylogenetic analyses and were compared to classical alignment-based phylogenetic methods. Comparative analysis of shared and unique satellite repeats also allowed the tracing of allopolyploid origin in Stylosanthes, especially those with high abundance such as the StyloSat1 in the Scabra complex. This satellite was in situ mapped in the proximal region of the chromosomes and made it possible to identify its previously proposed parents. Hence, with simple genome skimming data we were able to provide evidence for the recognition of parental genomes and understand genome evolution of two Stylosanthes allopolyploids.

Alcoholic beverage purchase by Brazilian adolescents: individual and contextual factors associated in a multilevel analysis.

OBJECTIVE: To analyze the individual and contextual factors associated with the purchase of alcoholic beverages by adolescents in Brazil. METHODOLOGY: A cross-sectional study with data from the National Adolescent Health Survey (2015). The study sample consisted of 21,125 adolescents who reported having consumed alcohol in the 30 days before the survey. Bivariate and multivariate analysis was performed by calculating the Prevalence Ratios in a multilevel Poisson Regression (95%CI) to verify the effect of individual variables, school context, and Brazilian federation units on the outcome. RESULTS: 17.54% (95%CI 17.03-18.06) bought the alcoholic beverage for their consumption. The outcome was associated with male gender (PR 1.69; 95%CI 1.56-1.83), the age group from 15 to 17 years old (PR 1.52 95%CI 1.41-1.65), who ingested alcohol more than six times in 30 days (PR 1.47; 95%CI 1.37-1.61), who work (PR 1.26 95%CI 1.16-1.37), who are children of women with low education, who study in public schools (RP 1.16 95%CI 1.04-1.30), who missed classes (RP 1.14 95%CI 1.05-1.23) and who do not have a follow-up responsible in their free time (PR 1.13 95%CI 1.04-1.21) and who live in states with higher illiteracy rates of people aged 25 years old and over (PR=1.19; 95%CI 1, 02-1.39). CONCLUSION: The adolescents' access to alcohol purchase was associated with individual factors, the school context, and the federation unit. These findings indicate the importance of strengthening health promotion aimed at vulnerable youth people.

Assessment of BDNF serum levels as a diagnostic marker in children with autism spectrum disorder.

There has been a significant increase in autism spectrum disorder (ASD) in the last decades that cannot be exclusively attributed to better diagnosis and an increase in the communication of new cases. Patients with ASD often show dysregulation of proteins associated with synaptic plasticity, notably brain-derived neurotrophic factor (BDNF). The objective of the present study was to analyze BDNF serum concentration levels in children with classic forms autism and a healthy control group to determine if there is a correlation between ASD and BDNF serum levels. Forty-nine children with severe classic form of autism, and 37 healthy children were enrolled in the study. Blood samples, from both patients and controls, were collected and BNDF levels from both groups were analyzed. The average BDNF serum concentration level was statistically higher for children with ASD (P < 0.000) compared to the control group. There is little doubt that BDNF plays a role in the pathophysiology of ASD development and evolution, but its brain levels may fluctuate depending on several known and unknown factors. The critical question is not if BDNF levels can be considered a prognostic or diagnostic marker of ASD, but to determine its role in the onset and progression of this disorder.

Melhorias para a qualidade de vida e trabalho na visão dos agentes comunitários de saúde / Quality of life and work improvements according to community health agents

Introdução: O agente comunitário de saúde (ACS) tem papel fundamental ao atuar nas comunidades, interligando os serviços de saúde à população. Nesse contexto, é importante que esses profissionais tenham qualidade de vida e trabalho, para que possam ter bem-estar e ao mesmo tempo proporcionar maior qualidade na prestação de suas atribuições. Dessa forma, a pesquisa justifica- se como uma forma de repensar o processo de trabalho dessa categoria, possibilitando traçar propostas de melhorias. Objetivo: Discutir estratégias de melhorias da qualidade de vida e trabalho aos ACSs. Métodos: Trata-se de um estudo exploratório de abordagem qualitativa, realizado com os ACSs que atuam na cidade de Currais Novos, Rio Grande do Norte. Resultados: Foi possível evidenciar que as estratégias relacionadas à qualidade de vida e ao trabalho referem-se aos aspectos mentais e físicos, assim como aos recursos básicos para o desenvolvimento do trabalho. Conclusão: Há necessidade de discutir e dar sustentação para a implementação de melhorias das condições de vida e trabalho dos ACSs, produzindo um impacto positivo nesses profissionais e, consequentemente, nas ações desempenhadas por eles em seu exercício diário

Background: For acting at the level of the community and mediating between it and health services, the role of community health agents (CHA) is essential. For this reason, this occupational group needs satisfactory quality of life and working conditions to ensure their well-being and improve the quality of their work. On these grounds, the present study is justified as a means to reflect on the work process of this occupational group and enable suggestions for improvements. Objective: To discuss strategies to improve CHA's quality of life and work. Methods: Exploratory study with qualitative analysis conducted with CHA in Currais Novos, Rio Grande do Norte, Brazil. Results: Strategies suggested to improve quality of life and work focused on mental and physical aspects and the essential resources needed for work. Conclusion: Discussions and sound grounds are needed for initiatives to improve the living and working conditions of CHA and thus achieve a positive impact on this population of workers, and consequently also on their daily actions

Quality of life and work improvements according to community health agents.

BACKGROUND: For acting at the level of the community and mediating between it and health services, the role of community health agents (CHA) is essential. For this reason, this occupational group needs satisfactory quality of life and working conditions to ensure their well-being and improve the quality of their work. On these grounds, the present study is justified as a means to reflect on the work process of this occupational group and enable suggestions for improvements. OBJECTIVE: To discuss strategies to improve CHA's quality of life and work. METHODS: Exploratory study with qualitative analysis conducted with CHA in Currais Novos, Rio Grande do Norte, Brazil. RESULTS: Strategies suggested to improve quality of life and work focused on mental and physical aspects and the essential resources needed for work. CONCLUSION: Discussions and sound grounds are needed for initiatives to improve the living and working conditions of CHA and thus achieve a positive impact on this population of workers, and consequently also on their daily actions.

INTRODUÇÃO: O agente comunitário de saúde (ACS) tem papel fundamental ao atuar nas comunidades, interligando os serviços de saúde à população. Nesse contexto, é importante que esses profissionais tenham qualidade de vida e trabalho, para que possam ter bem-estar e ao mesmo tempo proporcionar maior qualidade na prestação de suas atribuições. Dessa forma, a pesquisa justifica-se como uma forma de repensar o processo de trabalho dessa categoria, possibilitando traçar propostas de melhorias. OBJETIVO: Discutir estratégias de melhorias da qualidade de vida e trabalho aos ACSs. MÉTODOS: Trata-se de um estudo exploratório de abordagem qualitativa, realizado com os ACSs que atuam na cidade de Currais Novos, Rio Grande do Norte. RESULTADOS: Foi possível evidenciar que as estratégias relacionadas à qualidade de vida e ao trabalho referem-se aos aspectos mentais e físicos, assim como aos recursos básicos para o desenvolvimento do trabalho. CONCLUSÃO: Há necessidade de discutir e dar sustentação para a implementação de melhorias das condições de vida e trabalho dos ACSs, produzindo um impacto positivo nesses profissionais e, consequentemente, nas ações desempenhadas por eles em seu exercício diário.

Effect of Himatanthus sucuuba in Maternal Reproductive Outcome and Fetal Anomaly Frequency in Rats.

The aim of this study was to evaluate the effect of Himatanthus sucuuba on the maternal reproductive outcome and fetal anomaly incidence in rats. Pregnant rats were randomly divided into three experimental groups as follows: Control = treated with water (vehicle), treated 250 = treated with H. sucuuba at dose 250 mg/kg, and treated 500 = treated with H. sucuuba at dose 500 mg/kg. The rats were orally treated, by gavage, with H. sucuuba or vehicle (water) during preimplantation and organogenic period (from gestational day 0-14). At day 21 of pregnancy, all rats were killed to obtain maternal-fetal data. The treatment with H. sucuuba at dose of 250 mg/kg caused reduction in placental efficiency and an increase preimplantation loss rate and placenta weight compared with the control. The treated 500 group presented a significant decrease in maternal weight gain, maternal weight gain minus gravid uterus weight, fetal weight, and placental efficiency compared with the control. In this group, there was a decrease in body weight at day 20 of pregnancy and metacarpus ossification and an increase in the preimplantation loss rate and skeletal anomalies compared with other groups. Himatanthus sucuuba extract caused intrauterine growth restriction, preimplantation loss, and developmental delay in the high doses tested.