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BACKGROUND: Duration of neuropsychological disorders caused by long COVID, and the variables that impact outcomes, are still largely unknown. OBJECTIVE: To describe the cognitive profile of patients with long COVID post-participation in a neuropsychological rehabilitation program and subsequent reassessment and identify the factors that influence recovery. METHODS: 208 patients (mean age of 48.8 y.o.), mostly female, were reevaluated 25 months after their first COVID infection and 17 months after their initial evaluation. Patients underwent subjective assessment, Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS), Phonemic Verbal Fluency and Clock Drawing Tests (NEUPSILIN) for executive functions, Hospital Anxiety and Depression Scale (HADS) and WHOQol-Bref. RESULTS: We noted a discrete improvement of neuropsychological symptoms 25 months after the acute stage of COVID-19; nonetheless, performance was not within the normative parameters of standardized neuropsychological testing. These results negatively impact QoL and corroborate patients' subjective assessments of cognitive issues experienced in daily life. Improvement was seen in those who participated in psychoeducational neuropsychological rehabilitation, had higher levels of education, and lower depression scores on the HADS. CONCLUSION: Our data reveal the persistence of long-term cognitive and neuropsychiatric disorders in patients with long COVID. Neuropsychological rehabilitation is shown to be important, whether in-person or online.
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COVID-19 , Disfunção Cognitiva , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Síndrome de COVID-19 Pós-Aguda , Treino Cognitivo , Qualidade de Vida , COVID-19/complicações , Testes Neuropsicológicos , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/psicologiaRESUMO
Resumo Objetivo Identificar os usuários de um Centro de Atenção Psicossocial que apresentam dependência de cuidador e seus fatores associados. Métodos Estudo ecológico, com coleta de dados secundários de prontuários de pessoas que vivem com transtorno mental, ocorrida no ano de 2018 em um Centro de Atenção Psicossocial no Centro-Oeste brasileiro. Na análise, usou-se como variável dependente "necessidade de cuidador". Resultados Na amostra de 360 prontuários, houve prevalência do sexo feminino (220; 61,1%), idade entre 35 a 59 anos (190; 52,8%), tempo de tratamento ≤5 anos (164; 45,6%), cuidado exercido por família/amigos (162; 45,0%), diagnóstico principal de transtornos psicóticos (128; 35,6%) e em uso de antipsicóticos (275; 76,4%). Na análise múltipla, permaneceram associadas as variáveis ter escolaridade não letrado/fundamental (p=0,041), possuir transtorno psicótico (p=0,009) e usar antidepressivo (p=0,026). Conclusão O estudo apontou que fatores como ser do sexo masculino, possuir escolaridade não letrado/fundamental, ter transtorno psicótico e fazer uso de antidepressivo possuem maiores índices para dependência de cuidados e devem ser considerados e investigados pela equipe dos Centros de Atenção Psicossocial.
Resumen Objetivo Identificar los usuarios de un Centro de Atención Psicosocial que presentan dependencia de cuidador y los factores asociados. Métodos Estudio ecológico, con recopilación de datos secundarios de historias clínicas de personas que viven con trastorno mental, realizada en el año 2018 en un Centro de Atención Psicosocial en la región Centro-Oeste brasileña. En el análisis, se utilizó como variable dependiente "necesidad de cuidador". Resultados En la muestra de 360 historias clínicas, hubo prevalencia del sexo femenino (220; 61,1 %), edad entre 35 y 59 años (190; 52,8 %), tiempo de tratamiento ≤5 años (164; 45,6 %), cuidado ejercido por familia/amigos (162; 45,0 %), diagnóstico principal de trastornos psicóticos (128; 35,6 %) y en uso de antipsicóticos (275; 76,4 %). En el análisis múltiple, estuvieron asociadas las variables tener escolaridad no letrada/primaria (p=0,041), poseer trastorno psicótico (p=0,009) y tomar antidepresivos (p=0,026). Conclusión El estudio indicó que factores como ser de sexo masculino, tener escolaridad no letrada/primaria, tener trastorno psicótico y tomar antidepresivos poseen mayores índices para la dependencia de cuidados y deben ser considerados e investigados por el equipo de los Centros de Atención Psicosocial.
Abstract Objective To identify users of a Psychosocial Care Center who have caregiver dependence and their associated factors. Method This is an ecological study, with collection of secondary data from medical records of people living with mental disorders, which occurred in 2018 in a Psychosocial Care Center in the Brazilian Midwest. In the analysis, the dependent variable "need for caregiver" was used as a dependent variable. Results In the sample of 360 medical records, there was a prevalence of women (220; 61.1%), aged between 35 and 59 years (190; 52.8%), treatment time ≤5 years (164; 45.6%), care provided by family/friends (162; 45.0%), main diagnosis of psychotic disorders (128; 35.6%) and antipsychotic use (275; 76.4%). In the multiple analysis, the variables non-literacy/elementary school (p=0.041), having psychotic disorder (p=0.009) and antidepressant (p=0.026) remained associated. Conclusion The study pointed out that factors such as being men, non-literate/elementary school, having a psychotic disorder and using antidepressants have higher rates of dependence on care and should be considered and investigated by the Psychosocial Care Center team.
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This study aimed to evaluate the nutritional and bioeconomic potential of rehydrated ground grain corn silage (RGGCS), at different storage times associated with proportions of concentrates for better starch utilization by lambs. Forty Dorper-Santa Inês crossbred lambs were used, with an average body weight of 24 ± 3.9 kg, and an average age of 90 days. The lambs were feedlot for 63 days in experiment design completely randomized, with eight repetitions and five experimental diets: Diet 1: 850 g/kg concentrate including dry ground corn; diet 2: 850 g/kg concentrate including RGGCS ensiled for 45 days; diet 3: 650 g/kg concentrate including RGGCS ensiled for 90 days; diet 4: 650 g/kg concentrate including RGGCS ensiled for 45 days; diet 5: 850 g/kg concentrate including RGGCS ensiled for 45 days. As roughage, silage corn whole plant. Starch intake was higher (P < 0.05) with the dry ground corn diet; however, digestibility was lower (P < 0.05) for most nutrients compared to the RGGCS diet. A smaller amount of starch in the feces of animals that received the RGGCS diet was found. A diet with 850 g/kg of concentrate, including RGGCS ensiled for 45 days, generates higher net income, increases nutrient intake, and could be an alternative during the fluctuation of corn prices.
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Silagem , Zea mays , Fenômenos Fisiológicos da Nutrição Animal , Animais , Digestão , Grão Comestível , Ovinos , Carneiro Doméstico , Silagem/análise , AmidoRESUMO
Studying the occurrence of Leishmania in bats would help toward clarifying the role of these animals in epidemiological cycles. Therefore, the objective of this study was to detect Leishmania spp. in bats from the Brazilian State of Espírito Santo. In total, 105 bats from 11 species which had been collected from 17 municipalities of Espírito Santo were obtained from the IDAF Rabies Diagnostic Laboratory between December 2018 and June 2019. DNA was extracted from the bone marrow, skin, and spleen samples and analysed using conventional PCR, with primers specific for the kinetoplastic DNA minicircle of the parasitic species Leishmania (Viannnia) braziliensis, Leishmania (Leishmania) infantum, and Leishmania (Leishmania) amazonensis. To identify the Leishmania species, the positive PCR products were analysed using PCR-RFLP with the HaeIII enzyme and 8% polyacrylamide gel electrophoresis. Positivity for L. (V.) braziliensis was observed in five (4.76%) bats: namely, one male Eumops glaucinus from Vitória (in a skin sample), one male Artibeus lituratus from Vila Velha and one female Eumops glaucinus from Vitória (both in bone marrow samples), and one male A. lituratus from Vitória and one male Molossus rufus from Guarapari (both in the spleen samples). To our best knowledge, this is the first report of the detection of Leishmania in bats from Espírito Santo as well as of Leishmania DNA in the bone marrow of bats.
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Quirópteros , Leishmania braziliensis , Leishmania infantum , Animais , Brasil/epidemiologia , DNA de Cinetoplasto , Feminino , Leishmania braziliensis/genética , Leishmania infantum/genética , MasculinoRESUMO
Visceral leishmaniosis is one of the most important zoonotic diseases on the planet and dogs are the main reservoir of canine visceral leishmaniosis (CVL) in endemic areas. They play an important role in human infection because in dogs the disease appears long time after infection, and they can move uncontrollably, contributing to disperse the parasite. To take the decision to treat the animals or for euthanasia, in an elimination programme, in order to reduce the parasitic load, it is necessary to diagnose correctly, having more effective tools. Our group has developed a new recombinant antigen-based kinesin-related gene of Leishmania braziliensis (Lbk39), which shows 59% amino acid identity to the L. infantum homologue. The Lbk39 gene was synthesized, inserted into the pLEXSY-sat2 vector and transfected into L. tarentolae cells by electroporation. The recombinant protein was secreted in the culture with a C-terminal histidine marker, purified, generating a product at 337.68 µg mL-1. A total of 152 sera from dog's endemic and non-endemic areas were used, being 78 positives and 75 negatives. The antigen Lbk39 showed 100% sensitivity and 96.1% specificity. We compared this antigen with other antigens such as total extract of the parasite, TRDPP, and our data indicate that Lbk39 has potential application in the diagnosis of CVL through antibody detection.
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Doenças do Cão/diagnóstico , Leishmania braziliensis/genética , Leishmaniose Visceral/veterinária , Proteínas de Protozoários/uso terapêutico , Animais , Doenças do Cão/parasitologia , Cães , Leishmania/genética , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/parasitologia , Microrganismos Geneticamente Modificados/genética , Proteínas Recombinantes/uso terapêuticoRESUMO
The objective of this study was to develop a specific equation for the conversion of pressure values (psi) to volume (ml) for the Laboratory of Bromatology of the Federal University of Western Pará. To this end, the ruminal fermentation kinetics of regional feedstuffs were evaluated using the semi-automatic technique of in-vitro gas production. To set up the targeted equation, samples of ground corn, soybean meal, rice bran, Mombasa grass, cupuassu pie, cassava residues, and banana leaves were incubated and the pressure and volumes of the gases produced during the fermentation process were measured at predetermined times and related. These data on the volume of produced gases were used to determine, by applying the bi-compartmental logistic model, the ruminal fermentation kinetics parameters. The equation found for the laboratory was V = 0.3757P2 + 1.5972P + 0.2189. Ground corn and cassava residue showed a higher degradation rate of non-fibrous carbohydrates (0.120 and 0.163 %/h respectively) and higher final gas volume (228.91 and 273.17 ml/g of DM, respectively). As for the degradation rate of fibrous carbohydrates, ground corn (0.023 %/h), rice bran (0.023 %/h), and cassava residue (0.021 %/h) presented the highest degradation rate. Thus, a specific equation to be used at the Laboratory of Bromatology of the Federal University of Western Pará was identified, according to the method applied and the altitude of the premises. Ruminal fermentation kinetics of cassava residue and rice bran showed the same parameters as corn, which may suggest the possibility of replacing corn in the diet of ruminant animals.(AU)
O objetivo deste estudo foi desenvolver uma equação específica para a conversão de valores de pressão (psi) em volume (ml) para o Laboratório de Bromatologia da Universidade Federal do Oeste do Pará. Para tanto, avaliou-se a cinética fermentativa ruminal de rações regionais por meio da técnica semiautomática de produção de gases in vitro. Para configurar a equação alvo, amostras de milho moído, farelo de soja, farelo de arroz, capim Mombaça, torta de cupuaçu, resíduos de mandioca e folhas de bananeira foram incubadas e a pressão e os volumes dos gases produzidos durante o processo de fermentação foram medidos em tempos predeterminados e relacionado. Esses dados de volume de gases produzidos foram utilizados para determinar, por meio da aplicação do modelo logístico bicompartimental, os parâmetros cinéticos da fermentação ruminal. A equação encontrada para o laboratório foi V = 0,3757P2 + 1,5972P + 0,2189. Milho moído e resíduo de mandioca apresentaram maior taxa de degradação de carboidratos não fibrosos (0,120 e 0,163% / h respectivamente) e maior volume final de gás (228,91 e 273,17 ml / g de MS, respectivamente). Quanto à taxa de degradação dos carboidratos fibrosos, milho moído (0,023% / h), farelo de arroz (0,023% / h) e resíduo de mandioca (0,021% / h) apresentaram as maiores taxas de degradação. Assim, foi identificada uma equação específica para ser utilizada no Laboratório de Bromatologia da Universidade Federal do Oeste do Pará, de acordo com o método aplicado e a altitude das instalações.(AU)
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Ração Animal/análise , Pesquisa , Ruminação Digestiva , Técnicas In Vitro , Testes LaboratoriaisRESUMO
An amendment to this paper has been published and can be accessed via the original article.
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BACKGROUND: To improve the use of eRehabilitation after stroke, the identification of barriers and facilitators influencing this use in different healthcare contexts around the world is needed. Therefore, this study aims to investigate differences and similarities in factors influencing the use of eRehabilitation after stroke among Brazilian Healthcare Professionals (BHP) and Dutch Healthcare Professionals (DHP). METHOD: A cross-sectional survey study including 88 statements about factors related to the use of eRehabilitation (4-point Likert scale; 1-4; unimportant-important/disagree-agree). The survey was conducted among BHP and DHP (physical therapists, rehabilitating physicians and psychologists). Descriptive statistics were used to analyse differences and similarities in factors influencing the use of eRehabilitation. RESULTS: ninety-nine (response rate 30%) BHP and 105 (response rate 37%) DHP participated. Differences were found in the top-10 most influencing statements between BHP and DHP BHP rated the following factors as most important: sufficient support from the organisation (e.g. the rehabilitation centre) concerning resources and time, and potential benefits of the use of eRehabilitation for the patient. DHP rated the feasibility of the use of eRehabilitation for the patient (e.g. a helpdesk and good instructions) as most important for effective uptake. Top-10 least important statements were mostly similar; both BHP and DHP rated problems caused by stroke (e.g. aphasia or cognitive problems) or problems with resources (e.g. hardware and software) as least important for the uptake of eRehabilitation. CONCLUSION: The results indicate that the use of eRehabilitation after stroke by BHP and DHP is influenced by different factors. A tailored implementation strategy for both countries needs to be developed.
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Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Reabilitação do Acidente Vascular Cerebral/métodos , Telemedicina , Adulto , Afasia/reabilitação , Brasil , Estudos Transversais , Feminino , Grupos Focais , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Pesquisa Qualitativa , Centros de ReabilitaçãoRESUMO
The objective of this study was to develop a specific equation for the conversion of pressure values (psi) to volume (ml) for the Laboratory of Bromatology of the Federal University of Western Pará. To this end, the ruminal fermentation kinetics of regional feedstuffs were evaluated using the semi-automatic technique of in-vitro gas production. To set up the targeted equation, samples of ground corn, soybean meal, rice bran, Mombasa grass, cupuassu pie, cassava residues, and banana leaves were incubated and the pressure and volumes of the gases produced during the fermentation process were measured at predetermined times and related. These data on the volume of produced gases were used to determine, by applying the bi-compartmental logistic model, the ruminal fermentation kinetics parameters. The equation found for the laboratory was V = 0.3757P2 + 1.5972P + 0.2189. Ground corn and cassava residue showed a higher degradation rate of non-fibrous carbohydrates (0.120 and 0.163 %/h respectively) and higher final gas volume (228.91 and 273.17 ml/g of DM, respectively). As for the degradation rate of fibrous carbohydrates, ground corn (0.023 %/h), rice bran (0.023 %/h), and cassava residue (0.021 %/h) presented the highest degradation rate. Thus, a specific equation to be used at the Laboratory of Bromatology of the Federal University of Western Pará was identified, according to the method applied and the altitude of the premises. Ruminal fermentation kinetics of cassava residue and rice bran showed the same parameters as corn, which may suggest the possibility of replacing corn in the diet of ruminant animals.
O objetivo deste estudo foi desenvolver uma equação específica para a conversão de valores de pressão (psi) em volume (ml) para o Laboratório de Bromatologia da Universidade Federal do Oeste do Pará. Para tanto, avaliou-se a cinética fermentativa ruminal de rações regionais por meio da técnica semiautomática de produção de gases in vitro. Para configurar a equação alvo, amostras de milho moído, farelo de soja, farelo de arroz, capim Mombaça, torta de cupuaçu, resíduos de mandioca e folhas de bananeira foram incubadas e a pressão e os volumes dos gases produzidos durante o processo de fermentação foram medidos em tempos predeterminados e relacionado. Esses dados de volume de gases produzidos foram utilizados para determinar, por meio da aplicação do modelo logístico bicompartimental, os parâmetros cinéticos da fermentação ruminal. A equação encontrada para o laboratório foi V = 0,3757P2 + 1,5972P + 0,2189. Milho moído e resíduo de mandioca apresentaram maior taxa de degradação de carboidratos não fibrosos (0,120 e 0,163% / h respectivamente) e maior volume final de gás (228,91 e 273,17 ml / g de MS, respectivamente). Quanto à taxa de degradação dos carboidratos fibrosos, milho moído (0,023% / h), farelo de arroz (0,023% / h) e resíduo de mandioca (0,021% / h) apresentaram as maiores taxas de degradação. Assim, foi identificada uma equação específica para ser utilizada no Laboratório de Bromatologia da Universidade Federal do Oeste do Pará, de acordo com o método aplicado e a altitude das instalações.
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Ração Animal/análise , Ruminação Digestiva , Técnicas In Vitro , Testes LaboratoriaisRESUMO
The leishmaniases are multifactorial zoonotic diseases requiring a multidisciplinary One Health approach for diagnosis and control. For leishmaniasis diagnosis, here we describe production of a new recombinant protein based on a kinesin-related gene of Leishmania braziliensis (Lbk39), which shows 59% amino acid identity to the L. infantum homologue. The Lbk39 gene was synthesized, inserted into the pLEXSY-sat2 vector and transfected into L. tarentolae cells by electroporation. Culturing was carried out, and the secreted recombinant protein with a C-terminal histidine tag purified using nickel affinity chromatography on the culture supernatant, yielding a final product at 0.4â¯mg/mL. An indirect enzyme linked immunosorbent assay (ELISA) was standardised using sera from 74 Brazilian patients with cutaneous leishmaniasis and 11 with visceral leishmaniasis. Optimal ELISA conditions were established for the Lbk39 antigen in comparison with a crude extract from L. braziliensis. The sensitivity, specificity analysis and receiver operating characteristic (ROC) curve were determined with a significance level of 5%. The ROC curve showed a good accuracy with an area under curve (AUC)â¯=â¯0.967, pâ¯<â¯0.001 (0.941-0.993) for CL patients and an AUCâ¯=â¯100 (100-100) for VL patients. The values of sensitivity and specificity were 88 and 98% for CL and 100 and 100% for VL, respectively. The study showed good production and expression of the target protein and has generated a potential new antigen for the diagnosis of leishmaniasis.