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Comparative Nutritional Profile of Publicly Procured Foods for School Meals in Federal Schools in Northeastern Brazil Pre- and Post-COVID-19 Pandemic.
Silva, WFFD, Bezerra, IWL, Vale, D, Oliveira, AG, Seabra, LMJ
Nutrients. 2024;(1)
Abstract
UNLABELLED School meals play a critical role in supporting students' biopsychosocial growth, development, learning, academic performance, and the establishment of healthy eating habits. In public institutions, food procurement is conducted through formal public procurement processes. However, emphasizing cost-effectiveness in bidding criteria, such as prioritizing the lowest product price, may inadvertently encourage the acquisition of foods high in critical nutrients. In Brazil, specific guidelines for public school food procurement have been introduced to improve the nutritional quality of foods included in school menus. OBJECTIVE To evaluate the impact of legislative measures and regulations implemented during the COVID-19 pandemic on the nutritional composition of school meals provided by federal high schools in Rio Grande do Norte, located in northeastern Brazil. It also compared the composition and origin of foods procured before and after the pandemic. METHODS This is a longitudinal observational panel study conducted across 20 federal schools. Procurement documents from 2019 (pre-pandemic) and 2021 (post-pandemic) were analyzed to assess changes in the nutritional profile of procured foods. RESULTS Post-pandemic, the procurement of natural and minimally processed and processed foods increased, representing 73.39% and 10.34%, respectively, of the total approved foods. There was also a 39% reduction in ultra-processed foods compared to 2019, in addition to a reduction in culinary ingredients. Additionally, the proportion of foods containing excessive levels of critical nutrients declined. A significant shift was observed in the origin of procured foods, with a notable increase in the purchase of locally sourced items. CONCLUSIONS The findings indicate a positive shift in the nutritional quality of foods procured after the COVID-19 pandemic, with a decrease in ultra-processed food purchases and an increase in the procurement of natural and minimally processed options. Nonetheless, the continued presence of ultra-processed foods and items with excessive critical nutrients highlights the need for further improvements in public procurement practices to fully align with nutritional guidelines.
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2.
Comparison of antibody responses of heterologous and homologous Covid-19 booster vaccination: an observational study.
Rizvi, NB, Bibi, M, Rana, MZ, Zaffar, S, Farooq, H
Frontiers in immunology. 2024;:1448408
Abstract
OBJECTIVE Pakistan has been seriously affected by the COVID-19 pandemic, with numerous waves of infection. Using different vaccine and booster doses was a key component to control and combat this pandemic. This study aims to monitor the heterologous and homologous booster vaccination doses that generate immune responses in healthy adults after 9 months of vaccination. METHODS In this cross-sectional, observational study a total of 173 samples were collected. Participants from both genders (Male and Female) between the ages of 18 to 25 years were enrolled for the study. Participants who had booster shots of homologous Sinopharm BBIBP CorV and heterologous Pfizer-BioNTech vaccines were included only, with the use of a Roche Cobas-e601 analyzer, the antibody titers in the blood serum were quantified by the ECLIA method. IBM SPSS 22 was utilized for descriptive statistical analysis and P< 0.05 was considered significant. RESULTS In this study the IgG antibody levels were measured against the full length of receptor binding domain (RBD) of the spike (S) protein. The mean antibody titer in the Pfizer group was 9764 ± 10976 U/mL and 5762 ± 4302 U/mL in the Sinopharm group. The Mean IgG antibody levels of the Pfizer-vaccinated group were significantly higher than the Sinopharm-vaccinated group (P=0.000, each). Comparing the Sinopharm BBIBP CorV booster dosage to the Pfizer booster, Pfizer BNT162b2demonstrated a stronger immune response. However, there were no immunological gender-specific significant differences. The administration of a third dosage of Pfizer BNT162b2 after two doses of BBIBP CorV. CONCLUSION The administration of a third dosage of Pfizer BNT162b2 after two doses of BBIBP-CorV is recommended to boost the humoral immune response in the general population while there was no gender-specific difference observed. More effectiveness can be attained by administering additional doses due to the antibody decay.
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3.
A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia.
Short, V, Allen, R, Earley, CJ, Bahrain, H, Rineer, S, Kashi, K, Gerb, J, Auerbach, M
American journal of hematology. 2024;(6):1077-1083
Abstract
Restless legs syndrome (RLS) is a neurological disorder that can have a profound effect on sleep and quality of life. Idiopathic RLS is associated with brain iron insufficiency despite normal peripheral iron stores. There is, however, a five- to six-fold increase in prevalence of RLS in patients with iron deficiency anemia (IDA). Several open-label trials have demonstrated symptomatic improvement in RLS following treatment of IDA using oral or intravenous iron supplementation. To date, there have been no randomized double-blind controlled trials of intravenous iron compared with oral iron for the treatment of RLS patients with IDA. In the current study, oral ferrous sulfate and ferumoxytol were compared for efficacy and speed of response for treatment of RLS occurring in patients with IDA. The planned recruitment for this study was 70 patients with RLS and IDA, to be randomly assigned 1:1 to oral or intravenous iron, using double-blind, double-dummy procedures. At Week 6, the primary outcomes of Clinical Global Impression-Improvement score and change from baseline in the International Restless Legs Syndrome Study Group rating scale score were assessed. Due to challenges, performing the clinical trial during the COVID-19 pandemic, final-week data were found missing for 30 patients. As a result, in order to maintain the prespecified statistical analysis, an additional 30 patients were recruited. Both IV and oral iron were associated with a marked improvement in RLS symptoms, with no statistically significant difference between treatment groups. No serious adverse events were observed in either treatment group.
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Post-COVID-19 recovery and geriatric rehabilitation care: a European inter-country comparative study.
van Tol, LS, Lin, T, Caljouw, MAA, Cesari, M, Dockery, F, Everink, IHJ, Francis, BN, Gordon, AL, Grund, S, Matchekhina, L, et al
European geriatric medicine. 2024;(5):1489-1501
Abstract
PURPOSE There is variation in organization of geriatric rehabilitation across Europe. The purpose of this study was to describe the selection criteria for referral to geriatric rehabilitation, care provided, and recovery trajectories of post-COVID-19 patients referred to geriatric rehabilitation in Europe. METHODS This observational cohort study included 723 patients in 59 care facilities for geriatric rehabilitation across 10 countries. Patient data were collected from medical records on admission to geriatric rehabilitation (between September 2020 and October 2021), discharge, 6 weeks and 6 months follow-up. The primary and secondary outcomes were recovery in daily functioning (Barthel Index) and Quality of Life (EQ-5D-5L) from admission to discharge. These were examined using linear mixed models with two levels (measurements nested in patients) and country as an independent variable. Random intercept and random linear slope parameters were added when they improved model fit. A survey about organization of geriatric rehabilitation for post-COVID-19 patients was filled out by country coordinators and data were analyzed using descriptive statistics and inductive coding of answers to open questions. RESULTS Patients had a mean age of 75.7 years old and 52.4% were male. Many countries used various combinations of the selection criteria, such as functional status, age, frailty, Comprehensive Geriatric Assessment, comorbidities, and cognitive impairments. Most patients received physiotherapy (88.8%) and occupational therapy (69.7%), but there was substantial variance between countries in the percentages of patients that received protein or calorie enriched diets, oxygen therapy, and other treatment components. In all countries, patients showed recovery in daily functioning and quality of life, although there was variation in between countries in rate of recovery. Daily functioning seemed to increase most rapidly in the Czech Republic, Germany, and Russia. The steepest increases in quality of life were seen in the Czech Republic, Germany, and Spain. CONCLUSION Post-COVID-19 patients showed recovery during geriatric rehabilitation, albeit at variable rates. The observed variation may be explained by the heterogeneity in selection criteria and care provided. This study highlights the need for harmonization of measurements in geriatric rehabilitation order to perform explanatory research and optimize geriatric rehabilitation throughout Europe to ensure optimal patient recovery.
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A Comparative Analysis of SARS-CoV-2 Variants of Concern (VOC) Spike Proteins Interacting with hACE2 Enzyme.
Chen, J, Chen, L, Quan, H, Lee, S, Khan, KF, Xie, Y, Li, Q, Valero, M, Dai, Z, Xie, Y
International journal of molecular sciences. 2024;(15)
Abstract
In late 2019, the emergence of a novel coronavirus led to its identification as SARS-CoV-2, precipitating the onset of the COVID-19 pandemic. Many experimental and computational studies were performed on SARS-CoV-2 to understand its behavior and patterns. In this research, Molecular Dynamic (MD) simulation is utilized to compare the behaviors of SARS-CoV-2 and its Variants of Concern (VOC)-Alpha, Beta, Gamma, Delta, and Omicron-with the hACE2 protein. Protein structures from the Protein Data Bank (PDB) were aligned and trimmed for consistency using Chimera, focusing on the receptor-binding domain (RBD) responsible for ACE2 interaction. MD simulations were performed using Visual Molecular Dynamics (VMD) and Nanoscale Molecular Dynamics (NAMD2), and salt bridges and hydrogen bond data were extracted from the results of these simulations. The data extracted from the last 5 ns of the 10 ns simulations were visualized, providing insights into the comparative stability of each variant's interaction with ACE2. Moreover, electrostatics and hydrophobic protein surfaces were calculated, visualized, and analyzed. Our comprehensive computational results are helpful for drug discovery and future vaccine designs as they provide information regarding the vital amino acids in protein-protein interactions (PPIs). Our analysis reveals that the Original and Omicron variants are the two most structurally similar proteins. The Gamma variant forms the strongest interaction with hACE2 through hydrogen bonds, while Alpha and Delta form the most stable salt bridges; the Omicron is dominated by positive potential in the binding site, which makes it easy to attract the hACE2 receptor; meanwhile, the Original, Beta, Delta, and Omicron variants show varying levels of interaction stability through both hydrogen bonds and salt bridges, indicating that targeted therapeutic agents can disrupt these critical interactions to prevent SARS-CoV-2 infection.
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Comparison of 2 methods for sterilization of filtering facepiece respirators worn for extended periods during the COVID-19 pandemic: An experimental laboratory study.
Costa, DG, Margatho, AS, Ciol, MA, Hoffman, JM, Ferreira, EB, do Monte, AFG, Silveira, RCCP
American journal of infection control. 2024;(11):1263-1268
Abstract
BACKGROUND During the COVID-19 pandemic, there was a shortage of filtering facepiece respirators (FFR), leading to prolonged use and reuse of FFRs. METHODS FFRs were collected in 3 hospitals after extended use (up to 15 or 30days). We assessed the physical characteristics and filtration levels of worn FFRs, before sterilization. Respirators that achieved at least 94% filtration of aerosol particles, nasal clip still attached, had no tears, had preserved elastic bands, and had no dirt were randomized to receive or not receive cleaning before being submitted to hydrogen peroxide plasma gas sterilization. RESULTS A total of 1,055 FFRs were collected. Over 85% of them exhibited secured nose clips, preserved strap elasticity, and no tears. However, more than 78% of samples contained dirt, leaving only 101 (19.6%) eligible to undergo sterilization. After sterilization, none of the FFRs in either group achieved minimum filtration, although 72% without cleaning and 80% with cleaning had filtration between 90.0% and 93.9%. DISCUSSION A large proportion of FFRs were ineligible for sterilization due to factors unrelated to health care (eg, dirt from makeup). CONCLUSIONS Prolonged reuse of FFRs significantly reduced aerosol filtration efficiency. Eligible FFRs did not maintain 94% filtration after sterilization with or without cleaning.
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Postintensive care syndrome in patients and family members. Analysis of COVID-19 and non-COVID-19 cohorts, with face-to-face follow-up at three months and one year.
Giménez-Esparza Vich, C, Oliver Hurtado, B, Relucio Martinez, MA, Sanchez Pino, S, Portillo Requena, C, Simón Simón, JD, Pérez Gómez, IM, Andrade Rodado, FM, Laghzaoui Harbouli, F, Sotos Solano, FJ, et al
Medicina intensiva. 2024;(8):445-456
Abstract
OBJECTIVE Compare prevalence and profile of post-intensive care patient (P-PICS) and family/caregiver (F-PICS) syndrome in two cohorts (COVID and non-COVID) and analyse risk factors for P-PICS. DESIGN Prospective, observational cohort (March 2018-2023), follow-up at three months and one year. SETTING 14-bed polyvalent Intensive Care Unit (ICU), Level II Hospital. PATIENTS OR PARTICIPANTS 265 patients and 209 relatives. Inclusion criteria patients: age > 18 years, mechanical ventilation > 48 h, ICU stay > 5 days, delirium, septic shock, acute respiratory distress syndrome, cardiac arrest. Inclusion criteria family: those who attended. INTERVENTIONS Follow-up 3 months and 1 year after hospital discharge. MAIN VARIABLES OF INTEREST Patients: sociodemographic, clinical, evolutive, physical, psychological and cognitive alterations, dependency degree and quality of life. Main caregivers: mental state and physical overload. RESULTS 64.9% PICS-P, no differences between groups. COVID patients more physical alterations than non-COVID (P = .028). These more functional deterioration (P = .005), poorer quality of life (P = .003), higher nutritional alterations (P = .004) and cognitive deterioration (P < .001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; P = .013). Independent predictors of PICS-P: first years of the study (OR: 0.484), higher comorbidity (OR: 1.158), delirium (OR: 2.935), several reasons for being included (OR: 3.171) and midazolam (OR: 4.265). CONCLUSIONS Prevalence PICS-P and PICS-F between both cohorts was similar. Main factors associated with the development of SPCI-P were: higher comorbidity, delirium, midazolan, inclusion for more than one reason and during the first years.
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Reduction of SARS-CoV-2 viral load in saliva after rinsing with mouthwashes containing cetylpyridinium chloride: a randomized clinical study.
Bezinelli, LM, Corrêa, L, Beyerstedt, S, Franco, ML, Rangel, ÉB, Benítez, CG, Hamerschlak, N, Pinho, JRR, Heller, D, Eduardo, FP
PeerJ. 2023;:e15080
Abstract
BACKGROUND Symptomatic patients with COVID-19 typically have a high SARS-CoV-2 viral load in their saliva. Procedures to reduce the viral load in their oral cavity are important for mitigating the viral transmission. METHODS This randomized clinical trial investigated the impact of two mouthwashes (0.075% cetylpyridinium chloride plus 0.28% zinc lactate (CPC+Zn) (n = 32), and 0.075% cetylpyridinium chloride (CPC) (n = 31)) on the viral load of SARS-CoV-2 in saliva when compared to the distilled water negative control (n = 32). Saliva was collected before (T0) and after (5 min, T1; 30 min, T2; and 60 min, T3) the intervention. Viral load in saliva was measured by qRT-PCR assays. The data in both groups was normalized for T0 and Negative Control, resulting in fold change values. RESULTS CPC+Zn oral solution reduced the viral load in saliva by 6.34-fold at T1, 3.6-fold at T2 and 1.9-fold at T3. Rinsing with the CPC mouthwash reduced the viral load in saliva by 2.5-fold at T1, 1.9-fold at T2 and 2.0-fold at T3. CONCLUSION CPC+Zn mouthwash or with the CPC mouthwash reduced the viral load in saliva of COVID-19 patients immediately after rinsing. These reductions extended up to 60 min.
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9.
Shared Decision-Making in General Surgery: Prospective Comparison of Telemedicine vs In-Person Visits.
Hawkins, AT, Ueland, T, Aher, C, Geiger, TM, Spann, MD, Horst, SN, Schafer, IV, Ye, F, Fan, R, Sharp, KW
Journal of the American College of Surgeons. 2023;(4):762-771
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has accelerated a shift toward virtual telemedicine appointments with surgeons. While this form of healthcare delivery has potential benefits for both patients and surgeons, the quality of these interactions remains largely unstudied. We hypothesize that telemedicine visits are associated with lower quality of shared decision-making. STUDY DESIGN We performed a mixed-methods, prospective, observational cohort trial. All patients presenting for a first-time visit at general surgery clinics between May 2021 and June 2022 were included. Patients were categorized by type of visit: in-person vs telemedicine. The primary outcome was the level of shared decision-making as captured by top box scores of the CollaboRATE measure. Secondary outcomes included quality of shared decision-making as captured by the 9-item Shared Decision-Making Questionnaire and satisfaction with consultation survey. An adjusted analysis was performed accounting for potential confounders. A qualitative analysis of open-ended questions for both patients and practitioners was performed. RESULTS During a 13-month study period, 387 patients were enrolled, of which 301 (77.8%) underwent in-person visits and 86 (22.2%) underwent telemedicine visits. The groups were similar in age, sex, employment, education, and generic quality-of-life scores. In an adjusted analysis, a visit type of telemedicine was not associated with either the CollaboRATE top box score (odds ratio 1.27; 95% CI 0.74 to 2.20) or 9-item Shared Decision-Making Questionnaire (β -0.60; p = 0.76). Similarly, there was no difference in other outcomes. Themes from qualitative patient and surgeon responses included physical presence, time investment, appropriateness for visit purpose, technical difficulties, and communication quality. CONCLUSIONS In this large, prospective study, there does not appear to be a difference in quality of shared decision making in patients undergoing in-person vs telemedicine appointments.
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10.
Chinese Medicine Meets Conventional Medicine in Targeting COVID-19 Pathophysiology, Complications and Comorbidities.
Wang, SS, Zeng, X, Wang, YL, Dongzhi, Z, Zhao, YF, Chen, YZ
Chinese journal of integrative medicine. 2022;(7):627-635
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Abstract
OBJECTIVE To investigate how the National Health Commission of China (NHCC)-recommended Chinese medicines (CMs) modulate the major maladjustments of coronavirus disease 2019 (COVID-19), particularly the clinically observed complications and comorbidities. METHODS By focusing on the potent targets in common with the conventional medicines, we investigated the mechanisms of 11 NHCC-recommended CMs in the modulation of the major COVID-19 pathophysiology (hyperinflammations, viral replication), complications (pain, headache) and comorbidities (hypertension, obesity, diabetes). The constituent herbs of these CMs and their chemical ingredients were from the Traditional Chinese Medicine Information Database. The experimentally-determined targets and the activity values of the chemical ingredients of these CMs were from the Natural Product Activity and Species Source Database. The approved and clinical trial drugs against these targets were searched from the Therapeutic Target Database and DrugBank Database. Pathways of the targets was obtained from Kyoto Encyclopedia of Genes and Genomes and additional literature search. RESULTS Overall, 9 CMs modulated 6 targets discovered by the COVID-19 target discovery studies, 8 and 11 CMs modulated 8 and 6 targets of the approved or clinical trial drugs for the treatment of the major COVID-19 complications and comorbidities, respectively. CONCLUSION The coordinated actions of each NHCC-recommended CM against a few targets of the major COVID-19 pathophysiology, complications and comorbidities, partly have common mechanisms with the conventional medicines.