Case Report: SARS-CoV-2 Infection in a Child With Suprasellar Tumor and Hypothalamic-Pituitary Failure

In early 2020, a novel coronavirus leading to potentially death was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread to become a worldwide pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the endocrinological impact that COVID-19 may have, especially in vulnerable individuals with pre-existing endocrinological health conditions. To date new information is emerging regarding severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in children but the literature is still scarce concerning this infection in patients with intracranial malignant neoplasms. We report a 9-year-old child infected with SARS-CoV-2 and recent diagnosis of suprasellar non-germinomatous germ cell tumor also suffering from diabetes insipidus and hypothalamic-pituitary failure (hypothyroidism, adrenal insufficiency, hypothalamic obesity and growth hormone deficiency) and its clinical course. The patient remained asymptomatic for the duration of the infection without requiring any change in the replacement therapeutic dosages taken before the infection. We then discuss the proposed approach to treat a pediatric patient with SARS-CoV-2 infection and hypothalamic-pituitary failure and we include a review of the literature. Our report suggests that SARS-CoV-2 infection is usually mild and self-limiting in children even those immunocompromised and with multiple endocrinological deficits. Patients are advised to keep any scheduled appointments unless informed otherwise

FATORES ASSOCIADOS À DURAÇÃO DOS COCHILOS ENTRE IDOSOS COMUNITÁRIOS: DADOS DO ESTUDO MULTICÊNTRICO FIBRA

This study aimed to analyze the association between the duration of the nap and the variables gender, age, education, family income, frailty levels and frailty criteria of community-dwelling elderly. This was a descriptive and cross-sectional study, an excerpt from the multicenter project Frailty in Elderly Brazilians. A total of 3,075 older adults were evaluated, aged 65 and over, using a sociodemographic questionnaire, question about nap (Minnesota Leisure Activity Questionnaire), phenotype of frailty proposed by Fried and screening test for cognitive impairment (Mini Mental State Examination). Descriptive analysis, Mann-Whitney and Kruskal-Wallis tests (p<0.05) and multiple linear regression were applied. Ethical principles were respected. Most of the elderly participants napped (61.7%), with an average of 53.4±42.7 min/day. There was an association between duration of naps and variables gender (p=0.002), frailty (p=0.022) and frailty criterion "hand grip strength" (p=0.008). It was observed that the length of the naps is greater for male and frail elderly.Objetivou-se analisar associação entre a duração do cochilo e as variáveis gênero, idade, escolaridade, renda familiar, níveis de fragilidade e os critérios de fragilidade de idosos comunitários. Estudo descritivo e transversal, recorte do projeto multicêntrico Fragilidade em Idosos Brasileiros. Foram avaliados 3.075 idosos, com idade de 65 anos ou mais, utilizando-se questionário sociodemográfico, questão sobre cochilo (Minnesota Leisure Activity Questionnaire), fenótipo de fragilidade proposto por Fried e o teste de rastreio de alterações cognitivas (Mini Exame do Estado Mental). Realizaram-se análise descritiva, testes Mann-Whitney e Kruskal-Wallis (p<0,05) e regressão linear múltipla. Os princípios éticos foram respeitados. A maioria dos idosos participantes cochilava (61,7%), com valores médios de 53,4±42,7 minutos/dia. Houve associação entre a duração dos cochilos e as variáveis gênero (p=0,002), fragilidade (p=0,022) e o critério de fragilidade "força de preensão manual" (p=0,008). Observou-se que a duração dos cochilos é maior entre idosos do gênero masculino e frágeis.25

Wound Healing: In Vitro and In Vivo Evaluation of a Bio-Functionalized Scaffold Based on Hyaluronic Acid and Platelet-Rich Plasma in Chronic Ulcers

Chronic ulcers are characterized by loss of substance without a normal tendency towards spontaneous healing. The Wound Bed Preparation Guideline advises that after diagnosis, the expert should correct the biological state of the ulcer micro-environment based on TIME principles (Tissue, Infection, Moisture balance, Epidermal). There are many ways to treat such ulcers, for example through use of advanced dressings, negative pressure, surgical toilets, dermal substitutes, autologous skin grafting, and free or local flaps. In vitro and in vivo pre-clinical models hold widely acknowledged potential yet complex limitations. Tissue bioengineering could be an ideal approach to foster innovative strategies in wound healing. Our observational study reports on an in vitro and in vivo evaluation of a bio-functionalized scaffold composed of platelet-rich plasma (PRP) and hyaluronic acid (HA) used in 182 patients affected by chronic ulcers (diabetic and vascular), comparing the results with a control group of 182 patients treated with traditional dressings (HA alone). After 30 days the patients who had undergone the combined treatment (PRP + HA), showed 96.8% +/- 1.5% re-epithelialization, as compared to 78.4% +/- 4.4% in the control group (HA only). Within 80 days, they had 98.4% +/- 1.3% re-epithelialization as compared to 87.8% +/- 4.1% in the control group (HA only; p &lt; 0.05). No local recurrence was observed during the follow-up period. PRP + HA treatment showed stronger regenerative potential in terms of epidermal proliferation and dermal renewal compared with HA alone

The Balance Between the Therapeutic Efficacy and Safety of [¹⁷⁷Lu]Lu-NeoB in a Preclinical Prostate Cancer Model

Purpose: Radiolabeled NeoB is a promising gastrin-releasing peptide receptor (GRPR)–targeting radiopharmaceutical for theranostics of GRPR-expressing malignancies, e.g., prostate cancer (PCa). The aim of this study was to evaluate the effect of different doses of [177Lu]Lu-NeoB on the balance between therapeutic efficacy and safety in a preclinical PCa model. Procedures: To determine the efficacy of [177Lu]Lu-NeoB, PC-3 xenografted mice received 3 sham injections (control group) or 3 injections of 30 MBq/300 pmol, 40 MBq/400 pmol, or 60 MBq/600 pmol [177Lu]Lu-NeoB (groups 1, 2, and 3, respectively) 1 week apart. To quantify tumor uptake, single-photon emission computed tomography/computed tomography (SPECT/CT) imaging was performed 4 h after the first, second, and third injection on a separate group of animals. For safety evaluations, pancreatic and renal tissues of non-tumor-bearing mice treated with the abovementioned [177Lu]Lu-NeoB doses were evaluated 12 and 24 weeks post-treatment. Results: Treatment of PC-3 tumors with all three studied [177Lu]Lu-NeoB doses was effective. Median survival times were significantly (p &lt; 0.0001) improved for treatment groups 1, 2, and 3 versus the control group (82 days, 89 days, 99 days versus 19 days, respectively). However, no significant differences were observed between treatment groups. Quantification of SPECT/CT images showed minimal differences in the average absolute radioactivity uptake, especially after the third injection. Histopathological analysis revealed no clear signs of treatment-related pancreatic toxicity. For the kidneys, atrophy and fibrosis were observed for one animal from group 1 and a chronic inflammatory response was observed for both animals from group 3 at 24 weeks post-treatment. Conclusions: Treatment with [177Lu]Lu-NeoB is effective in a preclinical PCa model. Adjusting the administered dose could positively impact the risk-benefit balance as a higher dose might not lead to an increased therapeutic effect, but it may lead to an increase in toxicological effects in healthy organs such as the kidneys.</p

Performance cognitive-linguistic and reading of students with attention deficit and hyperactivity disorder

OBJETIVO: o objetivo deste estudo foi comparar o desempenho cognitivo-linguístico e em leitura de escolares com Transtorno de Déficit de Atenção e Hiperatividade com escolares sem queixa de transtornos comportamentais e/ou de aprendizagem. MÉTODO: participaram deste estudo 20 escolares de 5° a 8° ano do ensino fundamental. Os escolares foram divididos em dois: Grupo I (GI): composto por 10 escolares com diagnóstico interdisciplinar de Transtorno de Déficit de Atenção e Hiperatividade, e Grupo II (GII): composto por 10 escolares sem queixa de transtornos comportamentais e/ou de aprendizagem. Como procedimento foi realizado o Teste de habilidades metalinguísticas e leitura (PROHMELE), composto de testes de identificação de sílabas e fonemas, manipulação de sílabas e fonemas, repetição de pseudopalavras e leitura. RESULTADOS: os resultados apresentaram diferença estatisticamente significante entre GI e GII, demonstrando que os escolares do grupo GI apresentaram desempenho superior quando comparados com os escolares do grupo GII. CONCLUSÃO: de acordo com os resultados deste estudo podemos concluir que as dificuldades apresentadas por escolares com Transtorno de Déficit de Atenção e Hiperatividade podem ser atribuídas à desatenção, hiperatividade e desorganização, característica do próprio diagnóstico, e não a uma desordem de linguagem de base fonológica.OBJECTIVE: the aim of this study was to compare the cognitive-linguistic skills performance and reading of students with Attention Deficit and Hyperactivity Disorder and students without behavioral and/or learning disorders. METHOD: the study included 20 students from 5th to 8th grade of elementary school. The students were divided into: Group I (GI): composed by 10 students with an interdisciplinary diagnosis of Attention Deficit and Hyperactivity Disorder, and Group II (GII): composed by 10 students without complaints of behavioral and/or learning disorders. The tests of metalinguistic skills and reading (PROHMELE) were used as procedure, composed of syllabic and phonemic identification, syllabic and phonemic manipulation, repetition of nonwords and reading tests. RESULTS: the results showed statistically significant differences between GI and GII, demonstrating that students from GI presented superior performances when compared to the students from GII. CONCLUSION: according to the findings of this study we can conclude that the difficulties presented by students with Attention Deficit and Hyperactivity Disorder can be attributed to inattention, hyperactivity and disorganization, characteristic of this diagnosis, and not to a disorder of language of phonological basis

Relação entre Fluência e Compreensão Leitora em Escolares com Dificuldades de Aprendizagem

The capacity to read and comprehending text is essential in our daily life and in the educational context. Considering this aspect the objective of this study was to compare fluency and reading comprehension of students from second to fifth grade of primary school with and without learning difficulties. The eighty students who participated were divided into eight groups: GI to GIV (students without learning difficulties); GV to GVIII (students with learning difficulties). Of the oral reading of a text were measured the time, accuracy, speed and reading comprehension. Statistically significant differences were observed on all these variables indicating inferior performance to the students with learning difficulties. It was found that difficulties in reading fluency interfered with reading comprehension.A capacidade para ler e compreender texto é fundamental tanto em nossa vida diária como no contexto educativo. Considerando este aspecto o objetivo deste estudo foi comparar a fluência e compreensão de leitura de escolares do segundo ao quianto ano do ensino fundamental com e sem dificuldade de aprendizagem. Participaram oitenta escolares divididos em oito grupos: GI a GIV (escolares sem dificuldades de aprendizagem); GV a GVIII (escolares com dificuldades de aprendizagem). Por meio da leitura oral de um texto, foram medidos tempo, exatidão, velocidade e compreensão de leitura. Houve diferenças estatisticamente significantes em todas as variáveis indicando desempenho inferior para os escolares com dificuldades de aprendizagem. Verificou-se que as dificuldades de fluência de leitura interferiram na compreensão leitora

Modulation of tregs and inkt by fingolimod in multiple sclerosis patients

The altered numbers and functions of cells belonging to immunoregulatory cell networks such as T regulatory (Tregs) and invariant Natural Killer T (iNKT) cells have been reported in Multiple Sclerosis (MS), an immune-mediated disease. We aimed to assess the frequencies of Tregs and iNKT cells in MS patients throughout a one-year treatment with fingolimod (FTY) and to correlate immunological data with efficacy and safety data. The percentage of Tregs (defined as Live Dead-CD3 + CD4 + FoxP3 + CD25++/CD127 12 cells) increased steadily throughout the year, while there was no significant difference in the absolute number or percentage of iNKT cells (defined as CD3 + CD14 12CD19 12 V\u3b124-J\u3b118 TCR+ cells). However, out of all the iNKT cells, the CD8+ iNKT and CD4 12CD8 12 double-negative (DN) cell percentages steadily increased, while the CD4+ iNKT cell percentages decreased significantly. The mean percentage of CD8+ T cells at all time-points was lower in patients with infections throughout the study. The numbers and percentages of DN iNKT cells were more elevated, considering all time-points, in patients who presented a clinical relapse. FTY may, therefore, exert its beneficial effect in MS patients through various mechanisms, including the increase in Tregs and in iNKT subsets with immunomodulatory potential such as CD8+ iNKT cells. The occurrence of infections was associated with lower mean CD8+ cell counts during treatment with FTY

Evaluation of Two-Month Antibody Levels after Heterologous ChAdOx1-S/BNT162b2 Vaccination Compared to Homologous ChAdOx1-S or BNT162b2 Vaccination

none11noWe evaluated the post-vaccination humoral response of three real-world cohorts. Vaccinated subjects primed with ChAdOx1-S and boosted with BNT162b2 mRNA vaccine were compared to homologous dosing (BNT162b2/BNT162b2 and ChAdOx1-S/ChAdOx1-S). Serum samples were collected two months after vaccination from a total of 1248 subjects. The results showed that the heterologous vaccine schedule induced a significantly higher humoral response followed by homologous BNT162b2/BNT162b2 and ChAdOx1-S/ChAdOx1-S vaccines (p < 0.0001). Moreover, analyzing factors (i.e., vaccine schedule, sex, age, BMI, smoking, diabetes, cardiovascular diseases, respiratory tract diseases, COVID-19 diagnosis, vaccine side effects) influencing the IgG anti-S response, we found that only the type of vaccine affected the antibody titer (p < 0.0001). Only mild vaccine reactions resolved within few days (40% of subjects) and no severe side effects for either homologous groups or the heterologous group were reported. Our data support the use of heterologous vaccination as an effective and safe alternative to increase humoral immunity against COVID-19.openBarocci, Simone; Orlandi, Chiara; Diotallevi, Aurora; Buffi, Gloria; Ceccarelli, Marcello; Vandini, Daniela; Carlotti, Eugenio; Galluzzi, Luca; Rocchi, Marco Bruno Luigi; Magnani, Mauro; Casabianca, AnnaBarocci, Simone; Orlandi, Chiara; Diotallevi, Aurora; Buffi, Gloria; Ceccarelli, Marcello; Vandini, Daniela; Carlotti, Eugenio; Galluzzi, Luca; Rocchi, Marco Bruno Luigi; Magnani, Mauro; Casabianca, Ann

Comparative overview of the effects of aerobic and resistance exercise on anxiety-like behavior, cognitive flexibility, and hippocampal synaptic plasticity parameters in healthy rats

Clinical studies show that physical exercise has anxiolytic and pro-cognitive properties for both healthy individuals and psychiatric patients. Most of these data refer to the effects of aerobic exercise. However, other modalities such as resistance exercise deserve more attention because they may also modulate brain function. This study aimed to compare the effects of an aerobic exercise protocol on a treadmill and a resistance exercise protocol on a ladder apparatus on anxiety-like behavior, cognitive flexibility, and neuroplasticity parameters in healthy animals. Adult male Wistar rats were divided into three groups: sedentary control, aerobic training, and resistance training. Subsequently, they were evaluated in the elevated plus-maze (EPM), light-dark box, and modified hole board (mHB) tests. The expressions of synaptophysin and postsynaptic plasticity protein 95 in the dorsal and ventral hippocampus were analyzed by immunofluorescence. The results demonstrated an anxiolytic effect promoted by exercise in the EPM, particularly in the animals submitted to aerobic training, and a mild pro-learning effect of both exercise modalities was observed in the mHB test. All groups showed similar outcomes in the other evaluations. Therefore, the exercise modalities investigated in the present study did not provide considerable modifications to such aspects of the emotional/cognitive functions and neuroplasticity under physiological contexts. Perhaps the two types of exercise acted in neurobiological pathways not analyzed in this study, or the effects may emerge under pathological contexts. These hypotheses should be tested in future studies