Long COVID Symptoms in Non-Hospitalised Patients: A Retrospective Study

Introduction: The COVID-19 pandemic has presented numerous challenges to healthcare systems. As the number of affected individuals continues to rise, it is crucial to find preventive, diagnostic, and therapeutic approaches. This study aims to describe different COVID-19 sequelae within a Primary Health Care population.Methods: A retrospective cohort study was conducted in adults diagnosed with COVID-19 from March 2020 to April 2022, excluding pregnant women, minors, nursing home residents, hospitalizations, and deaths. Data was gathered from surveillance records on the Trace COVID-19 (R) platform, a pre-set original questionnaire (which included the Portuguese version of the World Health Organization's Quality of Life Assessment Instrument), and, if needed, patient electronic health records. Information on sociodemographic and clinical characteristics of acute COVID-19 was collected along with long COVID symptoms.Results: This study included 284 patients, aged 19 to 99 years old. The five most prevalent acute COVID-19 symptoms were fever (50.0%), tiredness (48.2%), myalgias (44.7%), dry cough (37.7%) and odynophagia (36.3%). Symptoms related to the neurological system (23.2%) and tiredness (22.9%) were the most prevalent in long COVID symptoms. Acute tiredness and arthralgia were associated with all long COVID outcomes. The associations between acute COVID-19 symptoms with long COVID outcomes were stronger for anosmia [OR = 5.07, 95% confidence interval (CI) 2.49 -10.36, p < 0.001] on a neurological chapter, acute tiredness for long lasting tiredness (OR = 4.07, 95% CI 2.07 -8.02, p = 0.041), fatigue for muscles and/or bones chapter (OR = 7.55, 95% CI 3.06 -18.66, p < 0.001), tiredness on an endocrine/hormonal chapter (OR = 6.54, 95% CI 2.37 -18.04, p < 0.001), dyspnea for respiratory symptoms (OR = 5.67, 95% CI 1.92 -16.74, p = 0.002) and fever for stomach or intestine symptoms (OR = 8.06, 95% CI 2.55 -25.47, p < 0.001). Almost all quality of life dimensions were negatively associated with the number of long COVID symptoms.Conclusion: A higher number of acute symptoms, as well as the presence of specific COVID-19 symptoms were associated with reported symptoms = 12 weeks after infection. In the studied population, an increased number of symptoms in both acute and long COVID had a significant negative impact on the perception of overall quality of life. The identification of these relationships could provide a new perspective for post-COVID care

A espiritualidade conjugal segundo o pensamento do Pe. Henri Caffarel

A espiritualidade conjugal como caminho de santificação dos casais cristãos foi a pedra angular do pensamento do sacerdote francês Henri Caffarel ao conceber o Movimento das Equipes de Nossa Senhora (ENS). Tinha como objetivo solidificar a relação entre os cônjuges e seus familiares e contribuir com os casais para a busca da santidade conjugal. O desejo inspirador consistiu em proporcionar ao casal a possibilidade de converter a sua vida matrimonial, num verdadeiro estilo cristão de viver este sacramento no cotidiano, integrando a espiritualidade às tarefas humanas e da vida de igreja. A proposta, aos casais unidos pelo matrimônio, foi de vivenciarem uma sexualidade casta, agradável a Deus, sem, contudo, afastarem a nobreza do prazer do ato conjugal. Esposo e esposa, pela espiritualidade conjugal e com auxílio de instrumentos eficazes, seriam capacitados para gerar um itinerário do amor, da felicidade e da santidade em suas vidas, tendo na abnegação o fio condutor desta caminhada

Association of candidate gene polymorphisms with chronic kidney disease : Results of a case-control analysis in the NEFRONA cohort

Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Despite classical clinical risk factors for CKD and some genetic risk factors have been identified, the residual risk observed in prediction models is still high. Therefore, new risk factors need to be identified in order to better predict the risk of CKD in the population. Here, we analyzed the genetic association of 79 SNPs of proteins associated with mineral metabolism disturbances with CKD in a cohort that includes 2,445 CKD cases and 559 controls. Genotyping was performed with matrix assisted laser desorption ionization-time of flight mass spectrometry. We used logistic regression models considering different genetic inheritance models to assess the association of the SNPs with the prevalence of CKD, adjusting for known risk factors. Eight SNPs (rs1126616, rs35068180, rs2238135, rs1800247, rs385564, rs4236, rs2248359, and rs1564858) were associated with CKD even after adjusting by sex, age and race. A model containing five of these SNPs (rs1126616, rs35068180, rs1800247, rs4236, and rs2248359), diabetes and hypertension showed better performance than models considering only clinical risk factors, significantly increasing the area under the curve of the model without polymorphisms. Furthermore, one of the SNPs (the rs2248359) showed an interaction with hypertension, being the risk genotype affecting only hypertensive patients. We conclude that 5 SNPs related to proteins implicated in mineral metabolism disturbances (Osteopontin, osteocalcin, matrix gla protein, matrix metalloprotease 3 and 24 hydroxylase) are associated to an increased risk of suffering CKD

Association of a single nucleotide polymorphism combination pattern of the Klotho gene with non-cardiovascular death in patients with chronic kidney disease

Chronic kidney disease (CKD) is associated with an elevated risk of all-cause mortality, with cardiovascular death being extensively investigated. However, non-cardiovascular mortality represents the biggest percentage, showing an evident increase in recent years. Klotho is a gene highly expressed in the kidney, with a clear influence on lifespan. Low levels of Klotho have been linked to CKD progression and adverse outcomes. Single nucleotide polymorphisms (SNPs) of the Klotho gene have been associated with several diseases, but studies investigating the association of Klotho SNPs with noncardiovascular death in CKD populations are lacking. The main aim of this study was to assess whether 11 Klotho SNPs were associated with non-cardiovascular death in a subpopulation of the National Observatory of Atherosclerosis in Nephrology (NEFRONA) study (n ¼ 2185 CKD patients). After 48 months of follow-up, 62 cardiovascular deaths and 108 non-cardiovascular deaths were recorded. We identified a high non-cardiovascular death risk combination of SNPs corresponding to individuals carrying the most frequent allele (G) at rs562020, the rare allele (C) at rs2283368 and homozygotes for the rare allele (G) at rs2320762 (rs562020 GG/AG þ rs2283368 CC/CT þ rs2320762 GG). Among the patients with the three SNPs genotyped (n ¼ 1016), 75 (7.4%) showed this combination. Furthermore, 95 (9.3%) patients showed a low-risk combination carrying all the opposite genotypes (rs562020 AA þ rs2283368 TT þ rs2320762 GT/TT). All the other combinations [n ¼ 846 (83.3%)] were considered as normal risk. Using competing risk regression analysis, we confirmed that the proposed combinations are independently associated with a higher fhazard ratio [HR] 3.28 [confidence interval (CI) 1.51-7.12]g and lower [HR 6 × 10- (95% CI 3.3 × 10--1.1 × 10-)] risk of suffering a non-cardiovascular death in the CKD population of the NEFRONA cohort compared with patients with the normal-risk combination. Determination of three SNPs of the Klotho gene could help in the prediction of non-cardiovascular death in CKD

Consensus document for ultrasound training in the specialty of Nephrology

Grupo de Trabajo en Nefrología Diagnóstica e Intervencionista (GNDI) de la Sociedad Española de Nefrología (SEN).[ES] La ecografía es una herramienta esencial en el manejo del paciente nefrológico que permite el diagnóstico, el seguimiento y la realización de intervencionismo sobre el riñón. La utilidad de los ultrasonidos en Nefrología no se circunscribe exclusivamente al estudio ecográfico del riñón. Mediante ecografía el nefrólogo puede, además, optimizar el manejo de la fístula arteriovenosa para hemodiálisis, medir el riesgo cardiovascular (grosor íntima-media), implantar catéteres centrales para hemodiálisis ecoguiados y ayudar en la colocación de los peritoneales, así como calcular la volemia del paciente mediante ecografía cardiaca básica, ecografía de la vena cava inferior y pulmonar. Desde el Grupo de Trabajo en Nefrología Diagnóstica e Intervencionista (GNDI) de la Sociedad Española de Nefrología (SEN) hemos elaborado este documento de consenso en el que se resumen las principales aplicaciones de la ecografía en Nefrología, incluyendo los requisitos técnicos básicos necesarios, el marco normativo y el nivel de capacitación de los nefrólogos en esta materia. El objetivo de este trabajo es promover la inclusión de la ecografía, tanto diagnóstica como intervencionista, en la práctica clínica habitual del nefrólogo y en la cartera de servicios de Nefrología con la finalidad de ofrecer un manejo diligente, eficiente e integral al paciente nefrológico.[EN] Ultrasound is an essential tool in the management of the nephrological patient allowing the diagnosis, monitoring and performance of kidney intervention. However, the usefulness of ultrasound in the hands of the nephrologist is not limited exclusively to the ultrasound study of the kidney. By ultrasound, the nephrologist can also optimize the management of arteriovenous fistula for hemodialysis, measure cardiovascular risk (mean intimate thickness), implant central catheters for ultrasound-guided HD, as well as the patient's volemia using basic cardiac ultrasound, ultrasound of the cava inferior vein and lungs. From the Working Group on Interventional Nephrology (GNDI) of the Spanish Society of Nephrology (SEN) we have prepared this consensus document that summarizes the main applications of ultrasound to Nephrology, including the necessary basic technical requirements, the framework normative and the level of training of nephrologists in this area. The objective of this work is to promote the inclusion of ultrasound, both diagnostic and interventional, in the usual clinical practice of the nephrologist and in the Nephrology Services portfolio with the final objective of offering diligent, efficient and comprehensive management to the nephrological patient

Estudo das isotermas de equilíbrio do farelo de soja Study of the equilibrium isotherms of soybean meal

Este trabalho tem como objetivo estudar o comportamento das isotermas de equilíbrio do farelo de soja. Para tanto, foram realizados experimentos utilizando-se o método estático com soluções salinas saturadas a 50, 60 e 70ºC. Os dados obtidos foram ajustados às equações existentes na literatura, utilizando-se o software Statistica 6.0®. Os resultados indicam que a temperatura não exerce influência significativa sobre os valores da umidade de equilíbrio do farelo de soja na faixa de condições experimentais exploradas e que os modelos de HALSEY e de LUIKOV podem ser utilizados para prever a umidade de equilíbrio do farelo soja.<br>This work has as aim to study the behavior of the isotherms of the soybean meal. Therefore, experiments had been carried out by using the static method with saturated salt solution at 50, 60 and 70ºC. The data had been adjusted to the equations of the literature, using Statistica software 6.0®. The results indicated that the temperature does not affect significantly the moisture equilibrium values of the soybean meal in the range of temperatures studied and that the LUIKOV and the HALSEY models can be used to foresee the moisture equilibrium of the soybean meal

Destilação da Micela I: modelagem e simulação da evaporação do hexano

No processo de extração do óleo de soja forma-se a Micela, que é uma mistura de óleo e hexano. O processo de separação destes dois componentes é denominado de Destilação da Micela. Esta é composta basicamente da operação de evaporação e da operação de stripping do hexano. Neste trabalho, desenvolveu-se uma modelagem matemática para a evaporação do hexano. O modelo é baseado em balanços de massa e energia e em relações de equilíbrio; e a sua validação foi feita comparando-se os resultados obtidos com os dados operacionais da indústria da COAMO (Cooperativa Agrícola Mouraoense). Em seguida, com o modelo elaborado, fez-se as simulações para estudar: as influências da temperatura do fluido de aquecimento e da vazão de alimentação na concentração de saída do evaporador; os efeitos da temperatura da alimentação, da concentração e da pressão nos resultados operacionais dos evaporadores; e a comparação entre resultados considerando a micela como solução real e ideal