COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy?

Background: Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. Aims: To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for “respiratory diseases” within the current frame of the COVID-19 pandemic as an adjuvant treatment. Method: The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. Results: A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. Conclusions: Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches

A Study of Intense Local dB/dt Variations During Two Geomagnetic Storms

Interactions between the solar wind and the Earth's magnetosphere manifest many important space weather phenomena. In this paper, magnetosphere‐ionosphere drivers of intense dB/dt produced during geomagnetic storms that occurred on 9 March 2012 and 17 March 2015 are analyzed. A multi‐instrument approach combining Time History of Events and Macroscale Interactions during Substorms (THEMIS) mission space‐borne and ground‐based observations was adopted to examine the magnetosphere‐ionosphere signatures associated with the dB/dt extremes during each storm. To complement the THEMIS measurements, ground‐based magnetometer recordings and All‐Sky Imager observations, equivalent ionospheric currents derived from magnetometer chains across North America and Greenland, and geosynchronous observations from the Los Alamos National Laboratory Synchronous Orbit Particle Analyzer are also examined. Our results show that the most extreme dB/dt variations are associated with marked perturbations in the THEMIS magnetospheric measurements, poleward expanding discrete aurora passing over the magnetometer sites (seen by the ground‐based THEMIS All‐Sky Imagers), intense Pc5 waves, rapid injection of energetic particles, and intense auroral westward currents. Substorms are considered as the major driver with a possible contribution from magnetospheric waves. The findings of this study strongly suggest that the localization of extreme dB/dt variations is most likely related to the mapping of magnetosphere currents to local ionospheric structures

Gender-dependent differences in plasma matrix metalloproteinase-8 elevated in pulmonary tuberculosis.

Tuberculosis (TB) remains a global health pandemic and greater understanding of underlying pathogenesis is required to develop novel therapeutic and diagnostic approaches. Matrix metalloproteinases (MMPs) are emerging as key effectors of tissue destruction in TB but have not been comprehensively studied in plasma, nor have gender differences been investigated. We measured the plasma concentrations of MMPs in a carefully characterised, prospectively recruited clinical cohort of 380 individuals. The collagenases, MMP-1 and MMP-8, were elevated in plasma of patients with pulmonary TB relative to healthy controls, and MMP-7 (matrilysin) and MMP-9 (gelatinase B) were also increased. MMP-8 was TB-specific (p<0.001), not being elevated in symptomatic controls (symptoms suspicious of TB but active disease excluded). Plasma MMP-8 concentrations inversely correlated with body mass index. Plasma MMP-8 concentration was 1.51-fold higher in males than females with TB (p<0.05) and this difference was not due to greater disease severity in men. Gender-specific analysis of MMPs demonstrated consistent increase in MMP-1 and -8 in TB, but MMP-8 was a better discriminator for TB in men. Plasma collagenases are elevated in pulmonary TB and differ between men and women. Gender must be considered in investigation of TB immunopathology and development of novel diagnostic markers

Comfort from the perspective of families of people hospitalized in the intensive care unit

This study aimed at understanding the meaning of comfort to the families of people in intensive care units. It consists of a qualitative study carried out in the intensive care unit of a hospital in Salvador-Bahia. Fourteen family members were interviewed. The authors utilized the theoretical principles of symbolic interactionism and the technique of qualitative data analysis. Results indicated that the categories Safety, Receptiveness, Information, Proximity, Social and Spiritual Support, Convenience and Integration expressed the meaning of comfort, which was comprised of reliability in terms of technical-scientific competence and a supportive and sensitive attitude of the team, chance of recovery, access to information and the opportunity to be close to the patient, support of people in their social life, spiritual sources and the environmental structure of the hospital, preservation of self-care and routine activities. It was concluded that the family is important as objects and subjects of the actions in healthcare and must be the focus in public health policies and programs in Brazil

Comparação do equilíbrio postural entre adolescentes do sexo feminino e masculino

A adolescência compreende a fase entre os 10 e 19 anos de idade, a qual se caracteriza por uma aceleração no crescimento e desenvolvimento dos indivíduos. No entanto, essas mudanças não ocorrem no mesmo ritmo para ambos os sexos, o que pode trazer diferenças no equilíbrio postural. Este estudo tem como objetivo comparar o equilíbrio postural entre adolescentes dos sexos masculino e feminino. O grupo de estudo foi composto por 11 adolescentes do sexo feminino e 19 do sexo masculino. A análise da altura do centro de gravidade foi obtida com o uso de uma prancha de reação, e o equilíbrio postural por meio de uma plataforma de força Advanced Mechanical Technologies, Inc. modelo OR6-6. As variáveis avaliadas foram calculadas a partir do Centro de Pressão (COP): amplitude de deslocamento ântero-posterior do COP (COPap), amplitude de deslocamento médio-lateral do COP (COPml) e velocidade média de deslocamento do COP (COPvel). Os adolescentes do sexo feminino apresentaram amplitude de deslocamento do COPap (p=0,011) e COPml (p=0,003) significativamente menor na condição de olhos abertos que o sexo masculino, e na condição de olhos fechados nas três variáveis avaliadas, COPap (p=0,001), COPml (p=0,001) e COPvel p=0,004, sugerindo menor oscilação postural para as adolescentes deste estudo. Acredita-se que os resultados encontrados podem ser advindos das diferenças nas características antropométricas entre os sexos. Conclui-se que os adolescentes do sexo feminino apresentaram melhor equilíbrio postural quando comparados aos do sexo masculino

Resource Selection and Its Implications for Wide-Ranging Mammals of the Brazilian Cerrado

Conserving animals beyond protected areas is critical because even the largest reserves may be too small to maintain viable populations for many wide-ranging species. Identification of landscape features that will promote persistence of a diverse array of species is a high priority, particularly, for protected areas that reside in regions of otherwise extensive habitat loss. This is the case for Emas National Park, a small but important protected area located in the Brazilian Cerrado, the world's most biologically diverse savanna. Emas Park is a large-mammal global conservation priority area but is too small to protect wide-ranging mammals for the long-term and conserving these populations will depend on the landscape surrounding the park. We employed novel, noninvasive methods to determine the relative importance of resources found within the park, as well as identify landscape features that promote persistence of wide-ranging mammals outside reserve borders. We used scat detection dogs to survey for five large mammals of conservation concern: giant armadillo (Priodontes maximus), giant anteater (Myrmecophaga tridactyla), maned wolf (Chrysocyon brachyurus), jaguar (Panthera onca), and puma (Puma concolor). We estimated resource selection probability functions for each species from 1,572 scat locations and 434 giant armadillo burrow locations. Results indicate that giant armadillos and jaguars are highly selective of natural habitats, which makes both species sensitive to landscape change from agricultural development. Due to the high amount of such development outside of the Emas Park boundary, the park provides rare resource conditions that are particularly important for these two species. We also reveal that both woodland and forest vegetation remnants enable use of the agricultural landscape as a whole for maned wolves, pumas, and giant anteaters. We identify those features and their landscape compositions that should be prioritized for conservation, arguing that a multi-faceted approach is required to protect these species