Drug therapy and vascular devices used by patients hospitalized for COVID-19: a descriptive study / Terapia medicamentosa e dispositivos vasculares utilizados por doentes hospitalizados para a COVID-19: um estudo descritivo

To describe drug therapy and types of vascular access adopted in the treatment of patients with COVID-19 and admitted to the clinical wards of a university hospital, a referential institution for COVID-19 in Rio de Janeiro, Brazil. Descriptive, retrospective documentary study with a quantitative approach. The sample consisted of 243 electronic medical records from hospitalized patients with a laboratory-confirmed diagnosis of COVID-19, between April and June 2020. The selection of participants took place by intentional non-probabilistic sampling. Peripheral venous access was the mostly applied in 83.5% of the patients. The mostly used classes of drugs were analgesics, (81.9%), followed by antiemetics (70.4%), and antihypertensives (51.9%). For medications directed to COVID-19, azithromycin, oseltamivir, ceftriaxone, and hydroxychloroquine stands out with 67.5%, 58.8%, 50.2% and 27.2%, respectively.  Regarding the treatment directed to COVID-19, the medications mostly taken were azithromycin and hydroxychloroquine, justified to a large extent by being recommended by the Ministry of Health in the treatment, according to signs and symptoms (Brazil, 2020).  Patients treated with the medications described had good recovery from the clinical condition. Thus, studies based on randomized clinical trials are suggested to prove the efficacy of drug therapies, including their combination

Clinical nursing care protocol for convalescent plasma transfusion in patients with COVID-19

Introduction: The treatment of COVID-19 is still challenge. So convalescent plasma can be an important alternative of treatment. Protocols with nursing care during infusion is very important to guide an effective and safety care Objective: to analyze the evidence in the literature on the action of convalescent plasma, of the use of protocols with nursing care to use convalescent plasma and build a nursing care protocol for transfusion in patients with COVID-19. Methods: Methodological study carried out in two stages: scoping review. The search was done using the descriptors: convalescent plasma transfusion, convalescent plasma, and acute respiratory syndromes or COVID-19, to found protocols and effectiveness of convalescent plasm. Beside was done a specialist panel to build the protocol. Results: Low-evidence studies have shown improvement in the clinical signs of COVID-19 using Convalescent Plasma, reduction or elimination of viral load, benefits in the production of lymphocytes, decreases C-reactive protein, increases titers of anti-SARS-CoV-2 antibodies, positive evolution in lung involvement identified by X-rays, decrease in hospitalization. No studies were found in the databases on the protocol for clinical nursing care in plasma transfusion. Therefore, a protocol was developed with the description of clinical nursing care to be performed before, during and after the transfusion by plasma: checking of vital signs and indicative signs of transfusion reaction, measurement of oxygen saturation, assessment of venous access and checking of the level of consciousness. Conclusion: There are no evidence studies to support the use of plasma, nor anything related to bundles

Microglial Morphology Across Distantly Related Species: Phylogenetic, Environmental and Age Influences on Microglia Reactivity and Surveillance States

Microglial immunosurveillance of the brain parenchyma to detect local perturbations in homeostasis, in all species, results in the adoption of a spectrum of morphological changes that reflect functional adaptations. Here, we review the contribution of these changes in microglia morphology in distantly related species, in homeostatic and non-homeostatic conditions, with three principal goals (1): to review the phylogenetic influences on the morphological diversity of microglia during homeostasis (2); to explore the impact of homeostatic perturbations (Dengue virus challenge) in distantly related species (Mus musculus and Callithrix penicillata) as a proxy for the differential immune response in small and large brains; and (3) to examine the influences of environmental enrichment and aging on the plasticity of the microglial morphological response following an immunological challenge (neurotropic arbovirus infection). Our findings reveal that the differences in microglia morphology across distantly related species under homeostatic condition cannot be attributed to the phylogenetic origin of the species. However, large and small brains, under similar non-homeostatic conditions, display differential microglial morphological responses, and we argue that age and environment interact to affect the microglia morphology after an immunological challenge; in particular, mice living in an enriched environment exhibit a more efficient immune response to the virus resulting in earlier removal of the virus and earlier return to the homeostatic morphological phenotype of microglia than it is observed in sedentary mice