Acute TNFα levels predict cognitive impairment 6-9 months after COVID-19 infection.

A neurocognitive phenotype of post-COVID-19 infection has recently been described that is characterized by a lack of awareness of memory impairment (i.e., anosognosia), altered functional connectivity in the brain's default mode and limbic networks, and an elevated monocyte count. However, the relationship between these cognitive and brain functional connectivity alterations in the chronic phase with the level of cytokines during the acute phase has yet to be identified. Determine whether acute cytokine type and levels is associated with anosognosia and functional patterns of brain connectivity 6-9 months after infection. We analyzed the predictive value of the concentration of acute cytokines (IL-1RA, IL-1β, IL-6, IL-8, IFNγ, G-CSF, GM-CSF) (cytokine panel by multiplex immunoassay) in the plasma of 39 patients (mean age 59 yrs, 38-78) in relation to their anosognosia scores for memory deficits via stepwise linear regression. Then, associations between the different cytokines and brain functional connectivity patterns were analyzed by MRI and multivariate partial least squares correlations for the whole group. Stepwise regression modeling allowed us to show that acute TNFα levels predicted (R <sup>2</sup> = 0.145; β = -0.38; p = .017) and were associated (r = -0.587; p < .001) with scores of anosognosia for memory deficits observed 6-9 months post-infection. Finally, high TNFα levels were associated with hippocampal, temporal pole, accumbens nucleus, amygdala, and cerebellum connectivity. Increased plasma TNFα levels in the acute phase of COVID-19 predict the presence of long-term anosognosia scores and changes in limbic system functional connectivity

Evolução da enfermagem no contexto do hospital-escola: depoimentos de enfermeiros representantes da década de 70 Evolución de la enfermería en el contexto de hospital-escuela: declaraciones de enfermeros de la década de 70 Nursing evolution at university hospitals: declarations of nurses who worked in the 1970s

Este estudo é parte de um projeto mais amplo que visa resgatar aspectos significativos relacionados a revolução da assistência de enfermagem da década de 50 a 90. Este resgate é feito através da técnica de depoimentos orais de enfermeiros em exército e aposentados, no contexto de um hospital-escola do interior paulista. O presidente estudo particulariza os resultados obtidos, referentes a década de 70. Como resultado evidencia-se o esforço empreendido pelos enfermeiros na luta pelo reconhecimento e prestígio da profissão, as transformações intensas e profundas aos novos papéis da enfermeira enquanto líder da equipe e membro da equipe médica.<br>Este estudio es parte de un proyecto más amplio intentando la captación de aspectos significativos relacionados a la evaluación de la asistencia de enfermería en las décadas de 50 a 90. La captación se ha realizado a través de la técnica de declaraciones orales de los enfermeros en ejercicio de la profesión, en el contexto de un hospital-escuela de interior del Estado de São Paulo. El presente estudio particulariza los resultados obtenidos, referentes a la década de 70. Como resultados se evidencian el esfuerzo imprimido por las enfermeras en la lucha por el reconocimiento y prestigio de la profesión. Las transformaciones intensas y profundas relacionadas a los nuevos roles de la enfermera como líder de los trabajadores de enfermería y miembro del grupo de la salud.<br>This study is part of a more extensive project that proposes to recover significant aspects related to nursing care evolution from 1950s. This study is developed through the technique of oral declaration by active and retired registered nurses, in the context of an university-hospital from São Paulo State. The present study emphasizes the outcomes referring to the 1970s. As result becomes evident the undertaken effort by nurses in the struggle for profession's recognition and prestige; intense and deep transformations related to nurse's new roles as leadership of nursing staff and member of medical team