Vitamin E and Its Molecular Effects in Experimental Models of Neurodegenerative Diseases

With the advancement of in vivo studies and clinical trials, the pathogenesis of neurodegenerative diseases has been better understood. However, gaps still need to be better elucidated, which justifies the publication of reviews that explore the mechanisms related to the development of these diseases. Studies show that vitamin E supplementation can protect neurons from the damage caused by oxidative stress, with a positive impact on the prevention and progression of neurodegenerative diseases. Thus, this review aims to summarize the scientific evidence of the effects of vitamin E supplementation on neuroprotection and on neurodegeneration markers in experimental models. A search for studies published between 2000 and 2023 was carried out in the PubMed, Web of Science, Virtual Health Library (BVS), and Embase databases, in which the effects of vitamin E in experimental models of neurodegeneration were investigated. A total of 5669 potentially eligible studies were identified. After excluding the duplicates, 5373 remained, of which 5253 were excluded after checking the titles, 90 articles after reading the abstracts, and 11 after fully reviewing the manuscripts, leaving 19 publications to be included in this review. Experiments with in vivo models of neurodegenerative diseases demonstrated that vitamin E supplementation significantly improved memory, cognition, learning, motor function, and brain markers associated with neuroregeneration and neuroprotection. Vitamin E supplementation reduced beta-amyloid (Aβ) deposition and toxicity in experimental models of Alzheimer's disease. In addition, it decreased tau-protein hyperphosphorylation and increased superoxide dismutase and brain-derived neurotrophic factor (BDNF) levels in rodents, which seems to indicate the potential use of vitamin E in preventing and delaying the progress of degenerative lesions in the central nervous system.

Condições de Saúde e Utilização da Atenção Básica pelos Idosos: Revisão Integrativa

Introdução: O envelhecimento populacional e a prevalência de doenças crônicas nas pessoas com mais de 60 anos torna sua presença nos serviços de saúde, dentre eles a Atenção Primária, mais frequente. Objetivo: Conhecer as condições de saúde prevalentes no atendimento à população idosa e a utilização dos serviços da Atenção Primária por este público. Metodologia: Trata-se de uma revisão integrativa, nas bases de dados Scientific Eletronic Library Online (Scielo), Latino Americana e do Caribe em Ciências da Saúde (Lilacs), PubMed e Base de Dados de Enfermagem (BDENF). Utilizou-se para busca os descritores “Saúde do Idoso”, “Atenção Primária à Saúde” e “Estratégia Saúde da Família”, com recorte temporal de 2006 a 2021. Resultados: Os idosos que frequentam a Atenção Primária possuem faixa etária entre 60-69 anos, predominância de mulheres e prevalência de condições crônicas, com destaque para os distúrbios cardiovasculares e endócrinos. Nota-se ainda a alta procura por atendimento médico individual. Conclusão: As principais condições de saúde da população idosa que procura os serviços da Atenção Básica relacionam-se a morbidades crônicas, que demandam acompanhamento contínuo. No entanto, a busca ao serviço só é realizada em maior parte nas situações de agudização da condição de saúde, com grande procura por consultas médicas. Torna-se necessário o incentivo ao cuidado continuado e ações preventivas, através da análise multidimensional e trabalho multiprofissional, visando uma assistência integral à saúde da população idosa e o fortalecimento do vínculo entre idoso, comunidade e a Atenção Primária a Saúde.

Susceptibility to COVID-19 in Pregnancy, Labor, and Postpartum Period: Immune System, Vertical Transmission, and Breastfeeding

The new coronavirus (SARS-Cov-2) was first identified in late 2019 as the new RNA virus in the coronaviridae family responsible for causing COVID-19 in the residents of China's Hubei province. In mid-March 2020 WHO declared the pandemic caused by this virus as a result of thousands of people infected all over the world. Epidemiological evidence obtained from other pandemics, such as influenza and ebola, suggest that pregnant women are more susceptible to serious complications and death from viral infection. Physiological changes in the anatomical structure of the respiratory system as well as in the immune system during the pregnancy-puerperal period seem to contribute to this greater risk. Thus, pregnant women are more susceptible to be infected by the SARS-COV-2 or other viruses and to have serious COVID-19 disease. In fact, COVID-19 can alter immune responses at the maternal-fetal interface, affecting the well-being of both mother and her fetus. There is still no sufficient evidence in the literature to support the occurrence of vertical transmission and through breastfeeding, but the prevalence of prematurity was high among pregnant women infected by SARS-Cov-2. In this review, the changes in the immune system that may increase susceptibility to SARS-Cov-2 are discussed as well as the possible mechanisms involved in the transmission of the virus to the fetus by vertical transmission and during breastfeeding.

Pathophysiology and possible treatments for olfactory-gustatory disorders in patients affected by COVID-19

SARS-CoV-2 infects host cells mainly through the interaction between the virus's Spike protein and the viral receptors namely Angiotensin-Converting Enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2). Both are highly expressed in the gastrointestinal tract, in the nasal and bronchial epithelium, as well as in the type II alveolar epithelial cells. The aim of this review is to report the evidences from the scientific literature on the pathophysiology and the available treatments for olfactory-gustatory disorders in patients with COVID-19. The mechanisms involved in these disorders are still unclear and studies on specific therapies are scarce. However, it has been hypothesized that a decrease in the sensitivity of the sensory neurons as well as the co-expression of ACE2 and TMPRSS2 in the alveolar epithelial cells are the main causes of olfactory-gustatory disorders. The possible mechanisms described in the literature for changes in taste perception in patients with COVID-19 include olfactory disorders and a competitive activity of COVID-19 on ACE2 receptors in the taste buds. In addition, SARS-CoV-2 can bind to sialic acid receptors in the taste buds. In general, evidences show that there is no specific treatment for olfactory-taste disorders induced by SARS-CoV-2, even though some treatments have been used and have shown some promising results, such as olfactory training, intranasal application of sodium citrate and vitamin A, as well as systemic use of omega-3 and zinc. Corticosteroids have also been used as a pharmacological approach to treat patients with olfactory dysfunction with some contradictory results. The knowledge of the mechanisms by which SARS-CoV-2 influences the sensory systems and how effective therapies can treat the loss of smell and taste will have important implications on the understanding and clinical management of olfactory-taste disorders.

Therapeutic Options Against the New Coronavirus: Updated Clinical and Laboratory Evidences

The pandemic caused by the new coronavirus (SARS-Cov-2) has encouraged numerous in vitro studies and clinical trials around the world, with research groups testing existing drugs, novel drug candidates and vaccines that can prevent or treat infection caused by this virus. The urgency for an effective therapy is justified by the easy and fast viral transmission and the high number of patients with severe respiratory distress syndrome who have increasingly occupied intensive care hospital beds, leading to a collapse in health systems in several countries. However, to date, there is no sufficient evidence of the effectiveness of any researched therapy. The off-label or compassionate use of some drugs by health professionals is a reality in all continents, whose permission by regulatory agencies has been based on the results of some clinical trials. In order to guide decision-making for the treatment of COVID-19, this review aims to present studies and guidelines on the main therapies that have been and are currently being tested against SARS-CoV-2 and to critically analyze the reported evidences.

Prejudice, vulnerability, accession process, religiosity regarding the life routine with AIDS: life stories

Objective: To communicate life stories of people who suffer from acquired immunodeficiency-syndrome with a higher vulnerability registered at the Municipal Secretary of Social Assistance and the diagnostic’s influence on their daily routine. Method: Descriptive and exploratory study based on oral life history. Thirteen people with AIDs took part in the study via a semi-structured interview. The narratives were analyzed using Bardin’s thematic content analysis. Results: Three thematic axes emerged from Bardin’s content analysis: prejudice and discrimination regarding the life routine with aids; Reaction when facing the diagnostic and the adhesion process for the antiretroviral treatment; Confrontation of religion and religiousness on people with aids. Conclusion: The people living with aids, a chronic and stigmatizing disease, need the support of multidisciplinary teams and an improvement in relation to the access, the coverage and the meaning assigned to the disease, besides a better quality of life and social assistance. We conclude that religion did not contribute to facing these people’s conditions. It brought blame, incorrect information that may impair the treatment and their follow-up. One infers that health education regarding HIV/AIDS needs to be remodeled on all of society’s segments.

Care With The Potential Organ Donor In The Intensive Care Unit

Introduction: Organ transplants have expanded throughout the country, being extremely significant for the population. Objective: To know the reality of organ harvesting and describe the care with the potential organ donor in an Intensive Care Unit (ICU) and compare it with the pertinent literature. Method: It is a research of exploratory and descriptive nature, with a qualitative approach. The data were analyzed through the content analysis idealized by Bardin. Results: The findings indicate that the resolution of care and procedures with the potential donor is essential to the success of transplants in our country. Conclusions: Several difficulties have been encountered, as the lack of human and material resources generating impasses in the specific care of the potential organ donor and the lack of provision of continuing education. Keywords: Organ donation; Intensive Care Unit; Nursing.

[Clinical and epidemiological profile of patients with leprosy-related reactions]

OBJECTIVE

To identify the clinical and epidemiological profile of patients under treatment for leprosy-related reactions.

METHOD

This is a descriptive, cross-sectional and quantitative study, conducted from October 2013 to April 2014 with 61 individuals in a reference center in the Brazilian northeast region. The statistical test used considered a significance level of 0,05.

RESULTS

Most individuals were males (57.38%), with low family income (50.82%) and incomplete elementary education (75.41%). In the moment of leprosy diagnosis, 52.45% of patients presented some degree of physical disability established. There was significant association between the observed clinic form and the moment of manifestation of leprosy reactions (p= 0.034). The residual analysis indicated that pure neural leprosy is associated to a manifestation of reactions before treatment and dimorphous leprosy was associated to manifestations during treatment.

CONCLUSION

The disclosure of the clinical picture of pure neural leprosy and early detection of cases strongly contribute to the promotion of population health enabling the fulfillment of the goal of eradicating leprosy.