Abstract Background Literature is scarce on echocardiographic characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Objectives To describe echocardiographic characteristics of ICU COVID-19 patients and associate them with clinical signals/symptoms, laboratory findings and outcomes. Methods Patients with RT-PCR-confirmed COVID-19, admitted to the ICU, who underwent echocardiography were included. Clinical characteristics associated with an abnormal echocardiogram (systolic ventricular dysfunction of any degree — left and/or right ventricle — and/or high filling pressures and/or moderate to severe pericardial effusion) were analyzed. Groups were compared using the Student’s t-test, chi-square, and logistic regression. A p < 0.05 was considered statistically significant. Results A total of 140 patients met inclusion criteria, and 74 (52.9%) had an abnormal echocardiogram. A low number of left and right ventricular systolic dysfunction was observed, and 35% of the population had a normal diastolic function. In the univariate analysis, characteristics associated with abnormal echocardiogram were age, chronic kidney disease, elevated troponin, previous heart failure, and simplified acute physiology score 3 (SAPS 3). In the regression model, troponin and SAPS3 score were independent markers of abnormal echocardiogram. An abnormal echocardiogram was associated with a higher prevalence of in-hospital death (RR 2.10; 95% CI 1.04-4.24) and orotracheal intubation (RR 2.3; 95% CI 1.14-4.78). Conclusions COVID-19 has little effect on ventricular function, but it is common to find increased filling pressures. Elevated serum troponin level and SAPS3 score were the independent markers of an abnormal echocardiogram. In addition, the prevalence of in-hospital death and need for mechanical ventilation were higher in patients with abnormal echocardiogram.

Resumo Fundamento Alguns estudos demonstraram uma maior prevalência de óbitos em portadores de fatores de risco cardiovascular (FRC) durante internação por COVID-19. Objetivos Avaliar o impacto do alto risco cardiovascular em pacientes internados em terapia intensiva por COVID-19 Métodos Estudo retrospectivo com pacientes admitidos em terapia intensiva, com diagnóstico confirmado de COVID-19 por RT-PCR e com pelo menos uma dosagem de troponina durante a internação. Os critérios para definição de paciente de alto risco cardiovascular (ARC) foram: histórico de doença cardiovascular estabelecida (infarto, AVC ou doença arterial periférica), diabetes, doença renal crônica com clearance < 60ml/min ou presença de 3 FRC (hipertensão, tabagismo, dislipidemia ou idade > 65 anos). O desfecho primário deste estudo é mortalidade hospitalar por todas as causas. P<0,05 foi considerado significativo. Resultados Foram incluídos 236 pacientes, média de idade= 61,14±16,2 anos, com 63,1% homens, 55,5% hipertensos e 33,1% diabéticos. Um total de 47,4% dos pacientes apresentavam ARC. Observou-se um aumento significativo da mortalidade conforme aumento do número de fatores de risco (0 FRC: 5,9%; 1 FRC: 17,5%; 2 FRC: 32,2% e ≥3 FRC: 41,2%; p=0,001). Na regressão logística ajustada para gravidade (escore SAPS3), o grupo de alto risco cardiovascular e troponina elevada apresentou maior ocorrência de mortalidade hospitalar (OR 40,38; IC95% 11,78-138,39). Pacientes sem alto risco cardiovascular, mas com troponina elevada, também exibiram associação significativa com o desfecho primário (OR 16,7; IC95% 4,45-62,74). Conclusão Em pacientes internados em terapia intensiva por COVID-19, a presença de alto risco cardiovascular afeta a mortalidade hospitalar somente em pacientes que apresentaram elevação de troponina.

Abstract Background Some studies have shown a higher prevalence of deaths in patients with cardiovascular risk factors (CRF) during hospitalization for COVID-19. Objectives To assess the impact of high cardiovascular risk in patients hospitalized in intensive care for COVID-19 Methods Retrospective study with patients admitted to an intensive care unit, with a diagnosis of COVID-19 confirmed by RT-PCR, and with at least one troponin measurement during hospitalization. The criteria for defining high cardiovascular risk (HCR) patients were: history of established cardiovascular disease (myocardial infarction, stroke, or peripheral arterial disease), diabetes, chronic kidney disease with clearance < 60ml/min, or presence of 3 CRFs (hypertension, smoking, dyslipidemia, or age > 65 years). The primary outcome of this study is all-cause in-hospital mortality. P<0.05 was considered significant. Results This study included 236 patients, mean age = 61.14±16.2 years, with 63.1% men, 55.5% hypertensive, and 33.1% diabetic; 47.4% of the patients also presented HCR. A significant increase in mortality was observed as the number of risk factors increased (0 FRC: 5.9%; 1 FRC: 17.5%; 2 FRC: 32.2% and ≥3 FRC: 41.2%; p=0.001). In the logistic regression adjusted for severity (SAPS3 score), the HCR and myocardial injury group had a higher occurrence of in-hospital mortality (OR 40.38; 95% CI 11.78-138.39). Patients without HCR but with myocardial injury also exhibited a significant association with the primary outcome (OR 16.7; 95% CI 4.45-62.74). Conclusion In patients hospitalized in intensive care for COVID-19, HCR impacts in-hospital mortality only in patients with myocardial injury.

Resumo Fundamento A importância prognóstica da classificação ‘insuficiência cardíaca (IC) com fração de ejeção (FE) intermediária’ permanece incerta. Objetivo Analisar as características clínicas, comorbidades, complicações e mortalidade hospitalar e tardia de pacientes classificados em IC com FE intermediária (ICFEi - FE: 40%-49%) e comparar às daqueles em IC com FE preservada (ICFEp - FE > 50%) e IC com FE reduzida (ICFEr - FE < 40%) na internação por IC descompensada. Métodos Coorte ambispectiva de pacientes internados por IC descompensada em unidade cardiointensiva. Foram avaliadas características clínicas, comorbidades, complicações e mortalidade hospitalar e tardia. Utilizou-se o software R, com significância de 5%, para a realização dos testes qui-quadrado, análises de variância, multivariada de Cox e curva de sobrevida de Kaplan Meier, além de técnicas de machine learning (Elastic Net, árvore de sobrevida). Resultados Foram incluídos 519 indivíduos entre setembro de 2011 e junho de 2019, com média da idade de 74,87±13,56 anos, sendo 57,6% homens. Observou-se frequência de ICFEp, ICFEi e ICFEr de 25,4%, 27% e 47,6%, respectivamente. O infarto prévio foi mais frequente na ICFEi. O tempo médio de seguimento foi 2,94±2,55 anos, sem diferença estatística da mortalidade entre os grupos (53,8%, 52,1% e 57,9%). Na curva de sobrevida, não houve diferença entre os grupos ICFEp e ICFEi, nem entre ICFEp e ICFEr, mas houve entre os grupos ICFEi e ICFEr. Idade maior que 77 anos, IC prévia, história de readmissão, demência e necessidade de vasopressores foram associadas com maior mortalidade tardia na árvore de sobrevida. Conclusão A FE não foi selecionada como variável associada a mortalidade nos pacientes com IC descompensada.

Abstract Background The prognostic importance of the classification ‘heart failure (HF) with mid-range ejection fraction (EF)’ remains uncertain. Objective To analyze the clinical characteristics, comorbidities, complications, and in-hospital and late mortality of patients classified as having HF with mid-range EF (HFmrEF – EF: 40%-49%), and to compare them to those of patients with HF with preserved EF (HFpEF – EF > 50%) and with HF with reduced EF (HFrEF – EF < 40%) on admission for decompensated HF. Methods Ambispective cohort of patients admitted to the cardiac intensive care unit due to decompensated HF. Clinical characteristics, comorbidities, complications, and in-hospital and late mortality were assessed. The software R was used, with a 5% significance, for the tests chi-square, analysis of variance, Cox multivariate, and Kaplan-Meier survival curve, in addition to machine-learning techniques (Elastic Net and survival tree). Results 519 individuals were included between September 2011 and June 2019 (mean age, 74.87 ± 13.56 years; 57.6% were men). The frequencies of HFpEF, HFmrEF and HFrEF were 25.4%, 27% and 47.6%, respectively. Previous infarction was more frequent in HFmrEF. The mean follow-up time was 2.94 ± 2.55 years, with no statistical difference in mortality between the groups (53.8%, 52.1%, 57.9%). In the survival curve, there was difference between neither the HFpEF and HFmrEF groups, nor the HFpEF and HFrEF groups, but between the HFmrEF and HFrEF groups. Age over 77 years, previous HF, history of readmission, dementia and need for vasopressors were associated with higher late mortality in the survival tree. Conclusion The EF was not selected as a variable associated with mortality in patients with decompensated HF.

Abstract Persea americana Mill., belonging to the family Lauraceae, is noteworthy for the large amount of ethnopharmacological information in its regard, attributing to it many and varied medicinal properties. The tea and alcoholic extracts made from its leaves are used in folk medicine to treat various ailments. This study was designed to analyze the cytogenotoxicity and underlying chemistry of aqueous and hydroalcoholic extracts of avocado leaves, using the Allium cepa and micronucleus tests. The results obtained by applying the experimental models demonstrate that the extracts did not have a genotoxic effect at any of the concentrations analyzed, and even demonstrated a certain protective effect, possibly due to the presence of flavonoids and phenols, both of which are antioxidant substances. However, the extracts did present a cytotoxic effect. There were numerous karyorrhectic cells and those with nuclear alterations related to cell death. At the highest concentrations, it was possible to observe cytoplasmic alterations and binucleated cells. The extracts also caused a significant reduction in the number of cells undergoing division. These effects can be a response to the phytochemical agents present in the extracts. The results suggest that the extracts contain bioactive components that deserve further studies related to cancer therapies.

Laurus nobilis L. is a large shrub belonging to the Lauracea family. Its leaves are widely used for food seasoning as well as in folk medicine. Various studies have demonstrated the antiproliferative, antifungal and antibacterial effects of Laurus nobilis, but no studies have investigated the genotoxic effect of the aqueous extract of the plant. The objective of this study was to analyze the genotoxic potential of an aqueous extract of leaves, using the Allium cepa assay and mouse peripheral blood cell micronucleus test. The results showed that the extract did not have any genotoxic activity, but cytotoxic activity was observed in the two experimental models used. The extract had an antiproliferative effect, detected through the reduction of the mitotic index and the polychromatic/normochromatic erythrocyte (PCE/NCE) ratio. The tests also demonstrated a large number of cells undergoing apoptosis and with nuclear abnormalities related to cell death processes. These results can be explained by the presence of phenolic compounds, saponins, flavonoids and alkaloids, detected in the phytochemical analysis of the extract. Therefore, the extract from L. nobilis in the form generally used by the population does not pose risks related to its genotoxic potential, and also contains components with apoptotic and antigenotoxic potential.

Resumo: O objetivo deste trabalho foi determinar o coeficiente de digestibilidade aparente (CDA) de seis ingredientes, em dietas-referência prática e purificada, e determinar a influência das dietas-referência sobre a digestibilidade dos ingredientes em juvenis de pacamã. Avaliaram-se os seguintes ingredientes: farinha de peixe, farinha de carne e ossos, farelo de soja, soja integral tostada, farelo de trigo e protenose de milho. Houve interação entre a dieta-referência e os ingredientes estudados. A dieta purificada proporcionou maior CDA quanto à proteína bruta e energia bruta. O pacamã apresentou CDAs elevados quanto aos ingredientes proteicos de origem vegetal, nas duas dietas-referência.

Abstract: The objective of this work was to determine the apparent digestibility coefficient (ADC) of six ingredients, in practical and purified reference diets, and to assess the influence of these reference diets on the digestibility of the ingredients in pacman catfish juveniles. The following ingredients were evaluated: fish meal, meat and bone meal, soybean meal, roasted whole soybean, wheat meal, and corn protenose. There was interaction between the reference diet and the studied ingredients. The purified diet provided higher ADC for crude protein and gross energy. Pacman catfish showed high ADC for protein ingredients of vegetable origin for the two reference diets.

The objective of this study was to evaluate the performance of three Nile tilapia Oreochromis niloticus strains cultivated in cages and subjected to different feeding programmes. Initially, 31,200 Nile tilapia juveniles with an average weight of 61.15 g were distributed in 48 cages. Two genetically improved strains were used together with one from the Fish Culture Section of Universidade Federal de Lavras (UFLA). The fish were subjected to four feeding programmes, consisting of different levels of crude protein (CP) in diets provided at different stages of cultivation. There was no interaction effect of the strain and feeding programme for most variables. The UFLA strain presented the highest weight gain, but with greatest lack of uniformity at the end of cultivation. The feeding programme with diets containing 36%, 32% and 28% CP, consecutively, promoted the highest weight gain and highest final biomass. The UFLA strain has great growth potential, justifying the development of a breeding programme for this strain. Crude protein levels below 36% for tilapias between 60 and 170 g and below 32% for tilapias between 170 and 700 g worsen fish performance.

Um ensaio de digestibilidade foi conduzido para avaliar os efeitos da suplementação de ração com um complexo enzimático contendo celulase, protease e amilase sobre a digestibilidade dos nutrientes em juvenis de tilápia-do-nilo (Oreochromis niloticus). As rações experimentais eram isoprotéicas (30% PB), isoenergéticas (4.243 kcal/kg EB) e foram suplementadas com complexo enzimático comercial contendo celulase, protease e amilase nos níveis de 0,0; 0,025; 0,050; 0,075 e 0,1%. A determinação da digestibilidade aparente foi realizada pelo método indireto, com uso de óxido de cromo (Cr2O3) como indicador de digestibilidade. Foram utilizados 50 juvenis machos de tilápia-do-nilo (90 ± 15 g) distribuídos aleatoriamente em dez incubadoras adaptadas para ensaio de digestibilidade. O experimento foi conduzido em três períodos experimentais, com cinco tratamentos e duas repetições por período. A adição do complexo enzimático à ração melhorou o coeficiente de digestibilidade aparente de matéria seca, proteína bruta, energia bruta, amido, cácio e fósforo. Entre os níveis testados, o de 0,05% de complexo enzimático proporcionou os valores mais expressivos.

A digestibility trial was conducted to evaluate the effects of the supplementation of the ration with a enzyme complex containing cellulase, protease and amylase on the digestibility of nutrients in Nile tilapia juveniles (Oreochromis niloticus). The experimental diets were isoprotein (30% CP), isoenergy (4,243 kcal/kg of GE) and supplemented with a commercial enzyme complex containing cellulose, protease and amylase at the levels of 0.0, 0.025, 0.050, 0.075, and 0.1%. The apparent digestibility was determinated by the indirect method using chrome oxide (Cr2O3) as an indicator of digestibility. A total of 50 male Nile tilapia juveniles (90 ± 15 g) were randomly allotted to ten hatchers adapted for the digestibility trial. The experiment was conducted in three experimental periods, with five treatments and two replicates per period. The addition of the enzyme complex to the diet improved the apparent digestibility coefficient of dry matter, crude protein, gross energy, starch, calcium and phosphorus. Among the tested levels, the 0.05% of enzyme complex provided the most expressive values.