Importance: Owing to its anti-inflammatory properties and antiviral ''in vitro'' effect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cannabidiol (CBD) has been proposed as a potential treatment for coronavirus disease 2019 . Objective: To investigate the safety and efficacy of CBD for treating patients with mild to moderate COVID-19. Design: Randomized, parallel-group, double-blind, placebo-controlled clinical trial conducted between July 7 and October 16, 2020, in two sites in Brazil. Setting: Patients were recruited in an emergency room. Participants: Block randomized patients (1:1 allocation ratio-by a researcher not directly involved in data collection) with mild and moderate COVID-19 living in Ribeira ˜o Preto, Brazil, seeking medical consultation, and those who voluntarily agreed to participate in the study. Interventions: Patients received 300 mg of CBD or placebo added to standard symptomatic care during 14 days. Main Outcome and Measure: The primary outcome was reduction or prevention of the deterioration in clinical status from mild/moderate to severe/critical measured with the COVID-19 Scale or the natural course of the resolution of typical clinical symptoms. Primary study outcome was assessed on days 14, 21, and 28 after enrollment. Results: A total of 321 patients were recruited and assessed for eligibility, and 105 were randomly allocated either in CBD (n = 49) or in placebo (n = 42) group. Ninety-one participants were included in the analysis of efficacy. There were no baseline between-group differences regarding disease severity (v 2 = 0.025, p = 0.988) and median time to symptom resolution (12 days [95% confidence interval, CI, 6.

Considering the historical and academic relevance of the Brazilian Archives of Cardiology (ABC), as its MEDLINE indexing began in 1950, it was assumed as a hypothesis that the analysis of the publications over the last 60 years could reflect the changing trends of heart disease in Brazil.The study data were collected using a program developed for this purpose, allowing the automatic extraction of information from the MEDLINE database. The study information were collected by searching "Brazilian Archives of Cardiology AND selected parameter in English". Four observational groups were determined: (1) major groups of heart diseases (coronary artery disease, valvular heart disease, congenital heart disease and cardiomyopathies); (2) relevant diseases in clinical practice (cardiac arrhythmias, cor pulmonale, myocardial infarction and congestive heart failure); (3) cardiovascular risk factors (hypertension, diabetes, dyslipidemia and atherosclerosis); and (4) group determined due to the growing trend of publications on congestive heart failure seen in previous groups (congestive heart failure, myocardial infarction, rheumatic heart disease and Chagasic heart disease)All publications within the established groups were described, highlighting the increasing importance of heart failure and diabetes as risk factors. A relatively easy search was carried out, using the computer program developed for literature search covering six decades. Emphasizing the limitations of the study, we suggest the existence of an epidemiological link between cardiac diseases that are prevalent in Brazil and the publications of the Brazilian Archives of Cardiology.

A modern concept considers acute coronary syndrome as an autoinflammatory disorder. From the onset to the healing stage, an endless inflammation has been presented with complex, multiple cross-talk mechanisms at the molecular, cellular, and organ levels. Inflammatory response following acute myocardial infarction has been well documented since the 1940s and 1950s, including increased erythrocyte sedimentation rate, the C-reactive protein analysis, and the determination of serum complement. It is surprising to note, based on a wide literature overview including the following 30 years (decades of 1960, 1970, and 1980), that the inflammatory acute myocardium infarction lost its focus, virtually disappearing from the literature reports. The reversal of this historical process occurs in the 1990s with the explosion of studies involving cytokines. Considering the importance of inflammation in the pathophysiology of ischemic heart disease, the aim of this paper is to present a conceptual overview in order to explore the possibility of curbing this inflammatory process.

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Background: Repeated migraine attacks and aura could independently cause structural changes in the central nervous system. Our research aims to study the correlation of migraine type, attack frequency, and other clinical variables with the presence, volume and localization of white matter lesions (WML), in a controlled study. Methods: Sixty volunteers from a tertiary headache center were selected and divided equally into four groups: episodic migraine without aura (MoA), episodic migraine with aura (MA), chronic migraine (CM) and controls (CG). Voxel-based morphometry techniques were used to analyze WML. Results: There were no differences in WML variables between groups. There was a positive correlation between age and the number and total volume of WMLs, which persisted in the comparison categorized by size and brain lobe. Disease duration was positively correlated with the number and total volume of WML, and when controlled by age, the correlation maintained significance only for the insular lobe. Aura frequency was associated with frontal and temporal lobe WMLs. There was no statistically significant correlation between WML and other clinical variables. Conclusion: Migraine overall is not a risk factor for WML. Aura frequency is, however, associated with temporal WML. Disease duration, in adjusted analyses that account for age, is associated with insular WML.

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Introdução As lesões de substância branca (LSB) são as alterações macroestruturais mais comuns na migrânea e estão relacionadas à perda mielínica/axonal, rarefação neuronal e gliose; porém seu significado clínico é incerto. A inflamação neurogênica, a depressão alastrante cortical e a oligoemia podem estar implicados na gênese dessas lesões. Assim, aventa-se o papel das LSBs como biomarcadores na migrânea. Objetivos Caracterizar as LSBs em mulheres com migrânea quanto à presença, número, volume e localização. Comparar as LSBs entre os grupos: migrânea sem aura, migrânea com aura, migrânea crônica e grupo controle. Avaliar a influência de variáveis clínicas sobre as características das LSBs. Material e Métodos Estudo transversal com 60 voluntárias, entre 18-55 anos, alocadas igualmente entre os grupos, pareadas por média de idade, submetidas à ressonância magnética de alta resolução. As imagens foram processadas por softwares de morfometria baseada em voxel. As lesões foram identificadas e segmentadas manualmente por um neurologista e avaliadas cegamente por 2 neurorradiologistas.  Resultados Os testes de Mann-Whitney, Kruskal-Wallis e Coeficiente de Spearman foram utilizados para análise estatística. Não houve diferença nas variáveis de LSB entre os grupos, o que se manteve nas análises de subgrupo quando as lesões foram caracterizadas por tamanho e localização. A idade e o tempo de doença foram as variáveis clínicas que mais influenciaram as LSB, sobretudo na ínsula. A frequência de aura influenciou as LSBs do lobo temporal. Não foram encontradas correlações com frequência de crises, intensidade de dor e tratamento profilático. Todas as LSBs foram supratentoriais e predominaram nos territórios de circulação anterior. Conclusão O tipo de migrânea não influencia na formação de LSBs. A ínsula e o lobo temporal podem estar envolvidos na fisiopatologia da crise migranosa. Não foi possível estabelecer se a migrânea é um fator de risco para LSBs