Objectives: To examine the longitudinal prevalence and recovery of olfactory, gustatory, and oral chemesthetic deficits in a sizable cohort of SARS-CoV-2 infected persons using quantitative testing. To determine whether demographic and clinical factors, mainly the medications used after the COVID-19 diagnosis, influence the test measures. Methods: Prospective cohort in a hospital with primary, secondary, tertiary, and quaternary care. Patients with confirmed COVID-19 were tested during the acute infection phase (within 15 days of initial symptom, n = 187) and one (n = 113) and 3 months later (n = 73). The University of Pennsylvania Smell Identification Test, the Global Gustatory Test, and a novel test for chemesthesis were administered at all visits. Results: During the acute phase, 93% were anosmic or microsmic and 29.4% were hypogeusic. No one was ageusic. A deficit in oral chemesthesis was present in 13.4%. By 3 months, taste and chemesthesis had largely recovered, however, some degree of olfactory dysfunction remained in 54.8%. Remarkably, patients who had been treated with anticoagulants tended to have more olfactory improvement. Recovery was greater in men than in women, but was unrelated to disease severity, smoking behavior, or the use of various medications prior to, or during, COVID-19 infection. Conclusions: When using quantitative testing, olfactory disturbances were found in nearly all SARS-CoV-2 infected patients during the acute infection phase. Taste or chemesthetic deficits were low. Olfactory impairment persisted to some degree in over half of the patients at the 3-month follow-up evaluation, being more common in women and less common in those who had been treated earlier with anticoagulants. Level of Evidence: 3
Abstract. Educational recommendation systems require different models from those applied in other areas. An important factor is recommend Learning Objects (LO) that improve the learning process and not only match with the student's personal preference. We used a game ranking technique, the ELO, to compare students and LO. The interaction of student and L.O. is like a game match. Analyzing the history of an online programming problem tool, we observed that recommending to the student problems that have ELO next to him tends to bring better results.Resumo. Sistemas de recomendação para sistemas em educacionais demandam modelos diferentes dos utilizados em outrasáreas. Um fator importanté e apresentar objetos de aprendizagem (O.A.) que catalizem o aprendizado e não necessariamente operem em função dos gostos pessoais do estudante. Utilizando uma técnica de ranking em jogos, o ELO, comparamos estudantes e problemas como se os O.A. fossem duelos. Analisando o histórico de uma ferramenta online de problemas de programação, observamos que recomendar ao estudante problemas de ELO próximo ao seu tende a trazer melhores resultados. IntroduçãoO problema de escolher, dentre diversos objetos, o mais adequado para um usuárió e um problema já bastante trabalhado nos sistemas de recomendação. Sistemas de recomendação utilizam técnicas computacionais para selecionar itens de forma personalizada a usuários, levando em conta critérios como histórico e interesse. Esses sistemas têm sido construídos a fim de nos recomendar filmes,produtos ou sites mais adequados a nossa vontade. No entanto, o processo de recomendação na educaçãoé diferente. Enquanto na escolha de filmes e sites podemos nos basear nos gostos do usuário e em seu histórico de utilização, a educação exige modelos específicos e uma análise diferente desses critérios, de forma que os objetos recomendados potencializem o aprendizado.Os sistemas baseados em análise pedagógica geram sua recomendação através da modelagem de fundamentos pedagógicos, tornando assim a análise mais sofisticada no sentido de observar os dados sob aótica de um modelo pedagógico.
Introduction: Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) was first detected in December 2019 in the city of Wuhan, China, and has since taken on worldwide proportions. It is known that individuals with Coronavirus disease-19 (COVID-19) have systemic clinical manifestations. Among the multisystemic effects, cerebral venous thrombosis (CVT) is responsible for high mortality rates. In this sense, understanding the association between CVT and SARS-CoV-2 infection directly impacts the disease's morbidity and mortality. Methodology: Literature review in the PubMed and Embase databases, with the following search terms: “COVID-19”, “SARS-CoV-2”, “Venous thromboembolism”, “Thrombosis”, “Cerebral Venous Thrombosis”, “Intracranial Sinus Thrombosis” and “Cranial Sinus Thrombosis”. The selected articles were written in English, which addressed the various aspects of COVID-19. Results and discussion: CVT are a rare complication of COVID-19, with an incidence between 0.02 to 1% of hospitalized patients. However, it can reach about 75% of mortality in affected individuals. Pathophysiology seems to be associated with the state of hypercoagulability and the systemic inflammatory process resulting from viral infection. Thus, recent studies show a consensus on the early anticoagulation of patients affected by the virus, to reduce mortality in these cases. However, the differences between the types of anticoagulation, Low Molecular Weight Heparin (LMWH), Unfractionated Heparin (UFH), Dabigatran have not yet been well established, although there is a predilection for the use of LMWH. Also, thrombectomy is a therapeutic intervention option that should be evaluated, due to the risk of additional endothelial injury from the use of stent retrievers. Conclusion: Although it has a relatively low incidence, CVT aggravates the condition and increases the risk of death for patients with COVID-19. Because of this, early diagnosis and evaluation of therapeutic options for CVT are essential for the development of clinical management.
Background: Infection with SARS-CoV-2 can cause COVID-19, which mainly affects the respiratory system. However, neurological complications are frequent, including the group of acquired immune-mediated demyelinating neuropathies (NDAI), including Miller-Fisher syndrome (SMF), characterized by the triad of ophthalmoparesis, ataxia and areflexia. Infection with C. jejuni is the main precipitant of NDAI, but viruses are also related. Objectives: This report aims to describe a case of SMF with concomitant SARS-CoV-2 infection, seen at a tertiary hospital in Northern Paraná and to compare it with the literature. Design and setting: case report of a patient at the hospital neurology service of the Evangelical Hospital, Londrina, Paraná, Brazil. Methods: Report a case of SMF right after confirmation of COVID-19 seen at a tertiary hospital in Northern Paraná and compare it with the literature. Results: Male, 70 years old, white, evolved with progressive and symmetrical crural paraparesis 17 days after confirmation of COVID-19. Upon admission, he presented ataxia, paraesthesia, and crural myotactic areflexia with no signs of pyramidal release, and a score on the Medical Research Council (MRC) muscle strength scale of 58 points. Analysis of CSF with albumin-cytological dissociation. Treatment was performed with intravenous human immunoglobulin (IVIG) and discharged after six days of hospitalization with partial symptomatic improvement. We compared this case with those described in the published literature. Not found Brazilian case published to date. Conclusion: Rare case report of SMF by SARS-CoV-2. The relationship has consistency, temporality, biological plausibility, coherence and analogy compatible with the current literature. Studies with a higher level of evidence are needed to determine the strength of such an association.
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