Abstract Background Cognitive impairment, anxiety, and depression are present in patients with heart failure (HF), but their mutual correlation in hospitalized patients is not well established. Objectives The aims of this study were to identify the presence of cognitive impairment and the most affected domain, to investigate possible associations of cognitive impairment with depression and/or anxiety, and to observe whether they correlated with occurrence of readmission within 30 days following hospital discharge. Methods This is a prospective observational study including patients with HF from a private hospital. Psychological distress and cognition were evaluated by the Hospital Anxiety and Depression Scale (HADS) and by the Mini Mental State Exam (MMSE), respectively. Clinical data were obtained from the medical record at the time of inclusion, and outpatient follow-up was performed 30 days after discharge via telephone calls. Results This study included 71 patients (83% men, 75 ± 11 years). Cognitive impairment was present in 53.5% of the patients, and recall memory was the most altered cognitive domain. The proportion of possible/probable anxiety and depression was 21.1% and 34.2% in patients with cognitive impairment, respectively. However, only depression demonstrated association with cognitive impairment (p = 0.018). Cognitive impairment, anxiety, and depression showed no relationship with the occurrence of readmission within 30 days. Conclusions Cognitive impairment and depressive symptoms are prevalent and associated, and recall memory was the most altered cognitive domain in patients hospitalized with HF. However, there was no relationship between these factors and readmission within 30 days.

RESUMO Com intenso consumo e lançamento contínuo em efluentes domésticos e industriais, a cafeína tem sido regularmente detectada em meios aquáticos por todo o mundo. Esse psicoativo é considerado um excelente indicador de contaminação na água, relacionada à atividade humana. No entanto, os impactos que pode ocasionar à saúde e ao ambiente ainda não são bem compreendidos. Dessa forma, o objetivo deste trabalho foi verificar a presença da cafeína em água bruta e tratada por uma estação de tratamento de água convencional, em diferentes períodos hidrológicos, e avaliar o risco potencial que ela representa ao ambiente aquático. A cafeína foi detectada em todas as amostras de água bruta. A maior concentração foi observada no período mais intenso de seca. Ela não foi detectada na água tratada. O composto é considerado como de alto risco ao ambiente aquático. Os resultados indicam a vulnerabilidade do manancial em questão.

ABSTRACT With an intense consumption and continuous release into domestic and industrial effluents, caffeine has been regularly detected in aquatic environments worldwide. This psychoactive is considered an excellent indicator of contamination in water, related to human activity. However, the impacts it can have on health and on the environment are still not well understood. Thus, the objective of this work was to verify the presence of caffeine in raw water treated by a conventional water treatment plant, in different hydrological periods, and to evaluate the potential risk that it represents to the aquatic environment. Caffeine was detected in all raw water samples. The highest concentration was observed in the most intense period of drought. It was not detected in the treated water. The compost is considered to be of high risk to the aquatic environment. The results indicate the vulnerability of the source in question.

Abstract Background Cognitive impairment, anxiety, and depression are present in patients with heart failure (HF), but their mutual correlation in hospitalized patients is not well established. Objectives The aims of this study were to identify the presence of cognitive impairment and the most affected domain, to investigate possible associations of cognitive impairment with depression and/or anxiety, and to observe whether they correlated with occurrence of readmission within 30 days following hospital discharge. Methods This is a prospective observational study including patients with HF from a private hospital. Psychological distress and cognition were evaluated by the Hospital Anxiety and Depression Scale (HADS) and by the Mini Mental State Exam (MMSE), respectively. Clinical data were obtained from the medical record at the time of inclusion, and outpatient follow-up was performed 30 days after discharge via telephone calls. Results This study included 71 patients (83% men, 75 ± 11 years). Cognitive impairment was present in 53.5% of the patients, and recall memory was the most altered cognitive domain. The proportion of possible/probable anxiety and depression was 21.1% and 34.2% in patients with cognitive impairment, respectively. However, only depression demonstrated association with cognitive impairment (p = 0.018). Cognitive impairment, anxiety, and depression showed no relationship with the occurrence of readmission within 30 days. Conclusions Cognitive impairment and depressive symptoms are prevalent and associated, and recall memory was the most altered cognitive domain in patients hospitalized with HF. However, there was no relationship between these factors and readmission within 30 days.