Symptoms of COVID-19 in children

The aim of this study was to review the symptomatic manifestations of COVID-19 in children in the scientific literature. An integrative review of studies published between December 2019 and September 5, 2021, from the Medical Literature Analysis and Retrieval System Online, Web of Science, Scopus, Literatura Latino-Americana em Ciência de Saúde, and Base de Dados de Enfermagem databases, was carried out to answer the following research question: What symptomatic manifestations does COVID-19 cause in children?". Twenty articles were included. The main symptoms described were fever, cough, diarrhea, vomiting, sore throat, dyspnea, headache, abdominal pain, malaise, and weakness or tiredness. The findings of this review can contribute to the diagnosis and clinical decision-making of the health team by providing information that facilitates the identification of COVID-19 in the target population, favoring early identification, better care, and consequently a better prognosis.

Correlations between forced oscillation technique parameters and pulmonary densitovolumetry values in patients with acromegaly

The aims of this study were to evaluate the forced oscillation technique (FOT) and pulmonary densitovolumetry in acromegalic patients and to examine the correlations between these findings. In this cross-sectional study, 29 non-smoking acromegalic patients and 17 paired controls were subjected to the FOT and quantification of lung volume using multidetector computed tomography (Q-MDCT). Compared with the controls, the acromegalic patients had a higher value for resonance frequency [15.3 (10.9-19.7) vs 11.4 (9.05-17.6) Hz, P=0.023] and a lower value for mean reactance [0.32 (0.21-0.64) vs 0.49 (0.34-0.96) cm H2O/L/s2, P=0.005]. In inspiratory Q-MDCT, the acromegalic patients had higher percentages of total lung volume (TLV) for nonaerated and poorly aerated areas [0.42% (0.30-0.51%) vs 0.25% (0.20-0.32%), P=0.039 and 3.25% (2.48-3.46%) vs 1.70% (1.45-2.15%), P=0.001, respectively]. Furthermore, the acromegalic patients had higher values for total lung mass in both inspiratory and expiratory Q-MDCT [821 (635-923) vs 696 (599-769) g, P=0.021 and 844 (650-945) vs 637 (536-736) g, P=0.009, respectively]. In inspiratory Q-MDCT, TLV showed significant correlations with all FOT parameters. The TLV of hyperaerated areas showed significant correlations with intercept resistance (rs=−0.602, P<0.001) and mean resistance (rs=−0.580, P<0.001). These data showed that acromegalic patients have increased amounts of lung tissue as well as nonaerated and poorly aerated areas. Functionally, there was a loss of homogeneity of the respiratory system. Moreover, there were correlations between the structural and functional findings of the respiratory system, consistent with the pathophysiology of the disease.

Aprimoramento da capacidade funcional de idosos submetidos a uma intervenção por isostretching / Improvement of functional capacity among elderly people undergoing isostretching intervention

OBJETIVO: Verificar o aprimoramento da capacidade funcional de idosos submetidos a uma intervenção por isostretching. MÉTODOS: Estudo composto por 39 idosos, de ambos os sexos, sedentários, clinicamente saudáveis, com idade média de 66,3±3,34 anos, divididos em dois grupos: controle (GC, n=19) e experimental (GE, n=20). O GE foi submetido à intervenção baseada no isostretching, classificado como um método postural, aplicada uma vez por semana, durante dez sessões. A capacidade funcional foi mensurada pelo teste de caminhada de seis minutos (TC6) em três momentos: após a avaliação de triagem (TC6 INI), um dia após a quinta sessão (TC6 INTER) e um dia após a décima sessão (TC6 FIN). A distância predita, tida como valor de referência (TC6 REF), foi calculada a partir dos dados antropométricos dos sujeitos aplicados na fórmula de Enright & Sherrill. Os dados foram normalizados pelos valores de referência e as comparações inter e intragrupos foram feitas, respectivamente, pelo teste t não pareado e pela análise de variância (ANOVA) medidas repetidas com teste post-hoc de Tukey, com α=0,05. RESULTADOS: Não houve diferença estatística no TC6 REF dos grupos. No GC, todas as medidas do TC6 foram significativamente menores do que o TC6 REF (p<0,001), indicando fraco desempenho. No GE, não se observou diferença estatística entre o TC6 REF e o TC6 FIN (p>0,05), indicando melhora do desempenho neste grupo. CONCLUSÕES: O isostretching aumenta a capacidade funcional dos idosos, podendo ser este um recurso terapêutico viável para impedir efeitos deletérios do envelhecimento sobre a capacidade funcional.

OBJECTIVE: To investigate the improvement in functional capacity among elderly people undergoing an isostretching intervention. METHODS: This study sample was composed of 39 elderly people of both genders who were sedentary, clinically healthy and aged 66.3±3.34 years. They were divided into two groups: control group (n=19) and experimental group (n=20). The experimental group underwent a ten-session intervention based on isostretching (which is classified as a postural method), applied once a week. Functional capacity was assessed using the six-minute walking test (6WT) at three times: after the screening evaluation (6WT INI), one day after the fifth session (6WT INTER) and one day after the tenth session (6WT FIN). The predicted distance, named the reference value (6WT REF), was calculated from the subjects' anthropometric data, through the formula of Enright & Sherrill. The data were normalized according to the reference values, and inter-group and intra-group comparisons were made, respectively, using independent t test and repeated-measures analysis of variance (ANOVA) with Tukey post-hoc test, with α=0.05. RESULTS: There was no statistical difference in 6WT-REF between the groups. In the control group, all of the 6WT measurements were significantly smaller than the 6WT REF (p<0.001), thus indicating weak performance. In the experimental group, no statistical difference was observed between the 6WT REF and 6WT FIN (p>0.05), suggesting better performance in this group. CONCLUSIONS: Isostretching increased the elders' functional capacity and it could be a viable therapeutic resource for preventing the deleterious effects of aging on functional capacity.

Profits and social performance of small-scale fishing in the Upper Paraná River floodplain (Brazil)

Small scale fishing profits in two communities in the Upper Paraná River floodplain (Porto Rico - PRI and Porto São José - PSJ villages) are assessed based on interviews carried out with professional fishermen. There is a high illiteracy level in both PRI (50 percent) and PSJ (44.5 percent). The main contributions to income are "vessel costs" and "fish consumption" by the family. Specific tackle (such as cevadeira) and gear used for fishing close to dams make the gear costs higher at PSJ, emphasising the heterogeneity of the activity. The majority of fishermen in both villages have income complementation activities associated with tourism, because floodplain fishing is not a profitable occupation with any poverty alleviation capacity. Since the ecosystem is seriously disrupted, nowadays fishers are vulnerable to high oscillations in costs and income due to uncertainty in catches aggravated by flood control of the dams.

A renda da pesca de pequena escala em duas comunidades na planície de inundação do Alto Rio Paraná (Porto Rico - PRI e Porto São José - PSJ) foi calculada a partir de informações com os pescadores profissionais. Há alto analfabetismo em PRI (50 por cento) e PSJ (44,5 por cento). Os itens que mais contribuem com a formação da renda são "custos com a embarcação" e "consumo do pescado pela família". Estratégias e tralhas específicas (como a cevadeira) são usadas para pescar perto da barragem e fazem os custos maiores em PSJ, destacando a heterogeneidade da atividade. A maioria dos pescadores em ambas as comunidades exercem atividades complementares à renda, como o turismo, já que a pesca não é uma atividade rentável. Uma vez que o ecossistema está seriamente fragmentado, os pescadores são altamente vulneráveis à oscilação em custos e lucros, devido à diminuição nas capturas, ocasionada entre outros fatores pelo controle de inundação exercido pelas barragens.

An ecological economics approach to estimate the value of a fragmented wetland in Brazil (Mato Grosso do Sul state)

The Upper Paraná River floodplain is the last lotic stretch of an ecosystem seriously threatened given that circa 50 percent of the original ecosystem has been converted into reservoirs. To assess the recreational value of the Upper Paraná River floodplain, 174 tourists were interviewed using the Willingness to Pay - WTP and Travel Cost - TC methods. The annual aggregated WTP attributed by tourists was US$ 122.50 million and the variables which determine the decision in willingness to pay for the Floodplain are: 'consider oneself as a Floodplain natural resources consumer' and 'marital state'. If the single person considers her/himself as a consumer of floodplain natural resources, the WTP increases by a multiplicative factor of 38.8. The value aggregated by the TC method was US$ 234 millions and decreased by zone as the distance increases. Higher income and traveling farther increases the travel cost, which is inversely related to annual trip frequency. The total recreational value (356.5 millions per year) is high and representative since it refers to an environment fragmented by dams and with many anthropogenic effects. Therefore, the progressive changes on the landscape are a threat to local tourism, since half of the visitors are attracted solely by the scenic beauty, thereby overtaking those factors considered more important by public decision makers and managers, such as recreational fishery or boating.

A planície de inundação do Alto Rio Paraná é o último trecho de um ecossistema seriamente ameaçado, visto que 50 por cento deste ambiente foi convertido em reservatórios. Para estimar o valor agregado pela recreação à planície, foram usados o Método de Valoração Contingente (Disposição à paga - DAP) e o Método do Custo de Viagem - CV pela entrevista de 174 turistas. A disposição a pagar anual agregada pelos turistas foi US$ 122,50 milhões, 'considerar-se um usuário dos recursos da planície' e 'estado civil' são as variáveis que determinam a decisão em pagar pela planície. Se o turista solteiro se considera um consumidor dos recursos da planície, a DAP aumenta por um fator multiplicativo de 38,8. O valor agregado pelo CV foi US$ 234 milhões e diminui por zona com o aumento da distância. Maior renda e viagens mais longas também aumentam o custo de viagem que, no entanto, é inversamente relacionado à freqüência anual de viagens. O valor recreativo total (356.5 milhões por ano) é alto e representativo por se tratar de um ambiente fragmentado por barragens e com muitos efeitos antropogênicos. Assim, as progressivas alterações na paisagem são uma ameaça ao turismo local, pois a metade dos visitantes entrevistados declarou ser atraída somente pela beleza cênica, sobrepujando outros bens e serviços naturais considerados importantes por gestores e administradores públicos, como a pesca recreativa e o passeio de barco.