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Introduction La COVID-19 est une pandémie mondiale de grande envergure et très contagieuse. Son traitement symptomatique jusqu'à ce jour souligne l'importance des mesures préventives (mesures barrières) pour lutter contre cette maladie. L'objectif de ce travail est d'étudier la pratique des mesures barrières contre le COVID-19 (PMBC) et les facteurs associés chez les étudiants de l'Université de Parakou en 2021. Méthodes Il s'agissait d'une étude d'observation transversale à visée analytique concernant les étudiants inscrits à l'Université de Parakou en 2020-2021, sélectionnés par sondage aléatoire à trois degrés. La variable dépendante était la pratique des mesures barrières. Les variables indépendantes étaient sociodémographiques, économiques, culturelles et psycho-cognitives. L'outil de collecte des données était un questionnaire auto-administré en ligne grâce à l'application KoBoCollect intégré aux smartphones. Un modèle de régression logistique binaire multivarié a été ajusté pour identifier des facteurs associés à la PMBC. Résultats Une majorité des 457 étudiants participants (84,7 %) avaient une bonne PMBC. L'entité principale de formation (p=0,029) et le montant mensuel d'argent de poche perçu par l'étudiant (p=0,003) étaient associés à la bonne PMBC. Conclusion L'Université constitue un lieu de circulation de la bonne information et des bonnes PMBC et les décideurs peuvent capitaliser sur cela pour proposer des stratégies idoines à toute la population. Mots clés COVID-19 , Pratique , Mesures barrières , Etudiants , Université de Parakou Déclaration de liens d'intérêts Les auteurs n'ont pas précisé leurs éventuels liens d'intérêts.
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Introduction: Acquired haemophilia A (AHA), characterized by neutralizing autoantibodies against factor VIII (FVIII), is a rare disorder (1.5/million/y). Pregnancy-relatedAHAis an even rarer disorder affecting 0.03/million/y with an incidence of 1 case/350000 births. Aim(s): to describe two pregnancy-related AHA presented at the same year of 2022. Method(s): We evaluate data from two women (patient 1 and 2) with AHA diagnosed within 1 year following childbirth. Result(s): Two women, patient 1 (P1) and P2 with 32 and 33-year old respectively, presented AHA seven (P1) and six (P2) months after delivery. They had no relevant medical history, except for COVID-19 vaccination fifteen days before the development of bleeding in P1, and late-pregnancy COVID-19 infection in P2. They had no complications related to childbirth. The bleeding events in both patients were haematuria and apparently spontaneous hematomas in the upper limb, requiring no haemostatic treatment. Laboratorial investigation, demonstrated in P1 a FVIII activity of 0.026 IU/ml and a FVIII antibody titer of 26 Bethesda Units (BU), and in P2 a FVIII activity of 0.005 IU/ml and a FVIII antibody titer of 34 BU. Concomitant disorders were excluded. The patients started eradication of the inhibitors with prednisone (1mg/kg/day orally). In P1, inhibitor titer was 0 BU and FVIII> 0.5 IU/ml after 8 weeks of immunosuppression. During eradication period, the P2 had a hematoma in right thigh treated with bypassing agent (FEIBA), but the inhibitor titer was 0 BU and FVIII>0.5 IU/ml after 1 month of inhibitor eradication. Curiously, P2 with FVIII< 0.01 IU/ml and a higher inhibitor titer than P1 had a faster response to prednisolone therapy (4 vs. 8 weeks). Currently, prednisone has been completely withdrawn in P1 and the prednisone dosage is being gradually reduced in P2. Discussion/Conclusion: Data from these two women with pregnancyrelated AHA are similar to previously described cases and expand the knowledge about this rare disorder. The peculiarity of this report is due to the emergence of two cases of a disease with markedly low incidence, in the same local and year, raising the question of whether there were new acquired factors (as immunological triggers such as COVID-19 infection or vaccination) that could be involved in the modification of the natural history of the disease. It cannot be excluded the possibility that these two cases were a coincidence.
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This article aims to describe the experience of undergraduate nursing students as a fellow of the Virtual Health Extension Project - Prevention within their home, linked to the State University of Tocantins (Unitins), with a focus on virtual assistance to the general population, valuing clarifications from doubts and providing information, in the context of prevention, care and combating the pandemic by covid-19. Descriptive study, type of experience report. The activities were carried out from April to July 2020, virtually in collaboration with professionals in various training areas. It was noticed that the performance of the virtual health project with its diverse activities and work tools was satisfactory. The experience in the area of nursing and others with the project, resulted in a unique opportunity with the practices and actions carried out, actively collaborating for the unfolding of the pandemic moment and for the sum in individual / personal, group, as well as professional growth.
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Background: COVID-19 pandemic motivated a reorganization of healthcare institutions, which may have led to a negative impact on cancer patients' treatment. This study compared the pathological response (PR) rate to neoadjuvant chemotherapy (NACT) in breast cancer (BC) patients who underwent treatment before (BCv) and during (DCv) the COVID-19 pandemic at our institution.
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The Covid-19 crisis has caused several social-related issues; the sanitary is, perhaps, the most significant one. Lockdowns and vaccination were implemented to fight the Covid-19 virus. From a sustainability perspective, Covid-19 has been considered a meaningful crisis driver that has affected nations' economies and social and natural capitals. The literature presents clues that effects appear to be different among countries. Recognizing its importance as public policies for sustainability, this study aims to assess how the sustainability of countries has changed after Covid-19, focusing on countries' economic power that reflects their capacity to face the crisis. A sample of 89 countries is considered, and 2019-2020 are set as base years for data gathering, which covers the first year of the Covid-19 crisis. Sustainability is conceptually supported and represented by a 3-D cube. The natural environment is expressed by the ecological footprint (EF) method, the economic capital by the gross domestic product (GDP), and the social capital by the happiness index. Results show that sustainability of economies was negatively affected after first year of Covid-19 crisis, but in different magnitudes, according to nations' economic power. While the sustainability of the wealthiest economies was slightly changed during 2019-2020 but maintained within the named 'useful-order' world (environmentally unsustainable, productive, and happy), the poorest economies pushed about 169 million people into the worst performance, reaching the 'ineffective' world (environmentally unsustainable, unproductive, and unhappy). Numbers highlight the inequalities of sustainability performance among countries, according to their capacity to face the Covid-19 crisis. The shield of the richest evaluated countries comprising 5 % of the world population is more powerful than the shield of the poorest evaluated countries carrying 67 % of the world population. Results claims for efforts to make different policies and provide economic support differently for countries, since although we are all under the same storm, but in different boats.
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COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Communicable Disease Control , Gross Domestic Product , EnvironmentABSTRACT
This article aims to reflect on the coverage of the political news and sensations present in the newspaper Estado de Minas, a journalistic reference publication. Based, specifically, on the 5-cover clippings that deal with the mo-ment of the COVID-19 Pandemic in Brazil, the text analyzes the way in which a traditional vehicle makes use of elements of the language of popular journalism to attract its readers. Thus, based on the Discourse Analysis (AD) perspective, it is possible to understand the choices made by the mining vehicle. In addition, methodologically, we seek to investigate how the colors used in the covers manage to obtain the meaning desired by the publication. We found that the discursive strategies present in the materials demonstrate the journal’s intention to impact the reader, thus promoting sensations and stimulating questioning. © 2022, Superior School of Advertising and Marketing. All rights reserved.
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This article aims to provide a reflection on the World Health Organization sponsored Project: "Responsibility for Public Health in the Lusophone World: Doing Justice In and Beyond the Covid Emergency". This initiative was designed to gather experiences and data regarding the preparedness and response to the SARS-CoV-2 Pandemic in Angola, Brazil, Mozambique, Portugal and the Macao Special Administrative Region. Launched in November 2020, it combines the in-depth analysis of the most recent legislation and bibliography on the matter with data obtained through a Questionnaire, addressed to a significant number of participants (from healthcare workers to academics and non-government organisations (NGOs), of which there were 41 respondents), which aims to gather different experiences and analyse ethical difficulties, identified in the response to the Pandemic.
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OBJECTIVE: The proportion of children with complex chronic conditions is increasing in PICUs around the world. We determined the prevalence and functional status of children with complex chronic conditions in Brazilian PICUs. METHODS: We conducted a point prevalence crosssectional study among fifteen Brazilian PICUs during the COVID-19 pandemic. The study had IRB consent. We enrolled all children admitted to the participating PICUs with complex chronic conditions on 3 different days, 4 weeks apart, starting on April 4th, 2020. We recorded the patient's characteristics and functional status at the admission and discharge days. RESULTS: During the 3 study days from March to June 2020, we enrolled 248 patients admitted to the 15 PICUs;148 had CCC (prevalence of 59.7%). Patients had a median of 1 acute diagnosis and 2 chronic diagnoses. The use of resources/devices was extensive. The main mode of respiratory support was conventional mechanical ventilation. Most patients had a peripherally inserted central catheter (63.1%), followed by a central venous line (52.5%), and 33.3% had gastrostomy or/and tracheostomy. The functional status score was significantly better at discharge compared to admission day due to the respiratory status improvement. CONCLUSIONS: The prevalence of children with CCC admitted to the Brazilian PICUs during the COVID-19 pandemic was higher than studies in other countries, representing 59.7% of patients in the PICUs. The functional status of these children improved during hospitalization, mainly due to the respiratory component.
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INTRODUCTION: Healthcare professionals are among the main risk groups for COVID-19 and can also be a source of transmission to patients to whom they provide care. The identification of symptoms is important in the clinical presumption of COVID-19. However, the infection may be asymptomatic or paucysymptomatic. MATERIAL AND METHODS: Cross-sectional study, with retrospective analysis of the clinical records of health professionals who went by self-initiative to the Occupational Health Service of a University Hospital Center, between March and August 2020, for presenting symptoms, risk contact with a confirmed case of COVID-19, or by both and, who in this context, performed the RT PCR SARS-CoV-2 test. RESULTS: 613 professionals were evaluated. Of the 420 symptomatic professionals, in 27 COVID-19 was confirmed, while only 3 of the 193 asymptomatic professionals being positive (95% CI, p = 0,009). In turn, of the 371 who had respiratory symptoms, 19 were positive for COVID-19, versus 11 among the 242 who had no respiratory symptoms, not being difference statistically significant (95% CI;p = 0,75). Nasal congestion and rhinorrhea were the respiratory symptoms with the highest proportion of positive cases (11,43% and 8,97%, respectively). CONCLUSIONS: Although COVID-19 is typically associated with respiratory symptoms, not all these symptoms were predictive of disease. It becomes crucial to value mild symptoms among healthcare professionals, even in the absence of risk contact.
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Background: The Covid-19 pandemic imposed a major challenge for universities around the world and required social distance due to the spread of the new coronavirus (Sars-Cov-2). Professors and students explored alternatives to continue university activities, including the adoption of Information and Communication Technologies and the expansion of the role of extracurricular activities. In this perspective, this article aimed to report the experience of The Dermatology Interest Group of the Federal University of Health Sciences of Porto Alegre (Liaderm - UFCSPA) during the Covid-19 pandemic and analyzed the importance of extracurricular activities and digital education as medical education tools. Experience report: During social isolation and suspension of classes, teaching, research and extension activities of Liaderm - UFCSPA needed to be adapted. The interest group in-person meetings started to take place as online meetings on videoconferencing platforms, such as Zoom® and Google Meet®, and consisted of theoretical classes and discussion of clinical cases. The group also held open classes for the academic community, such as a webinar on Surgical Dermatology, attended by medical students and other health students from all over the country. In addition, Liaderm organized activities to maintain the members' social engagement. One example is the manual with fundamental guidelines on dermatological injuries triggered by Personal Protective Equipment (PPE) on health care providers involved with the care of patients with Covid-19. Conclusions: During the pandemic, Liaderm maintained most of its activities using Information and Communication Technologies, such as video conferencing platforms. In addition, the participation of academics from different states of the country and abroad expanded the scope of the teaching activities. In this sense, the adaptations caused by the Covid-19 pandemic may have a long-term impact, both in the teaching models of medical schools and in the acknowledgment of extracurricular activities as a strategic educational resource for medical education. © 2021 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.
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Introduction: Recently during the COVID-19 pandemic there was a general belief in a reduction of hospital admissions due to non-infectious causes, namely cardiovascular diseases. Objectives: To evaluate the impact of the pandemic in the admissions by ST elevation acute myocardial infarction (STEMI), during the first pandemic wave. Methods: Multicentric and retrospective analysis of consecutive patients presenting in two Portuguese hospital centers with STEMI in two sequential periods - P1 (1st March to 30th April) and P2 (1st May to 30th June). A comparison of patient's clinical and hospital outcomes data was performed between the year 2020 and 2017 to 2019 for both periods. Results: A total of 347 consecutive STEMI patients were included in this study. The patient's baseline characteristics and cardiovascular risk factors were similar across the considered periods. During P1 of 2020, in comparison with previous years, a reduction in the number of STEMI patients was observed (26.0±4.2 vs 16.5±4.9 cases per month;p=0.033), contrary to what was observed during P2 (19.5±0.7 vs 20.5±0.7 cases per month;p=0.500). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs 9.1%;p=0.033). A global trend in longer delays in time-key bundles of STEMI care was noted, namely pain to first medical contact, door to needle, door to wire crossing and symptoms to wire crossing times, however without statistical significance. Mortality rate was six-fold higher during P1 comparing to previous years (1.9% vs 12.1%;p=0.005), and also an increase in the number of mechanical complications (0.0% vs 3.0%;p=0.029) was observed. Conclusions: During the first COVID-19 pandemic wave there were fewer patients presenting with STEMI at catheterization laboratory for coronary angioplasty. These patients presented more mechanical complications and higher mortality rates.
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Background: In COVID-19, as in SARS, the degree of kidney injury can have major implications for the clinical outcomes. Early reports indicate that, among patients with COVID-19, AKI is common and is associated with worse outcomes. However, COVID-19-related AKI among ICU patients in Brazil has not been well described. Methods: This was a retrospective observational study of the electronic health records of patients with COVID-19-related AKI admitted to the Hospital das Clínicas in the city of São Paulo, Brazil, between March and August of 2020. We applied only KDIGO criteria 2 and 3. We used logistic regression to analyze risk factors for the composite outcome of mortality or RRT. Results: Among the 694 patients with COVID-19-related AKI, the mean age was 63 years and mortality was 66.4%;41% needed vasoactive drugs, 66% needed mechanical ventilation, and 72% needed dialysis. Univariate analysis showed the following risk factors for mortality and RRT at admission: male sex;diabetes;CKD;vasoactive drug use;mechanical ventilation;acidemia;elevated lactate, magnesium, potassium, creatinine, C-reactive protein, creatine phosphokinase, total bilirrubin;proteinuria;hematuria;and increased fractional excretion of potassium (n=98) and sodium (n=110). The factors that remained significant in the multivariate analysis were male sex, vasoactive drug use, serum magnesium >2.5 mg/dL and oliguria (24-h urine output <500 mL). Conclusions: In ICU patients with COVID-19-related AKI, in Brazil and elsewhere, in-hospital mortality is high. The exact mechanism by which hypermagnesemia increases mortality in such patients merits further study.
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Anemia and jaundice are common health conditions that affect millions of children, adults, and the elderly worldwide. Recently, the pandemic caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), the virus that leads to COVID-19, has generated an extreme worldwide concern and a huge impact on public health, education, and economy, reaching all spheres of society. The development of techniques for non-invasive diagnosis and the use of mobile health (mHealth) is reaching more and more space. The analysis of a simple photograph by smartphone can allow an assessment of a person's health status. Image analysis techniques have advanced a lot in a short time. Analyses that were previously done manually, can now be done automatically by methods involving artificial intelligence. The use of smartphones, combined with machine learning techniques for image analysis (preprocessing, extraction of characteristics, classification, or regression), capable of providing predictions with high sensitivity and specificity, seems to be a trend. We presented in this review some highlights of the evaluation of anemia, jaundice, and COVID-19 by photo analysis, emphasizing the importance of using the smartphone, machine learning algorithms, and applications that are emerging rapidly. Soon, this will certainly be a reality. Also, these innovative methods will encourage the incorporation of mHealth technologies in telemedicine and the expansion of people's access to health services and early diagnosis.
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BACKGROUND AND AIMS: Coronavirus disease 2019 (COVID-19) has affected the care of patients on chronic hemodialysis (HD). It has been reported that older adults and those with comorbidities, such as diabetes mellitus, hypertension, cardiovascular disease and chronic kidney disease are prone to develop severe disease and poorer outcomes. By virtue of their average old age, multiple comorbidities, immunosuppression and frequent contact with other patients in dialysis facilities, chronic HD patients are at particular risk for severe COVID-19 infection. The aim of this study was to compare clinical presentation, laboratory and radiologic data and outcomes between HD and non-HD COVID-19 patients and find possible risk factors for mortality on HD patients. METHOD: A single center retrospective cohort study including patients on HD hospitalized with a laboratory confirmed COVID-19 infection, from March 1st to December 31st of 2020 and matched them to non-dialysis patients (non-HD) (1:1). Data regarding patient baseline characteristics, symptoms, laboratory and radiologic results at presentation were collected, as well as their outcomes. Categorical variables are presented as frequencies and percentages, and continuous variables as means or medians for variables with skewed distributions. A paired Student's t-test was performed on parametric continuous values or Mann-Whitney for non-parametric continuous variables. Chi-squared test was performed for comparing categorical variables. Logistic regression was used to identify risk factors for mortality on HD patients. A p-value of less than 0,05 indicated statistical significance. RESULTS: A total of 34 patients HD patients were included, 70,6% male, mean age of 76,5 years, median time of dialysis of 3,0 years. Among them 85,3% were hypertensive, 47,1% diabetic, 47,1% had cardiovascular disease, 30,6% pulmonary chronic disease and 23,5% cancer. The most frequent symptoms were fever (67,6%), shortness of breath (61,8%) and cough (52,9%). At admission, 55,9% of patients needed oxygen supply, one required mechanic ventilation and was admitted to intensive care unit. Regarding laboratory data, the most common features were lymphopenia in 58,9% (median-795/uL), elevated LDH in 64,7% (median-255 U/L), raised C-reactive protein in 97,1% (median-6,3 mg/dlL, raised D-dimer in 95,8% (median 1,7 ng/mL), and all patients presented high ferritin (median 1658 ng/mL) and elevated Troponin T (median 130ng/mL). The majority presented with radiologic changes, particularly bilateral infiltrates in 29,4%. Concerning clinical outcomes, the median hospitalization time was 11 days and 13 patients (38,2%) developed bacterial superinfection. Mortality rate was 32,4%. When matched to 34 non-HD patients there was no statistical significant differences in sex, age and comorbidities. The HD group had a tendency to more ventilator support need (p=0,051), higher ferritin and troponin levels (p=<0,001 for both), whereas the non-HD group presented with greater levels of transaminases (p= 0,017). There was o significant difference in hospitalization time (median of 11 vs 7 days, p=0,222) neither in mortality (median of 32,4 vs 35,3%, p=0,798). When the logistic regression was performed, only bacterial superinfection was a predictor for mortality on hemodialysis patients (p=0,004). CONCLUSION: Our study compared outcomes for COVID-19 patients on chronic HD to non-dialysis patients and showed no difference in hospitalization time nor in death rate. In spite of these results, the mortality in patients on chronic HD is still not negligible, with up to 32% of in-hospital mortality. Bacterial superinfection is a predictive risk factor for mortality. Hence the importance of interventions to mitigate the burden of COVID-19 in these patients, by preventing its spread, particularly in hemodialysis centers.
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Due to social distancing constraints during the COVID-19 pandemic, several experiments were designed in the Fall 2020 and Spring 2021 semesters in our Electrochemistry and Corrosion elective course to demonstrate electrochemical phenomena and applications at the students' homes with a kit sent by the school. We report here a student-designed experiment focused on water electrolysis, a well-studied phenomenon of great interest to the electrochemical industry. Its main appeal derives from the use of solar energy for the production of hydrogen gas, which is used in fuel cells. Here, the light-to-electricity converting function of light-emitting diodes is exploited to produce an electric current from solar radiation. This current is, in turn, utilized to perform microscale water electrolysis at graphite electrodes with the aid of a magnetic field. Lastly, the electrolysis products are employed to generate a voltage, demonstrating the fuel cell principle. ©
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As with the SARS-CoV-1 outbreak in 2003-2004 and the MERS outbreak in 2012, there were early reports of frequent transmission to healthcare workers (HCW) in the SARS-CoV-2 pandemic. Our hospital center identified its first COVID-19 confirmed case on March 9, 2020, in a 6-day hospitalized patient. The first confirmed COVID-19 case in a HCW happened 3 days later, in a nurse with a probable epidemiological link related to the first confirmed patient. Our study's first objective is to describe and characterize the impact of the first 3 months of the SARS-CoV-2 pandemic on the Centro Hospitalar Universitário Lisboa Norte (CHULN). Our second objective is to report the performance of the CHULN Occupational Health Department (OHD) and the impact of the pandemic on CHULN HCW and its adaptation across national, regional, and institutional epidemiological evolution. Over the first 3 months, 2,152 HCW were screened (which represent 29.8% of the total HCW population), grouped in 100 separate identifiable clusters, each one ranging from 2 to 98 HCW. The most prevalent profession screened were nurses (n = 800;37.2%) followed by doctors (n = 634;29.5%). The main source of potential infection and cluster generating screening procedures was co-worker related (n = 1,216;56.5%). A patient source or a combined patient co-worker source was only accountable for 559 (26%) and 43 (2%) of cases, respectively. Our preliminary results demonstrate a lower infection rate among HCW than the ones commonly found in the literature. The main source of infection seemed to be co-worker related rather than patient related. New preventive strategies would have to be implemented in order to control SARS-CoV-2 spread.
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Background/AimsThere is evidence for non-pharmacological interventions to supportpatients to self-manage fatigue, however implementation in clinicalpractice is a challenge. LIFT (Lessening the Impact of Fatigue ininflammatory rheumatic diseases: a randomised Trial) is a multi-centrethree-arm randomised trial using a remotely delivered cognitivebehavioural approach (CBA) or personalized exercise programme(PEP) interventions, in addition to usual care, compared to normal carealone. Interventions were delivered to patients by rheumatology healthprofessionals using a manual, after training. The aim of this nestedqualitative evaluation was to understand their perspectives ofdelivering the interventions. MethodsA subgroup of rheumatology healthcare professionals who haddelivered the CBA and PEP interventions took part in semi-structuredtelephone interviews to explore their experiences of training anddelivery, the challenges and benefits of learning new skills, and thebarriers and facilitators to supporting patients remotely (mainly bytelephone) using the LIFT manual.ResultsA total of 17 rheumatology healthcare professionals (13 women, 4 men)from the CBA (n = 9) and PEP (n = 8) arms contributed. SB conducted aninductive thematic analysis of the data set. ED, CA, AW and KL revieweda sub-set of transcripts. Five main themes were identified: The benefitsof informative, structured training: Rheumatology healthcare professionals reflected how training, including role-play, helped them topractice their skills, even though this could feel uncomfortable. Thoseallocated shorter four-hour training sessions would have liked more timeto practice. Many felt anxious before meeting patients for the first timebut liked the manual to refer to.Getting into the swing of it: Practice gave rheumatology healthcareprofessionals the confidence to tailor content to individual patients'requirements. Clinical supervision in the PEP and CBA arm supportedrheumatology healthcare professionals to query their own practice, gain valuable feedback, and request assistance where needed.Benefits of telephone delivery: The initial face-to-face session enabledrheumatology healthcare professionals to build rapport with patients.Thereafter, patients seemed engaged and valued the opportunity toaddress their fatigue and challenge their own beliefs via the telephone.Some patients not ready to change: Rheumatology healthcareprofessionals struggled to work collaboratively with a minority ofpatients who were not willing to make changes, lacked motivation tocomplete tasks or stopped engaging with the intervention.LIFT developing clinical skills: Rheumatology healthcare professionalswere confident that they were doing the 'right thing' for patients withfatigue and gained professional satisfaction seeing patients' fatigueimprove. Many felt that the skills they acquired and their experiencesof remote delivery were helping them to respond to the current COVID-19 related changes in service provision.ConclusionFindings support the value of skills training for rheumatology healthprofessionals to deliver fatigue management interventions remotely.These insights can inform service provision and clinical practice.