ABSTRACT
Together, SARS-CoV-2 and M. tuberculosis have killed approximately 5.7 million people worldwide over the past 2 years. The COVID-19 pandemic, and the non-pharmaceutical interventions to mitigate COVID-19 transmission (including social distancing regulations, partial lockdowns and quarantines), have disrupted healthcare services and led to a reallocation of resources to COVID-19 care. There has also been a tragic loss of healthcare workers who succumbed to the disease. This has had consequences for TB services, and the fear of contracting COVID-19 may also have contributed to reduced access to TB services. Altogether, this is projected to have resulted in a 5-year setback in terms of mortality from TB and a 9-year setback in terms of TB detection. In addition, past and present TB disease has been reported to increase both COVID-19 fatality and incidence. Similarly, COVID-19 may adversely affect TB outcomes. From a more positive perspective, the pandemic has also created opportunities to improve TB care. In this review, we highlight similarities and differences between these two infectious diseases, describe gaps in our knowledge and discuss solutions and priorities for future research.
Subject(s)
COVID-19 , Mycobacterium tuberculosis , Communicable Disease Control , Humans , Pandemics/prevention & control , SARS-CoV-2 , SyndemicABSTRACT
OBJECTIVE: to analyze the scientific evidence available in the literature on therapeutic interventions applied to Burnout Syndrome in health professionals during the COVID-19 pandemic. METHOD: An integrative review was carried out between August and October 2021, in which the databases and portals PubMed, BVS, SciELO, Google Scholar and CAPES Journal Portal were consulted, resulting in eleven articles analyzed. RESULTS: The analysis of the articles included in the study showed that self-care and organizational interventions in health professionals contributed to the reduction of symptoms of Burnout Syndrome. The studies reported that the measures of therapeutic interventions that were implemented, including aromatherapy, music therapy, the application of EFT, LMX strategies, minimize the effects of factors that contribute to the increase in Burnout Syndrome in health professionals, as well as the reorganization of the working day and improvements in the work environment that favor a more positive perception of professional practice. CONCLUSION: The COVID-19 pandemic contributed to the increased prevalence of Burnout Syndrome in healthcare professionals. Thus, measures such as mental health education, as well as therapeutic interventions for those already affected by the disease, are essential for professionals to maintain their physical and mental well-being.
ABSTRACT
A Síndrome de Steven-Johnson é uma reação adversa a drogas rara e grave, sendo ainda mais rara quando acontece após uma exposição à vacina. Relatamos neste texto um caso de reação alérgica classificada como Síndrome de Steven- Johnson após exposição a primeira dose da vacina contra COVID-19 fabricada pela AstraZeneca/Fiocruz. Paciente Feminina de 40 anos, sem comorbidades prévias, apresentou nos primeiros três dias da primeira dose da vacina quadro clínico progressivo, inicialmente com edema em região auricular à esquerda, e máculas em membros superiores, prosseguindo com disseminação ao restante do corpo, evoluindo com eritema polimorfo, lesões bolhosas em regiões de membros superiores, edema na palma das mãos, plantas dos pés, e acometimento de mucosa oral com lesões aftoides, sangramentos espontâneos, e exsudação. Em relação à etiologia medicamentosa, quando questionada, a paciente referiu uso crônico apenas de venlanfaxina e informou que fez uso de dexametasona 4mg/dia, durante 2 meses, para quadro articular de arbovirose, suspendendo sem desmame, no final de junho/2021. Visando descartar atividade e influência de infecções virais, foram coletados exames sorológicos, com resultados negativos. Inicialmente, foi levantada hipótese diagnóstica de eritema polimorfo Major, mas histopatológico foi sugestivo de Síndrome de Stevens-Johnson (SSJ), caracterizada por reação de hipersensibilidade tardia com depósito do complemento e imunoglobulina (IgG) na junção dermo-epidérmica e em torno dos pequenos vasos da derme, progredindo para necrose da epiderme. Apesar de a patologia apresentar regressão espontânea, o tratamento no início do quadro, com suporte clínico adequado é essencial para o melhor prognóstico do paciente.