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Objective: About 70% of cases of Acute Lymphoblastic Leukemia (ALL) affect children aged 1- 4 years. The incidence increases slightly again in adults over 50 years, characterizing a poor prognosis. According to data from the National Cancer Institute, for the year 2020 leukemias present in men as the fifth most frequent neoplasm in the Northeast Region with a risk of 8.20/100,000 inhabitants, occupying the fifth position. In the case of women, the risk in the Northeast region is 4.42/100,000 inhabitants and ranks tenth. This study aimed to identify the molecular and epidemiological profile of adult patients with ALL in the state of Ceara. Methodology: Sample collection was performed in patients with ALL treated at the General Hospital of Fortaleza (GHF), considered the main and largest hematology outpatient clinic in the metropolitan region of Fortaleza, as well as the State of Ceara. All patients participating in this study read and signed the informed consent form. Patients with other types of leukemias or other hematological diseases were excluded. This study was approved by the Research Ethics Committee of the Federal University of Ceara under protocol no. 38680520.9.0000.5054. Result(s): From July 2021 to July 2022, 25 patients with ALL were treated, of whom 9 are women and 16 are men. The mean age observed was 42.5 years. 44% of patients live in the capital (Fortaleza), while the other 56% of patients live in rural areas. Through immunophenotyping it was possible to verify that there were 22 patients (88%) compatible with ALL-B presenting CD19, CD10, CD45, CD38, CD22, CD79a, CD34, CD81 and CD58 as the main markers, while only 3 patients (12%) were compatible with ALL-T, expressing mainly CD3, CD45, CD5, CD7, CD2, CD11c and CD1a. Eleven patients (44%) had abnormal and complex karyotypes. Five patients had the BCR-ABL p190 mutation and two had the E2A-PBX1 mutation. A total of 9 patients died due to septic shock, COVID-19, or refractoriness to treatment. Discussion(s): The literature indicates a new peak of ALL cases after 50 years of age, however the highest incidence observed in the study participants was between 30 and 50 years. Studies indicate that immunophenotyping findings in patients with ALL B line are almost always CD19, CD79a, CD10, CD20 and CD22 positive, while T-strain ALL usually present CD7, CD3, CD1a and CD10 as the main markers, corroborating what was observed in the results. In addition, depending on the alteration observed in the karyotype, it may confer poor or good prognosis to the patient. The BCR-ABL1 and E2A-PBX1 mergers, for example, are alterations that give worse prognosis to patients and, therefore, may be targeted for treatment in an attempt to improve the survival of these patients. TEL-AML1 fusion, on the other hand, represents a good prognosis, being more incident in pediatric ALL. Conclusion(s): Epidemiological data from this preliminary study indicate that in the state of Ceara ALL is more common in male patients aged 30-50 years living in rural regions. In addition, the use of targeted therapies for patients with abnormal karyotypes as well as the adoption of stricter measures to prevent hospital infections may increase patient survival. Copyright © 2022
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Objective: Acute myeloid leukemia (AML) is the second most common leukemia in adults and older patients represent most cases. The states of the Northeast of the country have stood out in the frequency of leukemia cases, and the frequencies are higher than the rate of 35% compared to other neoplasms, especially in the metropolitan regions of Fortaleza. In the State of Ceara, the number of cases of leukemia expected for the year 2020 is 6.17 cases/100,000 inhabitants in men and 4.29 cases/100,000 inhabitants in women. In view of this information, the aim of this study was to identify the molecular and epidemiological profile of patients with AML in the state of Ceara. Methodology: Sample collection was performed in patients with AML treated at the General Hospital of Fortaleza, considered the main and largest hematology outpatient clinic in the metropolitan region of Fortaleza, as well as the State of Ceara. All patients participating in this study read and signed the informed consent form. Patients with other types of leukemias or other hematological diseases were excluded. This study was approved by the Research Ethics Committee of the Federal University of Ceara under protocol no. 38680520.9.0000.5054. Result(s): From July 2021 to July 2022, 31 patients with AML were treated, of which 8 are women and 23 are men. The mean age observed was 50.4 years. 54.8% of patients live in the capital, while the other 45.2% of patients live in rural areas. Through immunophenotyping it was possible to verify that the main markers presented by LMA patients were CD33, CD13, CD117, CD45, MPO, CD34, CD64, HLA-DR, CD11c, CD11b e CD38. Thirteen patients (42%) had abnormal and complex karyotypes, of which six died. Five patients (16,1%) had the t(15;17)(q24;q21.3) corresponding to the PML-RARA fusion. Six patients (19,3%) had the FLT3 mutation that confers a poorer prognosis. During the clinical follow up, a total of 16 patients died due to septic shock, COVID-19, or refractoriness to treatment. Discussion(s): The incidence of cases of adults over 50 years of age with AML was 58%, as it corroborates the expected incidence of cases regarding the age described in the literature. Studies indicate that immunophenotyping is critical to the differential diagnosis among AML subtypes. AML is defined by the mainly expression of the markers MPO, CD117, CD13, CD33, HLA-DR and CD38, corroborating what was observed in the results. In addition, depending on the alteration observed in the karyotype, it may confer poor or good prognosis to the patient. The PML-RARA merger, for example, is known as M3 AML or acute promyelocytic leukemia (APL), a subtype of AML with a better prognosis for patients. The FLT3 mutation is present in 1 in 3 patients with AML. The presence of this altered gene may mean a worse prognosis and a greater possibility of recurrence but allows a specific and differentiated treatment. Conclusion(s): Epidemiological data from this preliminary study indicate that in the state of Ceara AML is more common in male patients aged 50-80 years. In addition, the use of targeted therapies for patients with abnormal karyotypes as well as the adoption of stricter measures to prevent hospital infections may increase patient survival. Copyright © 2022
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Parallel to the covid-19 pandemic, the World Health Organization warns of an infodemic of fake news related to the disease. This integrative review investigates the dimension of this phenomenon and how science found ways to confront it. A bibliographic search was conducted on the Scopus/Elsevier and Medline/PubMed databases, retrieving 23 articles. Literature analysis found that fake news provide false social support and mobilize feelings which make them more acceptable than the truth. Hence, social media and the internet emerge as platforms to spread false information. Research suggests that government and media institutions can use communication channels and monitoring and infoveillance technologies as allies to alert, elucidate, and remove misleading content. We find the need of investments in scientific and digital literacy actions so people may assess the quality of the information they receive. Finally, this study proposes the adoption of creative strategies to foster reasoning skills together with scientific information translated into an accessible language, preferably approved by health and institutional authorities. Copyright © 2022, Universidade de Sao Paulo. Museu de Zoologia. All rights reserved.
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BACKGROUND: Lack of access to diagnostic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can limit disease surveillance in remote areas. Serological surveillance can indicate the true extent and distribution of infections in such settings. METHODS: This study monitored SARS-CoV-2 seroprevalence in residual serum samples salvaged from laboratories at five healthcare facilities across Timor-Leste from March to October 2021. RESULTS: Seroprevalence increased from 8.3% to 87.0% during the study period. Potential immunity gaps were identified among children aged 0-15 y (who had not been eligible for vaccination) and individuals aged >60 y. CONCLUSIONS: Efforts to vaccinate vulnerable individuals including older people should be maintained. Residual serum samples can be analysed to give local, contemporary information about the extent and distribution of antibodies to infections, especially SARS-CoV-2, in areas where epidemiological information is limited.
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This work analyzes the meanings attributed to alcohol consumption and the care strategies used by an indigenous group in Rio Grande do Norte (Brazil), through qualitative research involving residents and leaders. The results generated three analytical axes: determinants of alcohol consumption, health care settings and alcohol use in the context of the COVID-19 pandemic. It was found that the use of alcohol in the community has been marked by historical movements that have altered the modes of existence and limited access to traditionally occupied lands. Alcohol consumption appeared as a naturalized phenomenon, associated with social and health problems that are aggravated by the lack of public assistance perceived by the community. © 2022, Psicologia: Teoria e Pesquisa. All Rights Reserved.
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The objective of the present study was to reflect on psychosocial intervention programs for the development of digital skills aimed at kids between the seventh and tenth grade of schooling in situations of post-pandemic vulnerability. The research methodology was non-experimental, documentary, descriptive, and reflective. The information was collected from multinational organisms and scientific articles from indexed magazines and web platforms. Obtained results indicate that the COVID-19 pandemic aggravated the vulnerability conditions in children living in multidimensional poverty conditions. For this reason, international organisms-UN, World Bank, ILO-have proposed the creation of programs that promote resilience among the vulnerable population, based on the use of virtual platforms. In this context, this investigation proposes the implementation of psychosocial intervention programs for the development of digital skills aimed at kids in situations of post-pandemic vulnerability. © 2018, IGI Global.
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This research aims to identify the potentialities and limitations of emergency remote education in the Peruvian university context as a consequence of the COVID-19 pandemic based on teachers' experience of the Hermilio Valdizan National University (UNHEVAL). The type of this research was descriptive and the sample consisted of 123 teachers of the academic period 2020-I. For the data collection, a questionnaire was used, whose validation was made through the judgment of experts (0.96) and the reliability of the results through the Z-test. According to the results, flexibility stands out between the potentialities in regards to topics' distribution, time, and the possibility to produce greater interest in the participants. It was observed that time flexibility is not considered as favorable unlike what was detected through literature. Infrastructure stands out, especially when is related to the connectivity and Internet access as well as the distractors produced by the easy access to devices and applications that are not related to the class session. The paper revealed weakness in the digital competencies of both teachers and students, and the scarce level of social interaction caused by social isolation. It is concluded that the potentialities and limits of emergency remote education in a Peruvian university are conditioned by different elements specific to each context or country and must be considered for the production of new educational proposals as a policy of prevention of the possibility of new events that require mandatory isolation.
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Individualized non-face-to-face training is common in individual and group sports, especially in those more dependent on conditional support. This paper presents a virtual group training program (PEVG) at home, mediated by Zoom application, and developed by a women's soccer team during the Covid-19 confinement. The purpose of this study has been to assess the impact of PEVG on conditional stimulation, mood, and psychosocial support. To assess its effect on the first two aspects, a wellness questionnaire was completed at the end of each session. At the end of the confinement period, support for basic psychological needs scale (NPB) was applied. The procedural results of the wellness questionnaire show medium and high values, and stability in all its items, being the mood the one that obtains higher values and less fluctuation. Likewise, there are differences in the Rating of Perceived Exertion according to the characteristics of the players' profile, specific position(defenders-attackers), and age (young-seniors). At the end of the experience, the assessment of the conditional stimulus allows us to infer that the perception of effort seems to have been influenced by the mobility limitations imposed and the duration of the confinement state, and the types of sessions used. Regarding support for NPBs, a high score is found in the dimension support for the social relationship, which, taking into account the situation of separation of the players, is related to the use of the telematics application.
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Introduction: Obesity increases the risk of chronic non-communicable diseases (NCDs) and affects the course of diseases of infectious origin. Objective: Reviewing the literature on how obesity influences the severity of the clinical picture of some of the non-communicable and communicable diseases of greatest impact in Peru. Methods: Documentary research, from studies developed in various contexts associated with the presence of obesity along with infections or NCDs. Results: The condition of obesity reached by bad consumption habits and low physical activity is the main responsible for the high rate of NCDs, consequently, mortality. Conclusions: Excess weight affects the immune system, contributing specifically to exacerbated phenomena of a systemic inflammatory response, determined by increased secretion of adipocytokines, which predisposes the body to develop and contract NCDs and infectious diseases.
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Right after the Chinese example in conducting COVID-19 epidemic originated in Wuhan, the readiness to detect and respond by health authorities to local (sometimes global) epidemics has become central lately. Within the idea of health 4.0, information about the individual is essential in supporting public community health policies. This paper presents a proposal for an epidemiological surveillance system applied to arboviruses. Data mining techniques and Machine Learning (ML) are used to design mathematical models for detecting epidemics enhanced by Aedes Aegypti (vector for dengue, chikungunaya, yellow fever and zica). Based on data, it is proposed an adaptive manner to reach better stability on results. A Prove of Concept (PoC) is presented for dengue epidemics detection, a common endemic disease in the semiarid region of Brazil. © 2021 IEEE.
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Background: The Coronavirus disease of 2019 (COVID-19) global health crisis caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in unprecedented mortality, impacted society, and strained healthcare systems, yet sufficient data regarding treatment options are lacking. Convalescent plasma, used since 1895 for infectious disease outbreaks, offers promise as a treatment option for COVID-19. Methods: This is a retrospective study of patients diagnosed by a nasopharyngeal swab SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR), who received convalescent plasma between April to June 2020 at two large hospitals in Miami, Florida, as part of the US FDA Expanded Access Program for COVID-19 convalescent plasma (CCP). Results: A total of 23 patients received CCP, 13 (57%) had severe COVID-19 disease, while 8 (35%) had critical or critical with multiorgan dysfunction. Median time of follow up was 26 (range, 7-79) days. Overall, 11 (48%) survived to discharge, 6 (26%) died, while 6 (26%) are currently hospitalized. All deaths reported were due to septic shock from secondary infections. 15 (65%) showed improvement in oxygen requirements 7 days post CCP transfusion. Measured inflammatory markers, c-reactive protein, lactate dehydrogenase, ferritin and d-dimer improved 7 days post transfusion in 13 (57%) patients. No adverse events due to the transfusion were reported. 10 (43.4%) patients had a negative SARS-CoV-2 RT-PCR at a median of 14.5 (range, 4-31) days after receiving convalescent plasma. Conclusion: Administration of convalescent plasma was found to be safe, with favorable outcomes in this small cohort of relatively high acuity patients. Larger studies including control arms are needed to establish the efficacy of convalescent plasma on clinical and virologic outcomes for patients with COVID-19. (Table Presented).
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Background: As the COronaVIrus Disease 2019 (COVID-19) continues to unfold, drastic changes in daily life pose significant challenges on mental and clinical health. While public health interventions such as national lockdowns and social distancing are enforced to reduce the spread of COVID-19, the psychosocial and physical consequences have yet to be determined that may disproportionately affect people living with HIV (PLWH). Methods: To evaluate the impact of COVID-related stress on mental and clinical health, we conducted a 20-minute questionnaire eliciting sociodemographic information, clinical and psychological factors from people living in Miami, Fl. All individuals >18 years with or without a history of COVID-19 were included. Participating PLWH were recruited from an existing HIV registry and HIV uninfected participants from community flyers and word of mouth. Results: A total of 135 participants were recruited from 05/2020-06/2020. The mean age was 50 years old, 73/135 (54%) were female, and 102/135 (75%) were PLWH. Among participating PLWH, 60/102 (58.8%) self-identified as African American, and 9/102 (8.8%) were positive for COVID-19 by a commercially approved test. Among HIV-negative participants, 15/33 (45.5%) self-identified as White and 11/33 (33%) were positive for COVID-19. Both PLWH and HIVnegative participants described significant disruptions in health care access (47%), difficulty paying basic needs (41%), and feelings of anxiety and depression (48%);there was no statistically significant difference by HIV status. However, HIV negative participants were less likely to experience job loss and income disruption compared to PLWH during the pandemic (70% for HIV-negative vs 48% for PLWH;OR 0.40, p=0.03). Conclusion: The impact of COVID-19 on emotional and clinical health is significant in both PLWH and HIV-negative groups. These findings highlight the need for providing mental and physical health care during the pandemic, especially for coping with stress and anxiety during these difficult times and ensuring adequate access to health care.
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Through two quantitative longitudinal studies, we explored socio-demographic and psychosocial dimensions of 2,722 Colombians in the context of the pandemic on: government measures, coping with the personal economic situation and socio-emotional climate;to identify coping constraints and propose public policy guidelines on strategies to adapt to the new normality. The results are consistent with the theory. Among the findings we highlight: the need to articulate policies with strategies that allow for the channeling of anxiety and stress;avoid individualistic attitudes versus social trust;and disseminate clear, simple and transparent narratives. Likewise, we recommend particular measures for groups with differential affectation, related to socioeconomic conditions and gender. © 2020, Universidad Nacional de Colombia. All rights reserved.
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Introduction: the drug strontium ranelate (SR) is widely used in prophylactic therapy and in the control of osteoporosis. It acts by reducing reabsorption and increasing bone formation systemically, presenting unclear adverse events in the literature, such as the DRESS syndrome with hepatic involvement.
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During the COVID-19 pandemic, there have been important behavioral, clinical and government interventions to mitigate and prevent the spread of the virus in the popu-lation. However, there is no evidence of how these interventions, including the travel restrictions, affect the spread of COVID-19 in China and other countries. The objective of this research is to describe the main epidemiological characteristics of COVID-19 through the analysis of the main measures established. The sample included 40 scientific articles related to the pandemic and virus, considering relevant information regar-ding the behavior, symptomatology, epidemiology, treatment and methods of mitigation globally as well as a plan of control measures proposed in Peru to mitigate the spread of COVID-19 and to be prepared for future pandemics. © 2021, Universidad Nacional de Colombia. All rights reserved.