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The pandemic of Covid-19 began in Brazil in February 2020. To evaluate the evolution of pandemics some metrics can be estimated, such as the reproduction number, Rt, and the basic reproduction number, R0. Due to the delay in the notifications, these estimates may present a bias. Taking the reported data, besides a sample of individuals who reported the day of symptoms onset, it is possible to estimate delay probabilities and to perform a deconvolution to correct the notifications' delay. In this work, it was performed a corrected estimate of Rt. This estimate is done based on the curve of notifications corrected through deconvolution. The approach is applied in three country cities and in the capital of Minas Gerais state. The behavior of Rt concerning the Minas Consciente program was evaluated. It was observed that the corrected Rt was more suitable to measure the effect of the program when compared to the raw Rt. When it was determined a more rigid mobility and activities regime by the program, it was observed a decrease in the median of the variation of the Rt of the cities studied. © 2003-2012 IEEE.
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This article addresses some challenges for conducting research in a cross-border Amazon region, such as the Alto Rio Solimoes / AM, made up of nine municipalities, with an area equivalent to 214 thousand km(2). In this reality, little can be said that this locus refers to an object of investigation, since there are human groups inserted many years ago, with many forms of work, social organization, ways of educating, different religious practices, which they maintain despite the influences of the capitalist world. In these Amazonian communities, there are traditional groups that maintained their ways of life rooted in animal and plant extractivism, in the cultivation of the land and in animal husbandry. Thus, this article aims to discuss some theories that help to reflect on the research work in Amazonian communities, as a counterpoint to the positivist views that deny the indigenous and non-indigenous traditions of those localities, considering the practices and attitudes that respect the proper forms of social organization of ethnically differentiated peoples. The research, qualitative in nature, made a meticulous bibliographic survey that allowed some reflections on the central objective of the study. Finally, a critical reflection was raised that we hope can help researchers who want to carry out work in Amazonian contexts. These indications range from the instrumentalization of the gaze, hearing, and writing, to the need to carry out research with an interdisciplinary and inter-institutional perspective.
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Critical Thinking, is a complex construct that involves mental processes such as identifying, evaluating and analyzing problems, interpreting information, synthesizing evidence and reporting conclusions. In Peru, national assessments show that high school students score low on Critical Thinking items [1], which continues when they start university. This study aims to analyze the activities that form part of the Design Thinking methodology as potential enhancer of Critical Thinking in students starting university studies. 180 first year students of different careers, who were taking a course in which Design Thinking methodology is used, participated in the study. Critical Thinking was assessed at the end of the course by analyzing student's competencies through their final piece of class work. The results show that Design Thinking methods cover diverse activities that comply with the elements of Critical Thinking. These results provide promising evidence that Critical Thinking may support the development of further innovative thinking and that teachers can foster these competencies using Design Thinking in their classrooms. The present research was conducted in an emergency remote education context due to the Covid-19 pandemic. © 2021 IEEE.
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The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 continues to have a major impact on health and social systems around the world. The COVID-19 and influenza manifest themselves in a similar way, causing respiratory diseases that can present asymptomatically, as well as from the cold to severe respiratory problems until death. The form of transmission is similar, through contact with droplets or particles of saliva and secretions, which implies preventive actions that involve the same hygiene measures, use of masks and the need to cough using the elbow or disposable tissues. This characterizes a syndemic. It becomes necessary to monitor these diseases so that there are parameters for better decisionmaking on the appropriate clinical management of these respective diseases © 2022. Journal of Human Growth and Development.All Rights Reserved
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Introduction: SARS-COV2 infection has come to focus in 2020, when COVID-19 was declared pandemic worldwide. In addition to interstitial pneumonia, its physiopathology involves multiple mechanisms, mainly inflammatory dysregulation and thrombo-inflammation, affecting most tissues and organs. Unexpected manifestations have been described, both in the acute phase and later, as a post-infectious disease. Case descriptions: Our study focuses on muscle biopsies obtained from 4 post-COVID-19 patients who had recovered from the infection, when muscle symptoms emerged, all with very high CPK levels. Two were females, 7th decade of life, presenting mild to moderate respiratory symptoms that resolved within a few days. About a month later they developed weakness and biopsies showed necrotic fibers in different proportions, one with features of rhabdomyolysis. Treatment with immunosuppressants and immunoglobulin resulted in significant improvement in motor and sensory conditions. The third patient, a 49-year-old hypertensive, obese and diabetic male, had severe respiratory symptoms requiring orotracheal intubation. Discharged without symptoms, he developed severe muscle weakness and tetraparesis one month after the COVID- 19 onset. Muscle biopsy showed degenerate and regenerating fibers and CD8 lymphocytic infiltration. Immunostaining for SARS-COV2 was negative. Treatment with methylprednisolone and immunoglobulin was followed by improvement of symptoms, of inflammatory markers, and decrease in muscle enzymes. The forth one, a 53-year-old hypertensive and diabetic male, developed weakness and skin lesions 3 - 4 weeks after COVID-19 diagnosis. Muscle biopsy showed perifascicular atrophy and myofiber vacuolization, suggestive of dermatomyositis. Conclusion: Our observations, in correlation with clinical history, biopsy findings and negative immunohistochemical results for COVID-19, strongly suggest the possibility of post-infectious myopathies.
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Radiological chest examinations like chest X-ray play a fundamental role in the fight against the outbreak of COVID-19 pneumonia, caused by the coronavirus strain SARS-Cov-2. This study aims to investigate classification models to differentiate chest X-ray images of COVID-19-based and typical pneumonia using hand-crafted radiomic features, understanding the distinctive radiographic features of COVID-19. A total of 136 segmented chest X-rays from two public databases were used to train and evaluate the classification methods. The PyRadiomics library was used to extract first and second-order statistical texture features in the right (R), left (L), and in superior, middle and bottom lung zones for each lung side. For performing feature selection, data was split in training (80%) and test (20%) sets. Stratified K-folds (K=5) was used within the training dataset for cross-validation. The most relevant radiomic features were selected after measuring validation accuracy and relative feature importance. Support vector machines (SVM), random forest (RF), AdaBoost (AB), and logistic regression (LR) were analyzed as potential classifiers. The AB model was the best discriminant method between features related to COVID-19-based when compared to typical pneumonia, using a model of lung segmentation in six distinct lung zones (AUC = 0.98). Our study shows a predominance of radiomic feature selection in the right lung, with a tendency to the upper lung zone.
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Background and aims: Ischemic stroke is a severe complication of coronavirus disease 2019 (COVID-19) infection. Although the underlying mechanism remains uncertain, reports suggest that state of hypercoagulation, endothelial injury and inflammatory response in COVID-19 could contribute to developing ischemic stroke. Methods: We conducted a literature review using descriptors from the MeSH portal. The search for papers was made on the PubMed platform, using the formula: ((Coronavirus Infection) OR (COVID-19)) AND (Ischemic Stroke). Only case reports and case series published from 2020 to 2021 were considered. Studies which did not meet the criteria were excluded after analysis of title and abstract. Data regarding sex, age, comorbidities, and clinical outcome of patients were collected from the eligible articles. Results: The search strategy resulted in 65 studies, of which 39 were included. After reading, nine were excluded and a total of 61 patients were evaluated, of those, 57 patients with a proper ischemic stroke diagnosis were considered for this paper. There were 16 female and 46 male patients, the median age was 61.2 years old, the most common comorbidities were high blood pressure (23 patients), diabetes mellitus (18 patients) and tobacco exposure (7 patients). Conclusion: From that, it is possible to conclude that the epidemiologic profile for COVID-19 related ischemic stroke is a male patient in the seventh decade of life, with high blood pressure and diabetes mellitus. The most likely clinical outcome is recovery with disability.
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Background and aims: Meningococcal infection is transmitted mainly through respiratory secretions and saliva. For that, it is important to assess the impacts of the COVID-19 pandemic, through measures of social isolation and mandatory use of masks, on the meningococcal transmission chain. Methods: The first semesters of the years 2016 to 2019 and 2020 were compared. Data on hospitalizations were extracted from the Hospital Information System (SIH). Variables analyzed: absolute number of hospitalizations and percentage of hospitalized patients by age group. Results: Regarding the number of hospitalizations, the average in the period from 2016 to 2019 was 529.25;in 2020, 278. About hospitalizations by age group (average of 2016-2019, average of 2020): children under one year old (13.31%, 13.79%);from 1-19 years (27.7%, 40.62%);from 20-59 years (39.57%, 33.77%);individuals over 60 years (19.42%, 11.81%). Conclusion: In 2020, there was a 45.88% reduction compared to the previous four years. Thus, social isolation, increased individual health measures probably caused a decrease in meningococcal transmission. The absence of teaching activities justifies the 13% reduction in hospitalizations between 1-19 years. In the group from 20 to 59, it increased by 6%, probably by being active at work and therefore more exposed. In the elderly, hospitalizations increased 8%, possibly because they probably had work activities. Thus, individuals aged 20-59 or more started to represent a higher percentage among hospitalized patients, despite the reduction in the total number of hospitalizations.
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Access to drinking water is essential for life, and an adequate and constant distribution of water is necessary during the occurrence of contagious diseases and pandemic situations. Currently, COVID-19, caused by the SARS-COV-2 coronavirus, has spread throughout the world, and in Brazil, more than 5,300,000 cases and 157,000 deaths had been reported by 26th October 2020. Water is regarded as one of the most important resources in a pandemic, in order to provide the necessary sanitary conditions. Thus, the present study aims to analyse changes in hygiene behaviour in relation to the recommendations of the World Health Organisation and the impact on water consumption before and during the pandemic. The survey was conducted using a questionnaire, which was delivered online to 149 participants between June and July 2020. The results pointed to changes in hygiene behaviour, with a consequent effect on water consumption.
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Introduction The endoscopic endonasal transsphenoidal approach (EETA) is routinely used to treat sellar and suprasellar tumors. It provides safe and direct access to tumors in these locations, with wide visualization of anatomical landmarks and great surgical results. With the COVID-19 pandemic, despite the high risk of transmission involved, various surgical procedures cannot be postponed due to their emergency. Case Report A 62-year-old female presented in the previous two months with headaches, followed by bilateral severe visual loss. In 2016, she was submitted to subtotal resection of a non-secretory macroadenoma. Because of the progressive visual deficits, the EETA was used to the resect the pituitary adenoma. Technical Note We developed a low-cost adaptation to the surgical fields, covering the patient's head and superior trunk with a regular surgical microscope bag with a tiny slit to enable the endoscope and surgical instruments to enter the nose, thus protecting the personnel in the operating room from the aerosolization of particles. This makes surgery safer for the surgical team and for the patient. Conclusion In view of the lack of literature on this subject, except for some reports of experiences from some services around the world, we describe the way we have adjusted the EETA in the context of the COVID-19 pandemic.