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Background: Late presentation to care remains a major public health problem in Brazil, despite the countrys longstanding commitment to universal access to ART to all PLWH. The COVID-19 pandemic severely hit the country and further impacted the HIV care continuum, with worse disparities observed by gender and sexual orientation. By December 28th 2022, Brazil reported 10,493 and 14 mpox cases and deaths ranking second globall. Although mpox lethality is low, HIV-related immunosuppression may negatively impact mpox outcomes, increasing hospitalizations and fatalities. We aim to describe mpox hospitalization rates and explore the impact of HIV-infection on mpox-related hospitalizations and clinical outcomes. Method(s): Prospective, observational cohort study of individuals with confirmed mpox infection followed at the major mpox referral center in Rio de Janeiro, Brazil. Demographic and clinical data including reasons for hospitalization were systematically collected. Chi-squared or Fisher's exact tests for qualitative variables and the Moods median test for quantitative variables were used. Result(s): From June 12 to December 12, 2022, 402 participants had a laboratory-confirmed mpox diagnosis. Median age was 34 years, 365 (91%) were cisgender men, and 197 (49%) were PLWH. Overall, 39 (10%) participants were hospitalized due to mpox-related causes;20 (51%) were PLWH. All PLWH with CD4 counts< 200 cells/mm3 required hospitalization. Compared to nonhospitalized PLWH, a higher proportion of hospitalized PLWH had concomitant opportunistic infections (4/20 [20%] vs. 1/177 [0.6%];p< 0.001), were not virologically suppressed (7/20 [35.0%] vs. 22/177 [15.3%];p=0.1) and were not on ART (4/20 [20%] vs. 15/177 [7.6%];p=0.03). Among all hospitalized participants, PLWH were more frequently hospitalized due to severe proctitis than HIV-negative participants (12/20 [60%] vs. 5/19 [26.3%];p=0.03), with no differences regarding hospitalizations for pain control (Table). PLWH accounted for all cases of hospitalized individuals who required intensive care support (n=4), had deep tissue involvement (n=3) and had a mpox related death (n=2). Conclusion(s): Our findings suggest an association between worse outcomes in the HIV care continuum and mpox-related hospitalizations. Advanced immunosuppression (CD4< 200) contributed to more severe clinical presentations and death. Public health strategies to mitigate HIV late presentation and the negative impact of the COVID-19 pandemic to the HIV care continuum are urgently needed. Sociodemographic and clinical characteristics of mpox cases according to HIV and hospitalization status.
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During the pandemic of the COVID-19 several factors provided higher risks for pregnant women, which could negatively interfere in the ongoing pregnancies. This study aims to reflect on the impacts of the pandemic of COVID-19 caused in the health of pregnant women, related to the physical and psychological impacts and changes in prenatal care, as well as the changes made in maternity hospitals due to social distance. This is a methodology with a literature review based on scientific articles published during the pandemic period. In view of the records analyzed it was observed that the pandemic of COVID-19 brought difficulties in the scope of health services, directed to pregnant women.
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Background: The multimedia capturing of live lectures has increased within higher education institutions, even in the pre-COVID-19 period. Despite student satisfaction, the video lecture capture (VLC) influence on students' attainment and achievement of intended learning outcomes is controversial. Methods: To explore the impact of VLC, a cross-sectional study across 2016/17 (n=209 students) and 2017/18 (n=206 students) was conducted in the course of Mechanistic Toxicology in Pharmaceutical Education. Results: The results showed that 73% and 90% of the assessed students entirely viewed the videos of theoretical (550 minutes) and practical/laboratory classes (250 minutes), respectively. VLC impacted student attainment and the achievement of intended learning outcomes on the capacity to understand the subjects and apply knowledge. Conclusion: The effectiveness of VLC is to be considered under the framework of constructive alignment and the specificities of the course.
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There is a general notion that the COVID pandemic has made access to adequate health care difficult. A retrospective study looked at patients with acute myocardial infarction (AMI) admitted to a hospital, including the time between admission and diagnosis, the time until treatment, and the delay in transferring to a hospital with a catheterization laboratory in the case of ST-Elevation Myocardial Infarction (STEMI).The period analysed was March to July 2019 and March to July 2020 (first Covid pandemic wave). 197 patients, 101 in 2019 (SCA19) and 96 in 2020 (SCAcov), 142 males (72%) mean age 67.3±12.6. It was observed in 2019 29 STEMI and 72 acute myocardial infarct without ST elevation (NSTEMI) na 2020 36 STEMI and 60 NSTEMI, this proportions didn't achieve statistical meaning χ2(1)=1.719, p=0.226. When compared SCA19 versus SCAcov there were no differences between groups in relation to demographic data. The clinical presentation (none, hemodynamic instability, refractory pain, arrhythmia, mechanic complication, acute heart failure) not varied between groups χ2(6)=3.42, p=0.755. When analysed, between SCA19 and SCAcov, there were no significant time difference between the admission and the electrocardiogram execution (MSCA19 = 44.78;MSCAcov = 56.84;Tweich (132.66) = -0.73, p=0.476 g Hedge = 0.71, between time of admission and time of diagnosis MSCA19 = 264.84;MSCAcov = 254.2;Tweich (188.81) = -0.34, p=0.731 g Hedge = 0.05, and the duration of hospitalization MSCA19 = 5.90;MSCAcov = 5.78 U=9400, Z=-0.263, p<0.792. Conclusion: In COVID times even with the all restrictions and contingencies lived in hospitals our results pointed to no significant changes in the variables analysed. Interestingly, in spite of no significant difference, a slightly more delay in ECG execution, higher prevalence of STEMI but a short time of diagnosis were observed.
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Communication is a fundamental tool in health crisis management, such as the COVID-19 pandemic. This study addressed the communication of the official agencies and the main Brazilian governmental stakeholders on Twitter. The analysis carried out showed inconsistent, incongruous, and conflicting information that includes misinformation and scientific negationism, hindering the implementation of non-pharmacological care strategies measures needed to reduce the virus’s spread, contributing to thousands of deaths by COVID-19 reached by the country caused by the pandemic. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The Covid-19 pandemic is creating a health crisis and many economic difficulties. Uncertainties regarding the future are of great concern, not only in Brazil, but also in our MERCOSUR neighbors. The purpose of this paper is to explore the situation that workers in the economic bloc and how they will face the health and economic crisis. The objective is to investigate the economic measures taken by the governments of each MERCOSUR country and how they will affect household income, increasing social inequality. The procedural methods used in the present work were the historical study, through a brief bibliographic analysis of the emergence of social inequality and its concept;logical-deductive, through a bibliographic search, consultation of the Human Rights legislation and conventions, in scientific articles and on specialized websites, inferring the facts and premises, about the publication of the actions of each country and their effects in the worsening of inequality Social. The results obtained after the research carried out in the present study, demonstrate that, the common measure was the suspension of the employment contract with the reduction of workers' wages, and consequently, they will be subject to the impacts caused by the pandemic and the economic crisis, further aggravating social inequality, which is common to the bloc's countries. Therefore, it is realized that it will be essential for governments to seek the effectiveness of Human Rights, implementing social protection measures to face the pandemic and its economic consequences. © 2020, Centro Universitrio Curitiba - UNICURITIBA. All rights reserved.
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Objectives: to describe the clinical-epidemiological profile of children and adolescents notified by COVID-19 in Ceará. Methods: descriptive epidemiological study from open data repositories of the State Government of Ceará, about cases of OVID-19 in children and adolescents, from 03/15/2020 to 07/31/2020. For data analysis the tests χ2 Pearson, Fisher's exact and Poisson's regression with robust variance were used. Results: 48,002 cases of children and adolescents suspected of COVID-19 were reported, of which 18,180 (8.9%) were confirmed. The median of confirmed cases was 12 years old, 10.5% were newborns/lactants, 10.7% were pre-school children, 21.2% were school children and 57.7% were adolescents. They evolved to death 0.3% of the cases, of which 15% had comorbidities. They needed hospitalization 1.8% of the cases. The highest probability of hospitalization was found in newborns/lactants, male and with comorbidities. Conclusions: most of the confirmed cases occurred in adolescents, however, the evolution of the disease was more severe and with greater need for hospitalization in the age group of newborns/lactants, being the male gender and the presence of comorbidities additional factors for the need for hospitalization. © 2021, Instituto Materno Infantil Professor Fernando Figueira. All rights reserved.