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We aimed to report the experience in managing action research on hepatitis C investi-gation in the prison community in the Triangulo Mineiro region, Minas Gerais, Brazil. The proposal was developed from March 2019 to March 2020, reaching 240 people to contain the spread of the disease through a survey, testing, and mo-nitoring of positive cases. We adopted intersecto-ral action with articulation between Universities, Medical Society, Teaching Hospital, and State Secretariat for Justice and Public Security. Strategies for the management of action research are descri-bed: study settings and stakeholders, registration and formalization of the activity, application of tests, and management of reagent inmates. We identified difficulties regarding the accommoda-tion of routines among the research team and the proper functioning of the penitentiary, which required extensive training between the parties and managerial articulations. We consider that the report collaborates with the organization of future research aimed at accessing this still invi-sible population, the prison community when it highlights the strategies adopted to conduct the research. Copyright © 2022, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.
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Background and aims:The ongoing Covid pandemic has burdened the medical system, more so due to the limited availability of ventilators. Our study aims at identifying the role of hematological markers in the risk stratification and the need for ventilator support among ICU admitted COVID-19 patients. Method(s): A single centre prospective study was conducted on 100 Covid positive patients admitted in the ICU to determine association between the haematological markers such as Hb, Platelet count, Total and Differential leukocyte count, CRP, AST, ALT, LDH, Ferritin and D-Dimer with the need for oxygen therapy with or without invasive ventilatory support. Comparative analysis was performed between the 2 groups. Result(s): Neutrophilia, a mean of 76.7% among those ventilated and 71.6% among those non ventilated (p value 0.002;highly significant) and Lymphocytopenia (p value 0.004) with a mean of 14% and 18.6% respectively was noted. Hemoglobin levels were lower in ventilated (mean 11.6g/dl) as against those non ventilated (mean 12.58%) p value 0.046 which was significant. D-dimer was increased in COVID-19 patients;mean 5380 ng/ml in ventilated patients and mean 949ng/ml in those non ventilated (P < 0.001 highly significant). Elevated D-dimer and presence of diabetes correlated with increased chances of mechanical ventilation, while higher hemoglobin levels and associated COPD have a negative association with the need of mechanical ventilation. Conclusion(s): Hypercoagulability along with neutrophilia and lymphocytopenia can be used as positive associations for the need for invasive mechanical ventilation. Copyright © 2022, College of Anaesthesiologists of Sri Lanka. All rights reserved.
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Timor-Leste has dealt with the challenges posed by the Covid-19 pandemic in the context of a developing state undergoing political crisis with limited resources in the public health sector. The process of simultaneously overcoming this political crisis and fighting the pandemic with existing limited resources involved all the branches of government in strategic cooperation within the framework of the constitutional separation of powers. The result was the declaration of long periods of State of Emergency and the consequent suspension of constitutional rights for periods of time lengthier than originally anticipated. This article argues that this 'new normal' affirms the maturity of the constitutional regime in Timor-Leste but questions the future of some of the solutions applied. © 2022 Melbourne University Law Review. All rights reserved.
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Introduction and Aim: With the coronavirus disease 2019 (COVID-19) pandemic raging on, there is a need to identify clinical and laboratory predictors which predict progression towards severe and fatal forms of this illness. Our study aims to evaluate the ability of hematologic and biochemical biomarkers to discriminate between patients with and without severe or fatal forms of COVID-19. Materials and Methods: A retrospective study was conducted on 200 Covid positive patients;100 with mild disease and 100 with severe disease. Medical records were reviewed to collect demographic data and results of the following blood investigations were noted at admission: Hb, Platelet count, Total and Differential leukocyte count, CRP, AST, ALT, LDH, Ferritin and D-Dimer. Comparative analysis was performed between the 2 groups.
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COVID-19 , Influenza Vaccines , Humans , COVID-19 Vaccines , COVID-19/prevention & control , Health PersonnelABSTRACT
Background: The COVID-19 pandemic has changed the paradigm when it comes to infection control. However, there are still many doubts about pregnancy and the perinatal period in this context, even though many studies suggest the benignity of infection in this phase. The present study took place in a Level II Hospital with differentiated perinatal care and describes the newborns whose mothers were infected with COVID-19 during pregnancy. We aim to understand the mother-newborn pattern of transmission and clinical, analytical and serologic follow-up. Methods: Prospective observational study from 1/4/2020 to 31/5/2021, using the clinical files of every SARS-COV-2 PCR-positive mother and their newborns. Among others, we evaluated the state of infection of the newborn at 12 and 48h and after 14 days with SARS-Cov-2 PCR tests. In the first three months, serologic and clinical evaluation were performed. Results: Of the 1684 live births, 60 (3,6%) mothers were infected with SARS-COV-2 during pregnancy, 43% of which were diagnosed in the screening performed during/before labour. The median value of gestational age was 39 weeks, and the average weight was 3171g. 81,7% of the newborns remained with their mother in the hospital ward, and 85% were breastfed. 7 newborns (11,7%) needed NICU, one of which was born at 32 weeks because the mother needed ICU support due to COVID-19. Of the 26 newborns whose mothers were positive in labour, 15 were tested for SARS-Cov-2 PCR in the first 12 h, and 21 within 48h: all of them were negative.16 were tested after 14 days. Only one of them (6,2%) tested positive but remained asymptomatic. Serologic anti-spike and anti-nucleocapsid analyses were performed in 32 babies: 10 of them (31.3%) showed positive antibodies. In these cases, 80% of the mothers were positive in the 3rd trimester and 20% in the 2nd trimester. The clinical follow-up showed a positive outcome in all of them. Conclusions: This study supports others that show the benignity of perinatal SARS-COV-2 infection. There were no more significant rates of prematurity or NICU need. None of the newborns tested positive in SARS-Cov-2 PCR tests in the first 48h, supporting the rarity of the vertical infection, and only one has been affected by horizontal transmission.
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Introduction: In December 2019, the first group of patients with symptoms of atypical pneumonia was discovered in Wuhan, China. On January 7, 2020, the etiologic agent was identified;it was a new betacoronavirus, genetically similar to SARS-CoV-1, consisting of a simple RNA strand, an enveloped virus of 50-200nm in diameter, which was called SARS-CoV-2. Soon after, the disease was named COVID-19. On January 30, WHO declared a Public Health Emergency of International Importance due to the spread of the coronavirus. Tests for serological detection of IgM and IgG antibodies are those that provide an estimate of the immune response to SARS-CoV-2, highlighting the Rapid Diagnostic Tests (RDT), simple and accessible with a result within 5-30 minutes, based on sensitization of antigens/antibodies conjugated to colloidal gold capturing specific proteins present in the infected serum, plasma or blood. Objective: This work aims to show the analysis carried out with RDT for COVID-19 diagnosis in compliance with the current legislation from 02.04 to 18.08.2020. Method: In March of 2020, 25 serum/plasma samples were donated, without any identification. These samples were the remaining samples of tests performed on individuals with a confirmed diagnosis of SARS-CoV-2 infection by the RT-PCR technique from health services (National Institute of Infectious Diseases Evandro Chagas - INI and State Institute of the Brain Paulo Niemeyer - IEC) located in the metropolitan region of the state of Rio de Janeiro. The samples obtained in order to become a serological panel were stored at -20 degrees C until the moment of use. Simultaneously, a panel of samples with confirmed reactivity for IgM and IgG antibodies from COVID-19 was being made, throughout the pandemic and the samples used were evaluated against three Rapid Tests, of different antigenic compositions or different brands;two ELISA tests for IgM and IgG;two chemiluminescence tests and when applicable, a molecular test. In order to assess the specificity of the products sent, surplus donation plasma samples were selected, known to be negative for HIV, HTLV, hepatitis b and c, chagas and syphilis, collected between 2013 and 2014, in the southern regions of the country, period in which SARS-CoV-2 was nonexistent in the world. In addition to True Positive (VP) and True Negative (VN) samples, interfering serum or plasma samples with reactivity for HIV, HCV, HTLV, HBsAg, chagas disease, syphilis and dengue were also included in the evaluation. Results: Out of 178 TR lots, 74.1%, 132 lots were from China and 25.9%, 46 TR lots were from Brazil;Germany;South Korea;Canada;USA;Singapore;Ireland and Switzerland. The analytical result showed that 57.0%, 101 TR lots obtained a Satisfactory result and 43%, 77 lots had Unsatisfactory results, when compared to the Sensitivity and Specificity values declared by the manufacturer, in the Instructions for Use. Conclusions: The results obtained show the need for constant monitoring of TRs for COVID-19 with the primary purpose of guaranteeing the quality of products sold in the country, one of the National Health Surveillance System pillars of action.
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BACKGROUND AND AIMS: COVID-19 is a pandemic with no end in sight. There is only one approved antiviral agent but global stocks are deemed insufficient. Despite in vitro antiviral activity, clinical trials of chloroquine and hydroxychloroquine were disappointing, and they may even impair outcomes. Chloroquine causes zebroid deposits reminiscent of Fabry disease (a-galactosidase A deficiency) and endothelial cells are key targets of COVID-19. The study aims to investigate in vitro the effect of enzyme replacement therapy (ERT) in chloroquine-induced endothelial dysfunction. METHOD: We have explored the effect of chloroquine on cultured endothelial cells and its modulation by recombinant α-galactosidase A (agalsidase-β). Following doseresponse studies, 0.5 μg/mL chloroquine was added to cultured human endothelial cells. Neutral red and Lysotracker were used to assess lysosomes. Cytotoxicity was evaluated by the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) - MTT assay and cell stress by assessing reactive oxygen species (ROS) and nitric oxide (NO). In endothelial cells, chloroquine induced dose-dependent cytotoxicity at in vitro test concentrations for COVID-19 therapy. RESULTS: Chloroquine significantly induced the accumulation of acid organelles (P<0.05), increased ROS levels, and decreased NO production (P<0.05), in vitro. These adverse effects of chloroquine on endothelial cell biology were decreased by agalsidase-β (P<0.05). CONCLUSION: Chloroquine-induced endothelial cell cytotoxicity and stress is attenuated by agalsidase-β treatment. This suggests that endothelial cell injury may contribute to the failure of chloroquine as therapy for COVID-19 and may be at least in part related to causing dysfunction of the lysosomal enzyme α-galactosidase A. (Figure Presented).
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BACKGROUND: The year 2020 was marked by the new coronavirus pandemic, resulting in millions of cases and deaths, placing healthcare workers at high risk of infection. AIMS: The aim of this study was to describe the role of an occupational health service during coronavirus disease 2019 pandemic in an oncologic hospital and characterize the most likely sources of viral infection. METHODS: The information of all healthcare workers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from 11 March to 15 December 2020 was collected through an epidemiological survey conducted during contact tracing. The data extracted included gender, age, comorbidities, occupational group, source of infection, clinical presentation, duration of the disease, need for hospitalization and persistent or late symptoms after disease or upon returning to work. RESULTS: Out of a total of 2300 workers, 157 were infected, consisting of nurses (36%), nurse assistants (33%) and diagnostic and therapeutic professionals (10%). Physicians and administrative staff accounted for 8% each. The most frequently reported source of infection was occupational (43%), owing to worker-to-worker transmission (45%) and patient-to-worker transmission (36%). The most frequent moments of infection perceived corresponded to the removal of protective equipment during meals and moments of rest in the staff and changing rooms. CONCLUSIONS: The study revealed that occupational transmission from patients and colleagues might be an important source of SARS-CoV-2 infection in healthcare workers. Spread between colleagues accounted for 45% of the occupational source infections reported. Implementing physical distancing measures and limiting the number of people in changing and rest rooms could significantly reduce infection and related absenteeism.
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COVID-19 , Health Personnel , Hospitals , Humans , Pandemics , SARS-CoV-2ABSTRACT
Due to COVID-19, many countries implemented emergency plans, such as lockdown and school closures. This new situation has significantly affected families, namely, the involvement required to support children's learning at home. The current study aimed to analyze Portuguese parents' perceptions of their home-based parental involvement in their children's learning during the lockdown and school closures in 2020 due to COVID-19. An online survey, using a closed-ended questionnaire, was employed. Variables included parents' sociodemographic and COVID-19 related characteristics;students' sociodemographic characteristics;distance learning context;parental involvement;and students' autonomy. Data were collected from a sample of 21,333 parents with children from elementary school to secondary education, and statistical data analysis was performed using IBM SPSS Statistics 26. Findings revealed that Portuguese parents supported their children during the pandemic mainly through the monitoring of attention in classes and task realization. However, several variables appear to significantly determine parental involvement time, which is higher when students attend public schools, when they are less autonomous and younger, when parents' level of education is lower, when the child is a boy (except in secondary education where gender is not relevant), and when the online school time is higher. Findings highlight the need for a significant investment of time from parents, particularly of primary school children, making it difficult to cohere work or telework with school activities. Implications for policies, schools, families are discussed in order to promote children's learning and success.
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In times such as these of world pandemic where the spread of COVID-19 has resulted in the shutdown of schools and universities for face-to-face learning activities, the use of digital technology was intensified. The online learning environment is different to the regular classroom environment. Technology may offer multiple opportunities for learning and diverse means for teaching. The use of technological solutions to enable the continuity of learning from home raised challenges to continue effective teaching-learning processes. Considering online learning, some dimensions have been identified as relevant for learning to occur and be effective. Students' readiness for online learning is one of these dimensions. This brief study aimed to measure undergraduate Psychology students' online learning readiness at a Portuguese university. Participants exhibited above-medium levels of readiness toward online learning and presented highest readiness in the subscale of technical skills, followed by communication competencies, and the lowest readiness in the subscales related to social competencies both with classmates and the instructor/teacher. From these results, we can derive implications for teaching practice. © 2020 Owner/Author.
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INTRODUCTION: The outbreak of a highly infectious respiratory disease - COVID-19 - has spread globally and a novel type of coronavirus (SARS-CoV-2) was identified as its cause. Chest CT findings have been described as an aid for COVID-19 diagnosis and management. We aimed to describe the CT imaging characteristics in a group of COVID-19 patients while we also intended to assess if any of these radiological features were associated with short-term prognosis. MATERIALS AND METHODS: CT examinations from 164 consecutive patients with at least one positive RT-PCR nucleic acid assay for SARS-CoV-2 were retrospectively analyzed. Numerous CT imaging features were recorded independently by two radiologists. Patients were grouped according to their status 14 days after the initial CT scan in either discharged/hospitalized in a non-ICU ward (favorable prognosis group) versus deceased/admitted to an intensive care unit (unfavorable prognosis group). RESULTS: Ground-glass opacities (89.0 %) and consolidations (73.2 %) with multilobar involvement were the predominant imaging findings, while a nodular pattern (3.7 %) and cavitation (1.2 %) were uncommon. Mean age was higher in the mortality/ICU group. Ground-glass opacities and consolidations were dominant in both groups, but distribution pattern of abnormalities was different, being more often diffuse in the mortality/ICU group. Linear opacities and opacities that were rounded in shape were more frequently observed in the favorable prognosis group. CT severity index was significantly higher in the mortality/ICU group. For assessing unfavorable prognosis, the best cut-off for CT severity index was 24 (sensitivity 78 %; specificity 59 %). Interobserver agreement for all CT findings was excellent. CONCLUSION: COVID-19 pneumonia in Porto, Portugal, manifests as multilobar ground-glass opacities and consolidations. Older age, diffuse distribution and increasing CT severity index are associated with worse short-term prognosis while linear opacities resembling organizing pneumonia and rounded opacities herald a more favorable prognosis.
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Objective: to analyze how skin-to-skin contact occurred in a municipal maternity hospital in Metropolitan Region II of the state of Rio de Janeiro, Brazil, at the beginning of the COVID-19 pandemic, from the perspective of obstetric nurses. Method: a qualitative, descriptive, and exploratory study with seven obstetric nurses. The information was collected via Google Forms® and subjected to the thematic analysis proposed by Bardin. Results: two categories emerged: “maintenance of skin-to-skin contact and medical decision influence” and “evaluation of flu syndromes and COVID-19 at the beginning of the pandemic, interfering in the process of skin-to-skin contact”. Conclusion: the maintenance of skin-to-skin contact was linked to the recommendations of official protocols. The power of medicine influenced teamwork, directed by the use of procedures, during labor and birth, which, in a way, limited the respective practice in suspected cases for COVID-19. © 2022 Online Brazilian Journal of Nursing