Incidence of barotrauma in an intensive care unit: new data from COVID-19?

Introduction: During COVID-19 pandemic, the massive use of ventilatory support made its complications even more common. This study aimed to analyse the incidence of barotrauma in COVID-19 patients as well as its consequences. Method(s): Retrospective cohort study. All patients undergoing mechanical ventilation in an intensive care unit (ICU) during 2020- 2021 were included. The time of both noninvasive and invasive ventilation was considered together. Statistical analysis was performed using IBM SPSS Statistics 28.0. Result(s): A total of 967 patients were included, with 42 cases of barotrauma being reported (28 men and 14 women, median age 69 years [interval 22-94] and median APACHE 13). Out of those, 40 had severe COVID-19. Regarding patients with and without COVID-19, the incidence of barotrauma (episodes/1000 days of ventilation) was 0.64 and 9.22 (RR 14.86, p < 0.001) and the barotrauma rate (episodes/number of patients) was 0.4% and 8.5% (RR 21.25, p < 0.001), respectively. The most common type of barotrauma was subcutaneous emphysema (52.4%, CI 95% 37.3-67.5%), followed by pneumomediastinum (47.6%, CI 95% 32.5-62.7%) and pneumothorax (35.7%, IC 95% 21.2-50.2%). The median time to diagnosis was 11.5 days after initiation of ventilatory support [interval 1-67]. In the COVID-19 group, barotrauma was associated with longer ventilation (14.06 vs 7.91 days, p < 0.001), longer ICU stay (16.74 vs 8.17 days, p < 0.001) e higher mortality rates (45.0% vs 26.2%, RR 1.72, p 0.011). Conclusion(s): We found a higher susceptibility to developing barotrauma as a potential complication of COVID-19 patients undergoing mechanical ventilation. From those, subcutaneous emphysema and pneumomediastinum seem to be more prevalent than pneumothorax. Barotrauma seems to be associated with longer periods undergoing mechanical ventilation, longer ICU stays and higher hospital mortality rates.

Impact of COVID-19 on breast cancer screening in the Brazilian Unified Health System (SUS)

Objectives: investigating the impact of the pandemic on breast cancer screening in the Unified Health System, in addition to comparing the data obtained from other countries. Method(s): a quantitative cross-sectional observational study was carried out, with references from the Cancer Information System - SISCAN on the number of mammograms performed from 2014 to 2022 by women in Brazil. Result(s): data regarding mammography in the high-risk population showed a drop of 38, 39% from 2019 to 2020. While in screening mammography, the decline was slightly more significant, at 39.18% in the same period. Regarding diagnostic mammography, the reduction was 33.15%, and in target population mammography, the peak was in 2019 with 2.721.075. On the other hand, the performance of mammography in patients already treated had a smaller decrease of 9.35%. Conclusion(s): there was a significant reduction in the number of mammograms performed in 2019 and 2020, which might lead to a late diagnosis of the disease and a worse prognosis.Copyright © 2023 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.

Antiviral compounds from seaweeds: An overview

The interest in macroalgae has been growing worldwide in the recent years, due to the new discoveries regarding the numerous health benefits they provide to consumers, namely anti-viral, antibacterial, and anti-inflammatory properties that enhance resistance and ability to combat disease to consumers, granted by algae's bioactive molecules. In the light of the ongoing COVID-19 pandemic, there is a renewed need to find cures, treatments or novel means to create immunity in the population against not only to the recently emerging severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) but also to other viruses, in order to allow world populations to safely recover daily life routines. The aim of this chapter is to report the research and developments of possible treatments against virus, based on seaweed's bioactive compounds, from the first stage of development up to commercial products. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

Nocturnal hypoventilation and respiratory muscle/cough weakness in COVID-19 ICU survivors

Background: The impact of severe COVID-19 in nocturnal hypoventilation and respiratory muscles/cough strength is unknown. Aim(s): Characterize respiratory function in post-ICU COVID-19 patients and correlate these findings with COVID-19 associated outcomes. Method(s): Retrospective study with 55 post-ICU COVID-19 patients admitted to a rehabilitation center (RC). Clinical data were collected and patients performed arterial blood gas analysis, nocturnal oxy-capnography, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and peak cough flow (PCF) at admission. Result(s): Mean age was 64.4+/-10.2 years, 39 (70.9%) were male. Co-morbidities were present in 50 (90.9%): 39 (70.9%) hypertension;20 (36.4%) diabetes;3 (5.5%) OSA;1 (1.8%) COPD. None had neuromuscular disorders. Median of ICU length was 25.5 (min 5;max 190) days. Fifty-three (96.4%) needed mechanical and invasive ventilation, 6 (10.9%) ECMO and 22 (40%) tracheostomy (all decannulated before admission to our RC). Eighteen (32.7%) had criteria of nocturnal hypoventilation, 17 (30.9%) inspiratory, 16 (29.1%) expiratory and 17 (30.9%) cough weakness. Sepsis correlated with increased length of ICU stay (p=0.007) and with lower PCF values (p=0.048). Neurologic disfunction was associated with lower minimum SpO2 and more time of SpO2<88% (p=0.032;p=0.035). Renal disfunction was associated with higher values of mean and maximum TcCO2 (p=0.003;p=0.011). Patients with previously diagnosed OSA had higher values of MIP and PCF (p=0.006;p<0.001) at evaluation. Conclusion(s): In COVID-19 ICU survivors, nocturnal hypoventilation, inspiratory/expiratory muscle and cough weakness are common and may have an impact in rehabilitation outcomes.

Determinants of severe COVID-19 infection in Patients with Breast Cancer from a Community Oncology Practice in Brazil

Purpose: The SARS-CoV-2 pandemic was declared a global public health emergency. Determinants of mortality in the general population are now clear, but specific data on patients with breast cancer (BC) remain limited, particularly in developing nations. Material(s) and Method(s): We conducted a longitudinal, multicenter cohort study in patients with BC and confirmed SARS-CoV-2 infection. The primary end point was the proportion of patients on treatment for severe SARS-CoV-2 infection (defined as need for hospitalization) or early death (within 30 days of diagnosis). Data were evaluated sequentially in the following way: i) univariate Fisher's exact test;ii) multivariable logistic regression analysis;and iii) multivariable logistic regression. In items i and ii only those with P< 0.1 are considered significant and in stage iii only those with p< 0.05 were the final significant variables. We divided patients' data into three major variable domains: a) signs and symptoms;b) comorbidities;and c) tumor and treatment characteristics;in item ii each variable domain was tested separately, finally, in item iii the significant variables of all domains were tested together and we called it the integrative step. Result(s): From April 2020 to June 2021, 413 patients with BC and COVID-19 were retrospectively registered, of which 288 (70%) had an identified molecular subtype and 273 (66%) had stage information. Most patients were on active systemic therapy or radiotherapy (73.2%), most of them in the curative setting (69.5%). The overall rate of severe SARS-CoV-2 was 19.7% (95% CI, 15.3-25.1). In the integrative multivariate analysis, factors associated with severe infection were metastatic setting, chronic pain, acute dyspnea, and cardiovascular comorbidities. Recursive partitioning modeling used acute dyspnea, metastatic setting, and cardiovascular comorbidities to predict nonprogression to severe infection, yielding a negative predictive value of 84.9% (95% CI, 78.9%-88.3%). Conclusion(s): The rate of severe COVID-19 in patients with BC is influenced by prognostic factors that partially overlap with those reported in the general population. High-risk patients should be considered candidates to active preventive measures to reduce the risk of infection, close monitoring in the case of exposure or SARS-CoV-2 -related symptoms and prophylactic treatment once infected.

COVID-19 vaccines effectiveness against symptomatic disease and severe outcomes, 2021-2022: a test-negative case-control study.

OBJECTIVES: This study evaluated the effectiveness of COVID-19 vaccines in preventing symptomatic and severe disease. STUDY DESIGN: This was an observational test-negative case-control study. METHODS: Study participants were adults with at least one symptom included in the World Health Organization COVID-19 definition who sought health care in a public emergency department between 1 November 2021 and 2 March 2022 (corresponding with the fifth pandemic wave in Portugal dominated by the Omicron variant). This study used multivariable logistic regression models to estimate and compare the odds ratio of vaccination between test-positive cases and test-negative controls to calculate the absolute and relative vaccine effectiveness. RESULTS: The study included 1059 individuals (522 cases and 537 controls) with a median age of 56 years and 58% were women. Compared with the effectiveness of the primary vaccination scheme that had been completed ≥180 days earlier, the relative effectiveness against symptomatic infection of a booster administered between 14 and 132 days earlier was 71% (95% confidence interval [CI]: 57%, 81%; P < 0.001). The effectiveness of the primary series against symptomatic infection peaked at 85% (95% CI: 56%, 95%) between 14 and 90 days after the last inoculation and decreased to 34% (95% CI: -43%, 50%) after ≥180 days. CONCLUSIONS: Despite the known immunological evasion characteristics of the Omicron variant, results from this study show that vaccine effectiveness increases after booster administration. COVID-19 vaccine effectiveness decreases to less than 50% between 3 and 6 months after completion of the primary cycle; therefore, this would be an appropriate time to administer a booster to restore immunity.

Promoting physical activity among university students with a co-constructed program during Covid-19 pandemic

Introduction: Since the beginning of the COVID-19 pandemic, sanitary context and e-learning has greatly modified students' lifestyles. An increase of sedentary behaviors, a reduction in physical activity (PA) and a stronger tendency to move towards unhealthy diet have been demonstrated. Most of the research is largely descriptive and to date, no interventional studies have been conducted to prevent the deterioration of students' health. Objective(s): The objective of the present research aims to evaluate the effects of an intervention program on the lifestyle and psychological state of student. Its primary objective is to promote PA among students, to improve both physical condition and motivation to engage in physical activity for one's health by promoting motivational levers. Its second objective is to reduce and/or prevent the deterioration of the health of university students. Method(s): Students from University of Nimes were recruited and randomly assigned to one of the two following conditions: an experimental group and a control group. The experimental group participated to an 8-weeks program of PA (co-constructed by users during design-based innovative workshops) whereas the control group did not. For each group, measures of PA, sedentary time, anthropometric data, sleep, physical condition and psychological variables (anxiety, depression, motivation, body appreciation, perceived control, well-being,.) were carried out before (T1: october 2021) and after (T2: December 2021) these 8-weeks in order to evaluate the benefits from the PA program. Result(s): These assessments were performed in October 2021 (T1) and December 2021 (T2). Conclusion(s): Data are still being collected and will be presented in April 2022.

Student mental health during the first two years of the COVID- 19 pandemic

Introduction: The COVID-19 pandemic have had deleterious effects on mental health of students. Authors suggest that the psychological effects will persist long after COVID-19 has peaked, but we have no data to confirm this. Objective(s): Objective: The objective of this study is to compare clinical issues (concerns, anxiety and depression symptoms) and adjustment (coping strategies) in French university students during different phases of the COVID-19 pandemic in 2020 and 2021 (during two periods of lockdown and two periods after lockdown) Methods: Method: Data were collected anonymously at four timepoints: during France's first national lockdown (23 April- 8 May 2020;nT1= 1294);during the period after lockdown (9-23 June 2020;nT2=321);1 year after the first lockdown, which was also a lockdown period (23 April- 8 May 2021;nT3 = 2357);and 1 year after the first unlockdown, which was also a unlockdown period (9-23 June 2021, nT4 = 1174). The following variables were measured: concerns, coping strategies, anxiety and depressive symptoms. Result(s): In 2021, students have significantly higher levels of anxiety and depressive symptoms than in 2020, and this is even more pronounced during the lockdown periods. For example, 44.1% had probable anxiety symptoms in the 2021 lockdown, compared to 33% in the 2020 lockdown. In the unlockdown periods, the rates are 21.7% in 2020 and 26.4% in 2021. Conclusion(s): Our results suggest that university students, known to be a vulnerable population with significant mental health deterioration, have become even more vulnerable with the COVID-19 pandemic.

Personality and adherence to the COVID-19 vaccine: the role of agreeableness and openness traits

Aim: This study aimed to verify the relationship between personality traits and commitment to vaccination against COVID-19. Material and methods: The sample consisted of 595 Brazilian adults aged 18-72 years, who answered the Big Five Inventory 2 Short (BFI-2-S) and a COVID-19 Vaccine Questionnaire. Results and discussion: Higher scores in agreeableness and openness were associated with a higher probability of adhering to the vaccination program, and higher scores in extroversion and lower scores in agreeableness were associated with poor adherence to the vaccination, anti-vaccine movement, and conspiracy beliefs against the vaccine (p <= .01). These results show the agreeableness and openness traits seem to be crucial for adherence to the vaccination program. Conclusion: The findings indicate the importance of acknowledging agreeableness and openness traits as relevant in the adherence to the public policies programs against the COVID-19 pandemic.

Analysis of solid waste management during the COVID-19 pandemic in ISWA's associated countries

Waste management is essential in preventing diseases such as COVID-19, but its continuity requires contingency measures to ensure the safety of workers and the population. In this context, this work aimed to identify and evaluate changes and guidelines in waste sectors during the pandemic in the world. The method consisted of documentary research, analysing the data published by the International Solid Waste Association (ISWA) and its members in 2020. The results show that the majority's focus was continuity of operations and worker safety and that there was variation between stoppage and continuation of the collection and sorting of recyclables. The most adopted procedure for masks and other possible contaminated waste was the collection of them with common residues, and there were no changes in the management in health units. In summary, the pandemic required adaptations of the waste sectors, which varied from one country to another and did not always follow the ISWA recommendations.

PCL- And Gelatin-based Electrospun Biological Scaffolds For In Vitro Lung Tissue Engineering

Purpose/Objectives: Acute and chronic respiratory diseases constitute a substantial socioeconomic burden on a global scale, as made abundantly clear in the last two years with the rampant coronavirus disease 2019 (COVID-19) pandemic. Alas, the development of new therapies for pathological respiratory conditions has been hindered by the inadequacy of current preclinical models, which often fail to provide reliable predictions on drug safety and efficacy in humans. In particular, considerable anatomical and physiological differences between the respiratory systems of commonly used animal models and humans are one of the main issues leading to high drug attrition and clinical failure rates. Accordingly, the generation of physiologically relevant preclinical lung models for early drug development and pharmaceutical research is urgently needed. In this work, poly(ϵ-caprolactone) (PCL) and gelatin were used as raw materials to produce electrospun scaffolds for in vitro lung tissue engineering, in order to generate human biomimetic platforms for preclinical drug safety and efficacy testing. Methodology: PCL and gelatin were mixed at varying volume ratios: 1:0 (PP), 6:1 (PPG61), 4:1 (PPG41), and 2:1 (PPG21), so as to determine the optimal gelatin concentration for cell adhesion and growth. Poly(vinylpyrrolidone) (PVP) was added to every polymer mixture to facilitate the electrospinning process, and electrospun fibrous matrices were fabricated using a needleless electrospinning technique. Scaffold morphology, chemical composition, and wettability were characterized with scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, and water contact angle analysis, respectively. Biocompatibility testing was performed using human bronchial (16HBE) and alveolar (A549) epithelial cell lines, consisting of cell metabolic activity, proliferation, and adhesion evaluation over two weeks of in vitro culture. Results: All polymer blends resulted in the formation of electrospun scaffolds with a nanofibrous structure. The addition of gelatin in PPG61 scaffolds improved fiber morphology compared to PP formulations, but increasing proportions of this polymer in PPG41 and PPG21 mats caused a larger number of defects, such as beading and branching. FTIR analysis confirmed the presence of PCL and PVP in PP scaffolds, as well as the addition of gelatin in all PPG blends. Moreover, as expected, all scaffolds were hydrophilic, with water contact angles below 90°, being suitable for protein adsorption and cell adhesion. Regarding 16HBE and A549 cell viability, surprisingly, no major differences were found between the different formulations over the two-week culture period, showing that all polymer blends were equally capable of promoting cell adhesion and growth. While PP scaffolds significantly outperformed PPG electrospun mats in early timepoints, no such differences were identified at the end of the experimental period. Conclusion/Significance: These results suggested that PCL, PVP, and/or gelatin blend electrospun scaffolds are conducive to lung epithelial cell adhesion and proliferation. Nevertheless, further studies investigating epithelial cell differentiation and function should be conducted to fully assess the suitability of these biomaterials as platforms for in vitro lung tissue engineering.

Primary endpoint analysis of a randomized phase II of darolutamide or capecitabine in patients with triple-negative androgen receptor-positive advanced breast cancer (UCBG3-06 START trial)

Background: A subgroup of triple negative breast cancer (TNBC) expresses the androgen receptor (AR). In this trial we evaluated the efficacy and tolerability of the AR inhibitor darolutamide (D) or capecitabine (C) in patients (pts) with advanced AR-positive TNBC (NCT03383679). Methods: Pts with centrally reviewed AR-positive (≥ 10% by immunohistochemistry) TNBC treated with up to one line of chemotherapy for advanced disease were eligible. They were randomized in a 2:1 ratio to receive D 600 mg twice daily or C 1000 mg/m2 twice daily 2-weeks on/ 1-week off, until progression or unacceptable toxicity. Primary endpoint was clinical benefit rate (CBR) at 16 weeks and was assessed in the eligible population and in the sensitivity analysis population (pts with delayed tumour assessment performed in the context of COVID pandemic). Main secondary endpoints included objective response rate, overall survival, progression-free survival (PFS) and safety. Results: A total of 254 pts from 45 centres were screened;94 pts were randomized (61 in D arm, 33 in C arm) from April 2018 to July 2021. A clinical benefit was observed in D arm in 13 of 53 evaluable pts (CBR at 16 weeks 24.5%;95% CI: 12.9%-36.1%) including 2 PR and 1 CR and in C arm in 11 of 23 evaluable pts (CBR at 16 weeks 47.8%;95% CI: 27.4%-68.2%). In the sensitivity analysis, a clinical benefit was observed in D arm in 17 of 58 evaluable patients (CBR ≥ 16 weeks 29.3%;95% CI: 17.6%-41.0%) and in C arm in 19 of 32 evaluable patients (CBR ≥ 16 weeks 59.4%;95% CI: 42.3%-76.4%). 7 pts presented with drug-related serious adverse events: 3 in D arm and 4 in C arm. In D arm, asthenia (26.7%), nausea (25%) and ASAT increase (21.7%) were the most common adverse events, the majority being grade 1 or 2, similar to previous safety data. Median PFS were 1.8 months (CI 95% 1.7-3.1) and 3.6 months (1.8-9.1) in D arm and C arm respectively. Other secondary endpoints will be presented at the meeting. Conclusions: Despite not reaching the pre-specified CBR, darulotamide demonstrated clinical activity with significant benefit for a group of patients. A research program to identify predictive biomarkers of sensitivity is ongoing. Clinical trial identification: EudraCT: 2017-002284-18 NCT03383679. Legal entity responsible for the study: UNICANCER. Funding: BAYER. Disclosure: All authors have declared no conflicts of interest.

Impact of the COVID-19 pandemic on stage at diagnosis of patients with breast cancer: An analysis of 11,752 patients from Oncoclínicas

Background: As a reaction to the COVID-19 pandemic, a nation-wide lockdown was enforced in Brazil in March 2020, cancer care was impacted, and cancer screening reduced. Therefore, an increase in cancer diagnoses at more advanced stages was expected. In this study, we extracted data from our nationwide real-world database to evaluate the impact of the COVID-19 pandemic on the stage at diagnosis of breast cancer (BC) cases. Methods: We explored curated electronic medical record data of female patients, over 18 years of age, diagnosed with BC and with established disease stage based on the AJCC 8th edition, who started treatment or follow-up in the Oncoclínicas (OC) between Jan 1, 2018, and Dec 31, 2021. The primary objective was to compare stage distribution at first visit during COVID- 19 pandemic (2020-2021) with a historical control cohort from a period prior to the pandemic (2018- 2019). We investigated stage distribution according to age at diagnosis and tumor ER/HER2 subtype in univariate models. Associations were considered significant if they had a minimum significance (P < 0.1 in Chi-square test). The historical numbers of patients with BC at OC make it possible to identify differences in the prevalence of stages in the order of 5% comparing pre and post pandemic periods with a statistical power greater than 80%. Results: We collected data for 11,752 patients with initial diagnosis of BC, with 6,492 patients belonging to the pandemic (2020-2021) and 5,260 patients to the pre-pandemic period (2018-2019). For both ER+/ HER2- and HER2+ tumors, there was a lower percentage of patients with early-stage (defined as stage I-II) in the years 2020-2021 vs 2018-2019 and a considerable increase in advanced-stage disease (defined as stage IV). For triple negative BC (TNBC), there was a significant higher percentage of patients with advanced-stage disease in the pandemic vs pre-pandemic period (table 1). Age over 50 years was associated with a greater risk of advanced stage at diagnosis after the onset of the pandemic, with an absolute increase of 7% (P twosided <0.01). Conclusions: We observed a substantial increase in cases of advanced-stage BC in OC institutions as a result of delays in BC diagnoses due to the COVID-19 pandemic. The impact appeared greater in older adults, potentially because of stricter confinement in this group.

Experience of Basic Life Support with Automated External Defibrillation Course in the first year of Medical School

Introduction: The annual incidence of out of hospital cardiac arrest in Europe is between 67 to 170 per 100,000 inhabitants1. Basic Life Support (BLS) with Automated External Defibrillation (AED) are techniques with undoubted benefit2. Still, the use of AEDs remains low in Europe (average 28%)1. Training in BLS with AED is mandatory for health care professionals. Within the scope of the curriculum reform of the Integrated Master of Medicine (IMM), an Introduction to Medicine unit was created, which includes a BLS with AED course.We assessed medical students rating of this course. Material and methods: Assessment of satisfaction of the certified Portuguese Resuscitation Council/European Resuscitation Council BLS and AED course3 to first year students of the IMM at Instituto de Ciências Biomédicas Abel Salazar. School of Medicine and Biomedical Sciences, Porto, Portugal, since 2018 to 2021. Twelve questions regarding four areas, BLS, AED, Recovery position (RP) and Foreign body airway obstruction (FBAO), were graded from 0 = none to 5 = maximum. Results: In total, 38 courses were held, attended by 719 students. The global assessment was maximum on most questions. This trend was most pronounced in issues relating to the BLS (mean of 96,6% for grade 5) and AED (mean of 96,5% for grade 5). The relevance of the content in the four different areas was also very high (range 96,2 to 99,3%). In contrast, the RP (mean of 92,9% for grade 5) and FBAO (mean of 90,4% for grade 5) training ratings were the lowest, yet still quite high. The training conditions, either by limitations imposed by COVID, or by the training models, may have contributed to the less favourable results. Conclusions: Training in BLS and AED is confirmed as a very relevant practice for 1st year medical students. Improvement in its practical implementation may promote greater satisfaction and learning.

Worldwide research trends on the use of chemical-mechanical caries removal products over the years: a critical review.

BACKGROUND: Chemical-mechanical caries removal (CMCR) products are in constant evolution and were recommended during the COVID-19 pandemic as substitutes for conventional caries removal. AIM: Characterize the worldwide scientific literature about CMCR products, over the years, by means of a critical review. DESIGN: Electronic search was performed on Medline/PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, and Embase up to November 2020. Year, journal, country of authors, and type of study were the data extracted from the retrieved studies. Additional data of the clinical studies and systematic reviews were investigated. RESULTS: 2221 records were identified, 397 selected. 2011-2020 period concentrates higher number of publications (n = 169), in the Journal of Dental Research (n = 51), developed in Brazil (n = 45) and India (n = 44). Most studies were in vitro (n = 211) and clinical trials (n = 101). Carisolv™ (n = 48) and Papacarie Duo Gel™ (n = 33) were the most used products, prescript in isolated usage (n = 101), and compared with drills (n = 77). CMCR were more studied in primary teeth (n = 78), receiving glass ionomer cement (GIC) (n = 51) as restorative material. The most evaluated outcomes were time spent (n = 48) and pain (n = 41). Clinical application of CMCR takes more time than other techniques, but can also reduce patient anxiety, pain, and need for anesthesia. CONCLUSION: In vitro and clinical studies with CMCR products have been increasing, mostly carried out in developing countries, evaluating Carisolv™ and Papacarie Duo Gel™. Clinical studies tend to evaluate the time spent and pain compared to drills for removing caries in primary teeth, posteriorly restored with GIC. CMCR clinical application reduces anxiety, pain, and need for anesthesia, despite increase treatments' time.

Nurses' perception regarding their health and working conditions during the COVID-19 pandemic

Objective: to identify working conditions and their effects on nursing professionals' health during the COVID-19 pandemic, based on the workers' own perceptions.

EVENTOS ADVERSOS À PLAQUETAFÉRESE E PLASMAFÉRESE: UMA AVALIAÇÃO COMPARATIVA

Objetivos: O processo de doação de plaquetas por aférese (PLF) ou de plasma convalescente (PC) pode gerar reações adversas (RA) durante ou após o procedimento. Pela experiência negativa, as reações podem impedir que indivíduos se tornem doadores frequentes. Assim, é importante detectar as RA mais frequentes. Usualmente, se consegue esses dados através da observação antes da liberação pós-doação. Outra possibilidade seria a busca ativa, contatando os doadores pós-procedimento. O estudo objetivou comparar as RA entre doadores de PC (busca ativa) e PLF (observação) no Hemocentro de Goiás (HEMOGO). Materiais e métodos: Estudo observacional, prospectivo, sem intervenção realizado no HEMOGO. Foram avaliados 184 PFL de 23/04/2020 a 11/11/2020 e 61 PC entre 30/06/2020 a 11/09/2020. Dados demográficos foram coletados dos prontuários e analisados quanto à distribuição de sexo e idade. Resultados: Foram realizadas 184 PLF e 61 de PC. Para a PLF, 5 RA foram relatadas em indivíduos do sexo feminino, com 80% delas entre 18 a 30 anos. A reação mais comum nesse grupo foi lipotimia. Nenhum doador do sexo masculino reportou RA. Quanto à doação do PC, 14 homens relataram RA na busca ativa. A maioria tinha 31 a 40 anos e a maior parte das queixas foi dor/hematoma no local da punção e fraqueza. Ademais, 8 mulheres relataram reações, com 62,5% entre 18 e 30 anos. Grande parte delas reportou formigamento/hematoma no local da punção e sensação de rubor. A análise estatística mostrou que para PLF o sexo influencia nas RA e a idade não tem influência nesses eventos. Ainda, para PC, as RA não se correlacionaram com o sexo, mas tiveram correlação com a idade. Discussão: RA em aférese são esperadas devido ao tempo de procedimento mais longo, ao volume extracorpóreo ou alterações de fluidos. No estudo observamos um maior número de RA relatadas em doadores de PC em comparação aos de PLF. Outros estudos comparativos também observaram um aumento significativo no número de RA relatadas quando se realiza a busca ativa por RA. Houve diferenças quanto ao tipo de RA experimentada pelos doadores. Enquanto os doadores de PFL relataram sintomas sistêmicos, os de PC relataram sintomas locais. Isso pode estar relacionado ao próprio processo de doação, uma vez que reações vasovagais foram as RA imediatas mais comumente observadas após a doação. Estudos que avaliaram RA reportadas após busca ativa também observaram maior número de sintomas locais como hematoma e dor local. Na análise demográfica, sexo e idade influenciaram nas queixas reportadas por doadores de PFL e PC, respectivamente. Alguns estudos reportam que o sexo feminino e doadores mais jovens reportam mais RA, independente do tipo de doação. Porém devido a critérios de exclusão para doação, havia menos doadores de PC do sexo feminino, o que pode ter uma correlação negativa entre o sexo feminino e RA em PFL. Conclusão: As RA dos doadores de PC e PLF constituem um parâmetro significativo para a avaliação das repercussões desses procedimentos, tendo idade e sexo dos doadores como possíveis fatores preditores. Nesse estudo, a idade foi fator negativo para a RA pós doação de PC, enquanto o sexo foi fator negativo para as RA pós PLF. Destarte, a investigação desses eventos se torna necessária para o aperfeiçoamento da doação de PC e/ou de PLF, haja vista que, com a emergência da pandemia da COVID-19, essas técnicas tornaram-se importantes no cotidiano médico.

Personality and adherence to the COVID-19 vaccine: the role of agreeableness and openness traits

Aim: This study aimed to verify the relationship between personality traits and commitment to vaccination against COVID-19. Material and methods: The sample consisted of 595 Brazilian adults aged 18-72 years, who answered the Big Five Inventory 2 Short (BFI-2-S) and a COVID-19 Vaccine Questionnaire. Results and discussion: Higher scores in agreeableness and openness were associated with a higher probability of adhering to the vaccination program, and higher scores in extroversion and lower scores in agreeableness were associated with poor adherence to the vaccination, anti-vaccine movement, and conspiracy beliefs against the vaccine (p ≤ .01). These results show the agreeableness and openness traits seem to be crucial for adherence to the vaccination program. Conclusion: The findings indicate the importance of acknowledging agreeableness and openness traits as relevant in the adherence to the public policies programs against the COVID-19 pandemic. © 2022 Polish Psychiatric Association. All rights reserved.