IMPACT in PRENATAL EVALUATION of PREGNANT WOMEN with RHEUMATIC DISEASES by the SARS-COV2 PANDEMIC

Background: Due to the SARS-CoV-2 pandemic, an increase in stress, anxiety, and depression has been seen, as well as greater use of substances and a decrease in prenatal care in pregnant women. (1) Women of childbearing age with autoimmune rheumatic diseases (ARDs) experience greater psychological stress, which can negatively influence behavior. (2) Objectives: This study aims to compare changes in prenatal laboratory and ultrasound tests by trimester, as well as the detection of anxiety and depression in pregnant women with ARDs due to the SARS CoV-2 pandemic. Methods: This study was carried out on pregnant patients with ARDs from the Pregnancy and Rheumatic Diseases clinic of the rheumatology department of the University Hospital 'Dr. José Eleuterio González' during the period from February 2018 to August 2021. Two standardized evaluations of anxiety and depression were carried out using the Inventory of Trait and State Anxiety (IDARE) and the Edinburgh Postpartum Depression Scale (EPDS) respectively in the third trimester of pregnancy. Maternal report of alcohol consumption during any trimester of pregnancy, as well as adherence to routine laboratory studies such as structural ultrasound and gesta-tional diabetes screening, was addressed. Positive COVID-19 nasopharynx PCR results were evaluated during pregnancy beginning in the pandemic period (March 2020). The pre-pandemic recruited group was compared with the pandemic group. The comparison of the groups was carried out using the Chi-Square and Fisher tests. A significant value of p < 0.05 was considered. Statistical analysis was performed using the IBM SPSS v.25 program. Results: 50 pregnant patients with ARDs were recruited, of which 24 were included in the pre-pandemic group and 26 in the pandemic group. Compared with the pre-pandemic group, pregnant women recruited during the pandemic had a statistically signifcant higher positivity for state anxiety (p=0.023), likewise trait anxiety, depression, and suicidal ideation were detected more frequently, but the difference was not statistically signifcant, a higher rate of adherence to laboratory and cabinet studies was found, being signifcant for laboratories performed in the 1st and 2nd trimesters (0.005 and 0.025 respectively). See Table 1. Conclusion: A higher frequency of positivity for state anxiety was demonstrated in pregnant women with ARDs recruited during the pandemic, as well as higher trait anxiety, depression, and suicidal ideation, although this increase was not statistically signifcant. On the other hand, concern about the pandemic and health status could positively influence better adherence to screening and routine studies during pregnancy.

'No risk in the rural': information on COVID-19 among rural university

This article analyzed the reception, evaluation and circulation of information on COVID-19 between people living in rural communities located in municipalities in the interior region of the state of Minas Gerais, Brazil. This research is part of an extension project created in April 2020 with 128 students from a training course aimed at teachers for rural schools, offered by a Brazilian federal public university. Questionnaires with closed and open questions were applied in three stages: 35 students in the first stage (April/May 2020), 46 students in the second stage (July 2020) and 29 students in the third stage (June/July 2021). Data were analyzed using categorical content analysis. The results were organized into the following categories: a) means of communication to access information, b) focus of information, c) immunization through vaccine and d) false or misleading information. There is an excess of false information that could have aggravated the effects of the pandemic among rural and peasant populations in the analyzed context. Thus, given the insecurities of the pandemic scenario and the way in which the pandemic affects and is perceived by rural populations, there is still a need to create qualified spaces for access to scientific information as well as health guidelines for these people.

Cardiac troponin as major mortality risk factor in SARS-CoV-2 infection

Background: The COVID-19 pandemic has collapsed the health system, making it necessary to identify factors that help to predict and stratify the risk of patients on admission. Many factors have been used in clinical practice, but the scientific evidence available to date is limited. Purpose: The objective of this study was to identify clinical and analytical predictors of 30-day mortality in SARS-CoV- 2 infection. Methods: A total of 1708 consecutive patients hospitalized in our centre between 18th and 23rd March 2020 and 22nd August and 9th January 2021 with a confirmed microbiological diagnosis of COVID-19 by PCR were prospectively included. Cox regression analysis was performed to assess whether sex and race, smoking habit, chronic kidney disease, D-dimer, heart disease (defined as a history of acute myocardial infarction, heart failure, atrial fibrillation) and troponin at admission (cTnI levels greater than the 99th percentile of a healthy population) were related to the 30-day mortality of these patients. Results: Baseline characteristic are shown in the table 1. Median hospital length of stay was 9 days (IQR 5 to 16). A total of 338 patients (19.8%) died within 30 days and 153 (9.0%) were admitted to the ICU. Furthermore, 52.1% of patients developed ARDS and 9.3% required non-invasive ventilation. A troponin at admission greater than the 99th percentile of a healthy population (HR 1.9, 95% CI 1.4-2.5, p<0.001) and a Charlson Comorbidity Index above 4 (HR 2.6, 95% CI 1.9-3.6, p<0.001) were independent predictors of 30-day mortality in patients admitted due to COVID- 19 infection. Conclusions: At admission time, troponin values and patient comorbidity (Charlson Comorbidity Index ≥4) can be useful as prognostic markers of SARS-CoV-2 infection. (Figure Presented).

The perception of the professionalism of the doctor by the population Veracruz-boca del rio, Mexico

Introduction Medical professionalism not only encompasses the face-to-face aspect where the doctor-patient relationship is maintained in a care manner, it goes beyond the doctor's office. During the COVID19 pandemic in Mexico, many doctors were attacked indicating their lack of vocation and professionalism, even though the patient had not dealt with the doctor at any time. Objective To analyze the perception of the professionalism of doctors by the population of the Veracruz-Boca del Río Material and methods A quantitative study was carried out with a non-experimental, observational, analytical and cross-sectional research design We include men and women between the ages of 20 and 70, residents of Veracruz, Mexico. A virtual survey was carried out to identify the attitudes that patients consider to be unprofessional in doctors, however, all the attitudes evaluated were actions that the doctor performs outside of his working hours or that he registers in his personal social networks. Results 1339 subjects were included, with an average age of 33.6 (± 12.7). The use of vulgar language (30.9%), publication in social networks against feminism (36.2%) or sexual content (73.3%) is perceived as unprofessional for both sexes. Regarding female doctors, 34.5% of patients indicate as unprofessional the publication of alcohol on social networks (34.5%), being at an informal party (29.6%) or smoking tobacco (34.2%), while for a male doctor the publication in social networks of drinking alcohol (40%) or being in an informal party (36.1%) consider it unprofessional. Less than 20% of those surveyed consider their position on cannabis use, feminism or abortion, type of clothing, sedentary lifestyle, religion, age, tobacco or alcohol consumption unprofessional in their daily life. Conclusions The patient perceives the professionalism of the doctor from social networks in actions that are not directly related to how professional he can be when performing his work as a doctor. Key messages The patient perceives the professionalism of the doctor from social networks. The patient perceives the professionalism of the doctor from social networks in actions that are not directly related to how professional he can be when performing his work as a doctor.

1061P Safety of cemiplimab for advanced cutaneous squamous cell carcinoma: The Spanish named patient programme

Background: Cemiplimab is a programmed cell death receptor-1 inhibitor with antitumour activity for cutaneous squamous cell carcinoma (CSCC) and acceptable safety proved in its pivotal trial. We provide the first data on cemiplimab safety in daily practice from the named patient programme (NPP) for advanced CSCC in Spain. Methods: This cemiplimab NPP was performed from March 2019 to March 2020. It included patients aged ≥18 years with advanced CSCC and ineligible for surgery, radiation therapy or clinical trials. The cemiplimab safety was assessed according to treatment-emergent adverse events (TEAEs) reported until March 2021. Results: 140 patients were included (median age [interquartile range, IQR] 77.0 [65.0-84.0] years;age ≥80 38%;men 71.7%;≥1 comorbidity 83%;ECOG 0-1 86.3%;locally advanced CSCC 60.7%;cemiplimab as first-line therapy 67.7%). Cemiplimab was received for a median (IQR) of 8.0 (3.0-14.0) cycles. Fifty-eight (41.4%) patients showed ≥1 of the 163 TEAEs reported, which most frequently included diarrhoea n=7, asthenia n=6, constipation n=4 and abdominal pain n=4. Fourteen (8.6%) were immune-mediated, mainly bronchitis n=2, pneumonitis n=2 and hepatitis n=2. Seventy-eight (47.9%) TEAEs were grade ≥3, most frequently pneumonia n=3, COVID-19 n=3, general physical health deterioration n=2, pyrexia n=2, renal transplant failure n=2, sepsis n=2, acute kidney injury n=2 and respiratory failure n=2. Twenty-one (12.9%) were treatment-related (TREAEs): 11 (6.7%) were grade 1-2 (diarrhoea n=3 and asthenia, hepatotoxicity, malnutrition, odynophagia, polymyalgia rheumatica, pneumonitis, pruritus, and skin toxicity), 9 (5.5%) grade 3 (acute kidney injury, adrenal insufficiency, abdominal pain, blood creatinine increased, dysphagia, haematuria, immune-mediated enterocolitis, panniculitis, surgical wound infection) and 1 (0.6%) unknown grade. Cemiplimab was withdrawn due to TREAEs in only 5 (3.6%) patients. The TEAE outcome was fatal in 29 (17.8%);none related to cemiplimab. Conclusions: This NPP supports the real-life safety of cemiplimab for CSCC, showing an acceptable safety profile consistent with previous reports. Editorial acknowledgement: Editorial assistance was provided by Esther Álvarez-García at Dynamic Science S.L., funded by Sanofi. Legal entity responsible for the study: Sanofi. Funding: Sanofi. Disclosure: E. Muñoz Couselo: Financial Interests, Personal, Advisory Board: Amgen;Financial Interests, Personal, Advisory Board: Bristol-Myers Squibb;Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme;Financial Interests, Personal, Advisory Board: Novartis;Financial Interests, Personal, Advisory Board: Pierre Fabre;Financial Interests, Personal, Advisory Board: Roche;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Other, Honoraria: Amgen;Financial Interests, Personal, Other, Honoraria: Bristol-Myers Squibb;Financial Interests, Personal, Other, Honoraria: Merck Sharp & Dohme;Financial Interests, Personal, Other, Honoraria: Novartis;Financial Interests, Personal, Other, Honoraria: Pierre Fabre;Financial Interests, Personal, Other, Honoraria: Roche;Financial Interests, Personal, Principal Investigator: Amgen;Financial Interests, Personal, Principal Investigator: Bristol-Myers Squibb;Financial Interests, Personal, Principal Investigator: GlaxoSmithKline;Financial Interests, Personal, Principal Investigator: Merck Sharp & Dohme;Financial Interests, Personal, Principal Investigator: Novartis;Financial Interests, Personal, Principal Investigator: Pierre Fabre;Financial Interests, Personal, Principal Investigator: Roche;Financial Interests, Personal, Principal Investigator: Sanofi. A. Soria: Financial Interests, Personal, Invited Speaker: Novartis;Financial Interests, Personal, Invited Speaker: Sanofi Aventis;Financial Interests, Personal, Invited Speaker: Roche Pharma;Financial Interests, Personal, Invited Speaker: Merck Serono;Financial Interests, Personal, Invited Speaker: Merck Sharp & Dohme;Financial Interests, Perso al, Invited Speaker: Bristol-Myers Squibb;Financial Interests, Personal, Invited Speaker: Pierre Fabre;Financial Interests, Personal, Advisory Board: Novartis;Financial Interests, Personal, Advisory Board: Sanofi Aventis;Financial Interests, Personal, Advisory Board: Roche Pharma;Financial Interests, Personal, Advisory Board: Merck Serono;Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme;Financial Interests, Personal, Advisory Board: Bristol-Myers Squibb;Financial Interests, Personal, Advisory Board: Pierre Fabre;Financial Interests, Personal, Principal Investigator: Novartis;Financial Interests, Personal, Principal Investigator: Sanofi Aventis;Financial Interests, Personal, Principal Investigator: Roche Pharma;Financial Interests, Personal, Principal Investigator: Merck Serono;Financial Interests, Personal, Principal Investigator: Merck Sharp & Dohme;Financial Interests, Personal, Principal Investigator: Bristol-Myers Squibb;Financial Interests, Personal, Principal Investigator: Pierre Fabre. O. Sanmartin: Financial Interests, Personal, Invited Speaker: Sanofi Genzyme;Financial Interests, Personal, Advisory Board: Sanofi Genzyme;Financial Interests, Personal, Officer: Sanofi Genzyme;Financial Interests, Personal, Principal Investigator: Sanofi Genzyme;Financial Interests, Personal, Invited Speaker: Roche Pharma;Financial Interests, Personal, Advisory Board: Roche Pharma;Financial Interests, Personal, Officer: Roche Pharma;Financial Interests, Personal, Principal Investigator: Roche Pharma. J. Cañueto: Financial Interests, Personal, Invited Speaker: Hoffman-La Roche;Financial Interests, Personal, Invited Speaker: Sanofi-Genzyme;Financial Interests, Personal, Invited Speaker: AbbVie;Financial Interests, Personal, Invited Speaker: LeoPharma;Financial Interests, Personal, Other, Consultancy: Sanofi-Genzyme;Financial Interests, Personal, Other, Consultancy: InflaRx;Financial Interests, Personal, Other, Consultancy: Almirall. S. Beá Ardébol: Financial Interests, Personal, Invited Speaker: Meda;Financial Interests, Personal, Advisory Board: Sanofi;Financial Interests, Personal, Advisory Board: SunPharma;Financial Interests, Personal, Other, Trial subinvestigator: Sanofi Aventis;Financial Interests, Personal, Other, Trial subinvestigator: SunPharma;Financial Interests, Personal, Other, Trial subinvestigator: PellePharma. R. Fernández-de-Misa Cabrera: Financial Interests, Personal, Advisory Board: Sanofi. A.J. Cunquero-Tomás: Financial Interests, Personal, Invited Speaker: BMS;Financial Interests, Personal, Invited Speaker: Pierre-Fabre;Financial Interests, Personal, Writing Engagements: Sanofi;Financial Interests, Personal, Other, 2021 EADO/WMC Congress inscription fee: Sanofi. L. Fernández Franco: Non-Financial Interests, Personal, Invited Speaker: Merck;Non-Financial Interests, Personal, Invited Speaker: Sanofi;Non-Financial Interests, Personal, Invited Speaker: Servier. I. Romero: Financial Interests, Personal, Invited Speaker: Pharmamar;Financial Interests, Personal, Invited Speaker: Roche;Financial Interests, Personal, Invited Speaker: GSK;Financial Interests, Personal, Invited Speaker: Clovis;Financial Interests, Personal, Invited Speaker: AstraZeneca;Financial Interests, Personal, Advisory Board: Pharmamar;Financial Interests, Personal, Advisory Board: Roche;Financial Interests, Personal, Advisory Board: GSK;Financial Interests, Personal, Advisory Board: Clovis;Financial Interests, Personal, Advisory Board: AstraZeneca. J. Medina Martínez: Non-Financial Interests, Personal, Invited Speaker: Roche;Non-Financial Interests, Personal, Speaker’s Bureau: Roche;Non-Financial Interests, Personal, Advisory Board: Roche;Non-Financial Interests, Personal, Invited Speaker: Novartis;Non-Financial Interests, Personal, Speaker’s Bureau: Novartis;Non-Financial Interests, Personal, Advisory Board: Novartis;Non-Financial Interests, Personal, Invited Speaker: BMS;Non-Financial Interests, Personal, Speaker’s Bureau: BMS;Non-Financial Interests, Personal, Ad isory Board: BMS;Non-Financial Interests, Personal, Invited Speaker: MSD;Non-Financial Interests, Personal, Speaker’s Bureau: MSD;Non-Financial Interests, Personal, Invited Speaker: Pierre Fabre;Non-Financial Interests, Personal, Speaker’s Bureau: Pierre Fabre;Non-Financial Interests, Personal, Advisory Board: Pierre Fabre;Non-Financial Interests, Personal, Invited Speaker: Merk;Non-Financial Interests, Personal, Speaker’s Bureau: Merk;Non-Financial Interests, Personal, Invited Speaker: Sanofi;Non-Financial Interests, Personal, Speaker’s Bureau: Sanofi;Non-Financial Interests, Personal, Advisory Board: Sanofi;Non-Financial Interests, Personal, Invited Speaker: Servier. All other authors have declared no conflicts of interest.

Lung uptake detected by68ga-psma-11 pet/ct in prostate cancer patients with sars-cov-2: A case series

Coronavirus disease 2019 (COVID-19) pathology is associated with neoangiogenesis and interstitial pneumonia.68Ga-PSMA-11-PET/CT is able to image in vivo PSMA (Prostate-Specific Membrane Antigen) expression on both prostate cancer (PCa) cells and neovasculature endothelial cells. The aim of the case series was to explore pulmonary PSMA expression not related to cancer in patients with PCa and concomitant COVID-19. In this retrospective, multicenter case series, patients who underwent68Ga-PSMA-11-PET/CT for PCa and concomitant proven COVID-19 infection were analyzed. Patients were stratified according to68Ga-PSMA-11 intensity of uptake in the lung (SUVmax). Low uptake: < blood pool;mild-to-moderate uptake: > blood pool and < liver;intense uptake: > liver. Potential correlation between pulmonary68Ga-PSMA-11 uptake not related to PCa and CT patterns typical for COVID-19 was assessed. Nine patients were included, all of them presenting abnormal68Ga-PSMA-11 uptake, at different grades: 2/9 low, 6/9 mild-to-moderate, 1/9 high. Uptake distribution was generally bilateral, peripheral and posterior, positively matching with ground-glass CT alterations in 7/9 (78%) patients, while mismatch was observed in 2/9 (22%). 1/9 patients presented PCa lung metastases at68Ga-PSMA-11.68Ga-PSMA-11-PET/CT detected increased PSMA uptake within the lung, not related to PCa, matching with CT typical COVID-19 patterns in almost all patients. Further studies are needed to evaluate the role of68Ga-PSMA-11 PET in COVID-19 patients and the potential role of PSMA overexpression as a biomarker for neoangiogenesis, in both oncological and infective disorders.

Education, peasantry and pandemic of COVID-19: reflections from an extension project of a Brazilian public university

This paper analyzed the repercussions of the COVID-19 pandemic for education in rural communities in which students with a Degree in Rural Education from the Federal University of Minas Gerais (UFMG, Brazil) work and/or reside. The study refers to a broader research, linked to the extension project "Peoples of the Field and the COVID-19 pandemic", created in April 2020. The methodological course of the investigation consisted in the application of online questionnaires in two moments of the pandemic in Brazil (April/May and July 2020). These instruments were answered by 36 (thirty-six) students in the first stage and by 46 (forty-six) students in the second stage. The data were analyzed from the two moments of the research, described and compared to the literature in the rural education area. Thus, at first, a greater movement was observed to keep schools closed and, in the second moment, attempts were observed to establish an emergency remote education with distribution of materials and classes/online contacts. We evidence that the pandemic exposed and accentuated inequalities in school supply in the Brazilian public network, highlighting the historical precariousness of public policies aimed at the education of peasant populations.

Low cost volume sensors for mechanical ventilators

This paper presents and compares three volume sensors to be used in mechanical ventilators developed in laboratory: volume sensor based on the Pitot tube, volume sensor based on the Venturi tube and infrared(IR) volume sensor. The three sensors were calibrated and tested with a mechanical ventilator in Pressure-controlled Ventilation (PCV) mode. The maximum pressure changed, keeping textitPositive End-Expiratory Pressure (PEEP) and respiratory rate fixed. For each maximum pressure value: the value measured by the sensor was compared with the reference value, the value informed by the mechanical ventilator. The infrared sensor showed better performance for the specific application in a mechanical ventilator, being the only sensor considered adequate between the tested ones.

HEALTH, PANDEMIC AND RURAL PEOPLE: analyzes from an extension project

This paper was interested in knowing the repercussions of the COVID-19 pandemic on the health (social practice and public policies) of subjects and communities in the field in which students of rural education degree courses of the Faculty of Education Federal University of Minas Gerais (LECampo / FaE / UFMG) work and / or reside. This research is linked to the extension project "Peasantry and the COVID-19 pandemic", created in April 2020. The research methods consisted of the application of surveys with closed and open questions, answered by 36 students in the first stage (end of April / beginning of May 2020) and by 46 students in the second stage (mid-July 2020). The data were analyzed through content analysis and categories were constructed in dialogue with some SUS principles: a) health practices in the face of the pandemic;b) access and disclosure of information;c) public health actions, which included access to health services, systemic care and the establishment of priorities, and d) the country-city relationship. With the internalization of Covid-19, the fragility in the health system with centralization in urban centers became evident, evidencing the precarious historical assistance in small towns and in the countryside. Among other results, the reduction of access to public policies, especially health, by the rural population of the country persists. The fight for 'Educacao do Campo' is emphasized as a strategy in defense of the valorization of rural workers, family agriculture, ways of life and rural development.

Extracorporeal Membrane Oxygenation Dependent COVID19 Hospital Transfers

The World Health Organization has recorded over 8 Million cases of COVID19 as of October 2020. Despite receiving appropriate lung protective ventilation and medical treatment, some of these patients develop refractory hypoxemia and acute respiratory distress syndrome. Extracorporeal membrane oxygenation has been recognized as a lifesaving therapy for patients with ARDS secondary to COVID19. There are few centers in the United States equipped with the necessary staff and the experience to take care of such critically ill patients. Some patients are too ill to be transferred with conventional mechanical ventilation, and they require interhospital transport while on ECMO. We have developed a highly specialized ECMO Deployment Team dedicated to the cannulation and transport of COVID19 patients while on venous-venous (VV) ECMO or venous-arterial (VA) ECMO. We use routine bedside ECMO cannulation via bilateral femoral vessels configuration at the outside hospital. The patient is stabilized and transported by air or ground to one of our affiliated hospitals.Here we present a series of five patients who were cannulated by our team at an outside institution and transported while on ECMO support to one of our three system hospitals. Patient ages ranged between 49-64 years old. Four patients required VV ECMO for severe hypoxemia secondary to COVID19 ARDS. One patient required VA ECMO due to viral myocarditis secondary to COVID19. Time on ECMO ranged from 9-33 days. Three of the five patients recovered successfully and were discharged home, rehab or LTAC. One patient is still currently on ECMO and one patient is deceased. There were no reported or documented transmission of COVID19 to the members of the ECMO deployment team. The potential for survival of the critically ill due to COVID19 often demands a higher level of care. However, stable transport to an appropriate institution presents a limiting factor. Our method of a dedicated ECMO Deployment Team appears to provide favorable outcome for these patients. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Impact of COVID-19 pandemic on care of oncological patients: experience of a cancer center in a Latin American pandemic epicenter

Objective: Since the rising of coronavirus disease 2019 (COVID-19) pandemic, there is uncertainty regarding the impact of transmission to cancer patients. Evidence on increased severity for patients undergoing antineoplastic treatment is posed against deferring oncologic treatment. We aimed to evaluate the impact of COVID-19 pandemic on patient volumes in a cancer center in an epicenter of the pandemic. Methods: Outpatient and inpatient volumes were extracted from electronic health record database. Two intervals were compared: pre-COVID-19 (March to May 2019) and COVID-19 pandemic (March to May 2020) periods. Results: The total number of medical appointments declined by 45% in the COVID-19 period, including a 56.2% decrease in new visits. There was a 27.5% reduction in the number of patients undergoing intravenous systemic treatment and a 57.4% decline in initiation of new treatments. Conversely, there was an increase by 309% in new patients undergoing oral chemotherapy regimens and a 5.9% rise in new patients submitted to radiation therapy in the COVID-19 period. There was a 51.2% decline in length of stay and a 60% reduction in the volume of surgical cases during COVID-19. In the stem cell transplant unit, we observed a reduction by 36.5% in length of stay and a 62.5% drop in stem cell transplants. Conclusion: A significant decrease in the number of patients undergoing cancer treatment was observed after COVID-19 pandemic. Although this may be partially overcome by alternative therapeutic options, avoiding timely health care due to fear of getting COVID-19 infection might impact on clinical outcomes. Our findings may help support immediate actions to mitigate this hypothesis.

Religious practices, COVID-19 and peasantry: a two-part analysis of the pandemic from an extension project

This paper analyzed the repercussions of the COVID-19 pandemic on religious practices of peasant subjects and rural communities in which students of the Degree in Rural Education of the Faculty of Education of the Universidade Federal de Minas Gerais (LECampo/FaE UFMG) work and residency. This is an extract from an investigation that is linked to the extension project "The people of the countryside and the COVID-19 pandemic", created in April 2020. The methodological paths of the investigation consisted of the application of questionnaires with closed questions and open, answered by 36 students in the first stage (April/May 2020) and by 46 students in the second stage (July 2020). The data were analyzed by means of categorical content analysis. The results point to repercussions that relate to the following categories: a) socialization/sociability;b) interruption of activities in religious spaces;c) modes of remote participation in religious activities;d) hogar as a privileged place for remote religious practices;e) return from presential activities in collective religious spaces;f) relationship between pandemic, faith, punishment and divine protection.

Extracorporeal cardiopulmonary resuscitation for hypoxemic cardiac arrest secondary to COVID-19

Introduction: Due to the anticipated poor outcome, risk of health care worker exposure, and potential limited resource capacity during a pandemic, extracorporeal cardiopulmonary resuscitation (ECPR) in the COVID-19 population has been discouraged. Exception to this recommendation is when an arrest occurs in a patient already being evaluated or treated with extracorporeal membrane oxygenation (ECMO). To date, experience in this subset of patients has been limited. Methods: A retrospective review was performed for all patients supported with ECMO during the COVID-19 pandemic from March 2020 to August 2020 at a single institution including patient demographics, cannulation strategies, outcomes, and complications. Results: During the study period, 32 patients were supported with ECMO. Twenty-nine patients were supported with venovenous (VV) ECMO alone;3 patients suffered cardiac arrest secondary to an acute episode of hypoxemia requiring ECPR: 1 upon presentation and 2 while already supported on VV ECMO. All 3 patients were subsequently transitioned from venoarterial (VA) to veno-arterio-venous (VAV) ECMO to VV ECMO;1 has been weaned off ECMO and discharged alive, 1 has been weaned off ECMO and remains in the ICU on mechanical ventilation, and 1 remains on VV ECMO. None of the patients suffered any complications related to the cannulation procedure. None of the patients suffered any neurological complications and have a Cerebral Performance Category scale (CPC) of 1. Conclusions: ECPR is safe and feasible in COVID-19 patients being evaluated or treated with ECMO. Centers with significant ECPR experience should consider this option in COVID-19 patients.

Alcohol-free hand sanitizer and other quaternary ammonium disinfectants quickly and effectively inactivate SARS-CoV-2.

BACKGROUND: SARS-CoV-2 is the virus responsible for the current global pandemic, COVID-19. Because this virus is novel, little is known about its sensitivity to disinfection. METHODS: We performed suspension tests against SARS-CoV-2 using three commercially available quaternary ammonium compound (Quat) disinfectants and one laboratory-made 0.2% benzalkonium chloride solution. FINDINGS: Three of the four formulations completely inactivated the virus within 15 s of contact, even in the presence of a soil load or when diluted in hard water. CONCLUSION: Quats rapidly inactivate SARS-CoV-2, making them potentially useful for controlling SARS-CoV-2 spread in hospitals and the community.

Noninvasive Self-monitoring of Blood Glucose at Your Fingertips, Literally+ACE-: Smartphone-Based Photoplethysmography

Diabetes is a chronic disease and one of the major public health problems worldwide. It is a multifactorial disease, caused by genetic factors and lifestyle habits. Brazil had ∼ 16.8 million individuals living with diabetes in 2019 and is expected to reach 26 million people by 2045. There are global increasing needs for the development of noninvasive diagnostic methods and use of mobile health, mainly in face of the pandemic caused by the coronavirus disease 2019 (COVID-19). For daily glycemic control, diabetic patients use a portable glucometer for glycemic self-monitoring and need to prick their fingertips three or more times a day, generating a huge discomfort throughout their lives. Our goal here is to present a review with very recent emerging studies in the field of noninvasive diagnosis and to emphasize that smartphone-based photoplethysmography (spPPG), powered by artificial intelligence, might be a trend to self-monitor blood glucose levels. In photoplethysmography, a light source travels through the tissue, interacts with the interstitium and with cells and molecules present in the blood. Reflection of light occurs as it passes through the biological tissues and a photodetector can capture these interactions. When using a smartphone, the built-in flashlight is a white light-emitting LED and the camera works as a photodetector. The higher the concentration of circulating glucose, the greater the absorbance and, consequently, the lesser the reflected light intensity will be. Due to these optical phenomena, the signal intensity captured will be inversely proportional to the blood glucose level. Furthermore, we highlight the microvascular changes in the progression of diabetes that can interfere in the signals captured by the photodetector using spPPG, due to the decrease of peripheral blood perfusion, which can be confused with high blood glucose levels. It is necessary to create strategies to filter or reduce the impact of these vascular changes in the blood glucose level analysis. Deep learning strategies can help the machine to solve these challenges, allowing an accurate blood glucose level and interstitial glucose prediction.