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PurposeThis study aims to identify comfort food (CF) consumption and its associated factors during the pandemic period. The study also involves an online survey conducted five months after the quarantine started in Brazil. Design/methodology/approachData on lifestyle, eating habits and anthropometric data were collected before and during the pandemic, and the differences in these habits were analyzed. Univariate and multivariate logistic regression models were performed to identify predictors of CF consumption by gender. FindingsA total of 1,363 individuals were included in the sample, with a median age of 31 years old, of whom 80.3% were women. Since individuals were free to respond about the food consumed without predetermined categories, it was possible to carry out a faithful assessment of the occurrence of this behavior. At the same time, allowing the subjectivity and symbolism inherent to the concept of CF to be embraced. CF consumption was present for 54%, with "sweets" being the most mentioned group by both genders. The factors associated with CF consumption in women during the pandemic were increased snacking, increased bread, candies and alcoholic beverage intake, increased time spent at work, worsened sleep quality, reduced meals, perceived stress (PS), emotional eating (EE), age and increased frequency of meat intake. In men, the predictors for CF consumption were remote full-time work/study, PS, EE and early waking time. For both genders, CF consumption during the pandemic period was associated with PS and EE. Originality/valueThis study provides an important overview of the possible contributions of the pandemic on behaviors and food choices related to the consumption of CF in Brazilians. This information is valuable to support further studies to investigate and treat the impacts of the pandemic on lifestyle, eating habits and behavior, mental health and other factors in the postpandemic period.
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Background and objective: new population-level studies are needed to better assess the relationship between physical inactivity and mortality from COVID-19. The aim of the study was to evaluate the correlation between population prevalence of physical activity and standardized mortality rates by COVID-19 in Brazilian capital cities and the Federal District. Methods: this is an ecological study, whose analysis is secondary. The prevalence of physical inactivity, insufficient physical activity, and physical activity during free time was obtained from the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey 2019 (VIGITEL), according to minutes spent on leisure, commuting, and household activities. The COVID-19 mortality data was obtained from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe), adding the accumulated deaths until December 31, 2020. The resident population was estimated from the Instituto Brasileiro de Geografia e Estatistica (IBGE) for the year 2020. Pearson Correlation evaluated the correlation between the prevalence of different physical activity practices and the standardized mortality rate from COVID-19, in total, and according to age groups. Results: there was a significant positive correlation (r = 0.420;p = 0.029) between the overall prevalence of insufficient physical activity and the standardized COVID-19 mortality rate. No correlation was observed between the other prevalence of physical activity and the standardized mortality rate from COVID-19. Conclusion: there was a correlation between insufficient levels of physical activity and the standardized mortality rate from COVID-19 in people living in Brazilian capital cities.
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The COVID-19 pandemic boosted the production and circulation of false information, especially online, leading the World Health Organization to classify this phenomenon as an infodemic, i.e., a misinformation epidemic. In addition to this, the growing aging of the population is a reality not only in Portugal, but throughout the world. The Internet, and in particular social networks, can be an important contribution to the well-being of the elderly, reducing their social isolation. However, it makes them even more susceptible to the consumption of false information. Considering the increasing contact with fake news, it is important to evaluate the determinants of the ability of the elderly to identify fake news. In this article we present a research proposal with a quantitative methodology, based on a hypothetical-deductive process, supported by a self-administered online questionnaire survey for data collection, to meet this objective. © 2022 Associacao Portuguesa de Sistemas de Informacao. All rights reserved.
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This article analyzes the impact of the COVID-19 pandemic on public transport by bus in two Brazilian metropolia, Belo Horizonte and Joao Pessoa. Spearman's correlation pointed out a strong relationship between the variation in the number of passengers transported and the restrictive measures to combat the COVID-19 pandemic showing that they probably dictated the use of public transport by the population. However, the correlation between the number of new confirmed cases of COVID-19 and the variation of transported users was weak in Belo Horizonte and insignificant in Joao Pessoa. Given the influence of the stringency measures, the significant differences in correlation values with the variation of passengers were identified and proven, being 60% in Belo Horizonte and 76% in Joao Pessoa. The causality test confirmed that the pandemic intensified the drop in demand for public transport. Therefore, the more severe the policy to combat the transmission of the virus, the greater the relationship with the decrease in demand for buses. Thus, the pandemic was responsible for a significant drop in the number of passengers than the estimated trend for the same period. Finally, results show a crisis in the public transport system by bus in Brazil and the urgent need to rethink strategies to attract users to this service.
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The renin–angiotensin system is major endocrine, paracrine, and autocrine system that has a notorious role in regulating hemodynamics and electrolyte balance, thus controlling blood pressure. Nonetheless, the functions of RAS are multiple and continue to expand, as its receptors, enzymes, and peptides have been identified in different organs/tissues, implying novel local effects of RAS and participation in the pathogenesis of different diseases in multiple organs, including the eyes. Vascularized, fibrous, and nervous structures of the eyes and their fluids express several RAS components including angiotensinogen, prorenin, renin, (P)RR, ACE, Ang II, AT1R, AT2R, ACE2, Ang 1-7, and Mas. Additionally, abundant RAS hormones are present in intraocular tissues implicating local production. Ocular RAS functions seem to be diverse;first, RAS is proposed to modulate aqueous humor biosynthesis and drainage, consequently regulating IOP. Exacerbation of ACE/ Ang II/ AT1R actions is observed in glaucoma, and blockage of this axis with ACEIs and ARBs is a feature that can be explored to reduce IOP and treat glaucoma. Second, impairment of RAS with exacerbation of ACE/ Ang II/ AT1R and depletion of ACE2/ Ang 1-7/ Mas culminate in an angiogenic, inflammatory, proliferative, and oxidative phenotype, which is tightly related to retinal vascular disorders such as diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity. Indeed, treatments blocking ACE/ Ang II/ AT1R or enhancing ACE2/ Ang 1-7/ Mas are reported to be beneficial to prevent or restrain the progression of these diseases. Finally, clinical manifestations of COVID-19 include ocular disorders such as conjunctivitis, dry eyes, eye pain, discharge, and blurred vision. ACE2 expression in ocular tissues may define ophthalmic susceptibility to SARS-CoV-2 infection. Moreover, SARS-CoV-2 entry mechanisms may cause depletion of ACE2 biological effects, which can contribute to RAS dysregulation and the ocular disorders observed in COVID-19. This chapter focuses on reviewing the components and functions of the ocular RAS, its implications for eye homeostasis, and the potential of RAS as a therapeutic target to treat ocular disorders, including glaucoma, diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity. © 2023 Elsevier Inc. All rights reserved.
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Purpose: The purpose of this study is to describe the prevalence of a sedentary lifestyle (<150 min of physical exercise/week) and associated factors of this behavior in Brazil. Design/methodology/approach: An observational study was conducted through an online questionnaire in August–September 2020 (5.5 months after the beginning of the pandemic in the country). Socioeconomic, lifestyle, anthropometric, dietary and perceived stress data were evaluated as possible related factors to a sedentary lifestyle through multiple logistic regression analysis. Findings: A total of 1,347 individuals were evaluated (median of 31 years old, 80.1% women), of whom 76.7% were considered sedentary. Associated factors to a sedentary lifestyle were being overweight;a greater difference between current weight and prepandemic weight;female sex;lower percentage of home-cooked meals;greater increase in the frequency of consumption of alcoholic beverages;higher frequency of consumption of cereals, sausages and sweets during the pandemic;and higher score of perceived stress. Originality/value: To the best of the authors' knowledge, no studies have aimed to reveal the associated factors to a sedentary lifestyle during the COVID-19 pandemic in Brazil. Protective factors against a sedentary lifestyle were eating breakfast, being a student, living with parents, a higher frequency of fruit consumption, a higher rate of alcohol consumption and a higher cognitive restriction of food intake during the pandemic. Most of the study participants were sedentary, especially women. A sedentary lifestyle was associated with worse lifestyle/eating habits and stress. Such findings encourage an interdisciplinary approach because habits and lifestyle have numerous interferences. © 2023, Emerald Publishing Limited.
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Background: Breathox is a sodium chloride inhaler. Increase of the airway salinity has been proposed to reduce the symptomatic stage of a respiratory viral infection. Objective(s): to evaluate the effectiveness of nasal and inhaled sodium chloride therapy through Breathox on mild COVID-19 symptoms in patients >= 18 years-old compared to usual care. Method(s): a pilot, open, randomized clinical trial, including 100 patients with confirmed and symptomatic COVID-19 within 10 days of symptom onset. All patients received standard of care (SOC), i.e. antipyretic or analgesic. Breathox was administered as two oral inhalations and one nasal instillation in each nostril at each administration with 2mg per inhalation. Patients were randomized 1:1:1 into three groups: Group 1(G1): SOC + Breathox 10 times daily for 10 days;Group 2(G2): SOC + Breathox five times daily for 10 days;Group 3(G3): SOC. Recovery time for symptoms, such as cough was assessed. Result(s): In total 100 of 103 screened patients were included from December 1 2021 to March 03 2022. Of those, 33 from G1 and G3, and 32 from G2 completed the study. Mean age was 40.4/42.2/40.6 years old for G1, G2 and G3, (p=0.96). No patients were hospitalized or died during the study. Time to cough resolution was reduced in G1 (2.8+/-0.66 days) and G2 (2.4+/-0.66 days) compared to G3 (5.39+/-0.79 days) (p=0.001), with a hazard ratio (HR) for G2 of 2.17 (Confidence interval 1.17-4.04) and G3 of 2.01 (1.06-3.81) compared to SOC. Conclusion(s): ten days of Breathox use halved the time for resolution of COVID-19-induced cough.
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The coronavirus pandemic brought an unprecedented disruption to society, with this, the impacts fostered by the crisis also extended to educational institutions. The aim of this study was to investigate whether higher education activities can be considered a stressor in a pandemic context. The sample consisted of 136 students with remote academic activities and 131 with suspended academic activities, who answered a sociodemographic questionnaire and an open question about the factors that have raised the level of stress in the months of April, May, June and July 2020. The textual corpus was processed with the aid of the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software. As a result, there were several stressors related or not related to academic activities for both groups, although the performance of digital academic activities has been pointed out with great frequency. Thus, digital academic activities are related to the level of stress among students © 2023 Associação Nacional de Pós-Graduação e Pesquisa em Educação – ANPEd. This is an open access article distributed under the terms of the Creative Commons license
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COVID-19 let sequelae beyond the respiratory system, including in skeletal muscle and in immune response. We evaluated the effects of 12 weeks of pulmonary rehabilitation (PR), 3x/week, constituted by aerobic and resistance training on 28 moderate and severe post-COVID-19 patients. The results demonstrated that PR improved lung function, FVC (p<0.02), FEV1 (p<0.02), FEV1/FVC (p<0.01), MEF25% (p<0.006), MEF50% (p<0.03), and MEF75% (p<0.02). PR improved lung mechanics, respiratory impedance (Z5hz, p<0.03);respiratory reactance (X5Hz, p<0.01), resistance of the whole respiratory systems (R5Hz, p<0.03), central airway resistance (RCentral, p<0.03), and peripheral airway resistance (RPeripheral, p<0.02). PR improved peripheral muscle strength, increasing right (p<0.02) and left (p<0.01) hand grip strength and respiratory muscle strength, increasing maximum inspiratory (p<0.02) and expiratory (p<0.03) pressure. Of note, PR reduced pulmonary inflammation (breath condensate), reducing the levels of pro-inflammatory cytokine IL-1beta (p<0.0001) and IL-6 (p<0.0001), while increased the levels of anti-inflammatory cytokine IL-1RA (p<0.0004) and IL-10 (p<0.003), beyond to increase the levels of IFN-gamma (p<0.0002) and IFN-beta (p<0.008). PR reduced the serum levels of pro-inflammatory IL-1beta (p<0.006) and IL-6 (p<0.01), while increased the levels of anti-inflammatory cytokine IL-1RA (p<0.0001) and IL-10 (p<0.0001), increasing the levels of IFN-gamma (p<0.02) and IFN-beta (p<0.001). PR reveals to be beneficial for post-COVID-19 patients, mitigating the sequelae observed in the respiratory system, skeletal muscle and in the immune response.
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This research aimed to verify whether vaccination against Covid-19 should be considered a binding public policy in Brazil. According to Alexy's Fundamental Rights Theory (2015), the essential core of a fundamental right binds the State in absolute terms, since it is conveyed by a norm. To this end, the data from 53 countries, which on November 8, 2021, had exceeded 120 doses administered for every 100 people, were compared. From these data, based on a medical literature review and on observational studies, we conclude that vaccination is the most important measure for reducing the number of deaths from Covid-19 and the worsening of the disease, which can cause sequelae. Thus, vaccination against Covid-19 is an important measure to preserve life and a minimum level of human dignity, therefore it is an essential core of the right to health. © Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial 4.0 International License. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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The recent COVID-19 outbreak drove the attention to methods for monitoring the flow of people between human settlements, including traffic flow. Although the remote sensing of nighttime lights is a viable option to estimate traffic flow-derived indicators, changes in radiance levels at night are not all associated with traffic. This paper presents the theoretical approach proposed on the development of an algorithm able to identify spectrally unbiased control samples for regions of interest (ROI), namely roadway sections. Firstly, an experiment is presented to put in evidence the background dependency of the DNB monthly composites (vcm) radiance levels. Then, an overview of the algorithm is presented, followed by an empirical estimation of its time complexity. The results showed that the algorithm has an O(n) time complexity and that control samples and ROIs can have similar time series features, indicating that analysis without the use of control samples can lead to biased results. © 2021 Society for Industrial and Applied Mathematics.
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Background and Aims: The qualification course aims to encourage different health care professionals (HCP) to develop attitudes and educational actions in dealing with people who have diabetes, their families, and caregivers. Since 2008, more than 2000 HCP have been qualified. The activities during the course are workshops and case discussions through debates and awareness. Due to the COVID-19 pandemic, three editions of the qualification were made virtually. Method(s): This case report explores how changed the qualification course Educating Educators, through the explanation of how to apply diabetes education in health services, and teaching processes to the development and implementation of an educational project in diabetes. Result(s): As of the COVID-19 pandemic, the course, which was 50% practical and 50% expository and fully face-to-face, couldn't longer be held in this format. With this continuous demand to qualify HCP in diabetes education, the course during the pandemic had participants of the 39th, 40th, and 41st editions held in a fully online format. The digital model changed the four days of the course in face-to-face modality to two days in two weeks in a virtual way, with a break between the meetings for mentoring and discussion in small groups, some orientations to turn possible the conclusion of elaboration their projects. Conclusion(s): This new model of education appeared can be used to achieving people that don't can participate in face-to-face meetings. Also, the virtual model can provide a constant conversation between tutors and participants to improve their projects.
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Objective: This investigation aimed to evaluate SpO2, and the rate of perceived exertion (RPE) derived from a strength training session in two distinct scenarios: normal condition versus the usage of surgical masks for COVID-19 prevention. Methods: Fifteen trained men (81.66 ± 8.37 kg;177.66 ± 6.31 cm;26.88 ± 5.55 years of age;12.17 ± 5.98 % fat;1.15 ± 0.19 kg/kg bench press relative strength/body weight) were selected, and they performed two test sessions to determine 10-RM loads for all exercises adjusted for 80%. The SpO2 measurement was verified immediately after each set for every exercise, and, concomitantly, the participants were asked to identify their RPE to provide a subjective measure of fatigue. In the first session, subjects performed the training routine using the SARS-CoV-2 protection surgical mask with a passive rest interval of 2 minutes, but the second was performed without wearing a surgical mask. Results: The SpO2 showed a difference (p = 0.03) under the condition curve with the mask (481.33 ± 3.04) versus without the mask (484.46 ± 5.96), with increments in SpO2 for the condition without the mask at different verification times (p = 0.039). Regarding the initial sets and exercises, there were no significant differences between the RPE values between the different conditions, that is, regardless of the mask use (p = 0.052). However, for the final exercises, significant differences were observed in the second set (PD, p = 0.01;LC, p = 0.02) and in the three sets of the TE exercise (p = 0.006). Conclusion: Overall, we found that the use of surgical masks reduces SpO2 and increases RPE in a strength training session. © 2022, Drustvo Pedagoga Tjelesne i Zdravstvene Kulture. All rights reserved.
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This study aimed to analyze the economic and financial performance of the four largest companies in the Meat Agribusiness Sector listed on B3 S.A., before and after the onset of the Coronavirus Pandemic (period from 2018 to 2020). The analysis was carried out by means of financial indicators of capital structure and profitability, focusing in particular on the DuPont Identity, calculated based on values of accounting accounts in the companies' financial statements. The collection was performed through the structured financial statements presented on the B3 S.A. website and with the use of the Economatica database. The research is characterized as descriptive, documentary, and quantitative. Comparing the percentages corresponding to the indicators for each year and the economic scenario of the period, the research used Pearson's Correlation to analyze the relationship between the variations of the indicators with respect to the variation of the Gross Domestic Product (GDP) of the Livestock Branch, in the period studied. Among the main findings, a significant improvement of the Return on Assets and Return on Equity, in medium and strong positive correlations with the sector's GDP growth, is evident. Furthermore, an extremely strong positive correlation was found between the companies' Revenue from Goods and Services and the Livestock Industry GDP. It is concluded that, overall, in addition to the sector's GDP growth, despite the economic crisis resulting from the pandemic, companies raised their revenues and improved profitability and profitability.
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Healthcare organizational resilience is a key issue to face sudden or chronic crises, through planning and adaptive capacity. This exploratory study aimed to describe the or-ganizational resilience perceived by 311 healthcare workers in Barcelona before the COVID-19 pandemic. Participants perceived their respective hospitals as organizations with medium resilience, with greater capacity for crisis planning than for adaptive capacity after crises. The main resilience strengths were the belief that emergency plans should be practiced, and the importance of staff teamwork in response to crises. Lack of awareness about recovery priorities and lack of innovation in problem-solving were identified as main weaknesses. Significant differences were found by sociodemographic groups, which could be relevant for the design of intervention plans. The findings are even more meaningful after the COVID-19 pandemic occurred, rep-resenting a unique baseline for future studies.
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Objetivos: O projeto de extensao universitaria "Compartilhe Vida" tem o objetivo de incentivar a doacao de sangue e o cadastro no Registro Nacional de Doadores de Medula Ossea (REDOME). Foi criado em parceria com o Comite Transfusional do Hospital das Clinicas da Universidade Federal de Uberlandia (HC-UFU) e o Hemocentro de Uberlandia e visa envolver a comunidade interna e externa no estimulo a doacao de sangue, auxiliando na manutencao do estoque de hemocomponentes. A dificuldade na convocacao e fidelizacao de doadores de sangue e um grande desafio para as diversas unidades da Fundacao Hemominas, tendo em vista a alta demanda e a frequente baixa nos estoques. O HC-UFU e um um hospital de alta complexidade com uma media de 1500 transfusoes/mes, com o compromisso de auxiliar na captacao de doadores. Metodos: O projeto foi executado por discentes de cursos de graduacao da UFU e membros do Comite Transfusional, visando alcancar a interdisciplinaridade da proposta. Inicialmente, os discentes foram treinados no Hemocentro de Uberlandia e Agencia Transfusional do HC-UFU para entendimento do ciclo do sangue e do processo de captacao. Foi criada em Junho de 2020, pagina de rede social para esclarecimento e incentivo a doacao de sangue e medula ossea com divulgacao de diversas postagens relacionadas ao tema, alem de campanhas em datas pontuais, como o dia mundial do doador de sangue e dia mundial do doador de medula. Tambem foram realizadas acoes em casos excepcionais de estoques criticos. Todas as postagens e a criacao de artes foram supervisionadas pelas equipes envolvidas do Comite Transfusional do HC-UFU e Hemocentro de Uberlandia para permitir a divulgacao de informacoes de acordo com as evidencias cientificas e a legislacao. Resultados: Foram feitas 419 postagens com informacoes interativas de incentivo para a doacao de sangue. As postagens auxiliaram tambem na divulgacao do processo de agendamento que se tornou online durante a pandemia e na criacao de campanhas de restabelecimento de estoques. O projeto realizou parcerias para divulgacao das postagens com outras entidades academicas da instituicao, como programas de educacao tutorial, ligas e diretorios academicos de cursos de graduacao, o que ampliou as informacoes da doacao de sangue. Discussao: Estudos populacionais recentes mostram a reducao do numero de doadores de primeira vez e as dificuldades enfrentadas em bancos de sangue durante a pandemia de COVID-19. Diante desse cenario, foi necessaria a criacao do projeto "Compartilhe Vida"para incentivar a doacao de sangue e o cadastro no REDOME. O projeto auxiliou na disseminacao de informacoes para a comunidade externa sobre o ciclo do sangue e sobre a importancia da manutencao de um estoque de hemocomponentes adequado e da fidelizacao de doadores. As postagens tiveram impacto positivo entre a comunidade universitaria com a parceria do projeto com entidades academicas. Com o desenvolvimento do projeto foi visto que as redes sociais apresentam grande alcance na divulgacao, podendo aumentar numero de doadores jovens e de primeira vez. Conclusao: O incentivo a doacao por meio de redes sociais e uma estrategia para para captacao de doadores e manutencao dos estoques de sangue, principalmente em um cenario de pandemia. O alcance das redes sociais pode ser utilizado para multiplicacao da necessidade de reposicao do estoque de hemocomponentes na comunidade externa e, dessa forma, prosseguir o cuidado adequado nas instituicoes de saude. Copyright © 2022
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Objetivos: A COVID-19 foi a doenca que causou o quadro de pandemia, ocasionando diversos casos e obitos ao longo do mundo. Uma estrategia para o tratamento de quadros graves da COVID-19 foi o uso de plasma convalescente, obtido de doadores convalescentes da doenca, com alta producao de anticorpos, de forma a permitir a neutralizacao do virus e melhora no quadro clinico. Embora muitos estudos destaquem o uso do plasma convalescente, poucos descrevem propostas para coletar plasma com concentracao de anticorpos anti-Spike aceitaveis para o uso em individuos acometidos com a forma grave da COVID-19. Dessa forma, o objetivo deste estudo foi avaliar os fatores sociodemograficos ligados a producao de anticorpos IgG anti-Spike em candidatos a doacao de plasma convalescente na cidade de Manaus-AM. Material e metodos: Foram incluidos no estudo 123 candidatos a doacao de plasma convalescente, do genero masculino, que tiveram o diagnostico da COVID-19 30 dias antes da doacao, sem historico de vacinacao previa. Foi realizada uma coleta de 4 mL do sangue periferico para obtencao do soro, utilizado para quantificacao de anticorpos IgG anti-Spike por quimioluminescencia, expressos em AU/mL, atraves do kit Architect SARS-CoV-2 IgG II Quant (Abbott). Os doadores foram segregados com base na concentracao de anticorpos em baixa producao (< 50 AU/mL), producao intermediaria (50-1,280 AU/mL) e alta producao (> 1,280 AU/mL), segundo informacoes do kit, e recomendacao internacional. Os dados sociodemograficos de idade, genero, cor de pele, indice de massa corporal (IMC), uso de ventilacao mecanica e dias internados foram utilizados para fins de comparacao entre os grupos. Foi realizado o teste de ANOVA, Qui-Quadrado e teste exato de Fisher para comparacao dos dados sociodemograficos, alem dos testes de correlacao de Spearman. Resultados: Nossos dados demonstraram uma maior prevalencia de doadores com alto indice de IMC na populacao de alto produtores de anticorpos (p = 0.0254). Alem disso, tambem observamos que a concentracao dos anticorpos IgG anti-Spike apresentou grau de correlacao positiva com a idade (r = 0.240;p = 0.008) e IMC (r = 0.247;p < 0.006). Discussao: Nossos resultados demonstram uma relacao entre a idade e o IMC na producao de anticorpos anti-Spike em doadores convalescentes com alta concentracao de anticorpos. Essa relacao pode estar atrelada a efeitos de imunomodulacao, bem como ao grau de lesao tecidual e sistemico apresentado pelos pacientes mais velhos e/ou com maior IMC. A relacao desses fatores com a producao de anticorpos ainda e uma area pouco explorada, o que salienta a necessidade de compreender os mecanismos imunologicos associados a producao de anticorpos, junto com a protecao dos pacientes convalescentes. Conclusao: Nosso estudo demonstrou que o IMC dos acometidos pela COVID-19 pode contribuir para a alta producao de anticorpos de classe IgG anti-Spike. No entanto, estudos adicionais sao necessarios para compreender os aspectos imunologicos associados a maior protecao da populacao, bem como producao de anticorpos com maior eficacia pelos individuos acometidos pela COVID-19. *AM e AGC contribuiram igualmente para este trabalho. Copyright © 2022
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A pandemia do Covid-19 ocasionou em todos os servicos de saude grandes desafios pelo mundo afora, inclusive nas doacoes de sangue, que tiveram uma significativa queda nesse periodo da pandemia. As restricoes da quarentena aos doadores de sangue dificultaram a manutencao dos niveis dos estoques e seus hemocomponentes, obrigando a criacao de novas estrategias de recrutamento de doadores, frente ao isolamento social e o medo de se locomover para os hemocentros, na tentativa de evitar a diminuicao do numero de doadores devido ao risco de inaptidao clinica. O objetivo deste estudo foi avaliar o numero de doacoes realizadas no periodo da Covid-19 na sede do Hemocentro RP, de acordo com a idade, sexo, sistema ABO-Rh e os motivos que aprovam ou reprovam estes candidatos a doacao de acordo com os criterios da triagem clinica comparando os dados antes e durante a pandemia. Foi realizado um estudo observacional e retrospectivo dos numeros referente as doacoes de sangue na Sede Hemocentro de Ribeirao Preto, por meio da coleta dos dados do sistema informatizado no periodo de janeiro de 2019 a dezembro de 2021. No periodo estudado, foram analisadas 42.926 doacoes de sangue. Dividindo por ano os resultados foram: 14.421 doacoes em 2019, 13.763 doacoes em 2020 e 14.742 doacoes em 2021. Considerando os dados, temos uma reducao de 4.7% em 2020, em relacao ao periodo de 2019 (Periodo da pandemia de Covid-19) e um aumento de 7.1% em 2021, em relacao ao periodo de 2020. Houve uma reducao dos doadores recusados nos criterios de triagem clinica durante os anos de estudo. Uso de medicamento (13,4%) foi o principal motivo para recusa dos candidatos a doacao de sangue, seguido do Relacionamento Sexual de Risco (11%) e do HB/HT baixo (6%). Os motivos que mais reduziram candidatos inaptos a doacao de sangue foram Estado Gripal (79%, 23%) e Hipertensao Arterial (53%, 93%) nos anos de estudo. Nestes tres ultimos anos, a FUNDHERP deixou de receber 10.517 candidatos. A faixa etaria menor de 30 anos e a que apresentou maior numero de candidatos recusados a doacao de sangue. Foram 4.507 candidatos, 55,6% destes candidatos sao do sexo feminino. Em relacao ao sistema ABO/Rh, media, temos: 522 individuos (43,9%) do grupo O+, 348 individuos (29,3%) do grupo A+, 108 individuos (9,1%) do grupo B+, 36 individuos (3%) do grupo AB+, 96 (8,1%) individuos do grupo O-, 55 individuos (4,6%) do grupo A-, 18 individuos (1,5%) do grupo B- e 5 individuos (0,5%) do grupo AB-. Verificou-se dentre as oito classes fenotipicas, que houve predominancia da classe O+ (43,9%), seguida da classe A+ (29,3%). A menor frequencia (0,5%) foi a classe AB-. A perspectiva de pandemia, com periodo de quarentena, implantou as medidas de segurancas, tais como: adaptacoes de fluxos de atendimento, aprimoramento dos criterios de triagem clinicas, acoes de captacao de doadores e conscientizacao da populacao atraves das midias digitais. Estas estrategias garantiram a seguranca de doadores e dos demais usuarios, colaborando para manter os niveis de estoque de sangue estaveis. E importante o incremento de estrategias inovadoras para a manutencao de estoque de sangue, como um atendimento personalizado. Copyright © 2022
ABSTRACT
Introducao: A hemofilia A (HA) e uma doenca hemorragica caracterizada pela ocorrencia de sangramentos, principalmente articulares e musculares. Embora esses pacientes sejam considerados relativamente protegidos de eventos tromboticos, existem relatos de trombose venosa, associada a fatores de risco como pos-operatorio ou com reposicao de fator. Relato de caso: Homem, 22 anos, em seguimento no Hemocentro de Ribeirao Preto com diagnostico de HA grave sem inibidor em profilaxia com fator VIII recombinante (FVIIIR). Compareceu para avaliacao em marco de 2022 com queixa de dor e edema difuso na perna direita iniciados ha 10 dias, sem historia de trauma associado. No inicio do quadro clinico, o paciente nao procurou atendimento medico e realizou reposicao de FVIIIR diariamente, com dose superior a habitual (elevacao de FVIII em 50%), conforme julgamento pessoal e sem definicao diagnostica. Como nao apresentou melhora clinica, no decimo primeiro dia de evolucao, procurou atendimento e, apos avaliacao clinica, foi aventada a hipotese de hematoma muscular no compartimento posterior da perna direita, sendo optado pela manutencao do esquema de reposicao diaria, repouso muscular e reavaliacao em 72 horas. Na reavaliacao, paciente mantinha quadro clinico, realizada Tomografia Computadorizada, que nao identificou sangramento muscular. Nesse contexto, foi optado por realizacao de Doppler Venoso de membro inferior direito, que evidenciou tromboflebite de veia safena parva medindo cerca de 10 cm, estendendo-se do terco proximal ate o terco medio da perna, sem acometer o sistema venoso profundo. O hemograma nao evidenciava plaquetopenia. Como potencial fator de risco adicional, o paciente referiu ter recebido a 3degreedose da vacina para COVID19 (AstraZeneca) cerca de 3 semanas antes do inicio dos sintomas. Por se tratar de tromboflebite extensa, com repercussoes clinicas, caracterizadas por comprometimento funcional do membro, o paciente teria indicacao de anticoagulacao terapeutica. Porem, considerando contexto clinico e doenca de base, optamos por manter observacao clinica, repouso, medidas locais, reducao da reposicao de FVIIIR e repeticao do Doppler precocemente. O exame de controle com intervalo de 4 semanas mostrou recanalizacao completa da veia safena parva, bem como houve remissao completa dos sintomas e recuperacao funcional do membro acometido. Discussao: Apesar de ser uma complicacao rara, deve ser considerada, especialmente em casos que apresentem refratariedade clinica, como a situacao apresentada. Particularmente nesse caso, ha de se considerar o fato do paciente ter recebido a vacina para COVID19 anteriormente ao quadro, cuja associacao com quadros de trombose e plaquetopenia vem sendo descrito na populacao em geral, porem os dados sao escassos em paciente com coagulopatias. Ademais, estes pacientes pela "anticoagulacao natural", inerente a patologia de base, podem nao apresentar quadros tao floridos e graves quanto os descritos na literatura. Nao ha como se definir com precisao a contribuicao da reposicao de fator iniciada pelo paciente em regime domiciliar (doses maiores e de forma mais intensa) no desenvolvimento do quadro atual. Conclusao: Eventos tromboticos nessa populacao, apesar de raros, podem ocorrer, e, a decisao quanto a anticoagulacao e desafiadora. E importante avaliar os potenciais fatores de risco associados como traumas, cirurgias e, no contexto atual, a associacao com a vacina para COVID19. Copyright © 2022
ABSTRACT
Objective: The objective of this article is to understand issues concerning the defense of the rights of people with disabilities in the midst of the pandemic reality caused by COVID-19, under the perspective of the Public Defender's Office. Methodology: The methodology applied in this study has, as a method of procedure, bibliographic and documentary analysis, and, with regard to the approach method, the deductive is used. It is noteworthy that the present research is classified as a qualitative exploratory. Background: Covid-19 has negatively affected a relatively large number of people, especially the most vulnerable groups in society, such as people with disabilities. Results: It can be concluded that, in view of the current reality, there is a need for society in institutions and agents that seek measures that bring protection and security to overcome the current factual context with the least possible damage, being the work of public defender, at this moment, fundamental for the survival of thousands of people. Contribution: The main contribution of the work lies in the fact that it demonstrates the importance and responsibility of the institutions, especially the Public Defender's Office, which has the legitimacy to protect the rights of people with disabilities and to develop health policies that minimize the negative effects caused by the current pandemic towards those people. © 2022, Centro Universitario Curitiba - UNICURITIBA. All rights reserved.