Perfil Epidemiologico De Pacientes Com Doencas Neurologicas Submetidos a Plasmaferese Em 5 Hospitais De Sao Paulo

Introducao: O procedimento de plasmaferese tem como objetivo remover do sangue substancias patologicas. A primeira descricao de seu uso terapeutico ocorreu em 1952 em um paciente diagnosticado com Macroglobulinemia de Waldestrom. Desde entao, a plasmaferese tem sido empregada em diversas doencas, dentre essas, doencas neurologicas de etiologia imune. De acordo com o guideline da Sociedade Americana de Aferese (ASF), a plasmaferese e considerada categoria I (recomendacao em primeira linha de tratamento) em varias doencas neurologicas como por exemplo sindrome de Guillain Barre, polirradiculopatia desmielinizante cronica (PIDC) e miastenia gravis. Objetivo: O objetivo deste estudo e caracterizar o perfil epidemiologicos dos pacientes com diagnostico de doencas neurologicas submetidos a plasmaferese em 5 hospitais de Sao Paulo. Materiais e metodos: este e um estudo descritivo retrospectivo realizado atraves da revisao de prontuarios de pacientes submetidos ao procedimento de plasmaferese para tratamento de doencas neurologicas no periodo de janeiro de 2020 a junho de 2022. Foram analisados sexo, faixa etaria, numero de sessoes realizadas, diagnostico e variacao dos niveis de hemoglobina pre e pos procedimento. Resultados: Foram submetidos a plasmaferese 53 pacientes com diagnosticos neurologicos diversos. Destes, 34 (64,1%) eram do sexo feminino com uma mediana de idade de 40 anos. Diagnosticos incluidos: 12 neurites opticas, 8 miastenias gravis, 9 escleroses multiplas, 7 pacientes com sindrome de Guillan Barre, 5 mielites, 3 doencas desmielinizantes a esclarecer, 1 encefalite autoimune, 1 polirradiculopatia a esclarecer, 1 polineuropatia a esclarecer, 1 sindrome de Miller Fisher, 3 sindrome de Stiff-Person, 1 ataxia nao especificada e 1 neoplasia de sistema nervoso central. Todos realizaram troca de uma volemia plasmatica e 94% realizaram 5 sessoes. Dois pacientes realizaram apenas 3 sessoes (um paciente com diagnostico de neuromielite e uma miastenia gravis) e um realizou 7 sessoes (mielite pos covid). Seis pacientes nao foram submetidos a outros tratamentos (diagnosticos de miastenia gravis, esclerose multipla, sindrome de Stiff-Person e neurite optica). Todos os demais foram submetidos a pulso com corticoide, imunoglobulina ou rituximabe. A variacao media da hemoglobina foi de 0.14 pontos. Discussao: De acordo com os dados levantados, podemos perceber que a plasmaferese e indicada em diversas doencas neurologicas que nao estao classificadas na categoria I pela ASF. Esse numero de indicacoes em primeira linha pode estar aumentado devido a indisponibilidade de Imunoglobulina Humana neste periodo. Nos demais casos, a plasmaferese foi empregada apos pelo menos uma linha de tratamento. A demora para o confirmacao diagnostica devido a espera dos resultados de exames e tambem devido a evolucao lenta dos sintomas neurologicos dificulta a definicao da melhor abordagem terapeutica incluindo a indicacao da plasmaferese. Conclusao: A plasmaferese continua sendo amplamente empregada em doencas neurologicas de etiologia imune. A interacao entre as equipes de neurologia e hemoterapia sao essenciais para a correta indicacao do procedimento e planejamento terapeutico do paciente. Um estudo bem desenhado para avaliacao de resposta ao tratamento de forma objetiva, contribuira para adicionar dados em relacao a eficacia do tratamento. Copyright © 2022

Virtual Lab Virtues in Distance Learning

Since the start of the COVID-19 pandemic, Portuguese schools have been closed twice. This fact causes teachers to quickly adapt the content of learning to the characteristics of distance learning. In some courses, this adaption is straightforward, although all activities on lab were limited to videos of experiments without any interaction by the students. These aspects could be very prejudicial to the learning process since the success of students in lab is proportional to the experimentation and training. To address this problem, a design science research-based project was launched to develop a prototype of a virtual lab that could allow the students the training that is as much as possible a replication of the real experiences’ protocols. The preliminary results of the use of this virtual lab prototype were conducted by chemical teachers (as expert judgment). At the same time, we have implemented in the prototype checking points to give feedback to the student that are spread from the solid quantity calculation for the solution through the techniques of prevention of contamination of the solution in the process. Next step in this research will be the evaluation of vLab in large scale, addressing the evaluation of virtual lab versus real lab context, user friendly and early adoption of technology (students and teachers). Besides this, the prototype will still be developed to evolve for a virtual lab with haptics. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Prevalence of COVID-19 in oral health professionals of the Balearic Islands in the period of confinement and start of the deescalated

The aim of the present study is to perform an anonymous, quantitative and descriptive analysis about the prevalence of COVID-19 infections in oral care professionals in the Autonomous Community of the Balearic Islands, during the confinement of the copulation and the beginning of the deescalated. For this, an online self-filling survey was used. It was sento to the oral care professionals working in the Balearic Islands. Dentists and stomatologists (DS), superior technicians in oral hygiene (OH) and superior techniclans in dental prosthesis (DP). The oral care professionals received and answered the survey in the period between June 1st and 30th 2020, using a form served through the Google Forms Gsutt application. 148 professionals responded to the survey, of which 4% reported a positive serology to COVID-19. All positive professionals were from Mallorca and from urban (83,3%) and semi-urban areas (16,6%). Significantly more OH (76%) and DP (88%) did not undergone the COVID test in comparison with DS (49%, p = 0.0008). There was no statistically significant difference between the different professionals regarding the fear of contracting the virus. There was also no statistically significant diference between the type of mask (p=0.6166) used by the professionals. With the results of the present study was possible to find a prevalence of 4% of COVID-19 infection among the oral care professionals of the Balearic Islands who answered the survey.

An innovative, reusable and sustainable face-seal device to improve protection efficacy of surgical masks against COVID-19

The outbreak of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has had a direct impact on the global health system, causing an alarming shortage of Personal Protective Equipment (PPE). Recent studies have shown that a significant number of healthcare professionals have been contaminated by the COVID-19 at their workplace due to the lack of appropriate PPE. Consequently, the PEE requirements have changed, making the use of filtering face-piece respirators (FFR) N95 and NK95 (FFP2 or FFP3, respectively) mandatory in place of the surgical masks previously used by healthcare professionals. Applying individualized face-seal devices in surgical masks, such as a thermoplastic resin ring, may significantly avoid inhalation of unfiltered air. Besides reducing leakage around the mask, which could convert surgical masks into PPE dual masks due to the high percentage of face-seal, it would allow a bidirectional protection for both healthcare professionals and patients, thus becoming a medical device. The polylactic acid (corn starch) thermoplastic resin ring is the device proposed here to be used in order to decrease leakage of potentially contaminated air. The use of poly lactic acid is of particular interest due to the fact that is a material appropriate for sanitary use, reusable and biodegradable. Therefore, healthcare professionals and organizations can maintain clinical activity in a cost-efficient manner whilst improving clinical safety.