Effect of Non-Surgical Periodontal Therapy (Nspt) on Salivary Glutathione Reductase (Gr) in Smokers and Periodontitis Subjects

Introduction: Data mining is one of the five stages of Knowledge Discovery in Databases (KDD) and its application can be found on a daily basis in the most varied sectors of the economy and study, being widely used in the health area. Health concerns and efforts have been gaining relevance and strength as the entire world has been suffering from the fight against the coronavirus pandemic, especially in underdeveloped and developing countries, such as Brazil and other nations of the American continent.Method: Aiming to contribute to the area, the objective of this study was to apply a data mining task, using the Random Forest algorithm, to classify the population's behavior on the search for health services after the onset of the coronavirus pandemic. The database used was the Premise General Population Covid-19 Health Services Disruption Survey 2020 from the COVID-19 Health Services Disruption Survey 2020 project.Results: Using the Random Forest algorithm, 87.5% accuracy was obtained in the classification of people who whether or not they will use health services in American countries. A recall value of 93% and precision of 85% were reached in the best models.Conclusions: The model developed and the results achieved can be used to assist authorities in American countries on planning public health policies.

A randomised controlled trial of early intervention with oral favipiravir in patients hospitalised with COVID-19 (PIONEER Trial)

Background: Oral anti-viral therapies are licensed worldwide in COVID-19 but indications and efficacy rates vary. Aims and Objectives: To evaluate the safety and efficacy of oral favipiravir in patients hospitalised with COVID-19. Method(s): We conducted a multi-centre, open-label, randomised controlled trial of oral favipiravir in patients newly hospitalised with COVID-19, in five centres worldwide. 500 participants were randomised 1:1 to receive oral favipiravir (1800 mg twice daily (BD) for one-day;800 mg BD for nine-days) plus standard care (SC), or SC alone. NCT: 04373733. Result(s): Recruitment was performed between May 2020 and May 2021, with 251 patients randomised to favipiravir and 249 to SC. There was no difference in time to recovery in all patients (HR 1 06;95% CI 0 89-1 27;n=499;p=0.52). A faster rate of recovery was observed in patients receiving favipiravir under the age of 60 years (HR 1 35;95% CI 1 06-1 72;n=247, p=0 01). A 66 % improvement in mechanical ventilation free survival was evident in patients under 60-years of age (HR 0 34;95% CI 0 13-0 85;n=247, p=0 02). A non-significant 26 % reduction in mortality was observed in patients receiving favipiravir (favipiravir: 26;SC: 34;p=0 24). No significant differences were observed in serious adverse events (SAE) between arms (favipiravir: 36 in 27 patients;SC: 33 in 27 patients). Conclusion(s): Orally administered favipiravir has a beneficial effect on recovery, and mechanical ventilation freesurvival in patients under 60-years of age, hospitalised with COVID-19. Wider evaluation of anti-viral medications and their potential treatment combinations is warranted in patients with COVID-19.

I work hungry delivering food every day: precarious work and eating practices among food app delivery men in the COVID-19 pandemic

This paper proposed an analysis of aspects of violation of the Human Right to Adequate Food in experiences of food app delivery men in the city of Sao Paulo, as portrayed in journalistic materials published until September 2020 amid the COVID-19 pandemic. This work was a case study in an undergraduate course in Nutrition, through a project focused on situations of inequality and vulnerability. Journalistic materials were selected if food practices and/or demands associated with labor activities were present. Contents were approached through the definition of the Human Right to Adequate Food in the Brazilian National Food Policy of the Ministry of Health, considering recommendations from the Brazilian Dietary Guidelines and discussions of the sociology of work. Violations of the Human Right to Adequate Food were noted regarding: difficulties in access to food in proper quantity and quality, with a high consumption of ultra-processed foods;inadequate food practices regarding the act of eating and commensality, with a preponderance of an attitude toward "satisfying the hunger";and the insertion of delivery men in a food system characterized by unfair labor relationships, and unsustainable environmental and health aspects. Through the recognition of the circumstances of hunger and the demands presented by food app delivery men, this analysis highlighted the humanizing potential of food in stimulating such claims, especially in a pandemic context aggravated by the absence of labor rights. Better work conditions along with public policies that mitigate hunger and injustice are needed to promote healthier food environments and systems.

Use of the random forest algorithm to identify the behavior of the population in the search for health services after the beginning of the new coronavirus pandemic

Introduction: Data mining is one of the five stages of Knowledge Discovery in Databases (KDD) and its application can be found on a daily basis in the most varied sectors of the economy and study, being widely used in the health area. Health concerns and efforts have been gaining relevance and strength as the entire world has been suffering from the fight against the coronavirus pandemic, especially in underdeveloped and developing countries, such as Brazil and other nations of the American continent. Method: Aiming to contribute to the area, the objective of this study was to apply a data mining task, using the Random Forest algorithm, to classify the population's behavior on the search for health services after the onset of the coronavirus pandemic. The database used was the Premise General Population Covid-19 Health Services Disruption Survey 2020 from the COVID-19 Health Services Disruption Survey 2020 project.Results: Using the Random Forest algorithm, 87.5% accuracy was obtained in the classification of people who whether or not they will use health services in American countries. A recall value of 93% and precision of 85% were reached in the best models. Conclusions: The model developed and the results achieved can be used to assist authorities in American countries on planning public health policies. © 2022 Ariza, Nascimento, Malandrino & Santos.

O Psicologo No Pronto Socorro E as Emergencias Em Saude Mental Pos Pandemia

Embora os transtornos depressivos e de ansiedade, bem como os casos de TEPT ja se constituissem como endemicos no Brasil, com a pandemia da Coronavirus Disease 2019 (COVID 19), o aumento de casos foi exponencial. Na fase inicial da pandemia na China (2020), houve um aumento de 50% de pacientes apresentando sintomas moderados a severos de ansiedade, depressao e estresse. No inicio de maio de 2020, segundo a Associacao Brasileira de Psiquiatria, 48% dos psiquiatras apontavam um aumento de cerca de 25% no numero de consultas, sendo que 89% desses pacientes com diagnostico previo apresentavam sintomas agravados. Este trabalho tem como objetivo apresentar o aumento da incidencia de pacientes atendidos com queixas psicologicas nas unidades de pronto atendimento (Pronto Socorro) e os esforcos emergenciais em nivel de gestao e acompanhamento psicologico da nova realidade no Hospital Geral, referenciada como 4onda da pandemia Covid 19. Os dados coletados referem-se ao periodo de janeiro a julho de 2021, comparando-se ao ano de 2022, tendo sido avaliados 772 pacientes. A partir de avaliacao psicologica clinica e levantamento de prontuarios de atendimentos psicologicos no Pronto Socorro Adulto, comparando-se os anos de 2021 e 2022, constatou-se um aumento medio de 27,5% pacientes no periodo, com prevalencia de sintomas que incluiam mal estar subito e sensacoes de perigo recorrentes e imprevisiveis, incapacidade de relaxar, sensacoes de sufocamento, dor toracica, distorcoes cognitivas e intensa angustia de morte. Historia de doencas psiquiatricas diagnosticadas;perdas financeiras advindas da pandemia;temor aumentado e exacerbado de ser infectado pelo virus, adoecer e morrer;luto patologico (pela perda de familiares e amigos);sobrecarga e fadiga;estresse;ma qualidade do sono;desesperanca;comportamentos evitativos e irritabilidade tambem constituiram os achados clinicos. A sistematizacao da presenca do Psicologo como profissional de referencia no Pronto Socorro, foi fator fundamental para o melhor cuidado e encaminhamento seguro dos casos. Entender como se apresentou a pandemia em termos de estagios de evolucao do problema foi fundamental para nos preparar para o implemento de estrategias de controle. Passamos a avaliar a situacao critica como momentos encadeados e progressivos, o que facilitou o entendimento de especificidades de fatores estressores relativos a pandemia e o cuidado que deveria ser prestado intra e pos crise. Copyright © 2022

Achados Imuno-Hematologicos Em Pacientes Durante a Pandemia Covid-19

Objetivos: Descrever os principais achados imuno-hematologicos de pacientes com solicitacao de transfusao sanguinea durante a pandemia. Material e metodos: Esse e um estudo observacional e retrospectivo realizado atraves da coleta de dados dos arquivos do laboratorio de imuno-hematologia do Hemoce Crato, durante o periodo de janeiro a dezembro de 2021 (ano considerado de pico na regiao estudada). Foram utilizadas para o ensaio 371 amostras de pacientes que apresentaram reacao positiva na pesquisa de anticorpos irregulares pela tecnica de aglutinacao em gel liss/coombs, sendo realizadas tecnicas complementares de identificacao de anticorpos como eluicao, aloadsorcao, tratamento com dithiothreitol e autoadsorcao. Resultados: Durante os dois primeiros anos da pandemia tivemos um aumento da demanda transfusional, onde em 2020, foi de 16.971, 2021, de 18.419 quando comparado a 2019, que foi de 16.567. Como podemos ver o ano de 2021 foi o que tivemos maior demanda em decorrencia do aumento de numero de casos na regiao. O numero de casos enviados para estudo imuno-hematologico tambem foi maior em 2021 (364), 2020 (177), 2019 (170) dentre os casos enviados em 2021 tivemos 98 (27%) de casos inconclusivos, 54 (15%) foi encontrado somente autoanticorpos e 252 (69,2%) apresentaram anticorpos identificados. Dos 252 identificados, 174 (69%) apresentaram um aloanticorpo, e 78 (31%) possuiam mais de um aloanticorpo. Dos 252 pacientes identificados, 180 (72%) possuiam anticorpos contra antigenos do sistema Rh. Discussao: Os casos confirmados de COVID-19 no Ceara na fase inicial do processo epidemico, se concentravam na capital. Passado o periodo de um ano, tomando como base o coeficiente de incidencia de casos e obitos por 100.000 habitantes, verifica-se que, no entanto, no ano de 2021 os valores sao mais acentuados no interior cearense, justificando o aumento da demanda transfusional e aumento do numero de casos enviados para estudo imuno-hematologico. Nao tivemos a resolucao da investigacao imuno-hematologica em 98 (27%) dos casos enviados. Dos casos solucionados 180 (72%)% apresentavam anticorpos contra antigenos do sistema Rh. Conclusao: Neste trabalho, buscamos destacar os desafios de elucidacoes de casos imuno-hematologicos vivenciados durante a pandemia na regiao do cariri cearense. Os resultados mostram uma taxa alta de casos inconclusivos durante esse periodo. Copyright © 2022

ASSESSMENT OF SAFETY IN THE CORNEAL DONATION PROCESS DURING THE COVID-19 PANDEMIC

Purpose : To evaluate the impact of the covid-19 pandemic and the safety of the corneal donation process in an Eye Bank in Southern Brazil. Methods : This is a cross-sectional, observational, retrospective study involving 771 potential corneal donors and their respective RT-PCR COVID-19 results. The tests were performed by collecting secretions from the oropharynx and nasopharynx and processed in a laboratory at the University Hospital of Londrina-PR, from March 2020 to November 2021. The individuals were submitted to a complementary check list to the traditional one for clinical and epidemiological screening of potential corneal donors against coronavirus (SARS-Cov2). Patients not tested for COVID-19 in this first step were excluded using the main clinical screening criteria already routinely used. The criteria used for further validation of potential donors were: donor who had COVID-19 with complete remission of symptoms for more than 28 days, donor with no clinical suspicion, and no suspected or confirmed contact of COVID-19. Donors diagnosed with COVID-19, donor with COVID-19 suspected by clinical and epidemiological evaluation, contacts of suspected or confirmed COVID-19 less than 14 days ago, and donor with clinical suspicion less than 28 days ago but negative molecular test were discarded in this evaluation. Results : Among the 771 potential corneal donors, 710 individuals performed the RT-PCR test. A total of 689 (97.04%) individuals tested negative for COVID-19. The average age of suitable donors was 52.52 ± 18.10 years, 289 (41.9%) were female and 400 (58.1%) were male. However, 21 (2.96%) individuals tested positive for COVID-19 and were discarded, even after the complementary screening implemented due to the coronavirus pandemic. Among the positives, 9 (1.2%) cases were female and 12 (1.6%) were male;the average age was 55.10 ± 23.10. Conclusions : Despite the complementary exclusion criteria for potential organ and tissue donors in the pandemic, the use of RT-PCR for COVID-19 proved to be essential to maintain safety in the corneal donation process.

Mothers of premature newborns in the context of the COVID-19 pandemic: a qualitative approach

Objective: To know the perceptions of mothers of premature newborns hospitalized in the Neonatal Unit in the face of the COVID-19 pandemic. Method: Qualitative research carried out in June and July 2020, involving 12 mothers of premature newborns hospitalized in the neonatal units of a maternity hospital in the state of Ceará during the Coronavirus pandemic. Mothers were contacted via WhatsApp application. For the textual analysis, the descending hierarchical classification performed by the IRAMUTEQ software was used. Results: The mothers’ perception was centered on the difficulties faced in this pandemic period. The word “no” was strongly presented in the corpus of the text, evidencing the impact of the impediment of the visit, of the mothers’ permanence in the units and the fact of not being able to breastfeed. Conclusion: The provision of humanized care in neonatal units should not be limited to the newborn, and emotional support for mothers by the health team is essential © 2022. Online Brazilian Journal of Nursing. All Rights Reserved.

PEDIATRIC INFLAMMATORY MULTISYSTEM SYNDROME TEMPORALLY-ASSOCIATED with SARS-COV-2-A PORTUGUESE SINGLE CENTRE CASE SERIES

Background: Across the globe, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 appears to affect paediatric population in a milder and non-threatening way, when compared to adults. However, since April 2020 case reports of previously healthy children presenting with unremitting fever, biologic infammatory syndrome and cardiac dysfunction have been emerging. This syndrome, which has been termed Pediatric Infammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 infection (PIMS-TS), represents a rare complication of COVID-19 in children1. Objectives: To describe the clinical, laboratory and imaging characteristics, course, management and outcomes of hospitalized children diagnosed with PIMS-TS in a Portuguese tertiary care hospital. Methods: A retrospective study including children (< 18 years) that attended our hospital from April 2020 to December 2021 was performed. All the children included fulflled the case defnition of PIMS-TS published by the Centre for Disease Control and Prevention. Sociodemographic and clinical data, laboratory markers and imaging fndings were collected. Results: A total of 19 children met the criteria for PIMS-TS, 68% male with a mean age at diagnosis of 8 years old (IQR 5.8-15). They were all caucasian, except for a mixed-race patient, and all previously healthy, except one patient who was obese. Twelve had recent infection by SARS-CoV-2 detected by reverse transcriptase (RT) PCR and 18 had positive IgG serology. All had fever at diagnosis, with a median duration of 6 days (IQR 5-6) and 89.5% had mucocutaneous, gastrointestinal and hematological attainment, respectively. Other affected systems were respiratory (73.7%), cardiovascular (63%), lymphoid organs (52.6%), musculoskeletal (47%), genito-urinary (31.6%) and neurological (26.3%). Laboratory fndings can be found in Table 1. Thirty-six percent were admitted in intensive care unit for a median duration of 8 days (IQR 4-9). 42.1% needed respiratory support, 87.5% with supplemental oxygen therapy, 62.5% with mechanical ventilation and 12.5% with non-invasive ventilation. All patients received intravenous (IV) immunoglobulin, 52.6% IV cor-ticosteroid (CS) pulses and 78.9% IV and oral CS. Other treatments included acetylsalicylic acid (n=18), heparin (n=8) and antibiotic therapy (n=19)-Table 3. Seventeen fully recovered and 2 had sequalae: one of them with coronary artery aneurysms and other exertional dyspnea. Conclusion: In this case series, there was a broad spectrum of clinical symptoms and disease severity, ranging from fever and systemic infammation to critical care admission with myocardial injury, shock, and development of coronary artery aneurysms. Despite short-term morbidity, there were no mortality cases, with most of them recovering without sequelae. All physicians providing clinical care to children should consider this rare but severe delayed syndrome in paediatric population.

RELATO DE CASO: APLASIA MEDULAR SECUNDÁRIA A COVID-19

Introdução: Desde de dezembro de 2019, temos enfrentado a infecção pelo novo coronavírus (SARS-COV-2), causando repercussões diversas, que vão de síndrome respiratória aguda grave até formas assintomáticas. Uma hiperativação inflamatória parece estar associada a fenômenos autoimunes associada ao SARS-COV2. Se tratando de uma afecção emergente pouco se sabe dos fenômenos autoimunes induzidos pela infecção, sobretudo, patologias autoimunes hematológicas. Com esse intuito, o presente estudo vem relatar uma aplasia medular transitória em paciente internado pela infecção. Relato: Trata-se de paciente adulto, sexo masculino,52 anos, apresentando sintomas gripais e teste positivo para COVID-19, vinha em seguimento ambulatorial em uso de moxifloxacino, quando no 12°dia de sintomas foi internado em leito de terapia intensiva, após evolução com síndrome respiratória aguda grave (SRAG) e intubação orotraqueal. Iniciada terapia com dexametasona 10mg/dia, enoxaparina 40 mg de 12/12h SC, Ceftriaxona 1 g 12/12h. Intercorrendo após 10 dias de internação com disfunção renal, necessitando suporte dialítico. No 18°dia evoluindo com pancitopenia, sem sangramentos e sendo suspenso a profilaxia para tromboembolismo venoso (nesse momento era feita com heparina não fracionada devido a disfunção renal) e acionado o serviço de hematologia. Realizando seguimento diário com exames de sangue, e evoluindo para pancitopenia grave, com agranulocitose (neutrófilos: < 200). Exames Hb:7,90 Htc:22% VCM: 84,3 HCM: 30,30 GB:487 (Seg:194 — Lin:243 — Mon:49) Plaquetas: 50000. Havendo troca de esquema de antimicrobianos para Meropenem, Vancomicina e após 3 dias sem melhora clínica, introduzido Anfotericina B, e ampliado esquema antimicrobiano com associação de Polimixina B. Realizada biopsia de medula óssea com achados corroborando para hipótese de Aplasia de medula óssea. Afastados critérios para linfohistiocitose hemofagocítica e com sorologias negativas para outras infecções virais que sabidamente poderiam apresentar esse quadro. Após o 26°dia paciente iniciou melhora clínica e resolução espontânea da neutropenia, persistindo até o 30°dia com anemia e necessidade transfusional em raras ocasiões. Evolui com desmame ventilatório e recuperação da função renal, tendo alta após 45 dias de internação. Discussão: Acreditamos que a aplasia medular nesse caso foi associada a infecção pelo SARS-COV2, paciente que intercorreu com doença grave, necessidade de suporte ventilatório e acometimento sistêmico pela infecção. Dados da literatura trazem descrição de fenômenos imunes associados a infecção, como trombocitopenia imune, sem associação com linfohistiocitose ou coagulação intravascular disseminada. O mecanismo pelo qual os fenômenos imunes hematológicos ocorrem não estão claros.

OPORTUNIDADE DE ENVOLVIMENTO DO CORPO CLÍNICO DE UM HOSPITAL UNIVERSITÁRIO DE MÉDIA E ALTA COMPLEXIDADE, NA CAPTAÇÃO INTRA-HOSPITALAR DE DOADORES DE SANGUE

Objetivos: Em vigência da pandemia COVID-19, foi implementada uma rotina de captação intra-hospitalar de doadores de sangue no Hospital Universitário Pedro Ernesto (HUPE), tendo o corpo clínico do hospital como ponto focal através do engajamento de equipes das diversos setores clínicos e cirúrgicos, em campanhas mensais de doação de sangue, visando a manutenção do estoque de sangue no núcleo de hemoterapia do hospital. Material e métodos: Entre março e julho de 2021, identificadas as clínicas de maior demanda por hemocomponentes no hospital, foram realizadas reuniões de sensibilização para a doação de sangue entre as equipes, com atividades lúdicas e educacionais. O recurso de mídias sociais, principalmente Instagram® e FaceBook® foi utilizado para divulgação das ações visando a captação de doador. Foram contabilizados o número de setores e pessoas atingidas em cada ação, assim como número de doações de sangue nos respectivos meses de atividades de captação intra-hospitalar. Foi feita avaliação qualitativa sobre o conhecimento, sentimento e curiosidade das equipes sobre doação de sangue. Resultados: Os setores envolvidos foram 7, sendo eles, neurocirurgia, cirurgia cardíaca, pediatria, reumatologia, urologia, cirurgia vascular e hematologia. Foram realizadas 20 reuniões, atingindo 169 pessoas do corpo clínico dos diversos setores envolvidos. Cada equipe criou e desenvolveu atividades lúdicas educacionais nos respectivos setores, visando motivar a equipe para a doação de sangue. As principais dúvidas foram quanto aos critérios de inaptidão à doação, apesar de haverem doadores de sangue entre eles. Requisitos básicos para a doação, presença de tatuagem e mais recentemente, a doação de sangue por homem que tem sexo com homem, foram as dúvidas mais frequentes. As equipes não realizavam atividades de captação intra-hospitalar e não estavam diretamente envolvidas neste tipo de ação até as intervenções em questão. O número de candidatos aptos à doação entre março a julho de 2021, foi 17,6% maior, quando comparado com o mesmo período em 2020. Discussão: Apesar da captação intra-hospitalar não ser o modelo ideal para sensibilização à doação, diante de um recurso escasso e em vigência da pandemia COVID-19, considerou-se necessário incluir este tema de discussão, dentro de um hospital de elevado potencial transfusional. O não conhecimento sobre critérios básicos para doação de sangue entre a equipe de saúde, revela a necessidade de disseminar o conhecimento sobre esta atitude na sociedade como um todo, com ênfase neste grupo de pessoas. Mesmo durante atividades diárias extenuantes, os profissionais de saúde mostraram-se dispostos a participar do processo transfusional, seja como captador, ou como doador. Conclusão: Em vigência de situações que tragam risco para a manutenção do estoque de hemocomponentes, a captação intra-hospitalar parece viável e pode ser encorajada entre a equipe de saúde. Estas atividades são oportunidades educativas e devem ser estimuladas, incluindo o corpo clínico no processo transfusional.

Prophylactic anticoagulants for non-hospitalised people with COVID-19

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effects of prophylactic anticoagulants versus active comparator, placebo or no intervention, on mortality and occurrence of deep venous thrombosis and pulmonary embolism in non-hospitalised people with COVID-19.

Epilogue. Towards an education of resistance. Dialogue with Boaventura De Sousa Santos

The cultural domination of capitalism and its influence on the construction of modern democracies could not have been possible without educational institutions becoming one of the main territories for discursive, material and power disputes. This fact has conditioned the existence of a model that educates "from fear" and that, based on this, has ensured the non-expansion of emancipatory and supportive subjectivities. To explore this idea further, and as an epilogue to this dossier "Social movements, activism and resistance from the school", we spoke with Professor Boaventura de Sousa Santos to reflect on the role of education in the context of the COVID-19 pandemic and what the main challenges are for building more democracy and educational justice through resistance and emancipation.

Clinical Epidemiology and Outcomes of Invasive Pulmonary Aspergillosis as a Complication of Respiratory Viral Infection in Hospitalized Patients

Background. Invasive pulmonary aspergillosis (IPA) is increasingly recognized as a complication of severe respiratory viral infections (RVIs), including influenza and COVID-19. However, the incidence and outcomes of IPA following other RVIs is not well-described. We hypothesized that IPA may be an underreported complication of non-influenza RVIs. The objective of this study was to quantify the incidence and associated outcomes of IPA following RVI in hospitalized patients. Methods. We conducted a single-center retrospective cohort study of adult hospitalized patients with RVI diagnosed by multiplex PCR-based assay at the University of Kansas Hospital (Kansas City, Kansas) from September 2018-October 2019. Patients with a diagnosis of proven or probable IPA prior to RVI and those with hospital admission < 24 h were excluded from analysis. Proven or probable IPA was defined according to EORTC/MSGERC consensus definitions. The primary outcome was 1-year all-cause mortality. Results. A total of 195 patients met study criteria and were included in the analysis. The most common types of RVI observed were rhinovirus/enterovirus (57.9%, n=113), parainfluenza (13.3%, n=26), influenza (8.2%, n=16), and respiratory syncytial virus (7.7%, n=15). The cumulative incidence of IPA infection within 6 weeks of RVI was 5.6% (n=11). Excluding patients co-infected with multiple respiratory viruses (n=5), IPA was numerically more likely to occur following influenza compared to non-influenza RVI (12.5% [ n=2/16] vs. 4.6% [n=8/174];odds ratio, 2.96;95% confidence interval [CI], 0.57-15.3;P=0.176). Overall, one-year all-cause mortality was 20% (n=39/195) in this cohort. Development of IPA as a complication of RVI was associated with a significant decrease in 1-year survival (hazard ratio [HR], 3.04;95% CI, 1.19-7.78;P=0.021), and this relationship persisted after adjustment for age (HR, 2.77;95% CI, 1.08-7.10;P=0.034). Conclusion. In a cohort of hospitalized patients with RVI, 5.6% of patients developed proven or probable IPA. Although IPA was more likely to occur in patients with influenza, this complication was also observed with other types of RVI. Invasive pulmonary aspergillosis may be an underappreciated complication of non-influenza RVI in hospitalized patients and warrants continued study.

Trends in household energy-related GHG emissions during COVID-19 in four Chilean cities

The coronavirus disease 2019 (COVID-19) pandemic has strongly affected economies and human lifestyles globally. The changes observed in domestic energy consumption patterns have had an impact on household greenhouse gas (GHG) emissions. Since GHG emissions inventories are only available at the country level and at annual intervals, most studies have calculated the local emission variations by extrapolating annual emissions with smaller time and territorial scale consumption data. This research presents a bottom-up method, based on the exploitation of a survey addressed to 1200 households, that provides the information to calculate directly the variation in their energy-related GHG emissions, without the need for extrapolations. This method has been applied to four medium-sized Chilean cities with serious air quality problems. Given the high correlation between atmospheric pollutants such as NOx and CO2 emissions, we estimate that before the appearance of COVID-19, per capita CO2 emissions were already high. The results show that space heating-related GHG emissions have increased moderately (between 1 and 6%), while emissions from electricity and gas consumption for non-heating uses have increased significantly (between 8 and 23%). This has harmed the household economy, highlighting the importance of considering socioeconomic aspects when assessing the impact of COVID-19 in its entirety. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Occupational safety and health risk assessment and management challenges in Brazil – lessons from the AquaSafe mobile software application

Introduction: AquaSafe is a mobile learning application that can be used as one of the modalities for teaching, training and risk assessment in aquaculture occupational health and safety (AOHS). The app has checklists, risk assessment tools and other relevant information on AOHS. Materials and Methods: Content information was based on global scientific literature, ILO, FAO, WHO and OHSAS 18001. An online survey is also available to identify which application tools are used and to assess the application’s effectiveness in promoting prevention of injury and illness in aquaculture workers. Results: Available for Android, its interfaces promote learning through a questionnaire;risk assessment checklists;and tools to identify the root cause of the AOHS problem. Users can find information on risks, personal protective equipment and educational videos on AOHS as well as COVID-19. Findings from the online survey revealed that most responders indicated that AquaSafe increased their knowledge of AOHS. Participants reported that risk tools, checklists and what-if are used more frequently than quizzes, videos and the “5-whys”. Conclusions: While AquaSafe is designed to support knowledge awareness, risk assessment and decision making in AOHS, it is not used widely enough. The low response rate to the survey and downloads suggest that AOHS is not a priority in low-middle income countries, such Brazil. AOHS awareness remains a challenge and requires differentiated approaches.

Sympathetic neural overdrive, endothelial dysfunction and aortic stiffness in coronavirus disease 2019 survivors: A short-term study of cardiovascular sequelae

Introduction: Coronavirus disease 2019 (COVID-19) has become one of the more dramatic health problems in the century. This disease has enormous consequence for the health care worldwide. In addition to high mortality rate, patients recovered from COVID-19 present short and long-term cardiovascular sequelae including chest pain, myocardial dysfunction, arrhythmia, dyspnea, breathlessness, postural tachycardia syndrome, and thrombotic complications. The explanations for these clinical manifestations are still uncertain but can involve a constellation of physiological alterations. Hypothesis: To test if COVID-19 survivors have augmented sympathetic outflow, diminished endothelial function, elevated aortic stiffness, and reduced physical capacity compared to healthy individuals. Methods: Nineteen COVID-19 survivors [age: 47.0±2.3 years, BMI: 30.1±1.2 Kg/m2] and eighteen well-matched healthy controls (age: 44.0±2.0 years, BMI: 28.4 ±1.2 Kg.m2] were included in study. COVID-19 survivors were evaluated within 6 months of original diagnosis by RT-PCR. Muscle sympathetic nerve activity (MSNA) from fibular nerve (Microneurography), brachial artery flowmediated dilation (BAFMD;Doppler-Ultrasound), carotid-femoral pulse wave velocity (cf-PWV;Complior), beat-to-beat blood pressure (Peripheral BP;Finometer), heart rate (HR;Electrocardiography) and peak oxygen uptake (VO2peak, Cardiopulmonary exercise testing) were measured in both groups. Results: MSNA was higher in COVID-19 survivors compared to controls (33.0±1.0 vs. 22.0±1.0 bursts/min, p=0.001). Both BAFMD and VO2peakwere lower in COVID-19 survivors compared to controls (4.6±0.7 vs. 8.2 ±0.8%, p=0.005 and 22.2±1.5 vs. 29.7±1.6 mL/Kg/min p=0.001, respectively). Although COVID-19 survivors had greater cf-PWV than controls (8.6±0.5 m/s vs. 7.4±0.4 m/s, p=0.03), BP and HR were not different between groups. Conclusions: Our study revealed that patients recently recovered from COVID-19 have abnormal neurovascular control, vascular alterations and reduced physical capacity. These findings strongly indicate the need of further long-term investigations to uncover cardiovascular sequelae provoked by COVID-19.

Pediatric inflammatory multisystem syndrome temporallyassociated with SARS-COV-2 - a Portuguese single centre case series

Introduction: Across the globe, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 appears to affect paediatric population in a milder and nonthreatening way. However, since April 2020 case reports of previously healthy children presenting with unremitting fever, biologic inflammatory syndrome and cardiac dysfunction have been emerging. This syndrome, termed Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 infection (PIMSTS), represents a rare complication of COVID-19 in children. Objectives: The aim of this study is to describe the clinical and laboratory characteristics, course, management and outcomes of hospitalized children diagnosed with PIMS-TS in a Portuguese tertiary care hospital. Methods: A retrospective study including children that attended our hospital from April 2020 to April 2021 was performed. All the children fulfilled the case definition of PIMS-TS published by the Centers for Disease Control and Prevention. Data were collected. Statistical analysis was performed using SPSS 26.0. Results: A total of 19 children met the criteria for PIMS-TS, 68% male with a mean age at diagnosis of 8 years old (IQR 5.8-15). They were all caucasian, except for a mixed-race patient, and all previously healthy, except one patient who was obese. Twelve had recent infection by SARS-CoV-2 detected by reverse transcriptase (RT) PCR and 18 had positive IgG serology. One patient had negative RT-PCR and serology, but a positive contact history. All had fever at diagnosis, with a median duration of 6 days (IQR 5-6). 89.5% had mucocutaneous, gastrointestinal and haematological attainment, respectively. Other affected systems were respiratory (73.7%), cardiovascular (63%), lymphoid organs (52.6%), musculoskeletal (47%), genito-urinary (31.6%) and neurological (26.3%). Laboratory findings can be found in table 1. 36.8% were admitted in intensive care unit for a median duration of 8 days (IQR 4-9). 42.1% needed respiratory support, 87.5% with supplemental oxygen therapy, 62.5% with mechanical ventilation and 12.5% with non-invasive ventilation. All patients received intravenous (IV) immunoglobulin, 52.6% IV corticosteroid (CS) pulses and 78.9% IV and oral CS. Other treatments included acetylsalicylic acid (n=18), heparin (n=8) and antibiotic therapy (n=19). Seventeen fully recovered and 2 had sequelae: coronary artery aneurysms (n=1) and other exertional dyspnea (n=1). Conclusion: In this case series there was a wide spectrum of presenting signs and symptoms and disease severity, ranging from fever and systemic inflammation to critical care admission with myocardial injury, shock, and development of coronary artery aneurysms. Despite short-term morbidity, there were no mortality cases, with most of them recovering without sequelae. All physicians providing clinical care to children should consider this rare but severe delayed syndrome in paediatric population.

GRUPO ABO E A SUSCETIBILIDADE A INFECÇÃO POR SARS-COV-2: UMA REVISÃO DE LITERATURA

Objetivo: O presente estudo buscou analisar a suscetibilidade pela infecção por SARS-CoV-2 entre a tipagem sanguínea com base em estudos publicados. Introdução: O SARS-CoV-2 é um vírus pertencente à família dos Coronaviridae, tendo o RNA como seu material genético, que leva ao desenvolvimento da doença COVID-19. O novo coronavírus foi detectado pela primeira vez em dezembro de 2019 na cidade de Wuhan, China, tornando-se uma pandemia acometendo até agosto de 2020, 215 países. Neste sentido, a busca por entender os mecanismos e/ou suscetibilidade frente a infecção por este vírus, se tornou prioridade entre os pesquisadores do mundo, sugerindo então uma correlação entre o sistema ABO frente a infecção por SARS-CoV-2. Metodologia: Foi realizada uma revisão da literatura com base em artigos indexados nas plataformas: Pubmed e medRxiv, no ano de 2020. Ao final da aplicação dos critérios de exclusão para seleção dos artigos, foram selecionados 17 estudos. Resultados e discussões: Mesmo com a escassez de estudos, o que é justificável por se tratar de um novo vírus, as pesquisas apontam que o tipo A é o mais susceptível e o grupo O menos susceptível, todavia, a gravidade quanto ao risco de óbito está associado ao tipo AB. Até o presente momento não se sabe ao certo o porquê o SARS-CoV-2 é menos susceptível ao grupo O. Hipotetiza-se que o anti-A desse grupo é capaz de interferir na ligação entre a proteína Spike com o receptor da enzima conversora angiotensina 2 (ACE2), mecanismo este visto na infecção por SARS-CoV-1. Outro fato que pode ser considerado é em relação a neutralização que os anticorpos anti-A e/ou anti-B podem exercer em infecções virais semelhantemente visto nas infecções por HIV, que poderia neutralizar também o SARS-CoV-2. Conclusão: Em suma, nota-se que o tipo sanguíneo O apresenta uma menor suscetibilidade diante a infecção pelo novo coronavírus, porém, não há nenhum estudo que elucide de qual forma o SARS-CoV-2 se porta diante o grupo ABO, fazendo então a necessidade de pesquisas para esclarecer este processo.

Application drivers in Covid-19 times: Information and prevention trends in the Brazilian context

Objective:The study aims to verify, based on the guidelines of the Brazilian Ministry of Health for the prevention of Covid-19, how the application drivers use this information during their work routine. Methods: This isan applied research, with qualitative and quantitative character, which uses the Netnography Method for the collection and analysis of data immersed in groups of communication applications, especially the WhatsApp. Results: The results showed a tendency for Brazilian application drivers to comply with the World Health Organization and the Brazilian Ministry of Health guidelines for the prevention of Covid-19, in view of the self-care revealed in the questionnaire responses. Conclusions: It is concluded that, in the complex ecosystem of this research, which involves public health, discussions must be faced with academic research, and science of quality. © 2020, Universidade Federal de Santa Catarina. All rights reserved.