Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 704
Filter
Add filters

Year range
1.
Int J Dent ; 2022: 6570812, 2022.
Article in English | MEDLINE | ID: covidwho-1883335

ABSTRACT

During the COVID-19 pandemic, people worldwide, including the scientific community, were insecure and fearful. The lack of vaccines at the beginning of the pandemic and the high mortality rate led to a search for alternative treatments for COVID-19. Among these proposals, a postulated activity of azithromycin was frequently studied in early treatment. In view of this, many countries saw an increase in the consumption of this antibiotic. Thus, the objective of this study was to evaluate, in Brazil, whether there was an increase in azithromycin prescriptions made by dentists, as they may have been prescribing this antibiotic as a probable treatment for COVID-19. This is an interrupted time series that analyzed antimicrobial prescriptions data between January 2014 and July 2021. The data were taken from the National System of Controlled Products Management, and pre- and postpandemic periods were compared. To assess changes in azithromycin consumption, Joinpoint regression and analysis of variance, followed by Dunnett's test, were used. More than 38 million prescriptions written during the period were analyzed. Amoxicillin (72.3%), azithromycin (18.0%), cephalexin (6.1%), and metronidazole (3.58%) were the most prescribed antibiotics. At the beginning of the pandemic, there was a drop in amoxicillin prescriptions motivated by a decrease in consultations, but conversely, in less than three months, azithromycin prescriptions grew by more than 100%. The exaggerated use of this antibiotic during the pandemic will certainly have consequences in the short and medium term on indicators of bacterial resistance. The use of guidelines and respect for the therapeutic protocols of government agencies should be fundamental for collective and strategic action in the fight against health emergencies.

2.
Reproductive Health Eastern Europe ; 11(1):69-78, 2021.
Article in Russian | Scopus | ID: covidwho-1879829

ABSTRACT

This article presents the analysis of COVID-19 pandemic impact on European clinics specialized in assisted reproductive technologies;describes the influence of ART partial or complete suspension on patients’ psychological well-being;illustrates leading world scientists’ recommendations on safe ART practices during COVID-19 pandemic, and lists the most sensitive groups of infertile patients that will benefit from timely and prioritized medical assistance in regard to infertility treatment. © 2021, Professionalnye Izdaniya. All rights reserved.

3.
Informatica ; 46(1):1-12, 2022.
Article in English | ProQuest Central | ID: covidwho-1879799

ABSTRACT

Operating surgeons are constrained when interacting with computer systems as they traditionally utilize hand-held devices such as keyboard and mouse. Studies have previously proposed and shown the use of hand gestures is an efficient, touchless way of interfacing with such systems to maintain a sterile field. In this paper, we propose a Deep Computer Vision-based Hand Gesture Recognition framework to facilitate the interaction. We trained a 3D Convolutional Neural Network with a very large scale dataset to classify hand gestures robustly. This network became the core component of a prototype application requiring intraoperative navigation of medical images of a patient. Usability evaluation with surgeons demonstrates the application would work and a hand gesture lexicon that is germane to Medical Image Navigation was defined. By completing one cycle of usability engineering, we prove the feasibility of using the proposed framework inside the Operating Room.

4.
Aging (Albany NY) ; 14(11): 4624-4633, 2022 Jun 02.
Article in English | MEDLINE | ID: covidwho-1879716

ABSTRACT

Since the late 2020, the evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern has been characterized by the emergence of spike protein mutations, and these variants have become dominant worldwide. The gold standard SARS-CoV-2 diagnosis protocol requires two complex processes, namely, RNA extraction and real-time reverse transcriptase polymerase chain reaction (RT-PCR). There is a need for a faster, simpler, and more cost-effective detection strategy that can be utilized worldwide, especially in developing countries. We propose the novel use of direct RT-qPCR, which does not require RNA extraction or a preheating step. For the detection, retrospectively, we used 770 clinical nasopharyngeal swabs, including positive and negative samples. The samples were subjected to RT-qPCR in the N1 and E genes using two different thermocyclers. The limit of detection was 30 copies/reaction for N1 and 60 copies/reaction for E. Analytical sensitivity was assessed for the developed direct RT-qPCR; the sensitivity was 95.69%, negative predictive value was 99.9%, accuracy of 99.35%, and area under the curve was 0.978. This novel direct RT-qPCR diagnosis method without RNA extraction is a reliable and high-throughput alternative method that can significantly save cost, labor, and time during the coronavirus disease 2019 pandemic.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnosis , COVID-19 Testing , Clinical Laboratory Techniques/methods , Cost-Benefit Analysis , Humans , RNA, Viral/genetics , Real-Time Polymerase Chain Reaction/methods , Retrospective Studies , SARS-CoV-2/genetics , Sensitivity and Specificity
5.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-337967

ABSTRACT

Background: The ongoing Omicron wave of the COVID-19 pandemic has resulted in unprecedented levels of population transmission due to the variant’s high level of infectiousness. We have seen repeatedly that the epidemiological characteristics of new variants can have profound impacts on global health outcomes, and while the characteristics of these new variants are difficult to predict ahead of their emergence, considering the impact of potential future scenarios is of critical importance for planning and policy making. This paper samples across a range of potential variant-level characteristics to provide global forecasts of infections, hospitalisations, and deaths in the face of high (but waning) levels of past immunity, and evaluates a range of interventions that may diminish the impact of future waves. Methods: We created a susceptible-exposed-infectious dynamic model that accounts for vaccine uptake and effectiveness, new variants, and waning protection from both infection- and vaccine-derived immunity. Using this model, we first estimated past infections, hospitalisations, and deaths by variant, location, and day. We used these findings to more fully understand the global progression of the COVID-19 pandemic through May 31, 2022. Second, we forecasted these same outcome measures for five different scenarios based on future emergence of variants, and then four sub-scenarios within each potential variant scenario, to evaluate the impact of available intervention strategies through November 30, 2022. Findings: We estimated that from November 15, 2021, through May 31, 2022, there were 3.83 billion (95% uncertainty interval [UI] 2.99–4.67) SARS-CoV-2 infections, 10.4 million (8.26–13.4) hospitalisations, and 2.44 million (2.06–2.89) deaths, the majority of which were attributable to the Omicron variant (96.3% (92.5-97.6) of infections, 74.7% (59.7-82.3) of hospitalisations, and 61.9% (46.9-67.8) of deaths). Compared to the pre-Omicron pandemic period from January 1, 2020, to November 14, 2021, we estimated that there were approximately the same number of infections globally from November 15, 2021, to May 31, 2022, but only 23.6% (18.0-25.9) of the estimated deaths. The massive Omicron wave and relatively high vaccination rates in many high-income countries have together contributed to high levels of partial or full immunity against SARS-CoV-2 infection, leaving only 4.48% (3.15–6.21) of the global population with no protection as of May 31, 2022. Under the future scenario we consider most plausible (a scenario with a new Omicron-like variant emerging and reference levels of the drivers of transmission), we estimated there will be an additional 3.45 billion (1.67–5.34) infections, 3.57 million (1.69–6.33) hospitalisations, and 816,000 (367,000–1,420,000) deaths between June 1, 2022, and November 30, 2022, with the Americas and European WHO regions projected to sustain the highest rates of additional deaths. If we consider a variant that combines the high infectiousness of Omicron with the high severity of Delta, we again estimate 3.45 billion (1.67–5.34) new infections, but due to the presumed increase in severe outcomes, we estimate 4.62 million (1.47– 8.61) deaths over the forecasted period. We estimate that resumed mask usage (to 80% of the population in each location, or the current level, whichever is higher) would, on average, reduce the number of deaths by at least 50% across all the potential variant futures we considered, while a delayed but eventual global scale-up of antivirals would reduce deaths, on average, by at least 20% across variant scenarios. Interpretation: As infection-derived and conferred protection wanes, we expect infections to rise, but given the large proportion of the population that had some level of immunity to SARS-CoV-2 as of June 1, 2022, all but the most pessimistic forecasts in this analysis do not predict a massive global surge by November 30, 2022. All signs point towards COVID-19 transitioning into a more endemic transmission regime (lower, but sustained disease burden), and with the introduction and proliferation of novel therapeutic interventions expected in mid- to late 2022, the likelihood of returning to past levels of COVID-19 mortality is low. The characteristics of future COVID-19 variants are difficult to predict, and our forecasts do show some considerable variation in outcomes as a function of variant properties. Given the uncertainty surrounding what type of variant will next emerge, we must remain vigilant as we move to the next phase of the COVID-19 pandemic. Despite the very important role of vaccines and the potential role of new therapeutics, the contribution of mask usage to the prevention of infection and death cannot be understated. Masks are a simple and effective COVID-19 reduction strategy that—under a scenario in which an Omicron-like variant emerges on approximately June 1, 2022—could prevent about 433,000 deaths (223,000–712,130) between June 1 and November 30, 2022, if worn universally. Under our worst-case variant scenario, high mask use could prevent an estimated 2.33 million (0.836–4.08) deaths.

6.
Diabetes research and clinical practice ; 186:109389-109389, 2022.
Article in English | EuropePMC | ID: covidwho-1876715
7.
Brazilian Archives of Biology and Technology ; 65(e22210648), 2022.
Article in English | CAB Abstracts | ID: covidwho-1875203

ABSTRACT

COVID-19 rapidly spread across the world in an unprecedented outbreak with a massive number of infected and fatalities. The pandemic was heavily discussed and searched on the internet, which generated big amounts of data related to it. This led to the possibility of attempting to forecast coronavirus indicators using the internet data. For this study, Google Trends statistics for 124 selected search terms related to pandemic were used in an attempt to find which keywords had the best Spearman correlations with a lag, as well as a forecasting model. It was found that keywords related to coronavirus testing among some others, such as "I have contracted covid", had high correlations (0.7) with few weeks of lag (4 weeks). Besides that, the ARIMAX model using those keywords had promising results in predicting the increase or decrease of epidemiological indicators, although it was not able to predict their exact values. Thus, we found that Google Trends data may be useful for predicting outbreaks of coronavirus a few weeks before they happen, and may be used as an auxiliary tool in monitoring and forecasting the disease in Brazil.

8.
Preprint in English | medRxiv | ID: ppmedrxiv-22276569

ABSTRACT

BackgroundThe COVID-19 pandemic has disrupted cancer care, raising concerns regarding the impact of wait time, or lag time, on clinical outcomes. We aimed to contextualize pandemic-related lag times by mapping pre-pandemic evidence from systematic reviews and/or meta-analyses on the association between lag time to cancer diagnosis and treatment with mortality- and morbidity-related outcomes. MethodsWe systematically searched MEDLINE, EMBASE, Web of Science, and Cochrane Library of Systematic Reviews for reviews published prior to the pandemic (1 January 2010-31 December 2019). We extracted data on methodological characteristics, lag time interval start and endpoints, qualitative findings from systematic reviews, and pooled risk estimates of mortality-(i.e., overall survival) and morbidity- (i.e., local regional control) related outcomes from meta-analyses. We categorized lag times according to milestones across the cancer care continuum and summarized outcomes by cancer site and lag time interval. ResultsWe identified 9,032 records through database searches, of which 29 were eligible. We classified 33 unique types of lag time intervals across 10 cancer sites, of which breast, colorectal, head and neck, and ovarian cancers were investigated most. Two systematic reviews investigating lag time to diagnosis reported contradictory findings regarding survival outcomes among pediatric patients with Ewings sarcomas or central nervous system tumours. Comparable risk estimates of mortality were found for lag time intervals from surgery to adjuvant chemotherapy for breast, colorectal, and ovarian cancers. Risk estimates of pathologic complete response indicated an optimal time window of 7-8 weeks for neoadjuvant chemotherapy completion prior to surgery for rectal cancers. In comparing methods across meta-analyses on the same cancer sites, lag times, and outcomes, we identified critical variations in lag time research design. ConclusionsOur review highlighted measured associations between lag time and cancer-related outcomes and identified the need for a standardized methodological approach in areas such as lag time definitions and accounting for the waiting-time paradox. Prioritization of lag time research is integral for revised cancer care guidelines under pandemic contingency and assessing the pandemics long-term effect on patients with cancer.

9.
Preprint in English | medRxiv | ID: ppmedrxiv-22276668

ABSTRACT

We screened 65 longitudinally-collected nasal swab samples from 31 children aged 0-16 years who were positive for SARS-CoV-2 omicron BA.1. By day 7 after onset of symptoms 48% of children remained positive by rapid antigen test. In a sample subset we found 100% correlation between antigen test results and virus culture.

10.
Kybernetes ; 51(7):2416-2434, 2022.
Article in English | ProQuest Central | ID: covidwho-1874120

ABSTRACT

Purpose>Data science lacks a distinctive identity and a theory-informed approach, both for its own sake and to properly be applied conjointly to the social sciences. This paper’s purposes are twofold: to provide (1) data science an illustration of theory adoption, able to address explanation and support prediction/prescription capacities and (2) a rationale for identification of the key phenomena and properties of data science so that the data speak through a contextual understanding of reality, broader than has been usual.Design/methodology/approach>A literature review and a derived conceptual research model for a push–pull approach (adapted for a data science study in the management field) are presented. A real location–allocation problem is solved through a specific algorithm and explained in the light of the adapted push–pull theory, serving as an instance for a data science theory-informed application in the management field.Findings>This study advances knowledge on the definition of data science key phenomena as not just pure “data”, but interrelated data and datasets properties, as well as on the specific adaptation of the push-pull theory through its definition, dimensionality and interaction model, also illustrating how to apply the theory in a data science theory-informed research. The proposed model contributes to the theoretical strengthening of data science, still an incipient area, and the solution of the location-allocation problem suggests the applicability of the proposed approach to broad data science problems, alleviating the criticism on the lack of explanation and the focus on pattern recognition in data science practice and research.Research limitations/implications>The proposed algorithm requires the previous definition of a perimeter of interest. This aspect should be characterised as an antecedent to the model, which is a strong assumption. As for prescription, in this specific case, one has to take complementary actions, since theory, model and algorithm are not detached from in loco visits, market research or interviews with potential stakeholders.Practical implications>This study offers a conceptual model for practical location–allocation problem analyses, based on the push–pull theoretical components. So, it suggests a proper definition for each component (the object, the perspective, the forces, its degrees and the nature of the movement). The proposed model has also an algorithm for computational implementation, which visually describes and explains components interaction, allowing further simulation (estimated forces degrees) for prediction.Originality/value>First, this study identifies an overlap of push–pull theoretical approaches, which suggests theory adoption eventually as mere common sense, weakening further theoretical development. Second, this study elaborates a definition for the push–pull theory, a dimensionality and a relationship between its components. Third, a typical location–allocation problem is analysed in the light of the refactored theory, showing its adequacy for that class of problems. And fourth, this study suggests that the essence of a data science should be the study of contextual relationships among data, and that the context should be provided by the spatial, temporal, political, economic and social analytical interests.

11.
Preprint in English | medRxiv | ID: ppmedrxiv-22276229

ABSTRACT

Global observations have shown that the success or failure in preventing and controlling the spread of COVID-19 largely relies on human behaviours. Human behaviours in preventing and controlling the spread of the disease principally, is dependent on the level of knowledge of the disease, the attitudes adopted by persons due to the level of knowledge of the disease and the decision to adhere to the preventive practices (KAP) of the disease. Since the beginning of this pandemic, numerous studies have been conducted to investigate the KAP on the novel COVID-19 among diverse demographic groups. However, no reported studies have been found on the KAP of the COVID-19 pandemic among the deaf in various populations around the world. This study sought to assess the KAP of COVID-19 among deaf persons in the Greater Accra region of Ghana. The design of this study utilized the knowledge, attitude and practice (KAP) survey. Good attitude and adherence to the preventive practices of COVID-19 was observed among the deaf persons. However, knowledge about the science of the disease was lacking. Educational campaigns about COVID-19 should also emphasize the teaching and understanding of the science of the virus and the disease to its audience.

12.
Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine ; 32(4):409, 2021.
Article in English | Scopus | ID: covidwho-1871430
13.
Philippine Journal of Science ; 150(5):999-1015, 2021.
Article in English | CAB Abstracts | ID: covidwho-1870814

ABSTRACT

Coronavirus disease 2019 (COVID-19) continues to devastate the world's health and economy, affecting all aspects of life leading to widespread social disruption. Even as several vaccines have been developed, their availability in developing countries is limited and their efficacy against the variants of SARS-CoV-2 (severe acute respiratory syndrome-coronavirus 2) needs to be continuously assessed. The World Health Organization (WHO) has acknowledged that vaccines alone will not overcome the global challenges of COVID-19. Medicinal plants may provide the needed support. Herein, we identify Philippine medicinal plants that possess phytochemicals with potential anti-SARS-CoV-2 activity and/or immunomodulatory properties that may strengthen one's immune system against COVID-19. These plants were selected from 100 of the best-studied Philippine medicinal plants with antiviral and immunomodulatory properties. The general antiviral and specific anti-SARS-CoV-2 activities and immunomodulatory properties of the phytochemicals that these plants contained were searched. While many compounds assessed individually using in vitro and in silico techniques suggest potential anti-SARS-CoV-2 or immunomodulatory effects, this review sought to identify the medicinal plants which contain these compounds and which, based on literature, have the best potential application against COVID-19. These plants are Allium spp. bulbs (bawang), Andrographis paniculata (Burm.f.) Nees leaves (sinta), Cocos nucifera L. oil (niyog), Euphorbia hirta L. leaves (tawa-tawa), Euphorbia neriifolia L. leaves (sorosoro), Moringa oleifera Lam. leaves (malunggay), Ocimum basilicum L. leaves (balanoy), Piper nigrum L. seeds (paminta), Vitex negundo L. leaves (lagundi), and Zingiber officinale Roscoe rhizome (luya). This review provides a shortlist that can guide research on possible solutions to COVID-19 using Philippine medicinal plants.

14.
Southeast Asian Journal of Tropical Medicine and Public Health ; 53(2):123-141, 2022.
Article in English | GIM | ID: covidwho-1870651

ABSTRACT

Depression and anxiety are common among people living with human immunodeficiency virus (PLWHIV) infection. In this study, we aimed to determine the prevalence of and factors associated with depression and anxiety among PLWHIV infection in Davao City, Philippines, in order to inform programs to minimize these mental health conditions in the study population. Study subjects were chosen from patients who accessed the HIV and AIDS Core Team (HACT) Clinic at an urban tertiary care hospital in Davao City, Philippines, during August-September 2019. Eligible study subjects were asked to complete the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) questionnaire to assess their depressive and anxiety symptoms. Selected factors were evaluated to determine their association with depressive and anxiety symptoms. A total of 145 subjects were included in the study, 95.9% male. The study subject mean (+or- standard deviation) age was 33.0 (+or- 8.4) years old. Among study subjects, 51.7% and 41.4% had symptoms of depression and anxiety, respectively. Factors significantly associated with depressive symptoms were being aged 25-34 years (adjusted prevalence ratio (aPR)=1.55;95% confidence interval (CI): 1.06-2.26;p-value=0.023) compared to being aged >34 years and being unemployed (aPR=1.62;95% CI: 1.15-2.29;p-value=0.006) compared to being employed. The factor significantly associated with anxiety symptoms was being aged 25- 34 years (aPR=1.61;95% CI: 1.03-2.51;p-value=0.038) compared to being aged >34 years. In summary, a high prevalence of depressive and anxiety symptoms was observed among our study subjects;younger age and being unemployed were associated with depressive symptoms and being younger was associated with anxiety symptoms. We conclude there is a need for a program to reduce depression and anxiety in the study population. Further studies are needed to determine what specific interventions can reduce these mental health symptoms in this vulnerable study population.

15.
Preprint in English | medRxiv | ID: ppmedrxiv-22276483

ABSTRACT

BackgroundSARS-CoV-2 serologic surveys estimate the proportion of the population with antibodies against historical variants which nears 100% in many settings. New analytic approaches are required to exploit the full information in serosurvey data. MethodUsing a SARS-CoV-2 anti-Spike (S) protein chemiluminescent microparticle assay, we attained a semi-quantitative measurement of population IgG titres in serial cross-sectional monthly samples of routine blood donations across seven Brazilian state capitals (March 2021-November 2021). In an ecological analysis (unit of analysis: age-city-calendar month) we assessed the relative contributions of prior attack rate and vaccination to antibody titre in blood donors. We compared blood donor anti-S titre across the seven cities during the growth phase of the Delta variant of concern (VOC) and use this to predict the resulting age-standardized incidence of severe COVID-19 cases. ResultsOn average we tested 780 samples per month in each location. Seroprevalence rose to >95% across all seven capitals by November 2021. Driven proximally by vaccination, mean antibody titre increased 16-fold over the study. The extent of prior natural infection shaped this process, with the greatest increases in antibody titres occurring in cities with the highest prior attack rates. Mean anti-S IgG was a strong predictor (adjusted R2 =0.89) of the number of severe cases caused by the Delta VOC in the seven cities. ConclusionsSemi-quantitative anti-S antibody titres are informative about prior exposure and vaccination coverage and can inform on the potential impact of future SARS-CoV-2 variants. SummaryIn the face of near 100% SARS-CoV-2 seroprevalence, we show that average semi-quantitative anti-S titre predicted the extent of the Delta variants spread in Brazil. This is a valuable metric for future seroprevalence studies.

16.
Math Biosci Eng ; 19(7): 6731-6742, 2022 May 04.
Article in English | MEDLINE | ID: covidwho-1869896

ABSTRACT

People's attitudes and behaviors are partially shaped by the socioeconomic class to which they belong. In this work, a model of scale-free graph is proposed to represent the daily personal contacts in a society with three social classes. In the model, the probability of having a connection between two individuals depends on their social classes and on their physical distance. Numerical simulations are performed by considering sociodemographic data from France, Peru, and Zimbabwe. For the complex networks built for these three countries, average values of node degree, shortest-path length, clustering coefficient, closeness centrality, betweenness centrality, and eigenvector centrality are computed. These numerical results are discussed by taking into account the propagation of information about COVID-19.


Subject(s)
COVID-19 , COVID-19/epidemiology , Humans , Socioeconomic Factors
17.
Viruses ; 14(6)2022 May 26.
Article in English | MEDLINE | ID: covidwho-1869813

ABSTRACT

BACKGROUND: Immune response assessed by the quantification of neutralizing antibodies (nAbs) and predictors associated with immunogenicity after the prime-boost ChAdOx1 (Oxford-AstraZeneca) COVID-19 vaccine in hemodialysis (HD) patients remains unclear. METHODS: This prospective study enrolled 174 HD patients and 67 healthy subjects to evaluate antibodies against the spike protein 1 and receptor-binding domain of severe acute respiratory syndrome coronavirus type 2 after prime-booster vaccination, by using enzyme-linked immunosorbent assay and applied spline-based generalized additive model regression analysis to predict 50% neutralization titer (NT50). The correlation between HD parameters and NT50 was analyzed. RESULTS: NT50 was lower in HD patients compared with healthy controls after the prime-boost dose (p < 0.001). The geometric mean titer ratios were higher in first-dose seronegative than in the seropositive subgroup in HD patients and healthy controls (6.96 vs. 2.36, p = 0.002, and 9.28 vs. 1.26, p = 0.011, respectively). After two doses of ChAdOx1, one-way ANOVA showed that Ca × P was positively associated with NT50 (p trend = 0.043) and multiple linear regression showed the similar results (p = 0.021). Kt/V (a quantification of dialysis adequacy) (OR = 20.295, p = 0.005) could independently predict seroconversion (NT50 ≥ 35.13 IU/mL). CONCLUSION: Adequacy of hemodialysis could independently predict seroconversion in HD subjects vaccinated with prime-boost doses of ChAdOx1.

18.
Convergence ; : 13548565221105789, 2022.
Article in English | Sage | ID: covidwho-1868970

ABSTRACT

Conspiracy Theories (CTs) are a global phenomenon, but some societies are better equipped than others to resist them. This article discusses the characteristics of the China-related COVID-19 CTs in the Brazilian Facebook, based on 28,312 posts published from January 2020 to June 2021. We argue that, in Brazil, the spread of CTs was facilitated by a widespread political and knowledge institutions? legitimacy crisis. The rise of the extremist politician Jair Bolsonaro to the Presidency provides evidence in this regard. In consequence, the boundaries between fringe and mainstream politics become porous. This article discusses which agents disseminate China-related COVID-19 CTs, and which topics receive more attention. We found a significant presence of actors belonging to mainstream politics and the media among the CTs? main disseminators. Additionally, the CTs circulating in the Brazilian social media environment reproduce concerns about China?s growing presence in the global arena, which originate elsewhere. Still, they add a specific emphasis on the Communist threat. We sustain that this emphasis relates as much to Brazil?s internal politics as to China itself.

19.
eJHaem ; n/a(n/a), 2022.
Article in English | Wiley | ID: covidwho-1866543

ABSTRACT

Large granular lymphocyte leukemia is a rare chronic lymphoproliferative disorder of cytotoxic cells. Other hematological malignancies such as CLL and multiple myeloma have been associated with poor vaccination response and markedly increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mortality rates, specifically in patients who have undergone immunosuppressive therapy. Given the immunosuppressive therapies often used to treat the disease, large granular lymphocytic (LGL) patients may be especially vulnerable to SARS-CoV-2 infection. A questionnaire was sent to all patients in the LGL Leukemia Registry at the University of Virginia (UVA) to obtain information on vaccination status, type of vaccine received, side effects of vaccination, patient treatment status before, during, and after vaccination, antibody testing, history of coronavirus disease 2019 (COVID-19) infection, and presence or absence of booster vaccination. Antibody testing of 27 patients who had quantitative SARS-CoV-2 Spike Protein IgG levels determined by University of Virginia medical laboratories via the Abbott Architect SARS-CoV-2 IgG II assay were collected. The assay was scored as reactive at a threshold of ≥50.0 AU/mL or nonreactive with a threshold of <50.0 AU/mL. LGL patients without treatment as well as patients who held treatment prior to their vaccination have a robust humoral response to SARS-CoV-2 vaccines. Patients who did not hold their immunosuppressive treatments have signifigantly diminished vaccine response compared to those who held their immunosuppressive treatment. Our findings support a dual strategy of pausing immunotherapy during the vaccination window and administration of the SARS-CoV-2 booster to all LGL leukemia patients to maximize protective antibodies.

20.
Hematology, Transfusion and Cell Therapy ; 43:S56-S57, 2021.
Article in Portuguese | EMBASE | ID: covidwho-1859594

ABSTRACT

Introdução: A combinação de doxorrubicina, bleomicina, vinblastina e dacarbazina (ABVD) representa a principal opção de tratamento em primeira linha para o Linfoma Hodgkin classico (LH). Desde 2018, o desabastecimento de bleomicina no Brasil têm trazido consequências graves aos pacientes com LH. No âmbito da medicina privada, instituições têm feito o uso de A+AVD, esquema no qual a bleomicina é substituída por brentuximabe-vedotina, ou importado a bleomicina de forma independente. Para diversas instituições públicas, entretanto, estas opções não são acessíveis. Objetivo: Avaliar a segurança e a eficácia da combinação AEVD (doxorrubicina;etoposídeo, em substituição à bleomicina, na dose de 100 mg/m2;vinblastina e dacarbazina) para tratamento de LH em primeira linha, nos dias 1 e 15 de ciclos de 28 dias. Métodos: Realizamos estudo clínico aberto não-randomizado para avaliar o regime AEVD como tratamento de primeira linha em pacientes com diagnóstico recente de LH no Hospital Municipal São José em Joinville, Brasil. Resultados: Vinte e cinco pacientes com mais de 18 anos e diagnóstico de LHc entre junho e novembro de 2020 foram incluídos. Quatorze pacientes (56%) eram homens, com mediana de idade de 27 anos (variando de 18 a 66 anos). A maioria dos pacientes tinham doença Estágio II (60%, n = 15), tinham sintomas B (56%, n = 14) e lactate-desidrogenase (LDH, 52%, n = 13). Para estágios III-IV (n = 5), 3 pacientes apresentaram IPS alto risco (escore >2;60%). Para doença localizada (n = 20), alto risco conforme GHSG foi observado em 16 pacientes (n = 80%). Todos os pacientes passaram por 3 a 6 ciclos de quimioterapia e não se observou evento adverso com necessidade de internação hospitalar, interrupção ou descontinuação de tratamento. A realização de PET-CT ocorreu exclusivamente fora da nossa instituição. Oito pacientes tiveram acesso a PET-CT no ínterim, todos com escore Deauville de 1-3. A taxa de resposta global foi de 96%, com um paciente apresentando progressão da doença após 5 ciclos. Sete pacientes tiveram avaliação de final de tratamento (FT) apenas com TC, com 5 respostas completas (RC) e 2 respostas parciais (RP), com ambos os pacientes RP mantiveram remissão após 10 e 12 meses. Avaliação ao FT com PET-CT (n = 18) resultou em DS 1-3 em 72% (n = 13), 4 em 22% (n = 4) e 5 em 6% (n = 1). Todos os 5 pacientes DS 4-5 foram submetidos a biópsia após avaliação FT, com confirmação de LH recidivado ou refratário (RR) em 4 casos (mulher de 22 anos, estágio IV, alto risco com doença progressiva;homem de 65 anos, estágio III, baixo risco, com recidiva 11 meses após FT;homem de 26 anos, estágio II, alto risco com recidiva 6 meses após FT;mulher de 25 anos, estágio II, alto risco com recidiva 4 meses após FT). Dois pacientes LH RR (50%) tiveram atraso de mais de 30 dias no tratamento devido a fatores psicossociais ou financeiros secundários à pandemia Covid-19. Todos os pacientes LH RR tiveram acesso a terapia de resgate. Com mediana de seguimento de 16 meses (variando de 8 a 36 meses), nenhuma morte foi registrada e a probabilidade de sobrevida livre de progressão foi de 66% (IC95%: 72%-100%). Conclusões: A escassez de quimioterápicos tem sido um problema recorrente em todo o mundo, e é mais evidente em medicações citotóxicas sem substituições validadas, como é o caso da bleomicina. O uso do esquema AEVD para tratamento de LH recém-diagnosticado parece ser seguro, eficaz e factível, em uma população composta principalmente por pacientes de alto risco.

SELECTION OF CITATIONS
SEARCH DETAIL