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1.
Brazilian Journal of Infectious Diseases ; 26, 2022.
Article in Spanish | EMBASE | ID: covidwho-1693853

ABSTRACT

Introdução e objetivos: A incidência de Endocardite Infecciosa comunitária associada a hemoculturas negativas (EICAHN) varia de 5 a 78%. Há poucos relatos da incidência de endocardite infecciosa associada a Bartonella spp. (EIAB) no Brasil. Nesse estudo avaliaremos a incidência de endocardite (EI) por Bartonella spp. na série de 119 pacientes no Rio de Janeiro. Método: Estudo observacional, transversal, prospectivo, de 2009 a 2021, inclusos 119 pacientes com EI em hospital universitário na cidade do Rio de Janeiro. Os testes sorológicos e moleculares para Bartonella spp. foram realizados no laboratório de referência e resultados positivos de acordo com a literatura. Análise dos dados foi realizada no Stata Statistical Software. Resultados: A incidência de EIAB nesta série foi de 1,6%. Comparando os dados EICAHN (N=17) com o grupo EI comunitária com hemoculturas positivas (N = 35), 14,2% foi classificada com EICAHN. Um paciente (P1) com EIAB residia com dois cachorros e outra paciente (P2) com dois gatos. Ambos com evidência epidemiológica e laboratorial de infecção por Bartonella após visita do grupo One Health. No grupo de EIAB, o principal fator de risco foi a febre reumática (p = 0,031). A EI aórtica foi mais incidente na EICAHN (p = 0,001). Os dois casos de EIAB foram diagnosticados no ano da pandemia de COVID-19. O P1, homem branco de 47 anos, após investigação de síndrome febril e IC de evolução de três meses, foi submetido à cirurgia de troca valvar mitro-aórtica, onde foi observada vegetação valvar. Amostra de sangue submetida à imunofluorescência indireta para anticorpos anti-Bartonella, sendo reagente. A PCR sérica para Bartonella foi negativa, porém houve detecção de DNA para B. henseale na valva. Seus cachorros foram testados e em um deste houve detecção de anticorpos anti-Bartonella spp. no sangue. A P2, mulher branca, 62 anos, com prótese mitral biológica disfuncionante, internada para investigação de síndrome consumptiva há 8 meses, com insuficiência renal e anemia na ausência de febre. A pesquisa de anticorpos IgG Anti-Bartonella spp. no sangue foi positiva, assim como nos gatos que residiam com a mesma. O diagnóstico de EI se deu pelos critérios de Duke modificados. Conclusão: A incidência de EIB nesta série de 119 paciente do time de EI do Rio de Janeiro foi 1,6. Maior acometimento de EIAB foi na valva aórtica e o principal fator de risco a febre reumática. Abordagem One Health contribui em 2020 para o diagnóstico endocardite por B. henselae.

3.
Sistemas & Gestao ; 16(2):145-156, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1399721

ABSTRACT

Highlights: Working in distributed teams means that it does not take location into consideration and uses modern communication and computer technology. In terms of managerial implications, the impact of perceived proximity can add value to telecommuting in distributed teams. Distributed teams (or remote teams) are those in which the members are geographically dispersed. Some of the conflicts presented may be generated by the remoteness of the team from the project they are working on. Aim: Analyze the work in distributed teams through the use of information and communication technologies in companies from different sectors. Design/Methodology/Approach: In this article, literature and field research were used, and the approach used was qualitative. The field research was based on the method of multiple case studies in sectors such as education, technology, beverages, and industrial and medical gases, with respondents from higher education backgrounds. In addition, non-participant observation and semi-structured interviews aided by a script of questions (open and closed), and non-probabilistic sampling techniques were used. Results: The results indicate challenges such as language, time zone, culture, commitment, graduation, and trust. There was no concentration on any of the challenges, but language was the only challenge mentioned twice by the respondents. Research limitations: The main limitation of the research in terms of method and results was the number of companies investigated. Practical Implications: The identification of work conflicts in distributed teams and the benefits of information and communication technologies (ICTs) in reducing them. Originality/value: With the COVID-19 pandemic, researchers start their studies in distributed teamwork, but the theme has been discussed for a long time. The research was done in different sectors, with the analysis of a Brazilian perspective of the existing problems among Brazilian workers and between these and other collaborators abroad was not identified.

4.
HemaSphere ; 5(SUPPL 2):379, 2021.
Article in English | EMBASE | ID: covidwho-1393457

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic has imposed several constrains in the medical practice, especially in hematologic patients (pts) where a higher mortality rate is expected. In our center strict measures were implemented earlier, with the use of personal protective equipment, hand wash at all times, internal separated circuits, frequent prophylactic tests, teleconsultation and rapid isolation of positive cases. However, data is still limited and risk factors for increased susceptibility remain unclear. Aims: Characterize our pts with COVID-19 regarding the type of hematologic disease, the respective treatment, infection severity and identification of any possible risk factors that may have impact in the outcome. Methods: Pts with a positive quantitative RT-PCR from nasopharyngeal swab between 18/03/2020 and 02/02/2021 were identified. Epidemiologic, laboratory, and clinical characteristics were retrospectively collected. Chi-square and Mann-Whitney-U tests were performed to identify statistical differences between groups and logistic binary regression to assess predictive risk factors. Severity of illness was defined by level of care [ambulatory, general inpatient wards and intensive care unit (ICU)], need for respiratory support, incidence of thrombotic events, acute kidney injury and/or death. Active hematologic treatment was defined as therapy within 6 months of COVID-19 diagnosis. Results: A total of 81 pts were identified, with a median age of 61 years (19-88), 52% were male, 63% had an ECOG PS 0 and 69% had at least one comorbidity (hypertension 36%, dyslipidemia 21%, cardiovascular disease 21%, diabetes mellitus 14% and pulmonary disease 11%). Regarding the hematologic disease, 83% had a neoplastic malignancy (non-Hodgkin lymphoma 30%, myeloproliferative neoplasms 16%, acute myeloid leukemia 11% and multiple myeloma 11%), 64% were in active treatment and 43% had active disease. Concerning the COVID-19 infection, 46% required hospital admission among which 65% needed respiratory support and 9% admitted to an ICU. Median overall survival (OS) was not reached (84% at 1 month) and the mortality rate was 17%, mainly in pts with active disease and neoplastic malignancy. Non-survival pts had a lower hemoglobin level (8,3g/dL vs 12g/dL;p-value 0,016), a higher CRP (218mg/L vs 22mg/L;p-value 0,041), acute renal failure (36% vs 6%;p-value 0,014), more need of respiratory support (71% vs 27%;p-value 0,004) and mechanical ventilation (21% vs 5%;p-value 0,022). There were no statistical differences regarding age, absolute lymphocyte count, platelet count and LDH. Regression analysis revealed hemoglobin level (p-value 0,026), CRP (p-value 0,05) and respiratory support (p-value 0,003) as predictive factors for death. In our pts there were no thrombotic events. Summary/Conclusion: Nearly half of the pts were admitted to the hospital and discharged. In our analysis low hemoglobin level, high CRP and respiratory support were associated with poorer survival, however, given our small sample, these findings need to be confirmed. Contrary to most of the published results, the number of confirmed COVID-19 positive cases was surprisingly low, with only 81 cases in 11 months, with a mortality rate similar to the general population and lower than expected. We believe that implementing early and rigorous protective measures as well as create self-awareness may be the key to improve mortality rate in this highly susceptible population.

5.
Linha D Agua ; 34(1):60-80, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1257125

ABSTRACT

In this article, we propose the analysis of verb-visual texts - a newspaper cover story and an advertisement disclosed in magazines - which have in common marked female faces, to some extent, by evidence of the covid-19 pandemic. This analysis aims to highlight discursive resources that imply ideas, emotions and intentionalities in accordance, above all, with the sociodiscursive imaginary shared by the interactants of the exchange provided by those texts, in order to contribute with a theoretical-analytical basis for the elaboration of activities of interpretation focused on "Media Education" proposed by the National Common Basis. Based on the Semiolinguistic Theory of Discourse Analysis in liaison with other studies, the concepts of image as a sign, image -symptom and intericonicity will be initially explored. After that, taking the texts under analysis more specifically, the construction of the ethos and the controversial target in discursivization will be observed.

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