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In light of the world leaders' response to the critical time of pandemic, this paper offers first-hand evidence of the perceived impacts of pandemic and perceived resiliency in the context of health-quarantined communities in two Asian countries. The study utilized Partial Least Square Structural Equation Modeling (PLS-SEM) to determine perceived impacts of Covid 19 and to analyze comparatively the social resilience of two countries with opposing global economic statuses, the Philippines and Japan. Due to the global condition caused by the pandemic, the online survey was administered in both countries. Resiliency survey questions were tailored for suitability within the context of the coronavirus pandemic and for face validity. The instruments used in this study consist of a Japanese translation for ease of understanding of the community respondents in Japan. Data analysis using PLS-SEM revealed impacts of Covid-19 pandemic significantly influence the social resilience of communities in both countries. Impacts of Covid-19 outbreak similarly showed significant influence on building new normal resilience of communities in two countries. Resilience was anchored on reactive and proactive capacities of communities. Implications of this study contribute to the sustainable futures of the communities focusing on intervention models to mitigate the long-term impacts of the pandemic. Further research should be done on the development of policies and programs for government implementation to manage and mitigate social complexities brought about by the pandemic or other adversities. Linking through mediation analysis of resilience factors for sustainable development can be explored for future research © 2023, Journal for ReAttach Therapy and Developmental Diversities.All Rights Reserved.
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Objectives: To describe demographic characteristics, comorbidities, and exacerbations in a cohort of patients with COPD in Chile. Method(s): Retrospective cohort study using INTEGRAMEDICA (a network of ambulatory medical centers) electronic medical records of patients with COPD aged >=40 years at index with data available one year before (baseline) and after (follow-up) index. Index date was fixed at 28-Feb-2019 to avoid including data from the COVID-19 pandemic. Moderate and severe exacerbations were defined as prescription of systemic corticosteroid/antibiotics and emergency visit/hospitalization, respectively. Result(s): In total, 19,000 patients were included. In the baseline period, 86% (n=16,400) had no moderate or severe exacerbations (NMSE), 13% (n=2,503) had only moderate exacerbations (OME) and <1% (n=96) had >=1 severe exacerbation (SEV). Mean age/proportion of females was: 64 years/60% (total cohort), 65 years/59% (NMSE), 61 years/67% (OME) and 73 years/62% (SEV). The four most frequent comorbidities were: hypertension (total: 17.6%;NMSE: 16.2%;OME: 26.0%;SEV: 24.0%), asthma (total: 8.9%;NMSE: 7.8%;OME: 15.3%;SEV: 17.7%), diabetes type 1/2 (total: 6.3%;NMSE: 5.9%;OME: 9.1%;SEV: 7.3%) and congestive heart failure (total: 3.2%;NMSE: 3.2%;OME: 2.9%;SEV: 4.2%). The proportion of patients with >=1 moderate/severe exacerbation during follow-up was 14% (total), 10% (NMSE), 38% (OME) and 35% (SEV). The severe exacerbation rate was 2.00 per 1,000 person-years in the overall population and increased based on exacerbation history (NMSE: 0.91;OME: 1.60;SEV: 197.92) Conclusion(s): Preliminary results indicate that severe exacerbations were more frequent in patients with a history of SEV compared with patients with a history of OME or NMSE. In addition, comorbidities were more frequent in patients with a history of exacerbation. To improve patient health outcomes, strategies with a multisectoral approach should be prioritized as COPD can coexist with, and be aggravated by, other chronic comorbidities. Funding(s):GSK [209968].Copyright © 2023
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Intro: Coronavirus disease (COVID-19) is currently a global health crisis and is caused by a new strain of coronavirus. However, emerging literature of case reports noted possible extrapulmonary manifestations of the disease. Because COVID 19 is a relatively new disease, at present, little existing literature tackles the diagnosis and therapeutic management of COVID-19-related conditions outside the pulmonary system. Method(s): This is a case of a 24-year-old male presented with the chief complaint of sudden stiffening of all extremities. Non-contrast computed tomography (CT) scan was unremarkable. Chest X-ray revealed interstitial pneumonia and SARS-CoV-2 RT-PCR (OPS/NPS) was positive. Electrocardiogram (ECG) findings showed supraventricular tachycardia and had elevated Troponin I levels. Pertinent physical findings noted were slurring of speech, dysmetria, and vertical nystagmus. Finding(s): The patient was initially treated as a case of Bacterial Abscess versus Viral encephalitis. Pericardial ultrasound revealed small pericardial effusion and was started on Colchicine. Repeat cranial CT scan noted unremarkable results but due to persistence of symptoms, the patient was started with Dexamethasone. On Day 16 of illness, the patient was noted to have full resolution of symptoms. Rapid antibody testing was done which revealed positive for both IgG and IgM hence the patient was discharged with the final diagnosis of Viral Myopericarditis resolved, Viral encephalitis resolved, COVID-19 pneumonia recovered. Conclusion(s): Extrapulmonary manifestations have been reported increasingly as an atypical presentation of COVID 19 infection. Early recognition of viral myopericarditis and viral encephalitis as a manifestation of COVID 19 can lead to the initiation of proper treatment and management. More reports on these cases can aid future studies on diagnostics and therapeutic approaches during the COVID-19 pandemic.Copyright © 2023
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The research aims to analyze statistical data concerning racial inequality in Brazil during the Covid 19 pandemic period. In this regard, its object is the unfolding of the pandemic for the deepening of social asymmetries between blacks and non-blacks. Depending on the variables gender, race, class and region. For methodology, it adopts the literature review on the subject in question and with emphasis on the theoretical-methodological perspective of black feminism. As well, it focuses on the qualitative analysis of the main indicators of social vulnerability according to the Institute of Applied Economic Research (IPEA) and the Continuous Annual Household Sample Survey (PNAD) between (2015-2020). It also notes the budget line allocated by the Executive Branch to the Ministry of Health (2018-2021) to mitigate the effects of covid-19 in the country. The hypotheses of this research fall on the deepening of racial dissymmetries during the pandemic from the cut of race/color, class, gender and regional origin. Then, the current management of the Executive Branch would have played a fundamental role in the proportion of deaths affected by the covid-19 virus. In short, the research ends up reflecting on the data of social inequality funneled under the pandemic context and its impacts on the aforementioned identity minorities, as well as the inaction of the State in the design of public policies.
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Background: The development of vaccines against coronavirus disease 2019 (COVID-19) and the report of associated allergic reactions has led to growing concern about their safety, especially in populations at risk for anaphylaxis such as patients with systemic mastocytosis. Method(s): We conducted a retrospective descriptive analysis of patients with systemic mastocytosis referred to our Allergy and Clinical Immunology Department, between June 2021 and February 2022, for COVID-19 vaccination. Patients were divided into two groups according to their risk of allergic reaction: low/moderate-risk (no history of severe allergic reaction, with or without a history of allergic disease) and high-risk (history of any severe allergic reaction). All patients were premedicated with 60 mg of oral prednisolone 24 hours and 1 hour prior inoculation, and with an oral antihistamine 1 hour before vaccine administration. Low/moderate-risk patients were monitored for 30 minutes after vaccine inoculation. High-risk patients got a peripheral venous access and remained under medical surveillance for 60 minutes. Result(s): A total of 45 patients were included in the analysis: 62.2% females, with a mean age of 48.8 years (range: 22-85). All patients had indolent systemic mastocytosis subtype, with a median tryptase level of 15.6 ng/mL (range: 4.3-185 ng/mL);11 (24.4%) were in the high-risk group (8 with history of anaphylaxis to hymenoptera venom and 3 with prior drug anaphylaxis). Low/moderate-risk and high-risk groups had similar median levels of serum tryptase (15.5 vs. 16.6 ng/ mL, p = 0.932). All patients received BNT162b2 mRNA COVID-19 vaccine and a total of 118 doses were administered (24.6% in the high risk group). No adverse events, including allergic reactions, after vaccine inoculation were recorded during the surveillance period. Conclusion(s): To our knowledge, this is the largest series reporting safety of a mRNA COVID-19 vaccine in patients with systemic mastocytosis. Our data reinforce the fact that even patients with increased risk for allergic reactions can be safely vaccinated against COVID-19, and that earlier concerns should be abandoned so a widespread immunization can be achieved.
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Severe Acute Respiratory Syndrome (SARS) is a severe manifestation of COVID-19 infection that, in some cases, can result in death. In the current global epidemiological scenario, Brazil is the second country with highest number of deaths from the disease;thus, it is necessary to know the clinical and epidemiological characteristics of deaths and how they are spatially distributed across territories. Therefore, the objective was to describe the clinical and epidemiological characteristics and the spatial distribution of SARS deaths due to COVID-19 in the Brazilian federative units (states). This is a descriptive and ecological study of SARS deaths due to COVID-19 in Brazilian states, from March 2020 to June 2021, based on secondary data available on the openDataSUS database. Descriptive statistics were performed for the clinical-epidemiological variables and the monthly mortality rates were determined by state and thematic maps were made in QGIS software version 2.4.17. A total of 196,109 deaths were recorded in the investigated period, predominantly male, older, white, and low-educated. Among the clinical variables, cough, respiratory distress, dyspnea, and the presence of comorbidities stood out. A heterogeneous spatial distribution of deaths was observed, with rates ranging from 0.00 to 24.59 deaths/100,000 inhabitants, the highest rates were in the states of Rio de Janeiro, Amazonas, Ceara, Sergipe, Sao Paulo, and Pernambuco. These findings raise the need for investments on the part of public management and health systems and services in the most affected states, improvements in epidemiological surveillance, permanent health education, increased access to immunization and health prevention measures to control and monitor SARS caused by COVID-19. © 2022 Centro Universitario Sao Camilo. All rights reserved.
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This study aimed to analyze the economic and financial performance of the four largest companies in the Meat Agribusiness Sector listed on B3 S.A., before and after the onset of the Coronavirus Pandemic (period from 2018 to 2020). The analysis was carried out by means of financial indicators of capital structure and profitability, focusing in particular on the DuPont Identity, calculated based on values of accounting accounts in the companies' financial statements. The collection was performed through the structured financial statements presented on the B3 S.A. website and with the use of the Economatica database. The research is characterized as descriptive, documentary, and quantitative. Comparing the percentages corresponding to the indicators for each year and the economic scenario of the period, the research used Pearson's Correlation to analyze the relationship between the variations of the indicators with respect to the variation of the Gross Domestic Product (GDP) of the Livestock Branch, in the period studied. Among the main findings, a significant improvement of the Return on Assets and Return on Equity, in medium and strong positive correlations with the sector's GDP growth, is evident. Furthermore, an extremely strong positive correlation was found between the companies' Revenue from Goods and Services and the Livestock Industry GDP. It is concluded that, overall, in addition to the sector's GDP growth, despite the economic crisis resulting from the pandemic, companies raised their revenues and improved profitability and profitability.
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Aim: Since the early phases of the COVID-19 pandemic, health systems tried to adapt to ensure the continuity of care of oncological patients. This study aimed to describe the impact of SARS-CoV- 2 on rectal cancer screening and staging. Method(s): A two-year (March 2019 to March 2021) retrospective study concerning rectal cancer patients from a referral center was conducted. Patients clinical data from pre-COVID (March 2019 -February 2020) and COVID time (March 2020 -March 2021) was compared. Descriptive and inferential analysis was performed (Chi-Square test). Result(s): One hundred and sixty-five patients were discussed at the multidisciplinary meetings during the 2-year study period (mean age 69 years [+/- 11.1];M: 64%;F:36%). Upon comparative analysis both pre-COVID and COVID patients were found to have similar demographic characteristics, however during the pandemic a higher proportion of patients presented with low rectal cancers (36% vs. 42%;P = 0.1). Moreover, during the COVID period, fewer patients (minus 26%;npre-covid= 95 vs. ncovid = 70) were referred to the hospital, and a larger number of patients presented in Stage IV of the disease (17,9% (n = 17) in pre COVID period vs. 28,6% (n = 20) in COVID period (P = 0.07)). Lastly, the authors run a comparative sub-analysis between the above results and data from the 3 years prior to the pandemic (2017-2019) and still came across with lesser rectal cancer referrals during the pandemic year. Conclusion(s): Our data clearly shows that, during the COVID period, fewer patients received in-hospital care and a higher number were referred in Stage IV. This represents a red flag for the community and should alert the government to implement public health policies to reestablish colorectal cancer standard of care.
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The COVID-19 pandemic has been a natural global epidemiological experiment unique to our century and a massive shock to older adults and to systems that care for them. There was a lack of a global unified plan to mitigate and control the spread of COVID-19. Several middle-or-high income nations struggled to control the viral spread resulting in increased mortality due to a combination of lack of public health measures and existing disparities which were magnified during the pandemic. The purpose of this review by a team of international experts is to (1) to examine reasons for the varied COVID-19 responses within U.S. and among other middle-or-high-income countries and the emergence of variants and vaccine inequities, and (2) to examine the country specific burden of cultural/structural/political determinants on access to care and mortality among older adults in various settings.
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Objetivos: Correlacionar a associacao entre a infeccao pelo SARS-CoV-2, a coagulacao intravascular disseminada e a relacao do D-dimero com o agravamento do quadro clinico em pacientes com a COVID-19. Materiais e Metodos: Trata-se de uma revisao de literatura realizada pela analise de onze artigos publicados entre 2020 e 2022, nas linguas portuguesa e inglesa obtidos atraves das bases de dados PubMed e SciELO. Os descritores utilizados na pesquisa estao de acordo com o Sistema de Descritores em Ciencias da Saude (DeCS) e sao respectivamente "Coagulacao Intravascular Disseminada" e "COVID-19". Resultados: O SARS-CoV-2, agente etiologico responsavel pela COVID-19, pode causar um estado de hipercoagulabilidade devido ao seu efeito no aumento de citocinas inflamatorias. Sendo o D-dimero um produto de degradacao da fibrina, que tem sua producao influenciada pela inflamacao, este se torna um importante marcador de gravidade para diagnostico e manejo de eventos tromboticos. Uma das principais complicacoes dessa disfuncao da hemostasia no COVID-19 e o Tromboembolismo Pulmonar (TEP), que foi observado em cerca de 25% dos casos graves com maiores elevacoes do D-dimero. Ademais, a Coagulacao Intravascular Disseminada (CIVD) se enquadra como outra complicacao que ocorre, principalmente, nos casos em que a infecao e fatal, sendo relatada em 71,4% dos pacientes que vieram a obito e 0,6% dos sobreviventes. Niveis de D-dimero aumentados mais de 6 vezes o limite da normalidade foram associados com desenvolvimento de sindrome do desconforto respiratorio agudo, piora do padrao radiologico e aumento da mortalidade. Ainda, os valores desse parametro variavam entre 2.614 mug/L e 3.780 mug/L nos pacientes que vieram a obito, enquanto nos sobreviventes, na maioria das vezes, nao ultrapassavam 1.705 mug/L. Corroborando a isso, alguns estudos consideraram valores de D-dimero acima de 1.500 mug/L na admissao um ponto de corte para prever um maior risco de mortalidade dos pacientes com COVID-19. Discussao: Em caso de manifestacao grave da infeccao, pode repercutir em sepse, sendo uma circunstancia em que o sistema antitrombina, a proteina C e o inibidor da via do fator tecidual e a fibrinolise estao disfuncionais, ocorrendo um desbalanco do sistema de coagulacao. Ademais, a hipoxia fomentada pela infeccao pode ser outro fator contributivo para essa disfuncao. Esse estado pro-trombotico e denominado Coagulopatia Induzida pela Sepse (SIC) e precede a CIVD, uma condicao caracterizada por uma excessiva ativacao da trombina com formacao e deposicao de fibrina na microvasculatura. As formas mais graves de COVID-19 estao relacionadas com a SIC, que esta presente na maioria dos casos mais fatais. Tendo em vista que os marcadores laboratoriais podem se encontrar bastante alterados em decorrencia do desequilibrio da coagulacao provocado pela SIC, a avaliacao laboratorial por meio do monitoramento do D-dimero se torna importante para a profilaxia de eventos tromboembolicos mediante uso da terapia anticoagulante, sendo assim, quanto mais estudos forem feitos acerca do tema, melhor a indicacao dessa terapeutica aos pacientes. Conclusao: Desse modo, segundo os artigos pesquisados, houve uma importante relacao entre os niveis de D-dimero e um pior prognostico, sendo os pacientes mais susceptiveis a desenvolver CIVD e ao desenvolvimento de fenomenos tromboembolicos como TEP, e, consequentemente, estes estariam mais indicados a receber profilaxia anticoagulante. Copyright © 2022
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Objetivos: Levantar os principais achados acerca da possivel associacao entre a infeccao pelo SARS-CoV-2 e a manifestacao de Purpura Trombocitopenica Trombotica, compilando as complexidades do quadro e as dificuldades dos tratamentos mais evidenciados na literatura. Material e Metodos: Trata-se de uma revisao de literatura realizada pela analise de seis artigos publicados entre 2020 e 2021, nas linguas portuguesa e inglesa obtidos atraves das bases de dados PubMed e Science Direct. Os descritores utilizados na pesquisa estao de acordo com o Sistema de Descritores em Ciencias da Saude (DeCS) e sao respectivamente "COVID-19"e "Purpura Trombocitopenica Trombotica". Resultados: Foram analisados seis relatos de caso que exemplificam a relacao entre a COVID-19 e a Purpura Trombocitopenica Trombotica (PTT). Especula-se que infeccoes agudas, como as causadas pelo coronavirus, engatilhem uma deplecao da protease de clivagem do fator de von Willebrand, o ADAMTS13, por mecanismos fisiopatologicos ainda nao robustamente estabelecidos. De fato, ja foram registrados casos de PTT apos a exposicao viral pela vacinacao contra a COVID-19. O manejo desses pacientes e muitas vezes dificil visto que sintomas da PTT - piora da funcao renal, febre, alteracoes no nivel de consciencia e trombocitopenia - tambem sao encontrados em quadros de COVID-19;essa sobreposicao fisiopatologica estorva o reconhecimento diagnostico da PTT, comprometendo a adocao rapida e eficiente de condutas terapeuticas para tratar o quadro. E valido mencionar a suposicao de que a COVID-19 possa prolongar a duracao do tratamento de PTT, favorecendo a progressao da doenca. E pertinente ressaltar a importancia do diagnostico precoce da PTT ja que, sem tratamento adequado, esta associada a altas taxas de mortalidade. Dessa forma, o estudo dos tratamentos da PTT associada a COVID-19 fazem-se essenciais, apesar de ainda relativamente escassos. Houve consenso dos trabalhos estudados acerca da plasmaferese terapeutica diaria, primeira linha de tratamento para o quadro. Alguns deles, adicionalmente a plasmaferese, encaminharam a administracao de moduladores imunologicos como imunoglobulina endovenosa. Contudo, os artigos teceram discrepancias quanto a necessidade de corticoterapia, recomendada e bem-sucedida de acordo com a maioria dos estudos, que relataram evolucao favoravel mediante o pulso de corticoides. Um deles ainda exaltou a eficacia da infusao de plasma fresco congelado. Discussao: Perante o exposto, observa-se que a infeccao pelo SARS-CoV-2 possui relacao notoria com a PTT, o que tanto retarda como dificulta seu tratamento. Sofre-se com a carencia de estudos concretos que possam contribuir para a formulacao de uma abordagem sistematica e comprovadamente eficiente para a esquematizacao do diagnostico da PTT durante a COVID-19. Quanto ao tratamento, ha bons resultados com plasmaferese e a administracao de moduladores imunologicos. Conclusao: Pode-se observar que a PTT e um importante fator de piora da COVID-19, tanto pelas adversidades encontradas no diagnostico do quadro clinico - que ocorre frequentemente de forma tardia - quanto pela escassez de conhecimentos acerca dos tratamentos. O progresso cientifico em relacao ao tema ha de trazer nao so esclarecimentos aos profissionais da saude quanto ao manejo dessas configuracoes patologicas complexas, como tambem o estabelecimento de um cuidado mais adequado e preciso para os pacientes acometidos. Copyright © 2022
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Objective: To analyze the association between variables related to the management of Primary Health Care (PHC) services and professional characteristics at the beginning of the COVID-19 pandemic. Materials and Methods: Cross-sectional, survey-type study, carried out through convenience sampling, using the snowball method, which included 259 PHC professionals in the states of Mato Grosso do Sul and São Paulo, working in management and direct care in the initial period of the pandemic. A virtual semi-structured questionnaire was applied. The variables "state”, "professional category” and "function” were considered independent variables and "supply of human and material resources”, as well as "management support” were considered dependent variables. The association between variables was assessed using Fisher's exact test. The significance level adopted was 0.05. The project was approved by the ethics committee with the code number 31493920.8.0000.0021. Results: Health professionals perceive weaknesses in the supply of material and human resources, as well as dissatisfaction with logistics regarding municipal management (40%). The perception of flow and transport logistics also varied among professionals working in care and management (p≤0.05). Conclusion: Professionals perceive municipal management of the pandemic, in different aspects, as inadequate. Therefore, it is necessary to implement public and management policies that value PHC services and their professionals, ensuring adequate working conditions, which can reflect in better care and satisfaction for users of the Brazilian Unified Health System. © 2022, Universidad de Concepcion. All rights reserved.
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Background: SARS-COV-2, in most cases, only generates a mild acute respiratory disease. However, patients with severe disease show an exaggerated response of the immune system, creating a pro-inflammatory state, which could cause abnormalities in the coagulation system that increases mortality. Latin American countries, specially those with limited resources, have few studies about clinical features, coagulation and inflammatory biomarkers that could be useful at admission to assess poor outcomes. Objective: The objective of this study is to describe the clinical features, coagulation, and inflammatory biomarkers, and identify risk factors at admission that are associated poor outcomes in Honduran population. Methods: A cohort study was conducted. 210 patients were included, which 105 died during hospitalization due to COVID-19 and 105 were discharged alive, between September 2020 and January 2021. Clinical and laboratorial data was retrospectively collected. Results: 57,6% of the population were male. The median age was 58 years. The median time between symptom onset and hospital admission was 6 days. D-dimer median was higher in the dead group compared with the alive group. Poor prognosis factors in the Cox multivariable model were male gender, age, symptom's duration, obesity and an elevated d dimer at admission. Conclusion: In low-middle income countries, the assessment of these clinical and laboratory tools, especially in those with risk factors for prothrombotic states, could help clinicians to correctly stratify disease prognosis, establish a baseline to evaluate further evolution, and also predict outcomes, thus improving patient management. © 2022
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Introduction: Coronavirus disease (COVID-19) is currently a global health crisis and is caused by a new strain of coronavirus. However, emerging literature of case reports noted possible extrapulmonary manifestations of the disease. Because COVID 19 is a relatively new disease, at present, little existing literature tackles the diagnosis and therapeutic management of COVID‐19‐related conditions outside the pulmonary system. Case: A 24-year-old male presented with sudden stiffening of all extremities but non-contrast computed tomography (CT) scan was unremarkable. Chest X-ray revealed interstitial pneumonia and SARS-CoV-2 RT-PCR (OPS/NPS) was positive. Electrocardiogram (ECG) findings showed supraventricular tachycardia and had elevated Troponin I levels. Pertinent physical findings noted were slurring of speech, dysmetria, and vertical nystagmus. The patient was initially treated as a case of Bacterial Abscess versus Viral encephalitis. Pericardial ultrasound revealed small pericardial effusion and was started on Colchicine. Repeat cranial CT scan noted unremarkable results but due to persistence of symptoms, the patient was started with Dexamethasone. On Day 16 of illness, the patient was noted to have full resolution of symptoms. Rapid antibody testing was done which revealed positive for both IgG and IgM hence the patient was discharged with the final diagnosis of Viral Myopericarditis resolved, Viral encephalitis resolved, COVID-19 pneumonia recovered. Conclusion: Extrapulmonary manifestations have been reported increasingly as an atypical presentation of COVID 19 infection. Early recognition of viral myopericarditis and viral encephalitis as a manifestation of COVID 19 can lead to the initiation of proper treatment and management. More reports on these cases can aid future studies on diagnostics and therapeutic approaches during the COVID-19 pandemic. © 2022, Philippine College of Physicians. All rights reserved.
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Introdução Os dados de Covid-19 em indivíduos com câncer demonstram maior risco de complicações, maior chance de internações e pior prognóstico. Porém não está claro se essa gravidade se mantém com as mais recentes variantes e após a expansão da vacinação. Objetivo Avaliar os desfechos da infecção por SARS-CoV-2 em pacientes com câncer durante a predominância da variante Ômicron e após vacinação em larga escala, e comparar com os dados do período inicial da pandemia. Método Estudo de coorte retrospectivo, realizado em janeiro/2022 no Instituto do Câncer do Estado de São Paulo. Foram incluídos todos os casos confirmados de COVID-19, definidos por PCR ou Teste rápido (antígeno) positivos. Dados obtidos das planilhas do SCIH, derivadas de busca ativa e prospectiva do Serviço. As seguintes variáveis foram avaliadas: idade, sexo, etnia e diagnóstico oncológico. Os desfechos definidos foram: mortalidade, internação, internação em UTI e uso de ventilação mecânica invasiva (VMI) em pacientes internados na UTI. Dados comparados com a casuística publicada do Instituto, referente ao período de 31/03 a 02/09/2020. Resultados Foram incluídos no período de janeiro/2022 554 casos, e no período anterior (série histórica, 2020) 576 casos. Idade mediana 55a no grupo atual vs 63a na série histórica;55,6% vs 50,7% mulheres. Os principais diagnósticos oncológicos foram trato gastro-intestinal (19,9% no grupo atual vs 20,4% na série histórica), mamas (13,7% vs 13,7%), gênito-urinário (11,4% vs 10,5%) e onco-hematológicos (16,4% vs 17,7%). Os desfechos, com respectiva comparação com a série histórica, estão demonstrados na tabela 1. Conclusão No estudo atual, observamos melhora significativa na evolução da Covid-19 em pacientes com câncer, incluindo menor gravidade e mortalidade. A mudança no prognóstico pode dever-se a alguns fatores, ou associação dos mesmos: maioria da população com esquema vacinal completo;predominância de variante eventualmente menos virulenta (Ômicron);melhor manejo diagnóstico e terapêutico da infecção.
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introduction. The hospital surfaces can contribute to secondary cross contamination, through the hands of health care personnel or contaminated material. It has been necessary to develop ambiental automatic decontamination equipment without the problems related with manual disinfection. material and method. An analytical, prospective, cross-sectional study was carried out, to evaluate the the efficacy and effectiveness of ambiental decontamination at the hospital, with ultraviolet radiation of a 245 nm wavelength equipment, on two semi critical areas, meant for clinical attention to patients with sars-cov-2 infection, with pre and post intervention sampling. 2-stage study to evaluate efficiency and effectiveness. results. In stage 1 (efficacy evaluation) atcc reference strains were sown, subsequently intervention with uv radiation was carried out, the growth of microorganisms was 0/3 in the micas, that is;it was possible to eliminate the bacterial load in 100% (3 samples). In stage 2 (evaluation of effectiveness), microbiological samples were taken from 15 clinic sites under baseline conditions, it was found that there was growth of microorganisms on 12/15 surfaces prior to intervention. After decontamination with uv radiation, the growth of microorganisms was 4/15 in the micas, bacterial elimination was achieved in 73.34% of the sampled surfaces and the bacterial load persisted in 26.66% of the sampled areas. After the decontamination intervention through uv light, a significant bacterial count elimination was achieved (Chi Square test p = 0.0002). conclusions. The decontamination process with uv light in closed spaces with equipment that emits radiation with a wavelength of 254 nm for 30 minutes was an effective intervention to reduce and eliminate the bacterial load from hospital surfaces.
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This study evaluates the Brazilian agricultural commodities market and the dollar-real exchange price variation using the multifractal detrended fluctuations analysis methodology. We investigated the period from January 1, 2019 to September 25, 2019, outside the COVID-19 pandemic, and from January 1, 2020 to September 25, 2020, during the COVID-19 pandemic. We verified the fluctuations of commodities and dollar-real exchange prices during the pandemic caused by COVID-19 showed a record price. The results of Hurst exponent and multifractal parameters α0, w, and r indicate that during the COVID-19 pandemic, sugar was the most efficient commodity, while pork the less one. Compared to the identical months in 2019, the dollar-real exchange was the most efficient market, while ethanol was the least efficient. © 2022 World Scientific Publishing Company.