Emerging Invasive Group A Streptococcus M1UK Lineage Detected by Allele-Specific PCR, England, 20201.

Increasing reports of invasive Streptococcus pyogenes infections mandate surveillance for toxigenic lineage M1UK. An allele-specific PCR was developed to distinguish M1UK from other emm1 strains. The M1UK lineage represented 91% of invasive emm1 isolates in England in 2020. Allele-specific PCR will permit surveillance for M1UK without need for genome sequencing.

Cardiac manifestations in children with the multisystem inflammatory syndrome (MIS-C) associated with SARS-CoV-2 infection: Systematic review and meta-analysis.

According to the World Health Organisation, as of October 2022, there have been 55,560,329 reported cases of SARS-COV-2 in patients under 19 years old. It is estimated that about 0.06% of these patients may develop MIS-C, representing more than 2 million children worldwide. This systematic review and meta-analysis examined the pooled prevalence of cardiovascular manifestation and cardiac complications in children hospitalised with MIS-C. The PROSPERO register number is CRD42022327212. We included case-report studies, case-control studies, cohort studies, and cross-sectional studies, as well as clinical trials or studies describing cardiac manifestations of MIS-C and its sequelae in a paediatric population. Initially, 285 studies were selected, but there were 154 duplicates, and 81 were excluded because they did not fit the eligibility criteria. Thus, 50 studies were selected for review, and 30 were included in the meta-analysis. A total sample size of 1445 children was included. The combined prevalence of myocarditis or pericarditis was 34.3% (95% CI: 25.0%-44.2%). The combined prevalence for echocardiogram anomalies was 40.8% (95% CI: 30.5%-51.5%), that of Kawasaki disease presentation was 14.8% (95% CI: 7.5%-23.7%), and that of coronary dilation was 15.2% (95% CI: 11.0%-19.8%). The rate of electrocardiogram anomalies was 5.3% (95% CI: 0.8%-12.3%), and the mortality rate was 0.5% (CI 95%: 0%-1.2%). Furthermore, 186 children still had complications at discharge, with a combined prevalence of such long-lasting manifestations of 9.3% (95% CI: 5.6%-13.7%). Studies that assess whether these children will have an increased cardiovascular risk with a greater chance of acute myocardial infarction, arrhythmias, or thrombosis will be essential for healthcare planning.

Varicella zoster virus reactivation following COVID-19 vaccination: a report of 3 cases.

BACKGROUND: The advent of vaccination against COVID-19 brought great expectations for the control of the pandemic. As novel vaccines, much of the associated side effects were unknown. Currently, an increasing number of reports from side effects of COVID-19 vaccines have been published, namely on cutaneous reactions. These are of utmost importance to increase our knowledge about possible undesirable effects and its prevention. METHODS: We describe a series of 3 cases who presented with varicella zoster virus (VZV) reactivation following the first dose of 3 different COVID-19 vaccines. RESULTS: Three patients sought their Family Doctor after developing typical lesions of VZV reactivation, following a period of 3-13 days after COVID-19 vaccination. None was under immunosuppressive therapy. The 3 patients recovered in a few weeks and the subsequent doses of the vaccines were administered, without recurrence of the symptoms. CONCLUSIONS: These cases highlight the possibility of VZV reactivation after the first dose of COVID-19 vaccines. Family Doctors should be aware of this event and play an important role informing and reassuring local communities for this possible vaccine reaction.

Current status of MSK radiology training: an international survey by the European Society of Musculoskeletal Radiology (ESSR) Young Club.

OBJECTIVES: There is wide variation between Countries in the structures of residency programmes, need for subspecialisation, and health care system organisation. This survey was aimed at gathering information regarding current musculoskeletal (MSK) educational programmes offered both in European and non-European Countries. METHODS: We administered an online survey to European Society of Radiology (ESR) residents and radiologists aged up to 35 years. The questionnaire was further disseminated by delegates of the ESR Radiology Trainees Forum. Survey consisted of 20 questions about the structure and organisation of MSK training programmes. RESULTS: Overall, 972 participants from 86 Countries completed the survey, with a wide heterogeneity of answers. Of them, 636 were residents (65.9%), 329 were certified radiologists (34.1%), with a mean age of 30.8 ± 3 years. Almost half of the participants had a dedicated MSK rotation/block during residency, with a duration of 3-6 months in 62.5% of cases. A dedicated period in MSK Ultrasound was present in only one-third of residency programmes; 38% of participants were expected to learn interventional MSK procedures, but only 28.2% have been actively involved in interventions during their residency. Overall, 62.7% of participants rated the quality of their MSK training as poor to average. Almost all (93.1%) thought that MSK training could be improved in their residency, especially ultrasound practice (80.7%) and MRI reporting (71.1%). CONCLUSIONS: There are significant inconsistencies in the structure of MSK training offered by different Countries. Radiology trainees are showing substantial interest in MSK training, which necessitates strategic investments to standardise and enhance its quality.

A Validated Mathematical Model of the Cytokine Release Syndrome in Severe COVID-19.

By June 2021, a new contagious disease, the Coronavirus disease 2019 (COVID-19), has infected more than 172 million people worldwide, causing more than 3.7 million deaths. Many aspects related to the interactions of the disease's causative agent, SAR2-CoV-2, and the immune response are not well understood: the multiscale interactions among the various components of the human immune system and the pathogen are very complex. Mathematical and computational tools can help researchers to answer these open questions about the disease. In this work, we present a system of fifteen ordinary differential equations that models the immune response to SARS-CoV-2. The model is used to investigate the hypothesis that the SARS-CoV-2 infects immune cells and, for this reason, induces high-level productions of inflammatory cytokines. Simulation results support this hypothesis and further explain why survivors have lower levels of cytokines levels than non-survivors.

Telehealth in covid-19 times: user embracement, network organization and teaching-service integration

Objetivo: relatar a experiência da articulação ensino-serviço para a implantação de Serviço de Telessaúde como mecanismos de organização do fluxo de atendimento na Rede de Atenção à Saúde em um município de médio porte no oeste paulista. Método: estudo quantitativo, descritivo sob a forma de relato de experiência. Os dados foram analisados por meio da estatística descritiva. Resultados: a implantação da estratégia foi realizada por meio da articulação entre uma universidade privada e a secretaria de saúde local, compondo o Plano de Contingência para Enfrentamento da COVID-19. Participaram da ação docentes e estudantes dos cursos de enfermagem e medicina, organizados em turnos de 12 horas, todos os dias da semana. Após 60 dias da implantação, o serviço atendeu 1.575 pessoas, sendo 921 (58,4%) ligações, 614 (39%) contatos via aplicativo e 40 (2,6%) acessos via e-mail. As principais condutas foram orientações gerais (n.619/67,2%), medidas de isolamento domiciliar (n.150/16,3%), encaminhados ao Centro de Triagem ou Unidade de Saúde (n.95/10,3%), encaminhamento à Unidade de Pronto Atendimento (n.57/6,2%). Conclusão: a ação se mostrou robusta como estratégia de enfrentamento da atual pandemia, principalmente em relação ao acolhimento das necessidades singulares dos usuários, bem como na colaboração com a organização da rede de atenção à saúde. (AU) Objective: to report the experience of the teaching-service articulation for the implementation of the Telehealth Service as a mechanism to organize the care flow of the Healthcare Network in a medium-sized municipality from the Western Region of São Paulo state. Method: a quantitative and descriptive study in the form of an experience report. The data were analyzed by means of descriptive statistics. Results: the implementation of the strategy was carried out by the articulation between a private university and the local health department through the Contingency Plan for Coping with COVID-19. Teachers and students of the Nursing and Medicine Schools participated in the action organized in 12-hour shifts every day of the week. After 60 days of the implementation, the service reached 1,575 people, with 921 (58.4%) calls, 614 (39%) contacts via application and 40 (2.6%) accesses via e-mail. The main conducts were general guidelines (n. 619 / 67.2%), home isolation measures (n. 150 / 16.3%), referrals to the Sorting Center or Health Unit (n. 95 / 10.3%), referrals to the Emergency Care Unit (n. 57 / 6.2%). Conclusion: the action proved to be robust as a strategy to face the current pandemic, mainly in relation to welcoming users'specific needs as well as in collaboration with the organization of the health care network. (AU) Objetivo: reportar la experiencia de la articulación enseñanza-servicio para la implementación del Servicio de Telesalud como mecanismo para organizar el flujo de atención en la Red de Atención de Salud, en un municipio de tamaño mediano en el oeste de la provincia de São Paulo. Método: estudio cuantitativo y descriptivo en forma de relato de experiencia. Se analizaron los datos mediante estadística descriptiva. Resultados: la implementación de la estrategia se llevó a cabo mediante la articulación entre una universidad privada y el departamento de salud local a través del Plan de Contingencia para el Enfrentamiento del COVID-19. Profesores y estudiantes de las carreras de Enfermería y Medicina participaron en la actividad, organizados en turnos de 12 horas, todos los días de la semana. Luego de 60 días de la implementación, el servicio llegó a 1,575 personas, con 921 (58.4%) llamadas, 614 (39%) contactos a través de la aplicación y 40 (2.6%) accesos por correo electrónico. Las principales conductas fueron orientaciones generales (n.º 619 / 67.2%), medidas de aislamiento domiciliar (n.º 150 / 16.3%), referencias al Centro de Triaje o Unidad de Salud (n.º 95 / 10.3%), referencias a la Unidad de Atención de Urgencia (n.º 57 / 6.2%). Conclusión: la acción demostró ser robusta como estrategia para enfrentar la pandemia actual, principalmente con relación a la satisfacción de las necesidades específicas de los usuarios, así como en la colaboración con la organización de la red de atención a la salud. (AU)

Construction of an educational booklet on child care before the covid-19 pandemic: experience report

Objetivo relatar a experiência da produção e divulgação de tecnologia, em forma de cartilha educativa, para informar e orientar sobre os cuidados com as crianças frente à pandemia da COVID-19. Metodologia trata-se de relato de experiência sobre a construção de uma cartilha on-line e gratuita, tendo como público-alvo crianças a partir de dois anos de idade, os pais ou responsáveis e a comunidade. A construção foi realizada por estudantes de enfermagem, em maio de 2020. Resultados a construção da cartilha possibilitou a integração entre pesquisadoras, educadores e comunidade. O produto foi amplamente divulgado e houve retorno positivo das orientações passadas de forma lúdica, fidedignas e acessíveis. Conclusão a experiência oportunizou a disseminação de informações seguras, com fontes confiáveis e embasamento científico, além da integração das pesquisadoras à comunidade. Ampliou o vínculo extramuros da Universidade, fator imprescindível para atuação junto à população. Objetivo informar la experiencia de la producción y difusión de tecnología, en forma de folleto educativo, para informar y orientar sobre el cuidado de los niños frente a la pandemia de COVID-19. Metodología este es un informe de experiencia sobre la construcción de un folleto en línea y gratuito, dirigido a niños a partir de dos años de edad, padres o tutores y la comunidad. La construcción fue llevada a cabo por estudiantes de enfermería en mayo de 2020. Resultados la construcción del folleto permitió la integración entre investigadores, educadores y la comunidad. El producto fue ampliamente difundido y hubo un retorno positivo de las orientaciones anteriores de una manera lúdica, fiable y accesible. Conclusión la experiencia permitió la difusión de información segura, con fuentes fiables y base científica, además de la integración de los investigadores en la comunidad. Amplió el vínculo extramuros de la Universidad, un factor indispensable para trabajar con la población. Objective to report the experience of producing and disseminating technology as an educational booklet, to inform and guide about the childcare before the COVID-19 pandemic. Methodology this is an experience report on the construction of an online and free booklet, targeting children from two years of age, parents or guardians and the community. The construction was carried out by nursing students in May 2020. Results the construction of the booklet allowed integrating researchers, educators and the community. The product was widely disseminated and there was a positive return of the provided guidelines in a playful, reliable and accessible way. Conclusion the experience allowed for the dissemination of safe information, with reliable sources and scientific basis, in addition to integrating researchers into the community. It expanded the extramural bond of the University, an indispensable factor for working with the population.

Construction of an educational booklet on child care before the covid-19 pandemic: experience report

Objetivo relatar a experiência da produção e divulgação de tecnologia, em forma de cartilha educativa, para informar e orientar sobre os cuidados com as crianças frente à pandemia da COVID-19. Metodologia trata-se de relato de experiência sobre a construção de uma cartilha on-line e gratuita, tendo como público-alvo crianças a partir de dois anos de idade, os pais ou responsáveis e a comunidade. A construção foi realizada por estudantes de enfermagem, em maio de 2020. Resultados a construção da cartilha possibilitou a integração entre pesquisadoras, educadores e comunidade. O produto foi amplamente divulgado e houve retorno positivo das orientações passadas de forma lúdica, fidedignas e acessíveis. Conclusão a experiência oportunizou a disseminação de informações seguras, com fontes confiáveis e embasamento científico, além da integração das pesquisadoras à comunidade. Ampliou o vínculo extramuros da Universidade, fator imprescindível para atuação junto à população. Objetivo informar la experiencia de la producción y difusión de tecnología, en forma de folleto educativo, para informar y orientar sobre el cuidado de los niños frente a la pandemia de COVID-19. Metodología este es un informe de experiencia sobre la construcción de un folleto en línea y gratuito, dirigido a niños a partir de dos años de edad, padres o tutores y la comunidad. La construcción fue llevada a cabo por estudiantes de enfermería en mayo de 2020. Resultados la construcción del folleto permitió la integración entre investigadores, educadores y la comunidad. El producto fue ampliamente difundido y hubo un retorno positivo de las orientaciones anteriores de una manera lúdica, fiable y accesible. Conclusión la experiencia permitió la difusión de información segura, con fuentes fiables y base científica, además de la integración de los investigadores en la comunidad. Amplió el vínculo extramuros de la Universidad, un factor indispensable para trabajar con la población. Objective to report the experience of producing and disseminating technology as an educational booklet, to inform and guide about the childcare before the COVID-19 pandemic. Methodology this is an experience report on the construction of an online and free booklet, targeting children from two years of age, parents or guardians and the community. The construction was carried out by nursing students in May 2020. Results the construction of the booklet allowed integrating researchers, educators and the community. The product was widely disseminated and there was a positive return of the provided guidelines in a playful, reliable and accessible way. Conclusion the experience allowed for the dissemination of safe information, with reliable sources and scientific basis, in addition to integrating researchers into the community. It expanded the extramural bond of the University, an indispensable factor for working with the population.

Endoprotector: Protective box for safe endoscopy use during COVID-19 outbreak.

Background and study aim Outbreak of COVID-19 began in Wuhan in December 2019 and has rapidly spread from China to the rest of the world. Although it is primarily transmitted by contact and droplets, aerosol-generating procedures also seem to carry the possibility of airborne viral transmission. As such, upper gastrointestinal endoscopy can be considered a risky procedure, with several position statements recommending the adoption of safe practices in endoscopic procedures. This article aims to describe an additional tool to protect healthcare personnel during endoscopy. Methods A covering box made of acrylic plastic, named Endoprotector, was designed to cover the patient's head, while taking into consideration movements performed by patients and healthcare staff during an endoscopic procedure. Results A cough simulation using fluorescent dye confirmed the potential benefit of the box during endoscopy, thus protecting healthcare staff from air droplets. The feasibility and practicality of the box was also tested with patients during endoscopy. Conclusion The reusable Endoprotector is easily and affordably manufactured and may reduce air droplets and airborne transmission of SARS-CoV-2 and other microorganisms during endoscopy.

Role of point-of-care ultrasound during the COVID-19 pandemic: our recommendations in the management of dialytic patients.

COVID-19 is a viral disease due to the infection of the novel Corona virus SARS-CoV-2, that has rapidly spread in many countries until the World Health Organization declared the pandemic from March 11, 2020. Elderly patients and those affected by hypertension, diabetes mellitus, and chronic pulmonary and cardiovascular conditions are more susceptible to present more severe forms of COVID-19. These conditions are often represented in dialytic renal end-stage patients. Moreover, dialysis patients are more vulnerable to infection due to suppression of the immune system. Growing evidences, although still supported by few publications, are showing the potential utility of ultrasound in patients with COVID-19. In this review, we share our experience in using point-of-care ultrasound, particularly lung ultrasound, to indicate the probability of COVID-19 in patients with end-stage renal disease treated by hemodialysis. We also propose recommendations for the application of lung ultrasound, focused echocardiography and inferior vena cava ultrasound in the management of patients in hemodialysis.

LGBT+ Equal Representativity in Medical Training and Covid-19: Building Care and Solidarity Networks

Abstract: Introduction: Members of the LGBT+ community have historically faced structural obstacles denying them the protections and rights guaranteed by full citizenship. The COVID-19 pandemic has caused the vulnerability of these individuals to become even more intense and explicit. In light of these developments, this experience report presents and critically analyzes an action executed by medical students to promote equal representation and a care/support and solidarity network among LGBT+ students during the pandemic. Experience Report: This report describes the creation of a video entitled “Evoluiu Challenge” by medical students and graduates from a Brazilian public university. In the face of social isolation and the need for LGBT+ equal representation, encouragement and empowerment in medical schools, actions, such as producing the video, were identified as necessary in order to help the most vulnerable academics find a network of support, solidarity and empowerment among their peers. The project was developed with 20 students and 3 graduates from the same institution, with the video being viewed more than 85,000 times. Discussion: The experience reported here highlights the importance of technological advances to promote “togetherness” in times of isolation and social distancing. In this regard, the video increased the visibility of the LGBT+ population in the medical sphere. Furthermore, it fostered equal representation and the construction of a student support network promoting care, as described in the National Curriculum Guidelines. Conclusion: This experience report clearly demonstrates the need to implement strategies for actions that support the LGBT+ community at universities, such as care/solidarity networks. Such strategies, like the video, will therefore leverage the construction of a more inclusive teaching-learning space, representing an oasis of thought against oppression and space for contestation.