VV-ECMO in critical COVID-19 obese patients

Objectives: Obesity is a condition prone to pose difficulties to a successful extra-corporeal membrane oxygenation (ECMO) support. Not being a contraindication, it yields significant challenges to physicians and may interfere with patient;s outcome. The number of obese patients supported by ECMO has increased during COVID-19 pandemic due to severe illness in this population. We designed a retrospective study in order to identify prognostic factors for 180-day survival in critical COVID-19 obese patients in venovenous ECMO (VV-ECMO). Method(s): Single-center retrospective cohort of critical COVID-19 adult patients in VV-ECMO, obese and overweight (according to WHO classification), admitted in a tertiary hospital;s ICU from April 1st 2020 to May 31th2022. Univariate logistic regression analysis was performed to assess 180-day mortality differences. Result(s): The analysis included 41 patients. The median [interquartile range (IQR)] age was 55 (IQR 45-60) years and 70,7% were male. Median body mass index (BMI) was 36 (IQR 31-42,5) Kg/m2 ;39% of patients had a BMI >=40 kg/m2 . The sampling had 3 (IQR 1,5-4) days of invasive ventilation prior to ECMO and 63,4% were weaned from ECMO-VV support after a median of 19 (IQR 10-34) days. The median ICU length of stay was 31,9 (IQR 17,5-44,5) days. The invasive ventilation period was 30 (IQR 19-49,5) days. The 60, 90 and 180-day mortalities were 41,5%. On the univariate logistic regression analysis we found that higher BMI was associated with higher 180-day survival (odds ratio [OR] 1,157 (1,038-1,291), p 0,009). Younger age, female patients, less invasive ventilation time prior to ECMO and fewer complications at time of ECMO cannulation were associated with higher 180-day survival [respectively, OR 0,858 (0,774- 0,953), p 0,004;OR 0,074 (0,008-0,650), p 0,019;OR 0,612 (0,401-0,933), p 0.022;OR 0.13 (0,03-0,740), p 0,022)]. Conclusion(s): In this retrospective cohort of critical COVID-19 obese adult patients supported by VVECMO, a higher BMI, younger age and female patients were associated with higher 180-day survival. A shorter invasive ventilation time prior to ECMO and fewer complications at ECMO cannulation were also associated with increased survival.

Consumption of ultraprocessed foods by elementary school students associated with insufficient physical activity during the covid-19 pandemic

Objective: This study sought to analyze the consumption of ultra-processed foods and associated factors in elementary school II students. Materials and Methods: A descriptive, cross-sectional, quantitative study was carried out. Data collection was performed using Google Forms. The variables analyzed in the study were: food consumption, sociodemographic and anthropometric profile, level of physical activity, sedentary behavior, perception of body image, screen time, sleep patterns and self-perception of health status. Pearson's chi-square test was performed to assess associations between variables. Results: A total of 287 adolescents participated in the study, with a mean age of 12.97 years SD +/- 1.30, of which 60.3% (n=173) were female and 39.7% (n=114) were male. It was identified that most students (63.4%;n=182) excessively consumed ultra-processed foods during the period of social isolation due to the Covid-19 pandemic. A significant association was observed among students who practice physical activity less than 180 minutes per week (p=0.022). Conclusion: It is concluded that the social isolation imposed by the Covid-19 pandemic impacted the eating behavior of students, with a high prevalence of consumption of ultra-processed foods being recorded, this condition being associated with physical inactivity.

Life habits of school children during the covid- 19 pandemic: repercussions on body weight

This study sought to identify the repercussions of the pandemic on the body weight of adolescents during social isolation due to the COVID-19 pandemic and associated life habits. Materials and Methods: This is a cross-sectional and quantitative study, carried out with adolescents enrolled in elementary school II in public schools in the north of Minas Gerais. Data collection was performed in virtual format through Google Forms. Questions were collected about changes in body weight, sociodemographic profile, anthropometric data, self-perception of body image, physical activity, screen time, consumption of ultra-processed foods, sleep quality and self-perception of health status. Pearson's chi-square test was used for analysis. Results: A total of 287 adolescents participated in the study, with a mean age of 12.97 years SD & PLUSMN;1.30, 60.3% (n=173) were female and 39.7% (n=114) were male. When evaluating the impact of the pandemic on the body weight of adolescents through self-report, it was observed that 63.8% (n=183) increased, 27.5% (n=79) maintained, and 08.7% (n=25) decreased body weight during the period of social isolation. Significant associations were observed between age group, nutritional status, body image, practice, and changes in physical activity. Conclusion: It is concluded that the habits and life behaviors adopted by adolescents during social isolation had a negative impact on the adolescents' body weight. The practice of PA is insufficient and dissatisfaction with body image associated with weight gain. In addition, social isolation caused an increase in body weight in eutrophic adolescents.

Cone-Beam Computed Tomography Guided Percutaneous Cryoablation to Treat Bone Metastases Due to Endocrine Tumors: A Preliminary Analysis of a Prospective Clinical Trial

Objective: To assess the efficacy and safety of CBCT-guided percutaneous cryoablation of bone metastases due to endocrine tumors. Outcomes included reduction of skeletal-related events and pain control. Method(s): This is a prospective, single arm, tertiary single-center study. Inclusion criteria included age >18 years;ECOG 0-3;mean life expectancy >one month;biopsy-proven bone metastases <7.0 cm in diameter from thyroid, adrenal and neuroendocrine tumors, with pain, hypercalcemia or at risk to develop fracture or spinal cord compression. Prior to ablation, all patients were evaluated by a pain specialist and a brief pain inventory (BPI) was obtained. Follow-up was carried out weekly for the first 8 weeks and then at 3, 6, 12 and 24 months when a BPI was obtained and observation of skeletal-related events. Result(s): This is an interim analysis of 17 patients,12 women and 5 men, mean age of 64.2+/- 12.3 years. Ten patients had papillary thyroid cancer (58.8%), 5 medullary thyroid cancer (29.4%) and 2 with adrenocortical cancer. A total of 24 lesions were treated (21 sessions);current mean follow-up time: 11.1+/- 7.3 months.Cementoplasty was carried out in three lesions;mean size lesions were 3.3 +/- 1.3 cm. Only one mild adverse event was observed (transient sciatic neuropraxia). From the group of patients included with bone pain (N= 14), a mean pre-procedural BPI was 8.3 +/- 2.1 (10 being highest score). After procedure, all patients had reduction of the pain score;complete pain relief was observed in 6 (31.6%) patients within 1-week and the other patients reported a significant reduction of BPI score: mean 2.8+/- 3.3 (1-week);0.9 +/- 1.8 (6-months). Eleven (64.7%) patients achieved complete ablation;radiation therapy was required in 2 patients and no patients required additional surgery. Pathologic fracture was observed in 2 treated lesionswhich recovered spontaneously within 1month. Six non-procedure related deaths were reported during follow-up (oncologic disease progression n = 5;Covid-19 infection n = 1);Discussion/Conclusion: Cryoablation proved to be safe and effective to treat bone metastases due to endocrine tumors, providing a rapid and durable pain palliation, local disease control, and should be considered an option to improve patient care in selected cases.

SARS-CoV-2 variant strains and viral phylodynamics of ORF1a-1b genetic aspects in South America

Bioinformatics tools for online sequence analysis of variants have been used worldwide for the phylogenetic approach of SARS-Cov-2 and their variants. The purpose of this work is to contribute to the settlement of the SARS-CoV-2 genetic of the South America pandemic, presenting the ORF1a-1b evaluation. We proposed and reviewed two online bioinformatics pipelines for viral phylodynamic and phylogeographic analysis with an interactive visualization platform. The phylodynamics evaluation of South America shows a strong viral capacity to evoke immunity and an impressive multiplicity of variants in rapid expansion with mutations of potential importance, including ORF 1a-1b. They showed stately vital for infection and lethality, spreading and raising your frequency in South America from 1% to 20-30% in one year of pandemic occurrence. © 2021 IEEE.

Improvement of SARS-CoV-2 macromolecule conformation by algorithmic structural prediction

A fast way to reconstruct the three-dimensional molecular conformation of SARS-CoV-2 virus proteins is addressed in this article, involving the most worrying variant discovered in patients from Brazil, the lineage B.1.1.28/P.1. The proposed methodology is based on the sequencing of virus proteins and that, through the incorporation of mutations in silico, which are then computationally reconstructed using an enumerative feasibility algorithm validated by the Ramachandran diagram and structural alignment, in addition to the subsequent study of structural stability through classical molecular dynamics. From the resulting structure to the ACE2-RBD complex, the valid solution presented 97.06% of the residues in the most favorable region while the reference crystallographic structure presented 95.0%, a difference therefore very small and revealing the great consistency of the developed algorithm. Another important result was the low RMSD alignment between the best solution by the BP algorithm and the reference structure, where we obtained 0.483Å. Finally, the molecular dynamics indicated greater structural stability in the ACE2-RBD interaction with the P.1 strain, which could be a plausible explanation for convergent evolution that provides an increase in the interaction affinity with the ACE2 receptor. ©2021 IEEE

THE ROLE OF LEGISLATION IN PROMOTING ENVIRONMENTAL COMFORT AND CONTROLLING THE SPREAD OF CORONAVIRUS IN CITIES

The society evolves and materializes its social interactions, through technological innovations, constructions and laws. From the Federal Constitution of 1988, to the municipal codes of works, several principles, guidelines and urban parameters are established that regulate the land occupation, interfering in the urban space and in the population's quality of life. The aim of this article is to evaluate the legislation urban role in promoting environmental comfort, aiming at the cities healthiness and at controlling the spread of the new coronavirus, called SARS-CoV-2, which causes Covid-19. As an empirical object, it focused specifically on urban legislation and on the climatic and legal characterization of Recife/PE, inserted in a hot and humid tropical climate. Climatic elements (temperature, humidity and ventilation) and urban parameters (clearances, natural soil, template, occupation coefficients) were adopted as variables, noting that they are directly related. The qualitative approach was used, analyzing the theme from bibliographic and documentary research, relating urban planning, environmental comfort, bioclimatic principles, housing deficit and illness processes of the population. The methodology consisted in the construction of thoughts and reflections, which relate the laws and their contributions to urban health. It was concluded that, despite all the normative capital, legislation and management have not been able to sufficiently exercise the role of building a healthy city, which meets the needs of users.

Disinfectant products to face the pandemic COVID-19

The transmission of COVID-19 through contaminated surfaces is a significant route of disease transmission, although it is not the main one. This work deals with some disinfectant products approved by the Brazilian National Agency of Sanitary Vigilance (ANVISA) to face the pandemic COVID-19. The first part presents practical recommendations for persons willing to delve into the subject, and presents details about products such as alcohol, bleach, hydrogen peroxide and certain general-purpose disinfectants. The second part, dedicated to people with more technical training, provides the scientific basis for the recommendations provided in the first part and details the action of quaternary ammonium salts (QUATs) in the elimination of microorganisms. The third part provides an overview of actions worldwide for the disinfection of public environments and in more detail on public transportation. © 2020 Sociedade Brasileira de Quimica. All rights reserved.

Predictors of burnout syndrome in nursing technicians in an intensive care unit during the covid-19 pandemic

Objective: To evaluate the prevalence and existence of predictive factors for Burnout syndrome in nursing technicians who work in an intensive care unit during the COVID-19 pandemic. Methods: This is a descriptive, cross-sectional study with a quantitative approach with 94 intensive care nursing technicians. The instruments used were: a form for collecting sociodemographic, occupational, behavioral data and the Maslach Burnout Inventory (MBI) in its Human Services Survey (HSS) version. The association between the variables studied and the prevalence of Burnout syndrome was verified by bivariate analysis followed by hierarchical Poisson regression, with robust variance. Results: It observed a prevalence of the syndrome in 25.5% of the analyzed sample. The variables that, after multiple analysis, showed themselves as predictors associated with the higher prevalence of Burnout syndrome were: age > 36 years, working overtime, considering the workload as rigid and being alcoholic. Conclusion: It is concluded that the prevalence of Burnout syndrome in nursing technicians who work in intensive care units and who are in the front line in the COVID-19 pandemic was high and sociodemographic, occupational and behavioral factors were shown as predictors of the syndrome. © 2021, Editora Cientifica Nacional Ltda. All rights reserved.

Interprofessional work in health in the context of the COVID-19 pandemic: a scoping review Trabajo interprofesional en salud en el contexto de la pandemia del COVID-19: revision del alcance

Objective: to map the scientific production on interprofessional relationships in health in the first year of the COVID-19 pandemic. Method: this is a scoping review performed in PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar and Science Direct databases, covering the period of publication in 2020, using the acronym PCC (Population = health professionals;Concept = interprofessional relationships;Context = health services) and respective search strategies. Results: fourteen scientific articles were selected and the content discussed in the manuscripts was standardized, analyzed and organized into categories of affinities and similarities of their results: 1 - Interprofessional collaboration;2 - Collaborative practice;3 - Interprofessional work;4 - Interactive and interprofessional learning. Conclusion: the pandemic demanded quick and effective responses that were only possible through collaboration and interprofessionalism dimensions. Interprofessional work in health during the first year of the COVID-19 pandemic confirms the importance of interprofessional work and its dimensions for the provision of more comprehensive, resolute and safer health services.

Prevalence and factors associated with depression, anxiety, and stress symptoms among professors during COVID-19 pandemic

Objective: To estimate the prevalence and factors associated with symptoms of depression, anxiety and stress in university professors in the health field during the pandemic period of COVID-19. Methods: This is an analytical, cross-sectional study with a quantitative approach with 150 university professors in the health field. The instruments used were: a form for collecting socio-demographic, economic and labor data. Mental health was assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). The association between the variables studied and the prevalence of symptoms of depression, anxiety and stress was verified by bivariate analysis followed by Poisson regression, with robust variance. Results: The final sample consisted of 150 individuals with a mean age of 41.4 ± 7.9 years with the majority being female (74%). 50% of the teachers had symptoms of depression, 37.4% reported symptoms of anxiety and 47.2% had symptoms of stress. After multiple analysis, it was observed that the symptoms of depression were associated with the variable working in more than one institution of higher education. The variables that were shown to be associated with anxiety were: age group ≥ 40 years and people without a steady partner. Stress was associated with the variable marital status without a steady partner. Conclusion: The prevalence of symptoms of depression, anxiety and stress in university professors in the health area was high, and sociodemographic and labor factors remained associated with the investigated outcomes. © 2021, Editora Cientifica Nacional Ltda. All rights reserved.