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1.
Rev. Fac. Med. Hum ; 22(2): 225-227, Abril.- Jun. 2022.
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1884922

ABSTRACT

El trasplante de médula ósea, conocido actualmente como trasplante de progenitores hematopoyéticos (TPH), implica la infusión de células progenitoras hematopoyéticas sanas a pacientes con médula ósea disfuncional, disminuida o comprometida por neoplasias hematológicas. Desde su primera exploración en seres humanos en la década de 1950 basados en los resultados obtenidos en modelos animales, en la actualidad, en Europa y países colaboradores se han realizado más de un millón de procedimientos, gracias además a una red internacional de registro de donantes de medula ósea y al avance de la tecnología en cuanto al tratamiento de soporte, la detección temprana de complicaciones y la tipificación de la histocompatibilidad (HLA) con las que se puede seleccionar mejor a los donante potenciales.


Bone marrow transplantation, currently known as hematopoietic stem cell transplant (HSCT), involves the infusion of stem cells healthy hematopoietic cells to patients with dysfunctional bone marrow, diminished or compromised by hematological neoplasms. Since its rst exploration in humans in the 1950s based on the results obtained in animal models, more than one million procedures have now been performed in Europe and collaborating countries. Early detection of complications and histocompatibility typing (HLA) with which potential donors can be better-selected thanks to an international donor registry network of bone marrow and the advancement of technology in terms of support treatment.

2.
Gac. méd. Méx ; 158(2): 115-118, mar.-abr. 2022.
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1884918

ABSTRACT

Resumen En 2019, México fue uno de los primeros países en Latinoamérica en comprometer recursos para eliminar la hepatitis C antes de 2030. Un año después de este compromiso, la pandemia mundial de COVID-19 desvió la atención hacia las necesidades inmediatas de salud para combatir la propagación de esta última. Como resultado, los esfuerzos para implementar programas de prevención y manejo de la hepatitis C se suspendieron indefinidamente. Asimismo, las poblaciones con alto riesgo de contraer el virus de la hepatitis C y que representan el mayor peso de la epidemia nacional, como las personas que se inyectan drogas y las personas que viven con infección por el virus de la inmunodeficia humana, permanecen expuestas a disparidades de salud extremas que potencialmente se han exacerbado durante la pandemia de COVID-19. En este artículo discutimos el impacto potencial que la pandemia de COVID-19 ha tenido sobre los esfuerzos de eliminación de la hepatitis C en México y la necesidad urgente de reanudarlos, ya que sin ellos los objetivos de eliminación no se alcanzarán en el país en 2030.


Abstract In 2019, Mexico was one of the first countries in Latin America to commit resources to achieve hepatitis C elimination by 2030. One year after this commitment, the global COVID-19 pandemic diverted attention to address immediate health needs to combat the spread of the disease. As a result, efforts to implement hepatitis C prevention and management programs were indefinitely postponed. Furthermore, populations at high risk of contracting the hepatitis C virus (HCV) and who bear the greatest burden of HCV national epidemic, including people who inject drugs and people who live with human immunodeficiency virus infection, remain exposed to extreme health disparities, which have potentially been exacerbated during the COVID-19 pandemic. In this article, we discuss the potential impact the COVID-19 pandemic has had on HCV elimination efforts in Mexico and the urgent need to resume them, since without these efforts, HCV elimination goals are likely not be achieved in the country by 2030.

3.
Gac. méd. Méx ; 158(2): 119-119, mar.-abr. 2022.
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1884917
4.
Gac. méd. Méx ; 158(2): 81-85, mar.-abr. 2022. tab, graf
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1884916

ABSTRACT

Resumen Introducción: El estudio de anticuerpos IgG anti-SARS-CoV-2 permite identificar individuos asintomáticos con COVID-19 y evaluar la inmunidad posinfección y posvacunación. Objetivo: Conocer el comportamiento de los anticuerpos IgG anti-SARS-CoV-2 pre y posvacunación en trabajadores de un centro oncológico. Métodos: Antes de aplicar la vacuna se analizaron los anticuerpos IgG anti-SARS-CoV-2 (n = 171) con la evaluación de IgG anti-N; después de la segunda dosis se evaluó IgG anti-S (n = 60). Resultados: Prevacunación, los anticuerpos IgG estaban presentes en 18.71 % de los participantes; se detectaron en 65.22 % de aquellos con antecedente de diagnóstico de COVID-19 y en 11.49 % de aquellos sin antecedentes. Los profesiones con mayor prevalencia fueron enfermeros (28.26 %), paramédicos (27.59 %) y administrativos (27.78 %), p < 0.01. La anosmia, ageusia y opresión en el pecho se asociaron a la presencia de IgG (p < 0.05). Posvacunación, todos los participantes desarrollaron IgG; las personas con diagnóstico previo de COVID-19 presentaron mayores títulos: 10 277 versus 6819 UA/mL, p < 0.001. Conclusiones: El estudio de anticuerpos IgG anti-SARS-CoV-2 permitió identificar a trabajadores de salud asintomáticos. Un alto porcentaje de los participantes con diagnóstico previo de COVID-19 presentó anticuerpos. Todos los participantes desarrollaron anticuerpos IgG posvacunación; las personas con infección previa presentaron una cuantificación más alta de títulos.


Abstract Introduction: The study of anti-SARS-CoV-2 IgG antibodies allows asymptomatic individuals with COVID-19 to be identified, and post-infection and post-vaccination immunity status to be evaluated. Objective: To know the behavior of anti-SARS-CoV-2 IgG antibodies before and after vaccination in workers of a cancer center. Methods: Prior to the application of the vaccine, the presence of anti-SARS-CoV-2 IgG antibodies (n = 171) was analyzed by evaluating anti-N IgG antibodies; post-vaccination, after receiving the second dose, anti-S IgG antibodies were evaluated (n = 60). Results: Prior to vaccination, IgG antibodies were present in 18.71% of participants; they were detected in 65.22% of those with prior history of COVID-19 diagnosis and in 11.49% of those without it. The positions with the highest prevalence were nurses (28.26%), paramedics (27.59%) and administrative workers (27.78%), p < 0.01. Anosmia, ageusia and chest tightness were associated with the presence of IgG (p < 0.05). Post-vaccination, all participants developed IgG antibodies; people with a previous COVID-19 diagnosis had higher titers: 10,277 vs. 6,819 AU/mL, p < 0.001. Conclusions: The study of anti-SARS-CoV-2 IgG allowed asymptomatic health workers to be identified. A high percentage of participants with prior COVID-19 diagnosis had antibodies. All participants developed IgG after vaccination, with higher titers being identified in those with previous infection.

5.
Arch. argent. pediatr ; 120(2): 106-: I-110, II, abril 2022. tab
Article in English, Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1884619

ABSTRACT

Introducción. Los cambios en la rutina y en el entramado social que generó la pandemia por COVID-19 afectaron a los niños, niñas y adolescentes (NNyA). El objetivo de este trabajo fue conocer el estado de ánimo, las emociones y las conductas de los NNyA durante el aislamiento por COVID-19. Población y métodos . Estudio prospectivo, descriptivo y transversal. Se preguntó a los padres y/o cuidadores de niños de 3 a 15 años de edad, de la Ciudad Autónoma de Buenos Aires, cómo percibían el estado de ánimo, las conductas y las emociones de los NNyA durante el período de aislamiento. Resultados. Se incluyeron 1080 cuestionarios. El 81 % de los padres y/o cuidadores advirtió algún cambio en la salud emocional de los NNyA. El 76 % refirió que los niños de 3-5 años se mostraban aburridos, enojados y angustiados. Además, observaron un aumento de los episodios de llanto (52 %) y regresión a comportamientos ya superados (29 %). En el grupo de 6-11 años, el 43 % presentó dificultad en mantener la concentración. En 3 de cada 10 adolescentes, de 12 a 15 años de edad, los adultos percibieron abandono de actividades que antes disfrutaban, preocupación y tristeza. Conclusión. La pandemia de COVID-19 impactó en el estado de ánimo, las conductas y las emociones de los NNyA. Predominaron los sentimientos negativos, como aburrimiento, tristeza, angustia y preocupación.


Introduction. Changes in daily routine and social fabric resulting from the COVID-19 pandemic had an effect on children and adolescents. The objective of this study was to know the mood, emotions, and behaviors of children and adolescents during the COVID-19 lockdown. Population and methods. This was a prospective, descriptive, cross-sectional study. Parents and/or caregivers of children and adolescents aged 3-15 years in the Autonomous City of Buenos Aires were asked about their perceptions of the mood, behaviors, and emotions of children and adolescents during the lockdown. Results. A total of 1080 questionnaires were included. Results showed that 81% of parents and/or caregivers observed changes in children and adolescents emotional health; 76% referred that children aged 3-5 years were bored, angry, and upset. They also observed an increase in crying spells (52%) and regression to behaviors that had been outgrown (29%). In the 6-11-year-old group, 43% showed difficulty focusing. Adults noticed that 3 out of 10 adolescents aged 12-15 years discontinued activities they used to enjoy and were sad and worried. Conclusion. The COVID-19 pandemic impacted on the mood, behaviors, and emotions of children and adolescents. Negative feelings prevailed, such as boredom, sadness, anxiety, and worry.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , COVID-19/epidemiology , Communicable Disease Control , Prospective Studies , Emotions , Pandemics
6.
Interface (Botucatu, Online) ; 26: e210675, 2022. tab
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1883768

ABSTRACT

Este artigo analisa as relações entre políticas públicas de enfrentamento da Covid-19, desinformação da população e sofrimento psíquico por meio da integração de resultados de duas experiências extensionistas ocorridas no mesmo território e mesmo período de tempo: "Tira dúvidas sobre a Covid" (TDC), programa de rádio que respondia a perguntas dos ouvintes; e "Plantão Psicológico On-line" (PPO), que tem oferecido atendimento emergencial durante a pandemia. Foi realizada análise qualiquantitativa de perguntas direcionadas por ouvintes ao quadro radiofônico e de preocupações sobre a pandemia manifestadas por usuários do PPO no formulário de inscrição para o atendimento. Concluiu-se que a desinformação agravou o contexto de crise, não apenas ampliando as infecções e os óbitos, mas elevando também o sofrimento psíquico. A propagação de notícias falsas e o aumento de problemas de Saúde Mental durante a pandemia são, pois, faces do mesmo fenômeno complexo.


This article analyzes the relationship between Covid-19 response policies, disinformation and psychic suffering drawing on the results of two university outreach experiences conducted in the same region during the same period: "Answering Questions about Covid" (TDC), a radio program answering listeners queries; and the "On-line Counselling Service" (PPO), offering emergency therapy during the pandemic. We performed a quali-quantitative analysis of listeners' questions and concerns about the pandemic raised by PPO users on the counselling application form. It is concluded that disinformation aggravated the context of the crisis, leading to a rise in infections, deaths and psychic suffering. The spread of fake news and increase in mental health problems are therefore facets of the same complex phenomenon.


Este artículo analiza las relaciones entre políticas públicas de enfrentamiento de la Covid-19, desinformación de la población y sufrimiento psíquico a partir de la integración de resultados de dos experiencias extensionistas ocurridas en el mismo territorio y período de tiempo: "Solución de dudas sobre Covid ("Tira dúvidas sobre a Covid-TDC"), programa de radio que respondía a preguntas de los oyentes y "Guardia Psicológica On-line" ("Plantão Psicológico On-line-PPO"), que han ofrecido atención de emergencia durante la pandemia. Se realizó un análisis cuali- cuantitativo de preguntas dirigidas por oyentes al programa de radio y de preocupaciones sobre la pandemia manifestadas por usuarios del PPO en el formulario de inscripción para la atención. Se concluyó que la desinformación agravó el contexto de crisis, no solo ampliando las infecciones y los fallecimientos, sino aumentando también el sufrimiento psíquico. La propagación de noticias falsas y el aumento de problemas de salud mental durante la pandemia son, por lo tanto, caras del mismo fenómeno complejo.

7.
Cad. Saúde Pública (Online) ; 37(1): e00259120, 2021. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1883753

ABSTRACT

O Brasil é um dos países mais afetados pela pandemia de COVID-19 e o real número de mortes pela doença torna o cenário ainda mais desafiador. O objetivo deste estudo foi estimar o excesso de mortes e suas diferenças em adultos com 20 anos e mais em Manaus (Amazonas), Fortaleza (Ceará), Rio de Janeiro e São Paulo, de acordo com o local de ocorrência do óbito, características demográficas e trajetória ao longo do tempo. Os dados foram obtidos no Sistema de Informações sobre Mortalidade e na Central de Informações do Registro Civil Nacional. As estimativas de óbitos esperados foram obtidas por meio de modelos aditivos generalizados quasi-Poisson com ajuste de sobredispersão. Entre 23 de fevereiro e 13 de junho de 2020, foram registradas 74.410 mortes naturais nas quatro cidades, com excesso de mortes de 46% (IC95%: 44-47). O maior excesso de mortes ocorreu em Manaus, 112% (IC95%: 103-121), seguido por Fortaleza, 72% (IC95%: 67-78), Rio de Janeiro, 42% (IC95%: 40-45) e São Paulo, 34% (IC95%: 32-36). O excesso de mortes foi maior nos homens e não significativo nas Semanas Epidemiológicas (SE) 9-12, exceto em São Paulo, 10% (IC95%: 6-14). Em geral, o pico de mortes excedentes ocorreu nas SE 17-20. O excesso de mortes não explicado diretamente pela COVID-19 e de mortes em domicílios/via pública foi alto, especialmente em Manaus. A elevada porcentagem de mortes excedentes, de mortes não explicadas diretamente pela COVID-19 e de mortes fora do hospital sugerem alta subnotificação de mortes por COVID-19 e reforça a extensa dispersão do SARS-CoV-2, como também a necessidade da revisão de todas as causas de mortes associadas a sintomas respiratórios pelos serviços de vigilância epidemiológica.


Brazil is one of the most heavily impacted countries by the COVID-19 pandemic, and the real number of deaths from the disease makes the scenario even more challenging. This study aimed to estimate the excess deaths and their differences in adults 20 years and older in Manaus (Amazonas State), Fortaleza (Ceará State), Rio de Janeiro, and São Paulo, according to place of death, demographic characteristics, and trajectory over time. The data were obtained from the Mortality Information System and the Central Information Office of the National Civil Registry. The estimates of expected deaths were obtained from quasi-Poisson generalized additive models, adjusting for overdispersion. From February 23 to June 13, 2020, 74,410 natural deaths were recorded in the four cities, with 46% excess deaths (95%CI: 44-47). The largest amount of excess deaths was in Manaus, with 112% (95%CI: 103-121), followed by Fortaleza with 72% (95%CI: 67-78), Rio de Janeiro with 42% (95%CI: 40-45), and São Paulo with 34% (95%CI: 32-36). Excess deaths were greater in males and non-significant in Epidemiologic Weeks (EW) 9-12, except in São Paulo, 10% (95%CI: 6-14). The peak in excess deaths generally occurred in EW 17-20. The number of excess deaths not explained directly by COVID-19 and deaths at home or on public byways is high, especially in Manaus. The high percentages of excess deaths, deaths not explained directly by COVID-19, and deaths outside the hospital suggest high underreporting of deaths from COVID-19 and reinforce the extensive spread of SARS-CoV-2, as well as the need for epidemiological surveillance services to review all causes of deaths associated with respiratory symptoms.


Brasil es uno de los países más afectados por la pandemia de COVID-19 y el número real de muertes por la enfermedad lo convierte en un escenario todavía más desafiante. El objetivo de este estudio fue estimar el exceso de muertes y sus diferencias en adultos con 20 años y más en Manaus (Amazonas), Fortaleza (Ceará), Rio de Janeiro y São Paulo, de acuerdo con el lugar de ocurrencia del fallecimiento, características demográficas y trayectoria a lo largo del tiempo. Los datos se obtuvieron del Sistema de Información sobre Mortalidad y de la Central de Información del Registro Civil Nacional. Las estimaciones de óbitos esperados se obtuvieron mediante modelos aditivos generalizados quasi-Poisson con ajuste de sobredispersión. Entre el 23 de febrero y 13 de junio de 2020, se registraron 74.410 muertes naturales en las cuatro ciudades, con un exceso de muertes de un 46% (IC95%: 44-47). El mayor exceso de muertes se produjo en Manaus, 112% (IC95%: 103-121), seguido por Fortaleza, 72% (IC95%: 67-78), Río de Janeiro, 42% (IC95%: 40-45) y São Paulo, 34% (IC95%: 32-36). El exceso de muertes fue mayor en hombres y no significativo en las Semanas Epidemiológicas (SE) 9-12, excepto en São Paulo, 10% (IC95%: 6-14). En general, el pico de muertes excedentarias se produjo en las SE 17-20. El exceso de muertes no explicado directamente por la COVID-19 y de las muertes en domicilios/vía pública fue alto, especialmente en Manaus. El elevado porcentaje de muertes excedentarias, de muertes no explicadas directamente por la COVID-19, y de muertes fuera del hospital, sugieren una alta subnotificación de muertes por COVID-19 y refuerza la extensa dispersión del SARS-CoV-2, así como también la necesidad de una revisión de todas las causas de muertes asociadas a síntomas respiratorios, por parte de los servicios de vigilancia epidemiológica.


Subject(s)
Humans , Male , Adult , Registries , COVID-19 , Brazil/epidemiology , Pandemics , SARS-CoV-2
8.
Cad. Saúde Pública (Online) ; 37(4): e00252420, 2021. tab
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1883752

ABSTRACT

Estratégias nacionais para o controle de anemia e deficiência de vitamina A em crianças estão baseadas em estimativas de suas prevalências produzidas em âmbito nacional em 2006 com métodos não validados para este grupo etário e com nível de desagregação para macrorregiões. Com o intuito de subsidiar a gestão local para o (re)direcionamento de medidas de controle desses agravos, o presente trabalho apresenta estimativas de sua prevalência e, também, de marcadores de consumo alimentar de fontes de micronutrientes e do uso de suplementos de vitaminas e minerais em amostra probabilística de crianças de 6 a 59 meses, usuárias da atenção básica de saúde do Município do Rio de Janeiro, Brasil (n = 536). Foram coletadas amostras de sangue venoso para análise de hemoglobina, ferritina e retinol sérico e dados sobre o consumo alimentar, o uso de suplementos de vitaminas e minerais e as características sociodemográficas. As prevalências de anemia, anemia ferropriva e deficiência de vitamina A foram de, respectivamente, 13,7%, 5,5% e 13%. Quase todas as crianças haviam consumido alimentos ricos em ferro no dia anterior à entrevista, sendo altas as prevalências de consumo de fontes de origem animal. Somente 49,4% haviam consumido alimentos ricos em vitamina A. As prevalências de uso de algum suplemento, de suplemento com ferro e com vitamina A foram de, respectivamente, 51%, 14,7% e 24,4%. Os resultados apontam a necessidade de redirecionamento das estratégias de prevenção e controle de anemia e deficiência de vitamina A. Estudos futuros são necessários para examinar a evolução desses indicadores, tendo em vista as políticas de austeridade que entraram em vigor nos últimos anos e a crise econômica decorrente da pandemia da COVID-19.


Brazilian national strategies for the control of anemia and vitamin A deficiency in children are based on estimates of their nationwide prevalence rates in 2006 with methods not validated for this age group and with disaggregation at the level of major geographic regions. To back local administrations in (re)directing control measures for these two disorders, the current study presents estimates of their prevalence and markers of dietary intake of sources of micronutrients and use of vitamin and mineral supplements in a probabilistic sample of children 6 to 59 months of age, users of primary healthcare in the city of Rio de Janeiro, Brazil (n = 536). Venous blood samples were drawn for analysis of hemoglobin, ferritin, and serum retinol, besides collection of data on food consumption, use of vitamin and mineral supplements, and sociodemographic characteristics. Prevalence rates for anemia, iron deficiency anemia, and vitamin A deficiency were 13.7%, 5.5%, and 13%, respectively. Nearly all the children had consumed iron-rich food the day before the interview, with high prevalence of animal sources. Only 49.4% had consumed foods high in vitamin A. The prevalence rates for use of any supplement, iron supplements, and vitamin A supplements were 51%, 14.7%, and 24.4%, respectively. The findings point to the need to redirect the strategies for prevention and control of anemia and vitamin A deficiency. Future studies are necessary to examine trends in these indicators, focusing on austerity policies implemented in recent years and the economic crisis resulting from the COVID-19 pandemic.


Las estrategias brasileñas para el control de anemia y deficiencia de vitamina A en niños están basadas en estimaciones de sus prevalencias, producidas en el ámbito nacional en 2006 con métodos no validados para este grupo etario, y con un nivel de desagregación en las macrorregiones. Con el fin de apoyar la gestión local para la (re)orientación de medidas de control de esos problemas de salud, este trabajo presenta estimaciones de su prevalencia y, también, de los marcadores de consumo alimentario de fuentes de micronutrientes y del uso de suplementos de vitaminas y minerales, en una muestra probabilística de niños de 6 a 59 meses, pacientes de atención básica de salud del Municipio de Río de Janeiro, Brasil (n = 536). Se recogieron muestras de sangre venosa para el análisis de hemoglobina, ferritina y retinol sérico, así como datos sobre el consumo alimentario, de suplementos de vitaminas y minerales, así como de características sociodemográficas. Las prevalencias de anemia, anemia ferropénica y deficiencia de vitamina A fueron de, respectivamente, 13,7%, 5,5% y 13%. Casi todos los niños habían consumido alimentos ricos en hierro el día anterior a la entrevista, siendo altas las prevalencias de consumo de fuentes de origen animal. Solamente un 49,4% habían consumido alimentos ricos en vitamina A. Las prevalencias de consumo de algún suplemento, de suplemento con hierro y de suplemento con vitamina A fueron de, respectivamente, 51%, 14,7% y 24,4%. Los resultados apuntan la necesidad de reorientar las estrategias de prevención y control de la anemia y deficiencia de vitamina A. Se necesitan estudios futuros para examinar la evolución de esos indicadores, teniendo en vista las políticas de austeridad que entraron en vigor en los últimos años y la crisis económica a consecuencia de la pandemia de COVID-19.

9.
Cad. Saúde Pública (Online) ; 37(3): e00252220, 2021. tab, graf
Article in Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1883751

ABSTRACT

Medidas de distanciamento social adotadas em diversos países para mitigar o impacto da pandemia de COVID-19 podem acarretar efeitos indesejáveis sobre a saúde e o comportamento das populações. Este estudo objetivou investigar o comportamento de fumar na população adulta brasileira durante a pandemia de COVID-19 e analisar os fatores associados ao aumento do consumo de cigarro. Foi realizado um inquérito virtual e a amostra final correspondeu a 45.160 indivíduos. Foram utilizados pesos de pós-estratificação e calculadas as razões de prevalência (RP) brutas e ajustadas por sexo, idade e escolaridade, e os respectivos intervalos de 95% de confiança (IC95%). Modelos de regressão de Poisson com variância robusta foram aplicados para a análise de associação entre o aumento do consumo de cigarros e as variáveis sociodemográficas e as relativas à adesão ao distanciamento social, qualidade do sono, estado de ânimo, alteração no trabalho e nos rendimentos. A prevalência de fumantes foi de 12% (IC95%: 11,1-12,9), dos quais 34% relataram aumento no consumo de cigarros. Esse aumento foi maior entre as mulheres (RP = 1,27; IC95%: 1,01-1,59) e entre indivíduos com o Ensino Médio incompleto (RP = 1,35; IC95%: 1,02-1,79). O aumento do consumo de cigarros esteve associado à piora da qualidade do sono, sentir-se isolado dos familiares, triste ou deprimido, ansioso, ficar sem rendimentos e pior avaliação do estado de saúde. Estratégias de promoção da saúde, de prevenção do uso e de incentivo à cessação do consumo de cigarros, bem como intervenções em saúde mental, devem ser continuadas e reforçadas no contexto de distanciamento social durante a pandemia de COVID-19.


Las medidas de distanciamiento social adoptadas en diversos países para mitigar el impacto de la pandemia de COVID-19 pueden acarrear efectos indeseables sobre la salud y el comportamiento de las poblaciones. Este estudio tuvo como objetivo investigar el comportamiento de fumar en la población adulta brasileña, durante la pandemia de COVID-19, y analizar los factores asociados al aumento del consumo de tabaco. Se realizó una encuesta virtual y la muestra final correspondió a 45.160 individuos. Se utilizaron pesos de pos-estratificación y se calcularon las razones de prevalencia (RP) brutas y ajustadas por sexo, edad y escolaridad, así como los respectivos intervalos de 95% de confianza (IC95%). Se aplicaron modelos de regresión de Poisson con variancia robusta para el análisis de asociación entre el aumento del consumo de tabaco y las variables sociodemográficas, así como las relativas a la adhesión al distanciamiento social, calidad del sueño, estado de ánimo, cambios en el trabajo e ingresos. La prevalencia de fumadores fue de un 12% (IC95%: 11,1-12,9), de los cuales un 34% relataron un aumento en el consumo de cigarrillos. Este aumento fue mayor entre las mujeres (RP = 1,27; IC95%: 1,01-1,59) y entre individuos con la enseñanza media incompleta (RP = 1,35; IC95%: 1,02-1,79). El aumento del consumo de tabaco estuvo asociado con un empeoramiento de la calidad del sueño, sentirse aislado de los familiares, triste o deprimido, ansioso, quedarse sin ingresos, al igual que con una peor evaluación del estado de salud. Las estrategias de promoción de salud, prevención del consumo y de alicientes para dejar el hábito de fumar, así como intervenciones en salud mental, deben ser continuas y estar reforzadas en el contexto de distanciamiento social durante la pandemia de COVID-19.


Social distancing measures adopted in various countries to mitigate the impact of the COVID-19 pandemic can lead to unwanted effects on their populations' health and behaviors. This study aimed to investigate smoking behavior in the Brazilian adult population during the COVID-19 pandemic and analyze factors associated with the increase in cigarette consumption. An online survey was performed, and the final sample included 45,160 individuals. The study used post-stratification weights and calculated crude prevalence ratios (PR) and adjusted by sex, age, and schooling, and respective 95% confidence intervals (95%CI). Poisson regression models with robust variance were applied to analyze associations between increased cigarette consumption and sociodemographic variables and adherence to social distancing, quality of sleep, state of mind, and changes in work and earnings. Prevalence of smokers was 12% (95%CI: 11.1-12.9), 34% of whom reported an increase in cigarette consumption. The increase was greater among women (PR = 1.27; 95%CI: 1.01-1.59) and individuals with incomplete secondary schooling (PR = 1.35; 95%CI: 1.02-1.79). The increase in cigarette consumption was associated with worse quality of sleep, feeling isolated from family members or sad, depressed, or anxious, loss of earnings, and worse self-rated health. Health promotion strategies, smoking prevention, and encouragement for smoking cessation, as well as mental health interventions, should be continued and reinforced in the context of social distancing during the COVID-19 pandemic.


Subject(s)
Humans , Female , Adult , Tobacco Products , COVID-19 , Brazil/epidemiology , Pandemics , SARS-CoV-2
10.
Cad. Saúde Pública (Online) ; 37(2): e00203520, 2021. tab, graf
Article in Spanish | WHO COVID, LILACS (Americas) | ID: covidwho-1883747

ABSTRACT

Las investigaciones recientes sobre la COVID-19 se han centrado en los efectos de esta pandemia en la salud pública, así como en los controles de bioseguridad y sus implicaciones socioeconómicas. El presente estudio mixto aporta una nueva mirada acerca del tema, combinando estrategias cualitativas y cuantitativas para identificar las representaciones sociales de la recepción mediática, en un sector de la población en Colombia, durante la cuarentena por la COVID-19. Los resultados indican que estas representaciones son diversas y están asociadas con el canal mediático y la afectación que produce la recepción en el estado de ánimo y la salud mental. En total, se realizaron 80 entrevistas y 1.068 encuestas online en diferentes regiones de Colombia. En la fase cualitativa se encontró que los programas o mensajes recibidos fueron representados positivamente, cuando provienen de la recepción de entretenimiento audiovisual y contribuye a la unidad familiar y a reducir el estrés en la cuarentena. De modo contrario, la recepción mediática fue representada negativamente, cuando los mensajes o noticias recibidas provienen del periodismo o las redes sociales y aumenta la desinformación, la angustia y el miedo al contagio. En la fase cuantitativa se encontró que la recepción mediática disminuyó a medida que trascurría la cuarentena, debido a la sobresaturación informativa y a la proliferación de noticias que enfatizan los riesgos de la COVID-19. Los resultados revelan la necesidad de enfocar la comunicación en salud al desarrollo de habilidades informacionales que permitan a la ciudadanía aprender a evaluar la veracidad y relevancia de la información recibida en la pandemia.


As pesquisas recentes sobre a COVID-19 têm focado os efeitos da pandemia sobre a saúde pública, bem como nos controles de biossegurança e suas consequências socioeconómicas. O presente estudo misto traz um novo olhar sobre a questão, combinando estratégias qualitativas e quantitativas para identificar as representações sociais da recepção midiática em um setor da população na Colômbia, durante a quarentena causada pela COVID-19. Os resultados apontam que estas representações são diversas e estão associadas ao canal informativo e ao modo como afetam o estado de espírito e a saúde mental. No total, foram realizadas 80 entrevistas e aplicados 1.068 questionários online em diferentes regiões do país. Na fase qualitativa verificou-se que os programas ou mensagens recebidas foram representados positivamente, quando provenientes de entretenimento audiovisual, contribuindo para a união familial e para reduzir o estresse na quarentena. Já a recepção midiática teve representação negativa, quando as mensagens ou notícias recebidas procedem do jornalismo ou das redes sociais, aumentando a desinformação, a angústia e o medo do contágio. Na fase quantitativa verificou-se que a recepção midiática diminuiu à medida que transcorria a quarentena, por causa da saturação informativa e da proliferação de notícias enfatizando os riscos da COVID-19. Os resultados revelam a necessidade de direcionar a comunicação em saúde para o desenvolvimento de habilidades informacionais que permitam à população aprender a avaliar a veracidade e a relevância da informação recebida durante pandemia.


Recent studies on COVID-19 have focused on the pandemic's effects on public health and the biosafety controls and their socioeconomic implications. The current mixed-methods study takes a new look at the topic, combining qualitative and quantitative strategies to identify the social representations of media reception in a sector of the Colombian population during social isolation in the COVID-19 pandemic. The results indicate that these representations vary and are associated with the media channel and the effect the reception produces on mood and mental health. A total of 80 interviews and 1,068 online survey forms were applied in different regions of Colombia. The qualitative phase showed that the programs or messages received were represented positively when they came from audiovisual entertainment and contributed to the family unit and reduced stress during the lockdown. Meanwhile, media reception was represented negatively when the messages or news came from journalism or social networks and increased the misinformation, anxiety, and fear of contagion. The quantitative phase found that media reception decreased as the lockdown continued, due to information saturation and the proliferation of news emphasizing the risks of COVID-19. The results reveal the need to focus health communication on the development of information skills that allow people to learn and assess the veracity and relevance of information received during the pandemic.


Subject(s)
Humans , Social Media , COVID-19 , Brazil , Communicable Disease Control , Colombia , Pandemics , SARS-CoV-2
12.
Clin Exp Rheumatol ; 39 Suppl 132(5): 3-13, 2021.
Article | MEDLINE | ID: covidwho-1885095

ABSTRACT

This review aims to provide a critical digest of the recent studies that enhance our understanding of Behçet's syndrome by evaluating time trends, differences in disease course between men and women, and between patients with an early and late disease onset, progress in disease assessment, novel findings on immunopathogenesis and genetics, clinical features and differential diagnosis of eye, vascular, nervous system and gastrointestinal system involvement, and new data on treatment modalities including TNF-alpha, IL-17 and IL-6 inhibitors, tofacitinib, and apremilast, as well as surgical interventions.


Subject(s)
Behcet Syndrome , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , Behcet Syndrome/genetics , Disease Progression , Female , Humans , Male , Tumor Necrosis Factor Inhibitors
13.
An Sist Sanit Navar ; 0(0)2021 Oct 19.
Article in Spanish | MEDLINE | ID: covidwho-1884912

ABSTRACT

Patients who have recently suffered from SARS-CoV-2 infections may suffer serious complications, such as pneumothorax or pulmonary cavitations that increase morbi-mortality and imply a challenge for the design of the most appropriate therapeutic strategy to improve their prognosis. Pulmonary cavities are usually associated with secondary complications such as hemoptysis and pneumothorax, and so offer a poor prognosis. We present the case of two patients with COVID-19 disease confirmed by nasopharyngeal PCR who showed satisfactory evolution before readmission with pulmonary involvement compatible with pulmonary cavitation and respiratory failure. Cavitated lesions in the lungs of patients who recently suffered COVID-19 must be identified early in order to discard additional superinfections that may worsen the prognosis.

14.
Minerva Cardiol Angiol ; 70(2): 273-284, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1884909

ABSTRACT

Myocarditis is an inflammatory heart muscle disease characterized by heterogeneous clinical presentation and outcome. Clinical heterogeneity of myocarditis, ranging from acute onset chest pain with electrocardiographic changes resembling an acute coronary syndrome, to arrhythmic storm and chronic decompensated heart failure, makes diagnosis challenging. However, a correct diagnosis is fundamental to proper patients' management and should always be seeked. Although a definite diagnosis is only provided by endomyocardial biopsy, the European Society of Cardiology task force on myocardial and pericardial diseases provided specific criteria for the diagnosis of clinically suspected myocarditis, which has been facilitated by the advent of noninvasive imaging tests (i.e. cardiovascular magnetic resonance based myocardial tissue characterization). Due to the heterogeneous presentation and disease course of myocarditis, a tailored treatment would be the best strategy, but a standardized management is still not available. However, over the years, new, promising therapies, such as antiviral and immune-suppressive treatment, have come side by side to the standard pharmacological heart treatment, i.e. antiheart failure medications. In this paper we will review the basic principles of myocarditis management in clinical practice, including diagnostic work-up, conventional and disease-specific therapy and patients' follow-up.


Subject(s)
Heart Failure , Myocarditis , Biopsy/methods , Chest Pain/pathology , Disease Progression , Heart Failure/diagnosis , Heart Failure/therapy , Humans , Magnetic Resonance Imaging , Myocarditis/diagnosis , Myocarditis/pathology , Myocarditis/therapy , Myocardium/pathology
15.
J Sports Med Phys Fitness ; 2021 Apr 19.
Article in English | MEDLINE | ID: covidwho-1884905

ABSTRACT

BACKGROUND: COVID-19 pandemic has affected worldwide sports competitions and training in both amateur and professional leagues. We thus aimed to investigate changes in different training modalities in elite and amateur football players following COVID-19 lockdown in March 2020. METHODS: In this cross-sectional study we applied a Likert scale-based questionnaire with 20 items to quantify and classify time spent at standard training methods in 47 professional and 54 amateur football players from 12 Austrian clubs before and during lockdown. Additionally, McLean score was calculated to assess perceived training fatigue. RESULTS: Weekly amount of training time at endurance exercises (cycling) increased in both professional (37.5 [IQR 46.5] min/week vs. 187.5 [IQR 127.5] min/week, p<0.001), and amateur players (0.0 [IQR 45.0] min/week vs. 37.5 [IQR 112.5] min/week, p=0.015) during COVID-19 lockdown. Time on diverse muscle strengthening workouts was significantly elevated in both cohorts. Total training time at ball declined for professionals (from 472.5 [IQR 150] min/week to 15.0 [IQR 112.5] min/week, p<0.001) and amateurs (from 337.5 [IQR 285] min/week to 0.0 [IQR 37.5] min/week, p<0.001). Videoguided training was intensified in both groups (p<0.001 each). Location shifted from football fields and gyms to home and outdoors. Overall McLean score remained unchanged in amateurs (p=0.42) while elite players showed a trend towards an increase (p=0.056). CONCLUSIONS: COVID-19 lockdown compromised football training, especially training concepts with ball. Consequently, resulting changes in exercise loads and muscular burden might impact susceptibility for injuries and impair performances especially in amateur players, especially as they lacked training supervision and professional training plans. Minimum effective dose of training workload in order to maintain endurance- and neuromuscular-related performance parameters should be prescribed.

16.
Ann Intern Med ; 174(2): 285-286, 2021 02.
Article in English | MEDLINE | ID: covidwho-1884658
19.
Turk J Med Sci ; 51(SI-1): 3301-3311, 2021 12 17.
Article in English | MEDLINE | ID: covidwho-1884486

ABSTRACT

The COVID-19 pandemic has created a major alteration in the medical literature including the sepsis discussion. From the outset of the pandemic, various reports have indicated that although there are some unique features pertinent to COVID-19, many of its acute manifestations are similar to sepsis caused by other pathogens. As a consequence, the old definitions now require consideration of this new etiologic agent, namely SARS-CoV-2. Although the pathogenesis of COVID-19 has not been fully explained, the data obtained so far in hospitalized patients has revealed that serum cytokine and chemokine levels are high in severe COVID-19 patients, similar to those found with sepsis. COVID-19 may involve multiple organ systems. In addition to the lungs, the virus has been isolated from blood, urine, faeces, liver, and gallbladder. Results from autopsy series in COVID-19 patients have demonstrated a wide range of findings, including vascular involvement, congestion, consolidation, and hemorrhage as well as diffuse alveolar damage in lung tissue consistent with acute respiratory distress syndrome (ARDS). The presence of viral cytopathic-like changes, infiltration of inflammatory cells (mononuclear cells and macrophages), and viral particles in histopathological samples are considered a consequence of both direct viral infection and immune hyperactivation. Thromboembolism and hyper-coagulopathy are other components in the pathogenesis of severe COVID-19. Although the pathogenesis of hypercoagulability is not fully understood, it has been pointed out that all three components of Virchow's triad (endothelial injury, stasis, and hypercoagulable state) play a major role in contributing to clot formation in severe COVID-19 infection. In severe COVID-19 cases, laboratory parameters such as hematological findings, coagulation tests, liver function tests, D-dimer, ferritin, and acute phase reactants such as CRP show marked alterations, which are suggestive of a cytokine storm. Another key element of COVID-19 pathogenesis in severe cases is its similarity or association with hemophagocytic lymphohistiocytosis (HLH). SARS-CoV-2 induced cytokine storm has significant clinical and laboratory findings overlapping with HLH. Viral sepsis has some similarities but also some differences when compared to bacterial sepsis. In bacterial sepsis, systemic inflammation affecting multiple organs is more dominant than in COVID-19 sepsis. While bacterial sepsis causes an early and sudden onset clinical deterioration, viral diseases may exhibit a relatively late onset and chronic course. Consideration of severe COVID-19 disease as a sepsis syndrome has relevance and may assist in terms of determining treatments that will modulate the immune response, limit intrinsic damage to tissue and organs, and potentially improve outcome.


Subject(s)
COVID-19/immunology , Cytokine Release Syndrome , Inflammation , Lymphohistiocytosis, Hemophagocytic , Sepsis/complications , Chemokines/blood , Cytokines/blood , Humans , Lymphohistiocytosis, Hemophagocytic/immunology , Pandemics , SARS-CoV-2 , Sepsis/blood
20.
Turk J Med Sci ; 51(SI-1): 3273-3283, 2021 12 17.
Article in English | MEDLINE | ID: covidwho-1884472

ABSTRACT

As the COVID-19 pandemic continues, children can be infected with the virus that causes COVID-19. Clinical symptoms of children with COVID from China, where the disease was first reported, generally were less severe than adults. However, at the end of April 2020 in Europe, it was observed that some children with SARS-CoV-2 infection developed fever, abdominal pain, shock, myocardial insufficiency and they needed to be taken care of in intensive care unit. This new disease has been called multisystem inflammatory syndrome in children (MIS-C). Although the pathogenesis of MIS-C is unclear, it progresses with signs of multiorgan involvement as a result of uncontrolled inflammation of the immune system and even causes death. Therefore, the diagnosis and treatment of patients with MIS-C should be managed quickly. In this review, the pathophysiology, clinical and laboratory findings, diagnostic methods, and treatment regimens of MIS-C were discussed.


Subject(s)
COVID-19/complications , Pandemics , Systemic Inflammatory Response Syndrome , COVID-19/epidemiology , Child , Humans , SARS-CoV-2
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