Risk factors for severe and critical Covid-19 in pregnant women in a single center in Brazil.

BACKGROUND: Risk factors for severe SARS-CoV2 infection in pregnancy have not been extensively studied. This information can help guide the management of pregnant women with COVID-19. OBJECTIVE: Examine risk factors for severe COVID-19 in pregnant women. METHODS: We reviewed the records of all pregnant women with positive SARS-CoV2 tests (qRT-PCR) managed at a single tertiary private maternity in Sao Paulo, Brazil. We categorized women as having non-severe (mild or moderate) or severe (severe or critical) COVID-19. We conducted multivariable analyses to identify differences in sociodemographic and clinical characteristics of the two groups as risk factors for severe COVID-19. RESULTS: Between March 13 and June 7 2020, 114 women tested positive for SARS-CoV-2; 80.7% (n = 92) had non-severe disease (69 mild, 23 moderate), 15.7% (n = 18) had severe, and 3.5% (n = 4) had critical COVID-19. Women with severe/critical COVID-19 (n = 22) were significantly older (35.0 ± 5.9 × 31.8 ± 5.1 years, p = 0.011), more likely to have at least one medical comorbidity (81.8% × 52.2%, p = .011) or a history of asthma (18.2% × 3.3%, p = .025), and tended to have a higher median body mass index (30.1 kg/m2, IQR 28.1-33.9 × 28.6, IQR 26.2-32.0, p = .056) than women with non-severe disease. Multivariate logistic regression analysis identified four factors as independent predictors of severe/critical COVID-19: asthma (OR 34.469, 95% CI 1.151-78.030, p = .026), non-white ethnicity (OR 7.932, 95% CI 1.311-47.973, p = .024), maternal age with a best cutoff of ≥ 34 years (OR 1.195, 95% CI 1.001-1.427, p = .048) and gestational age at diagnosis with a best cut-off of ≥ 35 weeks (OR 0.876, 95% CI 0.780-0.983, p = .025). The predictive value of the model including all variables was 0.823 (p < .001). CONCLUSION: A history of asthma, non-white ethnicity, and older maternal age were risk factors for, while higher gestational age was protective against severe/critical COVID-19 in pregnant Brazilian women.

Interobserver agreement in interpretation of radiographicpulmonary changes in dogs in relation to radiology training / Concordância interobservador na interpretação de alteraçõesradiográficas pulmonares em cães e sua correlação com treinamentoem radiologia

Uma das maiores dificuldades na interpretação radiográfica em cães está nas alterações pulmonares sendo a variabilidade interobservador alta. O objetivo desse estudo é detectar as variações de interpretação entre radiologistas brasileiros em diferentes graus de treinamento e experiência, utilizando a interpretação de consenso feito por radiologistas americanos certificados pelo Colégio Americano de Radiologia Veterinária. Na tentativa de identificar os desafios e as particularidades dessa interpretação. Sessenta exames radiográficos digitais do tórax de cães foram interpretados por quatro grupos de observadores com diferentes graus de treinamento em leitura de exames radiográficos. O grau de discrepância entre as observadores foram comparados seguindo um escore com três subclassificações: sem discrepância, discrepância leve e maiores discrepâncias. Para análise dos dados os métodos estatísticos utilizados foram o Kappa e Cochran-Mantel-Haenszel. Os veterinários brasileiros com maior grau de treinamento e experiência foram o que apresentaram menores variações de interpretação quando comparado aos dados do consenso, seguidos pelos veterinários menor treinamento e por médicos veterinários práticos da clínica diária sem treinamento especializado em interpretação radiográfica. Os padrões radiográficos que foram associados ao alto grau de discordância foram em sequência...(AU)

Interpretation of pulmonary radiographs is one of the most difficult aspects of radiology and interobserver variability is high. The aim of this study was to assess variations in interpretation of pulmonary pathology amongst Brazilian veterinarians with different levels of training and experience, using the interpretation by American board-certified radiologists as a reference. We identified areas where interpretation is particularly challenging. Sixty digital canine thoracic radiographic examinations were interpreted by four groups of three Brazilian observers, each group being defined by different levels of training and experience. The radiographic findings of the 4 groups of observers in the study were compared to a reference interpretation established from the findings of three ACVR board-certified radiologists. The degree of discrepancy for each list between each group and the reference interpretation was assessed according to a three-level scoring system: no discrepancy, minor discrepancy, or major discrepancy. Data was analyzed using a Kappa and Cochran-Mantel-Haenszel tests. Brazilian veterinarians with the most training and experience showed the least interobserver variation and best performance when compared to the reference interpretation, followed by those with practical training, but with little work experience in professional practice. The radiographic patterns...(AU)

Interobserver agreement in interpretation of radiographicpulmonary changes in dogs in relation to radiology training / Concordância interobservador na interpretação de alteraçõesradiográficas pulmonares em cães e sua correlação com treinamentoem radiologia

Uma das maiores dificuldades na interpretação radiográfica em cães está nas alterações pulmonares sendo a variabilidade interobservador alta. O objetivo desse estudo é detectar as variações de interpretação entre radiologistas brasileiros em diferentes graus de treinamento e experiência, utilizando a interpretação de consenso feito por radiologistas americanos certificados pelo Colégio Americano de Radiologia Veterinária. Na tentativa de identificar os desafios e as particularidades dessa interpretação. Sessenta exames radiográficos digitais do tórax de cães foram interpretados por quatro grupos de observadores com diferentes graus de treinamento em leitura de exames radiográficos. O grau de discrepância entre as observadores foram comparados seguindo um escore com três subclassificações: sem discrepância, discrepância leve e maiores discrepâncias. Para análise dos dados os métodos estatísticos utilizados foram o Kappa e Cochran-Mantel-Haenszel. Os veterinários brasileiros com maior grau de treinamento e experiência foram o que apresentaram menores variações de interpretação quando comparado aos dados do consenso, seguidos pelos veterinários menor treinamento e por médicos veterinários práticos da clínica diária sem treinamento especializado em interpretação radiográfica. Os padrões radiográficos que foram associados ao alto grau de discordância foram em sequência...

Interpretation of pulmonary radiographs is one of the most difficult aspects of radiology and interobserver variability is high. The aim of this study was to assess variations in interpretation of pulmonary pathology amongst Brazilian veterinarians with different levels of training and experience, using the interpretation by American board-certified radiologists as a reference. We identified areas where interpretation is particularly challenging. Sixty digital canine thoracic radiographic examinations were interpreted by four groups of three Brazilian observers, each group being defined by different levels of training and experience. The radiographic findings of the 4 groups of observers in the study were compared to a reference interpretation established from the findings of three ACVR board-certified radiologists. The degree of discrepancy for each list between each group and the reference interpretation was assessed according to a three-level scoring system: no discrepancy, minor discrepancy, or major discrepancy. Data was analyzed using a Kappa and Cochran-Mantel-Haenszel tests. Brazilian veterinarians with the most training and experience showed the least interobserver variation and best performance when compared to the reference interpretation, followed by those with practical training, but with little work experience in professional practice. The radiographic patterns...

Ultrasonographic examination in non-human primates with acute abdomen signs.

BACKGROUND: The acute abdomen is any abdominal disorder resulting in pain, shock, or sepsis. Although it has a multifactorial etiology, the primary cause is gastrointestinal tract pathology. The aim of this study was to assess the contribution of abdominal ultrasound as a complementary diagnostic tool in non-human primates with an acute abdomen. METHODS: Three different non-human primates with clinical signs of acute abdomen were evaluated as follows: a chimpanzee (Pan troglodytes), a tufted capuchin (Cebus apella), and a black-tufted marmoset (Callithrix penicillata). RESULTS: Ultrasonographic examination assisted in the identification of a variety of differential diagnoses and was used in decision-making for exploratory laparotomy, which was performed in two animals. Ultrasound examination confirmed the source of the acute abdomen as the gastrointestinal tract in the three animals studied. CONCLUSIONS: Abdominal ultrasound is a useful technique for the investigation of signs of acute abdomen in non-human primates.

Parâmetros utilizados na avaliação do metabolismo do ferro em cães / Iron metabolism parameters in dogs

A avaliação do metabolismo de ferro associado aos resultados hematológicos constitui uma ferramenta importante para o diagnóstico, controle e diferenciação de estados anêmicos. O presente trabalho objetivou determinar os parâmetros utilizados na avaliação do metabolismo do ferro (ferro sérico, capacidade latente de ligação do ferro, capacidade total de ligação do ferro, índice de saturação do ferro, transferrina e ferritina) em cães sadios. Foram selecionados 120 cães, divididos em quatro grupos de sexo e faixa etária distintos (30 machos jovens e 30 adultos, 30 fêmeas jovens e 30 adultas). As amostras de sangue foram coletadas das 8h às 11h, com os cães em jejum. Os valores médios para as concentrações de ferro sérico, capacidade latente de ligação do ferro, capacidade total de ligação do ferro, índice de saturação do ferro e transferrina foram 138,2µl dl-1; 371µl dl-1; 232,6µl dl-1; 37,7 por cento e 259,6mg dl-1, respectivamente. Esses índices foram avaliados quanto às variações entre sexo e idade. Os valores médios foram submetidos ao teste de Tukey e não apresentaram variação significativa (P<0,01). A concentração de ferro sérico apresentou-se mais elevada em cães machos adultos, comparados aos machos jovens (P<0,05). O valor de ferritina obtido foi inferior a 1ng mL-1 com reagente comercial de imunoensaio quimioluminescente para humanos.

The determination of iron metabolism rates associated with hematological findings is an important tool to diagnosis, control and differentiation of anemic states. This study has as objective to determine the iron parameters (serum iron, unsaturated iron binding-capacity, total iron binding-capacity, transferrin saturation rate (IST), transferrin and ferritin) in healthy dogs. It was selected 120 dogs, shared in four different groups of sex and age (30 young males and 30 adult males, 30 young females and 30 adult females). The blood samples were collected between 8 and 11h AM, with fasted dogs. The average values to serum iron, unsaturated iron binding-capacity, total iron-binding-capacity, transferring percent saturation and transferrin are 138.2µl dl-1; 371µl dl-1; 232.6µl dl-1; 37.7 percent e 259.6mg dl-1 respectively. These rates were evaluated according to sex and age variation. The average values submitted to Tukey test it were not significant (P<0,01). Considering a 5 percent level variation of error probability, the serum iron was higher in adult male dogs, comparing with young male ones (P<0,05). The ferritin values were 0ng mL-1 in human chemiluminescent immunoassay kit.