Impact of COVID-19 mitigation strategies on asthma hospitalizations in Brazil.

Background: In 2020, a unique social experience was provided by the pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2. Interventions to tackle the pandemic may affect the burden of other respiratory diseases. Objective: This study aims to assess the impact of the COVID-19 mitigation strategies on hospitalizations for asthma in children aged between 1 and 14 years, adults aged between 20 and 59 years, and elderly older than 60 years. Methods: Data from hospital admissions for asthma were obtained from the Department of Informatics of Brazilian Public Health System database in the period between January 2016 and December 2020 and analyzed by age groups. To evaluate the effect of containment measures on the incidence of asthma and respiratory system diseases (total), the absolute reduction and relative reduction were calculated by analyzing the subsets from 2016 to 2019 versus 2020. Results: There was a significant reduction in the average incidence of hospitalizations in 2020, with numbers ranging from -59% (incidence rate ratio, 0.41 [0.37-0.45]) for age 1 to 14 years (prepandemic 1,393.2/100,000 vs pandemic 574.9/100.000), -37% (incidence rate ratio, 0.63 [0.49-0.80]) for age 20 to 59 years (prepandemic 160.2/100,000 vs pandemic 101.1/100,000), and -60% (incidence rate ratio, 0.40 [0.33-0.47]) for older than 60 years (prepandemic 460.6/100,000 vs pandemic 185.3/100,000). Conclusions: Ashtma hospitalizations decreased in 2020, especially in the pediatric group and the older group during the COVID-19 pandemic, which may be associated with the reduction in the incidence of many respiratory viral infections.

Analysis of the Influence of Food Colorings in Esthetic Orthodontic Elastomeric Ligatures.

PROPOSITION: The purpose of this study was to evaluate in vitro the color changes of esthetic orthodontic elastomeric ligatures of different shades when exposed to four food colorings commonly found in the diet of patients. MATERIALS AND METHODS: The sample consisted of esthetic orthodontic elastomeric ligatures in the colors pearl, pearl blue, pearl white and colorless, which were immersed for 72 hours in five different solutions: distilled water (control group), coffee, tea, Coca-Cola ® and wine. The color changes of the esthetic orthodontic elastomeric ligatures were measured with the aid of a spectrophotometer, at T1 - as provided by the manufacturer; and T2 - after colorings process. RESULTS: The results indicated that the esthetic orthodontic elastomeric ligatures of all initial hues are susceptible to pigmentation. Among the evaluated colors, all changed the finished look and the color of the samples tested. In ascending order, the color of the samples was as follows: distilled water, Coca-Cola®, black tea, wine and coffee. CONCLUSION: The substances that have a greater potential for pigmentation in esthetic orthodontic elastomeric ligatures were black tea, wine and coffee, respectively. All shades of esthetic orthodontic elastomeric ligatures are susceptible to color change.

Hospital-associated venous thromboembolism in children: incidence and clinical characteristics.

OBJECTIVE: To determine incidence and clinical characteristics of hospital-associated venous thromboembolism (VTE) in pediatric patients. STUDY DESIGN: A retrospective analysis of patients with hospital-associated VTE at the Johns Hopkins Hospital from 1994 to 2009 was performed. Clinical characteristics of patients aged 21 years and younger who developed VTE symptoms after 2 days of hospitalization or <90 days after hospital discharge were examined. International Classification of Diseases, Ninth Revision codes were used to categorize patients with complex chronic medical conditions and trauma. RESULTS: There were 270 episodes of hospital-associated VTE in 90,485 admissions (rate 30 per 10,000 admissions). Young adults (18-21 years) and adolescents (14-17 years) had significantly increased rates of VTE compared with children (2-9 years) (incidence rate ratio [IRR] 7.7, 95% CI 5.1-12.0; IRR 4.3, 95% CI 2.7-6.8, respectively). A central venous catheter (CVC) was present in 50% of patients, and a surgical procedure was performed in 45% of patients before VTE diagnosis. For patients without a CVC, trauma was the most common admitting diagnosis. CVC-related VTE was diagnosed most frequently in infants (<1 year old) and in patients with malignancy. Renal and cardiac diseases were associated with the highest rates of VTE (51 and 48 per 10,000, respectively). Rates were significantly higher among those with ≥ 4 medical conditions compared with those with 1 medical condition (IRR 4.0, 95% CI 1.4-8.9). CONCLUSION: Older age and multiple medical conditions were associated with increased rates of hospital-associated VTE. These data can contribute to the design of future clinical trials to prevent hospital-associated VTE in high-risk children.

Association between enhanced access services in pediatric primary care and utilization of emergency departments: a national parent survey.

OBJECTIVES: To measure the prevalence of enhanced access services in pediatric primary care and to assess whether enhanced access services are associated with lower emergency department (ED) utilization. STUDY DESIGN: Internet-based survey of a national sample of parents (n = 820, response rate 41%). We estimated the prevalence of reported enhanced access services and ED use in the prior 12 months. We then used multivariable negative binomial regression to assess associations between enhanced access services and ED use. RESULTS: The majority of parents reported access to advice by telephone during office hours (80%), same-day sick visits (79%), and advice by telephone outside office hours (54%). Less than one-half of parents reported access to their child's primary care office on weekends (47%), after 5:00 p.m. on any night (23%), or by email (13%). Substantial proportions of parents reported that they did not know if these services were available (7%-56%, depending on service). Office hours after 5:00 p.m. on ≥ 5 nights a week was the only service significantly associated with ED utilization in multivariable analysis (adjusted incidence rate ratio: 0.51 [95% CI 0.28-0.92]). CONCLUSIONS: The majority of parents report enhanced access to their child's primary care office during office hours, but many parents do not have access or do not know if they have access outside of regular office hours. Extended office hours may be the most effective practice change to reduce ED use. Primary care practices should prioritize the most effective enhanced access services and communicate existing services to families.

Economic feasibility of four grazing intensities of Tanzania grass for beef cattle / Viabilidade econômica de quatro intensidades de pastejo do capim Tanzânia na pecuária de corte

Were evaluated the economic effects of four grazing heights (20, 40, 60 and 80 cm) of Tanzânia grass for beef cattle. The total area was 12 acres divided into paddocks of one hectare, with three replications. We used three animals, males, Nelore per paddock, as more animals need additional adjustment to the height you want. The reduction in sward height allowed higher stocking rate, which, even with a reduction in individual performance, there was more beef production per area. The interest rate on capital given the property represented the largest share in the final cost of production. The participation of fixed variables showed a positive linear function of the increase in height from grazing, showing significant reduction of the production scale. A reduction in cost of production per hectare per year with increasing grazing height. No differences were found in certain economic indicators, and the four systems remunerate the capital invested.

Foram avaliados os efeitos econômicos de quatro alturas de pastejo (20; 40; 60 e 80 cm) do capim Tanzânia para bovinos de corte. A área total foi de 12 hectares divididos em piquetes de um hectare, com três repetições. Foram utilizados três bovinos, machos, Nelore por piquete, mais animais adicionais conforme necessidade de ajuste para as alturas pretendidas. A redução da altura do pasto permitiu maior taxa de lotação, onde, mesmo com redução no desempenho individual, houve maior produção por área. A taxa de juros atribuída sobre o capital do imóvel representou a maior parcela no custo final de produção. A participação das variáveis fixas apresentou comportamento linear positivo em função do aumento na altura dos pastos, se mostrando sensível à redução da escala de produção. Houve redução do custo de produção anual por hectare com aumento da altura de pastejo. Não foram detectadas diferenças nos indicadores econômicos determinados, e os quatro sistemas remuneraram o capital investido.

Economic feasibility of four grazing intensities of Tanzania grass for beef cattle / Viabilidade econômica de quatro intensidades de pastejo do capim Tanzânia na pecuária de corte

 Were evaluated the economic effects of four grazing heights (20, 40, 60 and 80 cm) of Tanzânia grass for beef cattle. The total area was 12 acres divided into paddocks of one hectare, with three replications. We used three animals, males, Nelore per paddock, as more animals need additional adjustment to the height you want. The reduction in sward height allowed higher stocking rate, which, even with a reduction in individual performance, there was more beef production per area. The interest rate on capital given the property represented the largest share in the final cost of production. The participation of fixed variables showed a positive linear function of the increase in height from grazing, showing significant reduction of the production scale. A reduction in cost of production per hectare per year with increasing grazing height. No differences were found in certain economic indicators, and the four systems remunerate the capital invested.

Foram avaliados os efeitos econômicos de quatro alturas de pastejo (20; 40; 60 e 80 cm) do capim Tanzânia para bovinos de corte. A área total foi de 12 hectares divididos em piquetes de um hectare, com três repetições. Foram utilizados três bovinos, machos, Nelore por piquete, mais animais adicionais conforme necessidade de ajuste para as alturas pretendidas. A redução da altura do pasto permitiu maior taxa de lotação, onde, mesmo com redução no desempenho individual, houve maior produção por área. A taxa de juros atribuída sobre o capital do imóvel representou a maior parcela no custo final de produção. A participação das variáveis fixas apresentou comportamento linear positivo em função do aumento na altura dos pastos, se mostrando sensível à redução da escala de produção. Houve redução do custo de produção anual por hectare com aumento da altura de pastejo. Não foram detectadas diferenças nos indicadores econômicos determinados, e os quatro sistemas remuneraram o capital investido.