Global review of COVID-19 mitigation strategies and their impact on cancer service disruptions.

During the COVID-19 pandemic, countries adopted mitigation strategies to reduce disruptions to cancer services. We reviewed their implementation across health system functions and their impact on cancer diagnosis and care during the pandemic. A systematic search was performed using terms related to cancer and COVID-19. Included studies reported on individuals with cancer or cancer care services, focusing on strategies/programs aimed to reduce delays and disruptions. Extracted data were grouped into four functions (governance, financing, service delivery, and resource generation) and sub-functions of the health system performance assessment framework. We included 30 studies from 16 countries involving 192,233 patients with cancer. Multiple mitigation approaches were implemented, predominantly affecting sub-functions of service delivery to control COVID-19 infection via the suspension of non-urgent cancer care, modified treatment guidelines, and increased telemedicine use in routine cancer care delivery. Resource generation was mainly ensured through adequate workforce supply. However, less emphasis on monitoring or assessing the effectiveness and financing of these strategies was observed. Seventeen studies suggested improved service uptake after mitigation implementation, yet the resulting impact on cancer diagnosis and care has not been established. This review emphasizes the importance of developing effective mitigation strategies across all health system (sub)functions to minimize cancer care service disruptions during crises. Deficiencies were observed in health service delivery (to ensure equity), governance (to monitor and evaluate the implementation of mitigation strategies), and financing. In the wake of future emergencies, implementation research studies that include pre-prepared protocols will be essential to assess mitigation impact across cancer care services.

Performance of lambs under four levels of dietary supplementation and artificially mix-infected with Haemonchus contortus and Trichostrongylus colubriformis / Efeito de quatro dietas na performance de cordeiros artificialmente infectados com Haemonchus contortus e Trichostrongylus colubriformis

Abstract The effect of four diets on the performance of Dorper lambs that were artificially mix-infected with 1000 infective larvae (L3) of Haemonchus contortus and 1000 L3 of Trichostrongylus colubriformis every three days for 12 weeks was evaluated. For each diet, one infected group (n = 7) and one control group (n = 4) were set up. The four diets contained the following proportions of hay (H) and concentrate (C): Diet 1 - 100%H; Diet 2 - 75%H:25%C; Diet 3 - 50%H:50%C; Diet 4 - 25%H:75. All the infected groups showed decreases in mean packed cell volume (PCV) and total plasma protein, especially the Diet 1-infected, which was also the group with the highest fecal egg count. The diets and infection had significant effects (P < 0.05) on daily body weight gain (DBWG), cold carcass weight and daily food consumption. The control and infected groups had mean DBWG (in kg), respectively, of 0.048 and 0.025 with Diet 1; 0.082 and 0.067 with Diet 2; 0.188 and 0.189 with Diet 3; and 0.303 and 0.221 with Diet 4. In conclusion, the infection affected the productive performance regardless of the diet; however, with increased metabolizable protein and energy, the risk of occurrence of anemia and hypoproteinemia diminished.

Resumo Avaliou-se o efeito de quatro dietas sobre o desempenho de cordeiros Dorper infectados artificialmente, a cada três dias, durante 12 semanas, com 1.000 larvas infectantes (L3) de Haemonchus contortus e 1.000 L3 de Trichostrongylus colubriformis. Um grupo infectado (n=7) e um controle (n=4) foram constituídos para cada uma das dietas, que continham a seguinte proporção de feno (F) e concentrado (C): Dieta 1 - 100%F; Dieta 2 - 75%F:25%C; Dieta 3 - 50%F:50%C; Dieta 4 - 25%F:75%C. Todos os grupos infectados apresentaram redução nas médias de hematócrito (VG) e proteína plasmática total (PPT), principalmente o grupo Dieta 1 infectado, que também apresentou maior contagem de ovos nas fezes. Houve efeito significativo da dieta e da infecção (P <0,05) no ganho em peso médio diário, peso da carcaça e consumo diário de alimento. Os grupos controle e infectado tiveram ganho em peso médio diário (em kg), respectivamente, de 0,048 e 0,025 na Dieta 1; 0,082 e 0,067 na Dieta 2; 0,188 e 0,189 na Dieta 3; e 0,303 e 0,221 na Dieta 4. Concluiu-se que a infecção afetou o desempenho produtivo independentemente da dieta, porém, com o aumento da proteína e da energia metabolizável, o risco de ocorrência de anemia e hipoproteinemia diminuiu.

Losses caused by gastrointestinal nematode infections in Dorper lambs under two nutritional status / Prejuízos causados pelas infecções por nematoides gastrintestinais em cordeiros Dorper submetidos a dois manejos nutricionais

Abstract The aim of this study was to evaluate the effect of two nutritional statuses on the productive performance of Dorper lambs naturally infected with gastrointestinal nematodes. Thirty-two lambs, grazing together on the same pasture, were allocated into four experimental groups: (G1) infected-supplemented diet, (G2) control-supplemented diet, (G3) infected-basal diet, and (G4) control-basal diet. Control animals received suppressive treatment with monepantel every two weeks, while precautionary anthelmintic treatments were given to all lambs of the infected groups with packed cell volume (PCV) <23%. There was reduction in the PCV means of all groups, which was more pronounced in the infected lambs that also presented reduction in total plasma protein values in comparison with the controls. Weight gain was affected by diet and infection status (P < 0.05). Daily body weight gain was 0.170 kg in the G1, 0.205 kg in the G2, 0.085 kg in the G3, and 0.116 kg in the G4. The cold carcass weight was 4.1% and 13.7% higher in controls in comparison with infected lambs, respectively, in the supplemented and basal diets. The infected groups, despite receiving precautionary anthelmintic treatments to prevent deaths due to haemonchosis, presented reduction in the production parameters in comparison with the controls.

Resumo O experimento teve por objetivo determinar o efeito de dois níveis de nutrição no desempenho produtivo de cordeiros Dorper naturalmente infectados por nematoides gastrintestinais. Trinta e dois cordeiros, mantidos juntos na mesma pastagem, foram alocados em quatro grupos experimentais: (G1) infectado-suplementado, (G2) controle-suplementado, (G3) infectado-dieta basal e (G4) controle-dieta basal. Os cordeiros suplementados receberam diariamente concentrado em quantidade equivalente a 2% do peso corporal (PC), enquanto na dieta basal receberam apenas uma pequena quantidade de concentrado (0,35% do PC). Os animais controles receberam tratamento supressivo com anti-helmíntico a cada duas semanas e os infectados foram tratados individualmente quando apresentaram volume globular (VG) <23%. Houve redução nas médias de VG em todos os grupos, as quais foram mais pronunciadas nos animais dos grupos infectados, que também apresentaram redução nos valores de proteína plasmática total em comparação com os controles. Houve efeito significativo da dieta e da infecção no ganho de peso (P <0,05). O ganho em peso diário foi de 0,170 kg no G1, 0,205 kg no G2, 0,085 kg no G3 e 0,116 kg no G4. Os grupos infectados, apesar de receberem tratamentos anti-helmínticos preventivos que evitaram mortes por haemonchose, apresentaram redução nos parâmetros produtivos em comparação com os controles.

PET Saúde/saúde mental - crack, álcool e outras drogas: pesquisa diagnóstica com profissionais do CERSAM-AD Pampulha e da atenção básica da Regional Norte / PET Health/mental health - crack, alcohol, and other drugs: diagnostic research with professionals from the CERSAMAD Pampulha and the North Regional basic attention

Trata-se de artigo que apresenta dados colhidos em pesquisa feita junto aos profissionais de Núcleos de Apoio à Saúde da Família (NASF ? Regional Norte) e do Centro de Referência em Saúde Mental ? Álcool e Drogas (CERSAM AD Pampulha) do município de Belo Horizonte (Minas Gerais) acerca das concepções, uso e dos problemas relacionados ao abuso e dependência de drogas.

This article presents data collected on research performed by professionals from the Family Health Support Nucleus (NASF-North Regional) and the Reference Center for Mental Health - Alcohol and Drugs (AD CERSAM Pampulha) in the municipality of Belo Horizonte (Minas Gerais state) about concepts, use, and problems related to drug abuse and addiction.

Glioblastoma multiforme primário de medula: relato de caso / Primary glioblastoma multiforme of the spinal-cord: report of a case

É apresentado um caso de glioblastoma multiforme primário em sua forma intramedular, em criança do sexo masculino com 13 anos de idade. Säo discutidos os dados da literatura e discutidos os aspectos referentes a conduta e evoluçäo do caso

Ideaçäo e tentativa de suicídio em uma populaçäo de estudantes de medicina / Idea and attempted suicide in a population of medical students

O suicídio entre estudantes de Medicina é um fenômeno ainda pouco estudado em nosso meio, mas aparentemente relevante nos índices de suicídio entre adultos jovens. Entrevistaram-se 194 estudantes de Medicina de três faculdades do Estado de Säo Paulo. Os dados obtidos foram analisados estatisticamente. A presença de ideaçäo suicida relevante nessa populaçäo mostrou associaçäo com a raça amarela, bem como com tratamento psicológico/psiquiátrico prévio. As razöes para que este seja considerado um grupo de risco säo introduzidas