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1.
PLoS Pathog ; 20(2): e1012021, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38377111

RESUMO

The interaction of viral surface components with cellular receptors and other entry factors determines key features of viral infection such as host range, tropism and virulence. Despite intensive research, our understanding of these interactions remains limited. Here, we report a systematic analysis of published work on mammalian virus receptors and attachment factors. We build a dataset twice the size of those available to date and specify the role of each factor in virus entry. We identify cellular proteins that are preferentially used as virus receptors, which tend to be plasma membrane proteins with a high propensity to interact with other proteins. Using machine learning, we assign cell surface proteins a score that predicts their ability to function as virus receptors. Our results also reveal common patterns of receptor usage among viruses and suggest that enveloped viruses tend to use a broader repertoire of alternative receptors than non-enveloped viruses, a feature that might confer them with higher interspecies transmissibility.


Assuntos
Receptores de Superfície Celular , Vírus , Animais , Receptores Virais , Proteínas de Membrana , Aprendizado de Máquina , Mamíferos
2.
Surg Endosc ; 37(9): 7060-7063, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37365391

RESUMO

BACKGROUND: High-resolution manometry (HRM) is vital in evaluating patients for surgery at the gastroesophageal (GE) junction. Previously, we reported manometry alters surgery choices at the GE junction over 50% of the time, and its components, i.e., abnormal motility and distal contractile integral (DCI), are vital in decision-making. This single-institution retrospective study examines how HRM characteristics, reported with the Chicago classification, can alter the intended surgical plans for foregut surgery. METHODS: We collected data on pre-operative symptoms for patients undergoing HRM studies from 2012 to 2016, i.e., Upper GI X-rays, 48-h pH studies, DeMeester scores, upper endoscopy, and biopsy reports. HRM results were further categorized via Chicago classification (i.e., normal or abnormal motility). The DCI was determined; Patients not seen by a surgeon were excluded. Then a single surgeon, blinded to patient identity and HRM results, determined the planned procedure. The reviewer was then exposed to the HRM results; procedural plans were revised if needed. HRM results were then evaluated to determine which factors most influenced the surgical decisions. RESULTS: 298 HRM studies were initially identified; 114 met search criteria. Overall, HRM altered the planned procedure in 50.9% of cases (n = 58), with abnormal motility in 54.4% (62/114) cases. Abnormal motility findings corresponded to 70.6% (41/58) of the patients in which HRM changed the surgery decision. A DCI of < 1000 was identified in only 31.6% (36/114) of all patients, but 39.7% (23/58) of cases where the surgical decision was altered. A DCI of > 5000 was identified in only 10.5% (12/114) of all patients but 10.3% (6/58) of cases with altered surgical decisions. A DCI < 1000 and abnormal motility were generally associated with a partial fundoplication. CONCLUSIONS: This study demonstrates the impact of identifying abnormal motility via the Chicago classification and factors like DCI on surgical choice at the GE junction.


Assuntos
Transtornos da Motilidade Esofágica , Refluxo Gastroesofágico , Humanos , Refluxo Gastroesofágico/cirurgia , Estudos Retrospectivos , Manometria/métodos , Fundoplicatura , Junção Esofagogástrica/cirurgia , Transtornos da Motilidade Esofágica/diagnóstico , Transtornos da Motilidade Esofágica/cirurgia
3.
Vascular ; 31(1): 83-89, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34971332

RESUMO

OBJECTIVES: This study describes an alternative carotid bifurcation endarterectomy technique in which the external carotid artery is used as a suture patch. METHODS: Charts of ten patients with atherosclerotic carotid stenosis that were treated using the neobulb technique between 2002 and 2019 were reviewed. RESULTS: No major surgical adverse event was observed in the postoperative assessments. No postoperative common or internal carotid stenosis was observed in the mid- or long-term follow-up. CONCLUSIONS: The neobulb technique allows carotid endarterectomy closure without a synthetic or venous patch, using the external carotid artery as an autologous patch, while preserving distal flow into the external carotid artery branches.


Assuntos
Estenose das Carótidas , Endarterectomia das Carótidas , Humanos , Endarterectomia das Carótidas/efeitos adversos , Endarterectomia das Carótidas/métodos , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/cirurgia , Estenose das Carótidas/etiologia , Artéria Carótida Externa/diagnóstico por imagem , Artéria Carótida Externa/cirurgia , Endarterectomia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/cirurgia
4.
J Anesth ; 37(1): 79-91, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36352048

RESUMO

PURPOSE: We developed prediction models for postoperative respiratory depression and respiratory complications for 958 patients who were on methadone preoperatively. METHODS: The primary outcome was postoperative respiratory depression as defined by respiratory rate < 10/min, oxygen saturation (SpO2) < 90%, or requirement of naloxone for 48 h postoperatively. Secondary outcome was the composite of postoperative respiratory complications. Prediction models for postoperative respiratory depression and respiratory complications were constructed using multivariate logistic regression with preoperative and intraoperative characteristics as the predictors. RESULTS: For the multivariate logistic regression model for postoperative respiratory depression, surgery duration (P = 0.005), body mass index (BMI) (P = 0.008), surgery involving digestive system (P = 0.031), and American Society of Anesthesiologists (ASA) physical status ≥ 4 (P = 0.038) were statistically significant predictors. The area under the receiver operating characteristic curve (AUROC) of the model was 0.581 (0.558-0.601) [median (95% confidence interval (CI))] with fivefold cross-validation. For the model for postoperative respiratory complications, surgery duration (P = 0.001), history of hypertension (P = 0.028), surgery involving musculoskeletal system (P < 0.001), surgery involving integumental system (P = 0.034), surgery categorized to miscellaneous therapeutic procedures (P = 0.028), combined general and regional anesthesia (P = 0.033), ASA physical status 3 (P < 0.001), and ASA physical status ≥ 4 (P < 0.001) were statistically significant predictors, and AUROC of the model was 0.726 (0.712-0.737). CONCLUSIONS: Multivariate logistic regression models including preoperative, and intraoperative characteristics as the predictors performed poorly to predict postoperative respiratory depression, and moderately for postoperative respiratory complications. Neither model is accurate enough to be subject to clinical use.


Assuntos
Transtornos Respiratórios , Insuficiência Respiratória , Humanos , Metadona , Taxa Respiratória , Complicações Pós-Operatórias/etiologia , Fatores de Risco , Estudos Retrospectivos
5.
J Vasc Bras ; 22: e20220017, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38076582

RESUMO

An arteriovenous fistula (AVF) is an uncommon sequela of spontaneous arterial aneurysm rupture into the adjacent venous system. We describe the case of a 74-year-old patient who underwent endovascular treatment of a right iliac AVF caused by a ruptured common iliac artery (CIA) aneurysm and a distal left CIA aneurysm. Surgery preserved the lumbar and inferior mesenteric arteries because of the need to simultaneously exclude the hypogastric arteries. Dynamic fluid balance phenomena provoked by closure of the AVF are described. The patient had a benign postoperative course with normalization of the severe hemodynamic changes presented prior to the intervention and resolution of respiratory symptoms attributed to pulmonary arterial hypertension.

6.
J Viral Hepat ; 29(9): 737-747, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35707957

RESUMO

The World Health Organization (WHO) has established a target to eliminate mother-to-child-transmission (EMTCT) of hepatitis B virus (HBV), defined as a prevalence of hepatitis B surface antigen (HBsAg) of ≤0.1% among children, by 2030. Using nationally representative serosurveys to verify achievement of this target requires large sample sizes and significant resources. We assessed the feasibility of a potentially more efficient two-phase method to verify EMTCT of HBV in Colombia. In the first phase, we conducted a risk assessment to identify municipalities at the highest risk of ongoing HBV transmission. We ranked the 1122 municipalities of Colombia based on the reports of HBV infection in pregnant women per 1000 population. Municipalities with ≥0.3 reports per 1000 persons (equating to the top quartile) were further assessed based on health facility birth rates, coverage with three doses of hepatitis B vaccine (HepB3) and seroprevalence data. Hepatitis B risk was considered to be further increased for municipalities with HepB3 coverage or health facility birth rate <90%. In the second phase, we conducted a multistage household serosurvey of children aged 5-10 years in 36 municipalities with the highest assessed HBV risk. HBsAg was not detected in any of 3203 children tested, yielding a 90% upper confidence bound of <0.1% prevalence. Coverage with HepB3 and hepatitis B birth dose was high at 97.5% and 95.6%, respectively. These results support the conclusion that Colombia has likely achieved EMTCT of HBV.


Assuntos
Hepatite B , Transmissão Vertical de Doenças Infecciosas , Colômbia/epidemiologia , Feminino , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Antígenos de Superfície da Hepatite B , Vacinas contra Hepatite B , Vírus da Hepatite B , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Gravidez , Prevalência , Estudos Soroepidemiológicos
7.
Psychol Med ; 52(1): 188-194, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-32404217

RESUMO

BACKGROUND: The current coronavirus disease (COVID-19) has a great impact worldwide. Healthcare workers play an essential role and are one of the most exposed groups. Information about the psychosocial impact on healthcare workers is limited. METHODS: 3109 healthcare workers completed a national, internet-based, cross-sectional 45-item survey between 9 and 19 April 2020. The objective is to assess the psychological impact of the COVID-19 pandemic in Spanish healthcare workers. A Psychological Stress and Adaptation at work Score (PSAS) was defined combining four modified versions of validated psychological assessment tests (A) Healthcare Stressful Test, (B) Coping Strategies Inventory, (C) Font-Roja Questionnaire and (D) Trait Meta-Mood Scale. RESULTS: The highest psychosocial impact was perceived in Respiratory Medicine, the mean (S.D.) PSAS was 48.3 (13.6) and Geriatrics 47.6 (16.4). Higher distress levels were found in the geographical areas with the highest incidence of COVID-19 (>245.5 cases per 100 000 people), PSAS 46.8 (15.2); p < 0.001. The least stress respondents were asymptomatic workers PSAS, 41.3 (15.4); p < 0.001, as well as those above 60 years old, PSAS, 37.6 (16); p < 0.001. Workers who needed psychological therapy and did not receive it, were more stressed PSAS 52.5 (13.6) than those who did not need it PSAS 39.7 (13.9); p < 0.001. CONCLUSIONS: The psychological impact in healthcare workers in Spain during COVID-19 emergency has been studied. The stress perceived is parallel to the number of cases per 100 000 people. Psychotherapy could have a major role to mitigate the experimented stress level.


Assuntos
COVID-19 , Pandemias , Humanos , Pessoa de Meia-Idade , COVID-19/epidemiologia , Espanha/epidemiologia , Estudos Transversais , Pessoal de Saúde/psicologia
8.
Anesth Analg ; 134(6): 1280-1287, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35130195

RESUMO

BACKGROUND: To predict opioid consumption and pain intensity after the index cesarean delivery, we tested a hypothesis that opioid consumption after the previous cesarean delivery of the same patient can predict the opioid consumption after the index cesarean delivery. We further tested a secondary hypothesis that the pain scores after the previous cesarean delivery can predict the pain scores after the index cesarean delivery. METHODS: This is a retrospective cohort study of 470 women who underwent both previous and index cesarean deliveries at a single institution from January 2011 to June 2019. To predict the opioid consumption (primary outcome) and average pain scores (on 11-point numeric rating scale) after their index cesarean delivery, we used a linear regression model incorporating only the opioid consumption and average pain scores after the previous cesarean delivery, respectively (unadjusted models). Demographic and obstetric variables were then added as predictors (adjusted models). The bootstrap was used to compare these models with respect to proportion of variance of the outcome accounted for (R2). RESULTS: Unadjusted models were weakly predictive of opioid consumption (R2 = 0.268; 95% confidence interval [CI], 0.146-0.368) and average pain scores (R2 = 0.176; 95% CI, 0.057-0.250). An adjusted model for opioid consumption was weakly predictive (R2 = 0.363; 95% CI, 0.208-0.478), but an adjusted model for average pain scores was not predictive of the outcomes (R2 = 0.070; 95% CI, -0.143 to 0.219). Adjusted models failed to explain variances of opioid consumption and average pain scores significantly better than unadjusted models (P = .099 and P = .141, respectively). CONCLUSIONS: Opioid consumption and pain scores after women's previous cesarean delivery only explain 27% of variance of opioid consumption and 18% of variance of their pain after their index cesarean delivery. Therefore, previous cesarean delivery analgesic metrics are not robust enough to be used as clinically applicable predictors for index delivery.


Assuntos
Analgésicos Opioides , Dor Pós-Operatória , Cesárea/efeitos adversos , Feminino , Hospitais , Humanos , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Gravidez , Estudos Retrospectivos
9.
J Res Adolesc ; 32(3): 1098-1108, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35349209

RESUMO

Although youth activism often is sparked by unexpected events, the seeds of activism are planted in learning environments that cultivate community, critical reflection, and sociopolitical action. Recent studies suggest promising outcomes from transformative student voice (TSV) programming, but more work is needed that assesses the impact of TSV participation for youth of color. We surveyed 294 students from 12 public high schools and found that students in TSV activities reported more critical reflection, sociopolitical efficacy, and participation in sociopolitical action than their non-TSV peers. Additionally, using regression analysis, we found that years of involvement in TSV activities predicted participation in sociopolitical action. These findings are significant, as they indicate how multiyear engagement in TSV activities can facilitate sociopolitical action in the youth of color.


Assuntos
Comportamento do Adolescente , Política , Adolescente , Humanos , Grupo Associado , Instituições Acadêmicas , Estudantes
10.
J Sci Food Agric ; 102(1): 167-174, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34080199

RESUMO

BACKGROUND: Nowadays a significant amount of land contaminated with toxic elements is being used for agriculture, posing a serious risk of crop contamination and toxicity. Several methodologies are being used to remediate soil contamination, including the use of amendments such as biochar. This work evaluated the effects of biochar combined with different fertirrigations (water, a conventional fertilizer solution, or a fertilizer solution with a commercial biostimulant derived from leonardite) on the availability of toxic elements and nutrients for pepper cultivated in a soil contaminated with As, Cd, Pb, and Zn. RESULTS: Irrigation with fertilizer solutions improved plant growth regardless of the biochar amendment. Biochar decreased the bioavailability of Cu and Pb in soil and the Cu content in pepper leaves. Combined with fertilization, biochar also decreased plant As and Pb content. Biochar combined with biostimulant decreased the bioavailable content of Cd in soil and its uptake by pepper plants. CONCLUSION: The use of biochar and biostimulant presented advantages for plant production in a non-suitable scenario of nutrient scarcity and contamination. © 2021 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.


Assuntos
Capsicum/metabolismo , Carvão Vegetal/química , Produção Agrícola/métodos , Fertilizantes/análise , Nutrientes/química , Poluentes do Solo/metabolismo , Adsorção , Transporte Biológico , Cádmio/química , Cádmio/metabolismo , Capsicum/química , Capsicum/crescimento & desenvolvimento , Chumbo/análise , Chumbo/química , Chumbo/metabolismo , Nutrientes/metabolismo , Folhas de Planta/química , Folhas de Planta/crescimento & desenvolvimento , Folhas de Planta/metabolismo , Solo/química , Poluentes do Solo/química , Zinco/química , Zinco/metabolismo
11.
Curr Opin Anaesthesiol ; 35(3): 285-291, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35671014

RESUMO

PURPOSE OF REVIEW: Limited English proficiency (LEP) impacts patient access to safe and comprehensive care during the antepartum, intrapartum, and postpartum periods. In this review, we explore disparities in care delivery and outcomes that LEP women experience, and discuss the importance of providing language concordant care and using interpretation services appropriately. RECENT FINDINGS: The number of individuals with LEP is steadily increasing in the United States. Pregnant women with LEP suffer disparities in obstetric care and are at risk for postpartum depression, breastfeeding difficulties, and substandard newborn care after neonatal ICU discharge because of insufficient education. Addressing these issues requires the implementation of language concordant care and education, along with the utilization of medically trained interpreters. Although further evidence is needed, the authors support these interventions to improve patient satisfaction, decrease medical errors, and curtail misdiagnoses. SUMMARY: The pregnant woman with limited English proficiency is at risk of receiving suboptimal care and experiencing negative outcomes during the antepartum, intrapartum, and postpartum periods. The use of medically trained interpreters and the provision of language concordant care, through workforce diversification and the creation of forms and educational materials in diverse languages, can improve patient safety, outcomes, and quality of care.


Assuntos
Trabalho de Parto , Proficiência Limitada em Inglês , Barreiras de Comunicação , Feminino , Humanos , Recém-Nascido , Gravidez , Estados Unidos
12.
Bull Environ Contam Toxicol ; 108(1): 15-23, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33779776

RESUMO

To describe the phytoplankton species composition, spatio-temporal distribution and habitats during different seasons along the central coast of the state of Campeche, Mexico, southeastern Gulf of Mexico, eight shallow-water (ca 1 m) sites from the city of Campeche Southwest to Villamar were monitored monthly from September 2016 to June 2017 by taking water-bottle samples. Average water temperature varied between 22.2 and 30.9°C and average salinity between 26.6 and 35.0. The Kolmogorov-Smirnov test, the Bartlett's test and canonical correspondence analyses were applied. Sixteen potentially harmful microalgal species were found: five species are bloom-forming, nine are potentially toxic to humans, and two affect aquatic organisms. At all sampling sites, massive algal proliferations occurred in June (beginning of rainy season) caused by the dinoflagellates Heterocapsa sp. (2.6 × 105 cells/L) and Blixaea quinquecornis (2.0 × 104 cells/L) and from October to March (windy season) by the cyanobacterium Trichodesmium sp. (2.6 × 105 cells/L).


Assuntos
Cianobactérias , Microalgas , Golfo do México , Fitoplâncton , Plâncton , Estações do Ano , Análise Espaço-Temporal
14.
BMC Med Res Methodol ; 20(1): 5, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924168

RESUMO

BACKGROUND: Multicenter studies from Europe and the United States have developed specifically standardized questionnaires for assessing and comparing sedentary behavior, but they cannot be directly applied for South American countries. The aim of this study was to assess the reliability and validity of the South American Youth Cardiovascular and Environmental (SAYCARE) sedentary behavior questionnaire. METHODS: Children and adolescents from seven South American cities were involved in the test-retest reliability (children: n = 55; adolescents: n = 106) and concurrent validity (children: n = 93; adolescents: n = 94) studies. The SAYCARE sedentary behavior questionnaire was administered twice with two-week interval and the behaviors were parent-reported for children and self-reported for adolescents. Questions included time spent watching television, using a computer, playing console games, passive playing (only in children) and studying (only in adolescents) over the past week. Accelerometer was used for at least 3 days, including at least one weekend day. We compared values of sedentary time, using accelerometers, by quartiles of reported sedentary behavior time and their sum. RESULTS: The reliability of sedentary behavior time was moderate for children (rho ≥0.45 and k ≥ 0.40) and adolescents (rho ≥0.30). Comparisons between the questionnaire and accelerometer showed a low overall agreement, with the questionnaire systematically underreporting sedentary time in children (at least, - 332.6 ± 138.5 min/day) and adolescents (at least, - 399.7 ± 105.0 min/day). CONCLUSION: The SAYCARE sedentary behavior questionnaire has acceptable reliability in children and adolescents. However, the findings of current study indicate that SAYCARE questionnaire is not surrogate of total sedentary time.


Assuntos
Actigrafia , Comportamento Sedentário , Autorrelato , Adolescente , Criança , Pré-Escolar , Exercício Físico , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , América do Sul , Inquéritos e Questionários
15.
Anesth Analg ; 131(3): 850-856, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31804407

RESUMO

BACKGROUND: Neuraxial analgesia is the gold standard for labor analgesia in the United States, and postdural puncture headache (PDPH) is one of the most common complications. PDPH is frequently treated with an epidural blood patch (EBP), but conservative treatment approaches remain common. Our current understanding of the incidence of PDPH and the frequency of EBP utilization is heavily based on reports from academic medical centers. We studied a private insurance database to provide estimates of neuraxial labor analgesia (NLA) use and PDPH and EBP incidence in the United States. METHODS: Labor and delivery insurance claims from the Truven MarketScan Commercial Claims and Encounters database were analyzed. Mode of delivery, analgesic and/or operative anesthesia information, and EBP placement were identified using Current Procedural Terminology (CPT) codes. PDPH was identified using International Classification of Diseases, Ninth Revision (ICD-9) codes. RESULTS: The analytic dataset consisted of 1,752,243 deliveries. Vaginal deliveries (VD) comprised 64.6% of the sample. Of these, 72.9% received NLA, with a PDPH incidence of 0.58% (95% confidence interval [CI], 0.57-0.60). Using VD with NLA as a referent, the risk ratio for PDPH following cesarean delivery (CD) without a prior NLA was 1.1 (95 CI, 1.05-1.15; P = .0001), while the risk ratio for PDPH following CD with a prior NLA was 0.81 (95% CI, 0.76-0.87; P < .0001). EBP placement was documented in 68.4% PDPH cases following VD with NLA, 67.2% of PDPH cases following CD with prior NLA, and 59.7% of PDPH cases following CD without prior NLA. The median number of days between delivery and first and EBP was 3. A second EBP was performed in 8.3% of initially patched patients, and a third in 0.1%. In patients who went on to receive a repeat EBP, the median interval between delivery and the first EBP was 1 day. CONCLUSIONS: This analysis confirms findings of prior studies regarding the present utilization of neuraxial analgesia and the incidence of PDPH. When compared to patients undergoing VD with NLA, patients having CD without NLA had a higher incidence of PDPH, presumably due to intentional dural puncture. Women having CD with a prior NLA had a lower incidence of PDPH, possibly due to avoidance of pushing during the second stage of labor. EBP was a commonly pursued strategy for the treatment of PDPH and was more commonly pursued in patients with a history of NLA. Repeat EBP was rare.


Assuntos
Analgesia Obstétrica/efeitos adversos , Placa de Sangue Epidural , Cesárea , Seguro Saúde , Parto , Cefaleia Pós-Punção Dural/terapia , Setor Privado , Demandas Administrativas em Assistência à Saúde , Adulto , Placa de Sangue Epidural/efeitos adversos , Cesárea/efeitos adversos , Bases de Dados Factuais , Feminino , Humanos , Incidência , Cefaleia Pós-Punção Dural/diagnóstico , Cefaleia Pós-Punção Dural/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Estados Unidos/epidemiologia
16.
Anesth Analg ; 131(1): 7-15, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32265365

RESUMO

With increasing numbers of coronavirus disease 2019 (COVID-19) cases due to efficient human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States, preparation for the unpredictable setting of labor and delivery is paramount. The priorities are 2-fold in the management of obstetric patients with COVID-19 infection or persons under investigation (PUI): (1) caring for the range of asymptomatic to critically ill pregnant and postpartum women; (2) protecting health care workers and beyond from exposure during the delivery hospitalization (health care providers, personnel, family members). The goal of this review is to provide evidence-based recommendations or, when evidence is limited, expert opinion for anesthesiologists caring for pregnant women during the COVID-19 pandemic with a focus on preparedness and best clinical obstetric anesthesia practice.


Assuntos
Anestesia Obstétrica/métodos , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Complicações Infecciosas na Gravidez/prevenção & controle , Adulto , Betacoronavirus , COVID-19 , Infecções por Coronavirus/transmissão , Cuidados Críticos , Família , Feminino , Pessoal de Saúde , Humanos , Recém-Nascido , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias , Pneumonia Viral/transmissão , Período Pós-Parto , Gravidez , SARS-CoV-2
17.
Tohoku J Exp Med ; 251(1): 47-49, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32461502

RESUMO

The reported number of new cases underestimates the real spread of COVID-19 pandemic because of non-tested asymptomatic people and limited global access to reliable diagnostic tests. In this context, COVID-19 mortality with confirmed diagnosis becomes an attractive source of information to be included in the analysis of perspectives and proposals. Objective data are required to calculate the capacity of resources provided by health systems. New strategies are needed to stabilize or minimize the mortality surge. However, we will not afford this goal until more alternatives were available. We still need an effective treatment, an affordable vaccine, or a collective achievement of sufficient immunity (reaching up to 70% of the whole population). At any time, the arriving waves of the pandemic are testing the capacity of governments. The health services struggle to keep the plateau in a steady-state below 100 deaths per million inhabitants. Therefore, it is necessary to increase the alternatives and supplies based on the current and near-future expected demands imposed by the number of deaths by COVID-19. Estimating COVID-19 mortality in various scenarios with the gradual release of social constraints will help predict the magnitude of those arriving waves.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Monitoramento Epidemiológico , Mortalidade , Pneumonia Viral/mortalidade , População , Betacoronavirus/patogenicidade , Betacoronavirus/fisiologia , COVID-19 , Sistemas Computacionais , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Sistemas de Informação Geográfica/organização & administração , Sistemas de Informação Geográfica/normas , Mapeamento Geográfico , Geografia , Recursos em Saúde/organização & administração , Recursos em Saúde/normas , Necessidades e Demandas de Serviços de Saúde , Humanos , Mortalidade/tendências , Pandemias , Pneumonia Viral/epidemiologia , SARS-CoV-2 , Fatores de Tempo
18.
Tohoku J Exp Med ; 252(2): 159-168, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33041315

RESUMO

The double burden of malnutrition is the coexistence of two different conditions, mainly reflected as excess or deficit in weight. Anemia is a specific nutritional deficit not always included in the double burden assessment. We reviewed overweight and/or obesity (OW/OB) and anemia studies from Latin-American Children over the last ten years up to 2019. Two authors evaluated the MEDLINE, SCOPUS, and LILACS databases. A scale of ten questions was used to assess the risk of bias in prevalence studies. Fourteen studies were selected. The population studies' size ranged from 147 to 20,342 children with different socio-economic backgrounds, such as urban, peri-urban and rural settings, socio-economic status, schooling, population (ethnic minorities and indigenous), and environmental differences (sea level or high altitude). The prevalence of OW/OB ranged from 4.9% to 42%. The prevalence of anemia was from 3.4% to 67%. The double burden, including OW/OB and anemia, ranged from 0.7% to 67%. A higher prevalence of excess weight and anemia was found in rural and high altitude above sea level environments, extreme poverty, low education level, and indigenous communities. These heterogeneous data, before the 2020 (COVID-19 pandemic), reflect the vast inequities between countries and within each country. Food insecurity linked to poverty and the induced change in eating habits and lifestyles threaten optimal child nutrition in ongoing and future scenarios. The existence of OW/OB and anemia and their simultaneous coexistence in the community, home, and individual levels, indicates that interventions should be comprehensive to face the double burden of malnutrition.


Assuntos
Anemia/epidemiologia , Efeitos Psicossociais da Doença , Obesidade/epidemiologia , Adolescente , Criança , Pré-Escolar , Geografia , Humanos , Lactente , América Latina , Prevalência , Publicações
19.
J Environ Manage ; 260: 110161, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32090848

RESUMO

This paper reports the mobility and total balance of chlorotoluron (CTL), flufenacet (FNC) and bromide ion (Br-) throughout a sandy soil profile after the application of spent mushroom substrate (SMS) and green compost (GC). Obtaining mobility dataset is crucial to simulate the herbicides' fate under amended soil scenarios by application pesticide leaching models with regulatory application (FOCUS models). The application of organic residues is nowadays increased to improve the crop yields and there is a gap in the simulations of this kind of amended scenarios. A two-year field experiment involving unamended soil (S) and SMS- or GC-amended soil plots was conducted. CTL, FNC, and Br- were annually applied and their residual concentrations were determined in soil profiles (0-100 cm) regularly sampled. In all the treatments the order of mobility is followed as FNC < CTL < Br-. SMS and GC increased herbicide retention in the top 10 cm by the higher organic carbon (OC) content than the unamended soil, and their ability to increase the soil's water-holding capacity and to decrease water percolation. Simultaneously dissolved organic carbon (DOC) content facilitated herbicide transport being it favoured by the initial soil moisture content and the rainfall shortly after the chemicals' initial application. Over the first year, residual amounts (<2.6%) of Br-, CTL and FNC were leached down to 90-100 cm depth in the three treatments. However, over the second year low CTL and FNC amounts (<1.0%) reached the bottom layer only in S + SMS although high Br- concentrations did so in the three treatments (<20%). According to the total balance of Br-, CTL, and FNC in the soil profiles other processes (degradation, mineralisation, bound residues formation, and/or crop uptake) different from leaching below 1 m depth might play a key role in their dissipation especially in the amended soil profiles. SMS and GC are likely to be used as organic amendments to preserve the soil and water quality but in the case of SMS, its higher DOC content could imply a higher potential risk for groundwater contamination than GC.


Assuntos
Agaricales , Compostagem , Herbicidas , Poluentes do Solo , Solo
20.
Environ Geochem Health ; 42(7): 2147-2161, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31848783

RESUMO

Following the occurrence of a fire at a tire landfill in the surrounding area of Madrid City (Spain), polycyclic aromatic hydrocarbons (PAHs) and trace elements present in soils were analyzed to assess the impact of the fire. The capacity of the soils' clay mineral fraction to reflect this air pollution incident was studied. Fourteen soil samples were collected at different distances under the smoke plume, and they were subjected to high-performance liquid chromatography-photodiode array detection, inductively coupled plasma mass spectrometry and X-ray diffraction analyses. Clay minerals content showed a strong correlation with the pollutants potentially released in the tire fire, acenaphthene, pyrene, benzo(a)pyrene and benzo(a)fluoranthene. Trace metals Zn and Se were related to the proximity of the tire fire without any relationship with clay minerals content. This work suggests the use of natural clay minerals as potential PAHs geo-indicators in response to air pollution, complementary to current air and biological analyses.


Assuntos
Argila/química , Monitoramento Ambiental/métodos , Incêndios , Minerais/química , Poluentes do Solo/análise , Acidentes , Hidrocarbonetos Policíclicos Aromáticos/análise , Espanha , Oligoelementos/análise , Instalações de Eliminação de Resíduos
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