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1.
Braz. j. oral sci ; 20: e213587, jan.-dez. 2021. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1254537

RESUMO

Aim: One of the main factors that play a pivotal role in the transmission of COVID-19 from human to human is saliva; according to the subject's importance, the present study aimed to evaluate the potential of transmission via the saliva of coronavirus disease. Methods: PubMed, ISI, Embase, Scopus, Medicine have been used until September 2020 to search for articles. Therefore, EndNote X9 used to manage electronic resources. A 95% confidence interval (CI) effect size, fixed effect model, Inverse-variance methods have been calculated. The positive rate of SARS-CoV2 assessed with meta analysis. To deal with potential heterogeneity, random effects were used, and I2 showed heterogeneity. I2 values above 50% signified moderate-to-high heterogeneity. The Meta-analysis has been evaluated with Stata/MP v.16 (the fastest version of Stata) statistical software. Results: According to the study's purpose, in the initial search with keywords, 19 articles were found, the full text of 3 studies was reviewed, and finally, three studies were selected. The positive rate of SARS-CoV2 was 86% (86%; 95% CI 67 %-100%). Conclusion: saliva can be a non-invasive specimen type for diagnosis of COVID-19. Dentists should be aware that saliva plays a major role in the transmission of COVID-19 from human to human, and failure to follow prevention protocols can contaminate them


Assuntos
Saliva , Serviços de Saúde Bucal , COVID-19
2.
Braz. j. oral sci ; 20: e213961, jan.-dez. 2021. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1254644

RESUMO

Aim: This cross-sectional study aimed to investigate where Brazilian dental students seek information about COVID-19 by a self-administered web-based questionnaire. Methods: A social network campaign on Instagram was raised to approach the target population. The dental students responded to a multiple-response question asking where or with whom they get information about COVID-19. The possible answers were government official websites or health and education institutions websites, TV Programs, professors, social media, scientific articles, health professionals, and family members. The data were analyzed by descriptive statistics, and the frequency distributions of responses were evaluated by gender, age, type of institution, and year of enrollment. Results: A total of 833 valid responses were received. The main source of information used by the dental students were government official websites or health and education institutions websites, which were reported by 739 (88.7%) participants. In the sequence, 477 (57.3%) participants chose health professionals while 468 (56.2%) chose scientific articles as information sources. The use of social media was reported by 451 (54.1%) students, while TV programs were information sources used by 332 (39.9%) students. The least used information sources were professors, reported by 317 (38.1%) students, and family members, chosen only by 65 (7.8%) participants. Conclusion: Brazilian dental students rely on multiple information sources to stay informed about COVID-19, mainly focusing their information-seeking behavior on governmental and health professional's websites


Assuntos
Faculdades de Odontologia , Estudantes de Odontologia , Inquéritos e Questionários , Comportamento de Busca de Informação , Mídias Sociais , COVID-19
3.
Recurso na Internet em Inglês, Espanhol, Francês, Português | LIS - Localizador de Informação em Saúde | ID: lis-48285

RESUMO

A diretora da Organização Pan-Americana da Saúde, Carissa F. Etienne, reassegurou aos países que as vacinas contra a COVID-19 são eficazes mesmo com a circulação das novas variantes do vírus SARS-CoV-2 nas Américas.


Assuntos
COVID-19 , Vacinas , Betacoronavirus , Eficácia , América Latina
4.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48278

RESUMO

Um estudo do Hospital das Clínicas da Faculdade de Medicina da USP (HC), realizado pelo Instituto da Criança e do Adolescente, indicou presença de anticorpos em leite de colaboradoras lactantes do HC, imunizadas com a vacina Coronavac, do Instituto Butantã. Foi observado que a segunda dose fornece um incremento no nível de anticorpos das gestantes e, em algumas das colaboradoras, níveis altos de anticorpos contra a covid-19 mantiveram-se no leite mesmo depois de alguns meses de amamentação.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Leite Humano , Aleitamento Materno , Gestantes
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48279

RESUMO

No início de 2021, foram publicados alguns estudos, em especial um israelense (Perl e colaboradores) e outro americano (Gray e colaboradores), que identificaram anticorpos no leite materno de lactantes vacinadas com a vacina da Pfizer-BioNTech, à época não disponível no Brasil. Esses anticorpos poderiam, provavelmente, proteger os recém-nascidos e crianças maiores em aleitamento materno contra a Covid-19.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Leite Humano/imunologia , Aleitamento Materno
6.
Geneva; World Health Organization; 2021-07-13.
em Inglês | WHO IRIS | ID: who-342906
7.
Geneva; World Health Organization; 2021-07-06.
em Inglês | WHO IRIS | ID: who-342524
8.
BMC Health Serv Res ; 21(1): 624, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193134

RESUMO

BACKGROUND: The COVID-19 pandemic and lockdown evoked great worries among professionals in the field of domestic violence and abuse (DVA) as they expected a rise of the phenomenon. While many countries reported increased DVA, the Netherlands did not. To understand this discrepancy and the overall impact of the lockdown on DVA support services, we interviewed DVA professionals about their experiences with DVA during the rise of COVID-19, the impact of the lockdown on clients and working conditions, and views on eHealth and online tools. METHODS: Semi-structured interviews were conducted among 16 DVA professionals with various specializations. This data was analyzed using open thematic coding and content analysis. RESULTS: Most professionals did not see an increase in DVA reports but they did notice more severe violence. They experienced less opportunities to detect DVA and worried about their clients' wellbeing and the quality of (online) care. Furthermore, their working conditions rapidly changed, with working from home and online, and they expressed frustration, insecurity and loneliness. Professionals feel eHealth and online tools are not always suitable but they do see them as an opportunity to increase reach and maintain services when physical contact is not possible. CONCLUSION: This study suggests DVA was probably under-detected during the lockdown rather than not having increased. The Dutch system heavily relies on professionals to detect and report DVA, suggesting a need for critical evaluation of the accessibility of professional help. Professionals experienced significant challenges and should themselves be supported psychologically and in their changed work practices to maintain their ability to aid survivors.


Assuntos
COVID-19 , Violência Doméstica , Controle de Doenças Transmissíveis , Humanos , Países Baixos , Pandemias , SARS-CoV-2
9.
Nihon Yakurigaku Zasshi ; 156(4): 208-213, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34193697

RESUMO

The mission of regulatory science is to promote human longevity by providing safer and more effective drugs and ensuring human health. At present, various in vitro and in vivo evaluation methods are used for drug development, and no major problems have been observed. However, there is still room for improvement in terms of risk prediction in humans. Thus, new approaches and methodologies (NAMs) have recently been developed to predict adverse events in humans more accurately. Based on the animal alternative methods and the current COVID-19 pandemic, in vitro methods, such as human iPS cells, and computational approach are accelerated to improve the efficiency of drug development, ensure the patients' safety and speed up the review process. In this review, we would like to summarize the current status and future perspectives of pharmacological assay system using NAM in drug development.


Assuntos
COVID-19 , Pandemias , Alternativas aos Testes com Animais , Animais , Desenvolvimento de Medicamentos , Humanos , SARS-CoV-2
10.
Vaccine ; 39(32): 4399-4403, 2021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34226102

RESUMO

The skin represents an attractive target tissue for vaccination against respiratory viruses such as SARS-CoV-2. Laser-facilitated epicutaneous immunization (EPI) has been established as a novel technology to overcome the skin barrier, which combines efficient delivery via micropores with an inherent adjuvant effect due to the release of danger-associated molecular patterns. Here we delivered the S1 subunit of the Spike protein of SARS-CoV-2 to the skin of BALB/c mice via laser-generated micropores with or without CpG-ODN1826 or the B subunit of heat-labile enterotoxin of E.coli (LT-B). EPI induced serum IgG titers of 1:3200 that could be boosted 5 to 10-fold by co-administration of LT-B and CpG, respectively. Sera were able to inhibit binding of the spike protein to its receptor ACE2. Our data indicate that delivery of recombinant spike protein via the skin may represent an alternative route for vaccines against Covid-19.


Assuntos
COVID-19 , Glicoproteína da Espícula de Coronavírus , Animais , Anticorpos Antivirais , Vacinas contra COVID-19 , Humanos , Imunização , Lasers , Camundongos , Camundongos Endogâmicos BALB C , Peptidil Dipeptidase A , Ligação Proteica , SARS-CoV-2 , Vacinação
11.
BMJ Case Rep ; 14(7)2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34226258

RESUMO

A 35-year-old woman, 6 months post partum, presented with acute onset back pain at the T8 level progressing to bilateral lower limb weakness and sensory loss with urinary retention and constipation. This patient had a pre-existing inflammatory disease, having recently developed ulcerative colitis antenatally. Five days prior to admission, she had tested positive asymptomatically on a SARS-CoV-2 reverse-transcriptase PCR nasopharyngeal swab. The positive swab result was confirmed on admission. Clinical examination revealed bilaterally exaggerated knee reflexes, lower limb weakness and positive Babinski's sign. Sensation was impaired at L4 and L5 dermatomes and absent at S1 and S2. MRI findings suggested longitudinal extensive transverse myelitis, with multiple regions of patchy hyperintensity seen in the thoracic region of the spinal cord both centrally and peripherally. She was started on a course of intravenous corticosteroids and improvement was seen both clinically and on repeat imaging. This case demonstrates a rare complication to an asymptomatic COVID-19 infection and explores the potential neurotropic properties of COVID-19.


Assuntos
COVID-19 , Mielite Transversa , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Mielite Transversa/diagnóstico , Mielite Transversa/tratamento farmacológico , Mielite Transversa/etiologia , SARS-CoV-2
12.
Nat Commun ; 12(1): 4117, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-34226537

RESUMO

Epidemiological and clinical reports indicate that SARS-CoV-2 virulence hinges upon the triggering of an aberrant host immune response, more so than on direct virus-induced cellular damage. To elucidate the immunopathology underlying COVID-19 severity, we perform cytokine and multiplex immune profiling in COVID-19 patients. We show that hypercytokinemia in COVID-19 differs from the interferon-gamma-driven cytokine storm in macrophage activation syndrome, and is more pronounced in critical versus mild-moderate COVID-19. Systems modelling of cytokine levels paired with deep-immune profiling shows that classical monocytes drive this hyper-inflammatory phenotype and that a reduction in T-lymphocytes correlates with disease severity, with CD8+ cells being disproportionately affected. Antigen presenting machinery expression is also reduced in critical disease. Furthermore, we report that neutrophils contribute to disease severity and local tissue damage by amplification of hypercytokinemia and the formation of neutrophil extracellular traps. Together our findings suggest a myeloid-driven immunopathology, in which hyperactivated neutrophils and an ineffective adaptive immune system act as mediators of COVID-19 disease severity.


Assuntos
COVID-19/complicações , COVID-19/imunologia , Síndrome da Liberação de Citocina/complicações , Monócitos/patologia , Ativação de Neutrófilo , Idoso , Células Apresentadoras de Antígenos/imunologia , COVID-19/sangue , COVID-19/virologia , Estudos de Casos e Controles , Síndrome da Liberação de Citocina/sangue , Síndrome da Liberação de Citocina/patologia , Síndrome da Liberação de Citocina/virologia , Citocinas/sangue , Armadilhas Extracelulares/metabolismo , Feminino , Antígenos de Histocompatibilidade Classe II/metabolismo , Humanos , Imunofenotipagem , Masculino , Pessoa de Meia-Idade , SARS-CoV-2/fisiologia , Índice de Gravidade de Doença
13.
Anal Chem ; 93(28): 9933-9938, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34227801

RESUMO

Sensitive detection of the SARS-CoV-2 protein remains a great research interest in clinical screening and diagnosis owing to the coronavirus epidemic. Here, an ultrasensitive chemiluminescence (CL) imaging strategy was developed through proximity hybridization to trigger the formation of a rolling circle-amplified G-quadruplex/hemin DNAzyme for the detection of the SARS-CoV-2 protein. The target protein was first recognized by a pair of DNA-antibody conjugates, Ab-1 and Ab-2, to form a proximity-ligated complex, Ab-1/SARS-CoV-2/Ab-2, which contained a DNA sequence complemental to block DNA and thus induced a strand displacement reaction to release the primer from a block/primer complex. The released primer then triggered a rolling circle amplification to form abundant DNAzyme units in the presence of hemin, which produced a strong chemiluminescent signal for the detection of the target protein by catalyzing the oxidation of luminol by hydrogen peroxide. The proposed assay showed a detectable concentration range over 5 orders of magnitude with the detection limit down to 6.46 fg/mL. The excellent selectivity, simple procedure, acceptable accuracy, and intrinsic high throughput of the imaging technique for analysis of serum samples demonstrated the potential applicability of the proposed detection method in clinical screening and diagnosis.


Assuntos
Técnicas Biossensoriais , COVID-19 , DNA Catalítico , Quadruplex G , DNA Catalítico/metabolismo , Hemina , Humanos , Imunoensaio , Limite de Detecção , Luminescência , SARS-CoV-2
14.
BJS Open ; 5(4)2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34228096

RESUMO

BACKGROUND: COVID-19 has brought an unprecedented challenge to healthcare services. The authors' COVID-adapted pathway for suspected bowel cancer combines two quantitative faecal immunochemical tests (qFITs) with a standard CT scan with oral preparation (CT mini-prep). The aim of this study was to estimate the degree of risk mitigation and residual risk of undiagnosed colorectal cancer. METHOD: Decision-tree models were developed using a combination of data from the COVID-adapted pathway (April-May 2020), a local audit of qFIT for symptomatic patients performed since 2018, relevant data (prevalence of colorectal cancer and sensitivity and specificity of diagnostic tools) obtained from literature and a local cancer data set, and expert opinion for any missing data. The considered diagnostic scenarios included: single qFIT; two qFITs; single qFIT and CT mini-prep; two qFITs and CT mini-prep (enriched pathway). These were compared to the standard diagnostic pathway (colonoscopy or CT virtual colonoscopy (CTVC)). RESULTS: The COVID-adapted pathway included 422 patients, whereas the audit of qFIT included more than 5000 patients. The risk of missing a colorectal cancer, if present, was estimated as high as 20.2 per cent with use of a single qFIT as a triage test. Using both a second qFIT and a CT mini-prep as add-on tests reduced the risk of missed cancer to 6.49 per cent. The trade-off was an increased rate of colonoscopy or CTVC, from 287 for a single qFIT to 418 for the double qFIT and CT mini-prep combination, per 1000 patients. CONCLUSION: Triage using qFIT alone could lead to a high rate of missed cancers. This may be reduced using CT mini-prep as an add-on test for triage to colonoscopy or CTVC.


Assuntos
COVID-19 , Neoplasias Colorretais/diagnóstico , Erros de Diagnóstico/estatística & dados numéricos , Sangue Oculto , Triagem/organização & administração , Auditoria Clínica , Colonoscopia , Árvores de Decisões , Detecção Precoce de Câncer/métodos , Humanos , Escócia , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
15.
ACS Chem Neurosci ; 12(14): 2555-2557, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34228437

RESUMO

Because SARS-CoV-2 uses the nasal cavity as a major route of entry to the human body, nasal administration of drugs and antibodies directed against the virus can prove to be effective for not only pulmonary COVID-19 but also prevention of potential early neuroinvasion caused by this virus. With recent reports of the potential application of antibody-laden nasal spray for the treatment of COVID-19, proposed here is the use of drugs recently proven to be effective against SARS-CoV-2 to be administered via inhalation route using a modified transcribrial device reported previously for its use against Naegleria fowleri, to target SARS-CoV-2 in our fight against COVID-1.


Assuntos
COVID-19 , Preparações Farmacêuticas , Anticorpos , Humanos , SARS-CoV-2
16.
BMJ Open Respir Res ; 8(1)2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34230034

RESUMO

INTRODUCTION: Many respiratory clinical trials fail to reach their recruitment target and this problem exacerbates existing funding issues. Integration of the clinical trial recruitment process into a clinical care pathway (CCP) may represent an effective way to significantly increase recruitment numbers. METHODS: A respiratory support unit and a CCP for escalation of patients with severe COVID-19 were established on 11 January 2021. The recruitment process for the Randomised Evaluation of COVID-19 Therapy-Respiratory Support trial was integrated into the CCP on the same date. Recruitment data for the trial were collected before and after integration into the CCP. RESULTS: On integration of the recruitment process into a CCP, there was a significant increase in recruitment numbers. Fifty patients were recruited over 266 days before this process occurred whereas 108 patients were recruited over 49 days after this process. There was a statistically significant increase in both the proportion of recruited patients relative to the number of COVID-19 hospital admissions (change from 2.8% to 9.1%, p<0.0001) and intensive therapy unit admissions (change from 17.8% to 50.2%, p<0.001) over the same period, showing that this increase in recruitment was independent of COVID-19 prevalence. DISCUSSION: Integrating the trial recruitment process into a CCP can significantly boost recruitment numbers. This represents an innovative model that can be used to maximise recruitment without impacting on the financial and labour costs associated with the running of a respiratory clinical trial.


Assuntos
COVID-19/terapia , Procedimentos Clínicos , Seleção de Pacientes , Ensaios Clínicos Controlados Aleatórios como Assunto , Hospitalização , Humanos , Terapia Respiratória
17.
BMJ Case Rep ; 14(7)2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34230050

RESUMO

We report the case of a 59-year-old woman who developed acute macroglossia following prolonged prone positioning for management of COVID-19. We found that Biotene mixed in glycerin was effective at removing keratinised lingual plaques and better tolerated than Biotene alone. Additionally, uniform tongue compression applied via tubular elastic dressing yielded more efficacious results than uneven tongue compression via Coban.


Assuntos
COVID-19 , Macroglossia , Insuficiência Respiratória , Feminino , Humanos , Macroglossia/etiologia , Pessoa de Meia-Idade , Posicionamento do Paciente , Decúbito Ventral , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , SARS-CoV-2
18.
Nat Commun ; 12(1): 4015, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34230477

RESUMO

Sex and gender differences impact the incidence of SARS-CoV-2 infection and COVID-19 mortality. Furthermore, sex differences influence the frequency and severity of pharmacological side effects. A large number of clinical trials to develop new therapeutic approaches and vaccines for COVID-19 are ongoing. We investigated the inclusion of sex and/or gender in COVID-19 studies on ClinicalTrials.gov, collecting data for the period January 1, 2020 to January 26, 2021. Here, we show that of the 4,420 registered SARS-CoV-2/COVID-19 studies, 935 (21.2%) address sex/gender solely in the context of recruitment, 237 (5.4%) plan sex-matched or representative samples or emphasized sex/gender reporting, and only 178 (4%) explicitly report a plan to include sex/gender as an analytical variable. Just eight (17.8%) of the 45 COVID-19 related clinical trials published in scientific journals until December 15, 2020 report sex-disaggregated results or subgroup analyses.


Assuntos
COVID-19/terapia , Estudos Clínicos como Assunto/estatística & dados numéricos , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Seleção de Pacientes , SARS-CoV-2 , Fatores Sexuais
19.
Nat Commun ; 12(1): 4144, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34230476

RESUMO

To investigate the duration of humoral immune response in convalescent coronavirus disease 2019 (COVID-19) patients, we conduct a 12-month longitudinal study through collecting a total of 1,782 plasma samples from 869 convalescent plasma donors in Wuhan, China and test specific antibody responses. The results show that positive rate of IgG antibody against receptor-binding domain of spike protein (RBD-IgG) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the COVID-19 convalescent plasma donors exceeded 70% for 12 months post diagnosis. The level of RBD-IgG decreases with time, with the titer stabilizing at 64.3% of the initial level by the 9th month. Moreover, male plasma donors produce more RBD-IgG than female, and age of the patients positively correlates with the RBD-IgG titer. A strong positive correlation between RBD-IgG and neutralizing antibody titers is also identified. These results facilitate our understanding of SARS-CoV-2-induced immune memory to promote vaccine and therapy development.


Assuntos
Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Imunoglobulina G/sangue , Receptores Virais/imunologia , SARS-CoV-2/imunologia , Adulto , Animais , Doadores de Sangue , COVID-19/terapia , Linhagem Celular , China , Chlorocebus aethiops , Convalescença , Feminino , Humanos , Imunidade Humoral/imunologia , Imunização Passiva , Memória Imunológica/imunologia , Estudos Longitudinais , Masculino , Fatores Sexuais , Glicoproteína da Espícula de Coronavírus/imunologia , Células Vero
20.
BMJ Open ; 11(7): e045441, 2021 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-34244254

RESUMO

INTRODUCTION: People living in slums face several challenges to access healthcare. Scarce and low-quality public health facilities are common problems in these communities. Costs and prevalence of catastrophic health expenditures (CHE) have also been reported as high in studies conducted in slums in developing countries and those suffering from chronic conditions and the poorest households seem to be more vulnerable to financial hardship. The COVID-19 pandemic may be aggravating the economic impact on the extremely vulnerable population living in slums due to the long-term consequences of the disease. The objective of this review is to report the economic impact of seeking healthcare on slum-dwellers in terms of costs and CHE. We will compare the economic impact on slum-dwellers with other city residents. METHODS AND ANALYSIS: This scoping review adopts the framework suggested by Arksey and O'Malley. The review is part of the accountability and responsiveness of slum-dwellers (ARISE) research consortium, which aims to enhance accountability to improve the health and well-being of marginalised populations living in slums in India, Bangladesh, Sierra Leone and Kenya. Costs of accessing healthcare will be updated to 2020 prices using the inflation rates reported by the International Monetary Fund. Costs will be presented in International Dollars by using purchase power parity. The prevalence of CHE will also be reported. ETHICS AND DISSEMINATION: Ethical approval is not required for scoping reviews. We will disseminate our results alongside the events organised by the ARISE consortium and international conferences. The final manuscript will be submitted to an open-access international journal. Registration number at the Research Registry: reviewregistry947.


Assuntos
COVID-19 , Acesso aos Serviços de Saúde/economia , Áreas de Pobreza , Bangladesh , Países em Desenvolvimento , Feminino , Instalações de Saúde , Humanos , Índia , Quênia , Masculino , Pandemias , Literatura de Revisão como Assunto , SARS-CoV-2 , Serra Leoa
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