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Mayo Clin Proc ; 96(1): 148-151, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33413811


Community transmission of severe acute respiratory illness Coronavirus-2 (SARS-CoV-2) in Arizona was noted in March 2020. It was our hypothesis that the associated implementation of physical distancing and masking led to a decline in circulation and detection of common respiratory viruses. Nasopharyngeal swabs processed with the Biofire, Film Array respiratory panel at Mayo Clinic Arizona were reviewed from January 1, 2017, to July 31, 2020. A total of 13,324 nasopharyngeal swabs were analyzed. Between April and July 2017- 2019 (Period A) a mean of 262 tests were performed monthly, falling to 128 for the corresponding months of 2020 (Period B). A reduction in the monthly mean number of positive tests (Period A 71.5; Period B 2.8) and mean positivity rate (Period A 25.04%; Period B 2.07%) was observed. Rhinovirus/enterovirus was the most prevalent virus, with a monthly mean of 21.6 cases (30.2% of positives) for Period A and 2 cases (72.7% of positives) for Period B. Positivity for a second virus occurred in a mean of 2.1 positive tests (3.3%) in Period A but was absent in Period B. Implementation of distancing and masking coincides with a marked reduction in respiratory virus detection and likely circulation. Data from the fall/winter of 2020 will help clarify the potential role for distancing and masking as a mitigation strategy, not only for SARS-CoV-2 but also in the seasonal battle against common respiratory viruses.

/prevenção & controle , Máscaras , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Arizona/epidemiologia , /transmissão , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
Surg Clin North Am ; 101(1): 109-119, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33212072


New telehealth platforms and interventions have proliferated over the past decade and will be further spurred by the COVID-19 pandemic. Emerging literature examines the efficacy and safety of these interventions. Early pilot studies and trials demonstrate equivalent outcomes of telehealth interventions that seek to replace routine postoperative care in low-risk patients who have undergone low-risk surgeries. Studies are underway to evaluate interventions in higher-risk populations undergoing more complex procedures. Tele-ICU platforms demonstrate promise to provide specialized, high-acuity care to underserved areas and may also be used to augment compliance with evidence-based protocols.

Assistência Ambulatorial , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Cuidados Críticos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Cuidados Pós-Operatórios , Telemedicina , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
J Infect Chemother ; 27(1): 62-64, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32896479


BACKGROUND: As countermeasures against the COVID-19 outbreak, sports and entertainment events were canceled (VEC) in Japan for two weeks from 26 February through 13 March. Moreover, most schools were closed (SC). OBJECTIVE: For this study, we estimated the basic reproduction number (R0) and SC and VEC effects. METHOD: After constructing a susceptible-infected-recovered model with three age classes, we used data of symptomatic patients in Japan for 14 January through 24 March. The SC and VEC effects were incorporated into the model through changes in contact patterns and contact frequencies among age classes. RESULTS: Results suggest R0 as 2.56, with 95% CI of [2.51, 2.96] before SC and VEC. The respective effects of SC and VEC were estimated as 0.4 (95% CI [0.3, 0.5]) and 0.5 (95% CI [0.3, 0.7]). CONCLUSION: The estimated R0 is similar to those found from other studies of China and Japan. Significant reduction of contact frequency has been achieved by SC and VEC. Nevertheless, its magnitude was insufficient to contain the outbreak.

Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Instituições Acadêmicas/organização & administração , Adulto , Idoso , Número Básico de Reprodução , Betacoronavirus , Criança , Surtos de Doenças/estatística & dados numéricos , Humanos , Japão/epidemiologia , Modelos Estatísticos
J Infect Chemother ; 27(1): 120-122, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32988731


INTRODUCTION: Information on the effectiveness of personal protective equipment (PPE) for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers (HCWs), especially among HCWs with frequent contact with patients with SARS-CoV-2, is limited. METHODS: We conducted a prospective cohort study on 49 HCWs who worked in close contact with patients with SARS-CoV-2 infection. HCWs had blood samples taken every 2 weeks to test for SARS-CoV-2 antibodies using two different types of assay. RESULTS: Forty-nine participants (31 nurses, 15 doctors, 3 other workers) were enrolled. In total, 112 blood samples are obtained from participants. The median work days in 2 weeks was 9 (interquartile range (IQR): 5-10) days. In a single work day, 30 of the 49 participants (61.5%) had contact with patients with suspected or conformed SARS-CoV-2 at least 8 times, and approximately 60% of participants had more than 10 min of contact with a single patient. The median self-reported compliance to PPE was 90% (IQR: 80-100%). Seven participants tested positive for SARS-CoV-2 antibody using enzyme-linked immunosorbent assay (ELISA); however, none were seropositive for SARS-CoV-2 neutralizing antibody, so the positive ELISA results were assumed to be false-positive. CONCLUSIONS: The study provides evidence that appropriate PPE is sufficient to prevent infection amongHCWs. It is necessary to establish a system that provides a stable supply of PPE for HCWs to perform their duties.

Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Adulto , Idoso , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/diagnóstico , Estudos Prospectivos , Adulto Jovem
Methods Mol Biol ; 2225: 25-38, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33108655


Various systems exist for the robust production of recombinant proteins. However, only a few systems are optimal for human vaccine protein production. Plant-based transient protein expression systems offer an advantageous alternative to costly mammalian cell culture-based systems and can perform posttranslational modifications due to the presence of an endomembrane system that is largely similar to that of the animal cell. Technological advances in expression vectors for transient expression in the last two decades have produced new plant expression systems with the flexibility and speed that cannot be matched by those based on mammalian or insect cell culture. The rapid and high-level protein production capability of transient expression systems makes them the optimal system to quickly and versatilely develop and produce vaccines against viruses such as 2019-nCoV that have sudden and unpredictable outbreaks. Here, expression of antiviral subunit vaccines in Nicotiana benthamiana plants via transient expression is demonstrated.

Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Plantas/imunologia , Pneumonia Viral/prevenção & controle , Vacinas de Subunidades/administração & dosagem , Vacinas de Subunidades/biossíntese , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Vetores Genéticos , Humanos , Plantas/genética , Pneumonia Viral/imunologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
Artigo em Espanhol | IBECS | ID: ibc-FGT-6260


INTRODUCCIÓN: La pandemia por COVID-19 ha supuesto el confinamiento de aproximadamente un tercio de la población mundial, provocando un cambio drástico en las actividades de la vida diaria con enorme impacto sanitario, económico y social. OBJETIVOS: El objetivo de este trabajo es presentar las variaciones epidemiológicas en la producción de fracturas en el período de confinamiento obligatorio en nuestra población de referencia. MATERIAL Y MÉTODOS: Estudio analítico retrospectivo comparativo de dos grupos de pacientes: Grupo A: personas ingresadas antes del estado de alarma que obligó al confinamiento en el período del 13 enero al 13 de marzo vs. Grupo B: individuos atendidos durante los dos meses de confinamiento, hasta que comenzó la desescalada, período del 13 marzo al 13 mayo. Se registraron variables epidemiológicas, incluyendo edad, antecedentes personales, tipo de fractura, mecanismo de lesión, porcentaje de ambulatorización y estancia hospitalaria. RESULTADOS: Se incluyeron un total de 190 pacientes. En el período de pre-confinamiento 112 y en el confinamiento 78 (disminución del 30%). La edad media (p = 0,007) y las caídas en domicilio (p < 0,001) fueron mayores en este último grupo. La estancia hospitalaria postoperatoria (p = 0,006) y global (p < 0,001) resultaron significativamente menores en el mismo grupo. No se encontraron diferencias en la localización anatómica de la lesión, el sexo, las comorbilidades, el mecanismo de lesión, la tasa de ambulatorización ni el éxitus. CONCLUSIONES: Con base en los resultados de nuestro estudio, el período de confinamiento forzoso por la pandemia de COVID-19 ha producido una drástica disminución del número total de fracturas ingresadas en el servicio de traumatología de un hospital de tercer nivel. Por otro lado, las fracturas osteoporóticas de cadera que requirieron tratamiento quirúrgico no variaron en número y se ha constatado un decremento de la estancia media postoperatoria y global

INTRODUCTION: The COVID-19 pandemic has led to the confinement of approximately one third of the world population, causing a drastic change in the activities of daily life with many repercussions at the health, economic and social levels. OBJECTIVES: The objective of the present work is to present the epidemiological variations in the production of fractures in the period of mandatory confinement in our reference population. METHODS: Analytical retrospective comparative study of two groups of patients: Group A: patients admitted before the state of alarm that forced confinement in the period from January 13 to March 13 compared to Group B: patients admitted in the two months of confinement, until the de-escalation period began, March 13-May 13. Epidemiological variables including age, personal history, type of fracture, mechanism of injury, outpatient rate, and hospital stay were recorded. RESULTS: A total of 190 patients were included. 112 in the pre-confinement period and 78 in the confinement (30% decrease). The mean age (p = 0.007) and falls at home (p < 0.001) were higher in the confinement group. The postoperative (p = 0.006) and overall (p < 0.001) hospital stay were significantly less in the confinement group. No differences were found in the anatomical location of the lesion, sex, comorbidities, mechanism of injury, outpatient rate, or death. CONCLUSIONS: Based on the results of our study, the period of forced confinement due to the COVID-19 pandemic has produced a drastic decrease in the total number of fractures admitted to the traumatology service of a third level hospital. On the other hand, osteoporotic hip fractures have not varied in their incidence and a decrease in the average postoperative and overall stay has been observed

Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Pandemias , Isolamento Social , Procedimentos Ortopédicos/estatística & dados numéricos , Fraturas Ósseas/epidemiologia , Estudos Retrospectivos , Espanha/epidemiologia
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48000


Motivada pela necessidade imediata de mudanças na resposta à pandemia do novo coronavírus e diante da inoperância por parte do Governo Federal, as organizações do campo da Saúde que participam da Frente pela Vida lançaram o Plano Nacional de Enfrentamento à pandemia de Covid-19 em 3 de julho. O documento foi elaborado pela Associação Brasileira de Saúde Coletiva (ABRASCO), Centro Brasileiro de Estudos de Saúde (CEBES), Associação Brasileira Rede Unida (Rede Unida), Associação Brasileira de Economia em Saúde (ABrES), Associação Brasileira de Saúde Mental (ABRASME), Associação Brasileira de Saúde do Trabalhador e da Trabalhadora (ABRASTT), Associação Brasileira de Enfermagem (ABEn), Sociedade Brasileira de Virologia (SBV), Sociedade Brasileira de Bioética (SBB), Conselho Nacional de Saúde (CNS), Sociedade Brasileira de Medicina Tropical (SBMT), Sociedade Brasileira para a Qualidade do Cuidado e Segurança do Paciente (SOBRASP), Rede de Médicas e Médicos Populares (RMMP), Associação Brasileira de Médicas e Médicos pela Democracia (ABMMD) e Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC). O documento, após Apresentação e Introdução, debate a complexidade da pandemia e faz uma análise aprofundada dos aspectos biomoleculares e clínicos e o panorama epidemiológico; analisando na sequência a Consolidação do SUS; a Ciência e Tecnologia (C&T) em saúde e produção de insumos estratégicos; o fortalecimento do sistema de proteção social; e a atenção às populações vulnerabilizadas e Direitos Humanos, mostrando que a ciência e sociedade brasileiras são capazes de produzir uma resposta alternativa ao descaso e descompasso geradores de morte. Ao final, indica responsabilidades e recomendações às autoridades políticas e sanitárias, aos gestores públicos e à sociedade em geral.

Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Pandemias/prevenção & controle , Monitoramento Epidemiológico , Sistema Único de Saúde/organização & administração
Rech Soins Infirm ; (142): 77-85, 2020 Dec 02.
Artigo em Francês | MEDLINE | ID: mdl-33319720


Introduction : The COVID-19 pandemic has warranted the implementation of barrier actions and the wearing of personal protective equipment (PPE). These behavioral adaptations counteract spontaneous self-touching reflex gestures. I propose to explore the mind-body experience generated by these gesture changes in this health context.Method : I conducted a qualitative study with nine nurses who volunteered as reinforcements. The semistructured interviews I carried out were analyzed using the interpretative phenomenological analysis approach.Results : The perception of the risk of self-inoculation is not related to the level of virus exposure. Facial PPE is perceived both as reassuring and difficult to put up with. The experience of self-touches is influenced by the level of attention the subject pays to his or her face and by the medical background related to this. Three kinds of mind-body adaptations are used to control self-touching : control by avoidance, control by keeping one’s hands busy, and compensatory bodily strategies. The representations of the bodily self are modified in terms of gestures and of the feeling of humanness. This generates a form of bodily abandonment and a lived experience of soiled bodies.Conclusion : The results highlight the cognitive load involved in refraining from self-touching and with the wearing of facial PPE. They emphasize the importance of questioning the implications of these sensorimotor modifications. Supporting health professionals in assessing the mind-body repercussions in a pandemic situation appears key.

Infecções por Coronavirus/prevenção & controle , Enfermeiras e Enfermeiros/psicologia , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/psicologia , Feminino , Humanos , Entrevistas como Assunto , Pandemias , Pneumonia Viral/psicologia , Pesquisa Qualitativa
Acta otorrinolaringol. esp ; 71(6): 367-378, nov.-dic. 2020. graf, ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-190281


La aparición de una nueva enfermedad por coronavirus denominada COVID-19 a finales de 2019 y su expansión pandémica en el mundo ha cambiado la práctica habitual de la especialidad de Otorrinolaringología (ORL). Tras una fase de crecimiento exponencial de los contagios, se ha logrado entrar en una fase de control de la expansión de la enfermedad en la que persiste la posibilidad de contagio, pero la aparición de nuevos casos se considera asumible por el sistema sanitario. El objetivo del presente documento es revisar la evidencia disponible y proponer estrategias y recomendaciones para la práctica médico-quirúrgica de la otorrinolaringología y cirugía de cabeza y cuello, que permitan establecer la actividad habitual, adecuando los estándares de seguridad y eficacia a la situación actual. Se requiere, por lo tanto, identificar y clasificar a los pacientes en función de criterios de estado infeccioso-inmunológico, y establecer las recomendaciones de protección en consultas, hospitalización y quirófano, que eviten la transmisión de la enfermedad a otros usuarios y al personal sanitario, en el contexto específico del desarrollo de nuestra especialidad. El presente documento es fruto de la colaboración de las comisiones científicas y del comité COVID-19 de la SEORLCCC

The appearance of a new coronavirus disease called COVID-19 at the end of 2019 and its pandemic expansion in the world has changed the usual practice of the specialty of Otorhinolaryngology (ENT). After a phase of exponential growth of infections, it has been possible to enter a phase of control of the spread of the disease in which the possibility of infection persists, and the appearance of new cases is considered acceptable by the health system. The aim of this document is to review the available evidence and propose strategies and recommendations for the medical-surgical practice of otorhinolaryngology and head and neck surgery, which allow establishing the usual activity, adapting the safety and efficacy standards to the current situation. Therefore, it is required to identify and classify patients according to criteria of infectious-immunological status, and to establish recommendations for protection in consultations, hospitalization and the operating room, which avoid the transmission of the disease to other users and healthcare personnel, in the specific context of the development of our specialty. This document is the result of the collaboration of all the scientific commissions and the SEORLCCC COVID-19 committee

Humanos , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Pandemias , Otolaringologia/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Equipamentos de Proteção , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico
Enferm. clín. (Ed. impr.) ; 30(6): 360-370, nov.-dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191719


OBJETIVO: Describir los factores relacionados con la situación de contagio del SARS-CoV-2 identificados por los profesionales de la salud en España y proponer estrategias de prevención. MÉTODO: Estudio descriptivo transversal. La población fueron profesionales de la salud trabajando en instituciones con atención a pacientes con COVID-19 y caso confirmado de infección por SARS-CoV-2. Se utilizó un cuestionario con variables sociodemográficas, laborales y epidemiológicas. Se realizó análisis descriptivo y bivariado según la naturaleza de las variables. RESULTADOS: Se analizan 2230 cuestionarios sobre una población potencial de 41,239 (5,47%). El motivo para realizar el diagnóstico fue: caso sospechoso (63,4%) y caso probable (12,3%). Se hizo estudio de contactos al 50,3%. La percepción sobre la disponibilidad de medidas de protección como "siempre/frecuentemente" fueron: mascarilla FPP1 57,3%, guantes 89,5%, jabón 95% y solución hidroalcohólica 91,5% y en EPIs, mascarillas FPP2, FPP3, gafas y batas desechables alrededor del 50%. La disponibilidad de medidas protectoras, por ámbito de trabajo, presentó diferencias significativas. La media de pacientes atendidos se relacionó con la realización de higiene de manos del momento 4 y en la percepción de realizarla correctamente en momentos 4 y 5. CONCLUSIONES: Se presentan datos con carácter preliminar y con variabilidad en la tasa de respuesta por Comunidad Autónoma. Los profesionales de la salud contagiados por SARS-CoV-2 identifican la gestión de la cadena de contagios, el uso y adecuación en la disponibilidad de equipos de protección, así como la efectividad en la realización del lavado de manos, como factores relacionados con el contagio de los profesionales

OBJECTIVE: To describe the factors related to the situation of SARS-CoV-2 transmission identified by health professionals in Spain and to propose prevention strategies. METHOD: Cross-sectional descriptive study. The population were healthcare professionals working in institutions caring forCOVID-19 patients and also confirmed cases of SARS-CoV-2 infection. A questionnaire with sociodemographic, occupational and epidemiological variables was used. Descriptive and bivariate analysis was performed according to the nature of the variables. RESULTS: Twenty-two hundred and thirty questionnaires were analysed on a potential population of 41,239 (5.47%). The diagnosis was made based on a suspicious case (63.4%) and a probable case (12.3%). A study of contacts was carried out at 50.3%. The perception about the availability of protective measures as "always/frequently" were: FPP1 mask 57.3%, gloves 89.5%, soap 95% and hydroalcoholic solution 91.5%. In PPE, FPP2, FPP3 mask, goggles and disposable gowns at around50%. The availability of protective measures, by field of work, presented significant differences. The average number of patients attended related to the performance of hand hygiene at moment 4 and the perception of performing it correctly at moments 4 and 5. CONCLUSIONS: Preliminary data are presented, with variability in the response rate by Autonomous Region. Healthcare professionals infected by SARS-CoV-2 identified the management of the chain of infection transmission, the use and adequacy of protective equipment, as well as the effectiveness of handwashing as factors related to the transmission of the virus among professionals

Humanos , Pessoal de Saúde/estatística & dados numéricos , Fatores de Risco , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Síndrome Respiratória Aguda Grave/epidemiologia , Planos e Programas de Saúde , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Síndrome Respiratória Aguda Grave/prevenção & controle , Espanha/epidemiologia , Estudos Transversais , Inquéritos e Questionários , Betacoronavirus