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3.
Washington, D.C.; PAHO; 2021-09-09. (PAHO/FPL/HL/COVID-19/21-0037).
Não convencional | PAHO-IRIS | ID: phr-54815

RESUMO

COVID-19 can have significant direct and indirect consequences for the health and well-being of young people. The objective of this publication is to contribute to the strengthening of a comprehensive response to young people and COVID-19 during the pandemic and in the recovery phase, to mitigate the short-, medium- and long-term consequences of COVID-19 for young people in the Americas, particularly those living in conditions of vulnerability. The publication summarizes relevant WHO and PAHO guidance, as well as recommendations from other United Nations partners, such as UNFPA and UNICEF. It also provides links to related resources and practical examples of actions taken by governments, youth leaders, and other stakeholders. Intended users include national and local decisionmakers, program managers, multidisciplinary teams working on adolescent and youth health and well-being, youth-serving and youth-led organizations, and young people.


Assuntos
COVID-19 , Coronavirus , Transmissão de Doença Infecciosa , Betacoronavirus , Saúde do Adolescente , América
4.
Turk J Ophthalmol ; 51(4): 231-242, 2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34461710

RESUMO

Immunomodulatory agents are often used in the systemic treatment of non-infectious uveitis. These drugs consist of corticosteroids, conventional immunosuppressives, and biological agents. As it is known that they suppress the immune system, the most important concern associated with immunomodulatory therapy (IMT) is the increased risk of infection. The World Health Organization declared COVID-19 a pandemic on 11 March 2020. Although severe acute respiratory distress syndrome secondary to SARS-CoV-2 infection may develop in all people, patients who receive IMT may be at higher risk in terms of both the transmission of the infection and more severe disease course. Therefore, guidelines on the management of patients receiving IMT due to uveitis during the pandemic are needed. In this review, we examined the immunomodulatory drugs used in the treatment of uveitis in terms of infectious complications and the data of patients who received IMT during the COVID-19 pandemic and discussed recommendations for the use of these drugs. According to the latest information, patients who receive IMT may continue their treatment as long as there are no disruptions in regular complete blood count (especially white blood cell count >4,000/µL) and liver and kidney function tests. Patients diagnosed with COVID-19 should be managed with a multidisciplinary approach.


Assuntos
COVID-19/epidemiologia , Glucocorticoides/uso terapêutico , Imunomodulação , Imunossupressores/uso terapêutico , SARS-CoV-2 , Uveíte/tratamento farmacológico , COVID-19/transmissão , Tomada de Decisão Clínica , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Testes de Função Renal , Contagem de Leucócitos , Testes de Função Hepática , Oftalmologia , Medição de Risco
5.
Nat Commun ; 12(1): 5096, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413294

RESUMO

Nearly all mass gathering events worldwide were banned at the beginning of the COVID-19 pandemic, as they were suspected of presenting a considerable risk for the transmission of SARS-CoV-2. We investigated the risk of transmitting SARS-CoV-2 by droplets and aerosols during an experimental indoor mass gathering event under three different hygiene practices, and used the data in a simulation study to estimate the resulting burden of disease under conditions of controlled epidemics. Our results show that the mean number of measured direct contacts per visitor was nine persons and this can be reduced substantially by appropriate hygiene practices. A comparison of two versions of ventilation with different air exchange rates and different airflows found that the system which performed worst allowed a ten-fold increase in the number of individuals exposed to infectious aerosols. The overall burden of infections resulting from indoor mass gatherings depends largely on the quality of the ventilation system and the hygiene practices. Presuming an effective ventilation system, indoor mass gathering events with suitable hygiene practices have a very small, if any, effect on epidemic spread.


Assuntos
Poluição do Ar em Ambientes Fechados/prevenção & controle , COVID-19/transmissão , Higiene/normas , SARS-CoV-2/patogenicidade , Ventilação/métodos , Aerossóis , COVID-19/diagnóstico , COVID-19/virologia , Simulação por Computador , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação
7.
Science ; 373(6558)2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34446582

RESUMO

The COVID-19 pandemic has revealed critical knowledge gaps in our understanding of and a need to update the traditional view of transmission pathways for respiratory viruses. The long-standing definitions of droplet and airborne transmission do not account for the mechanisms by which virus-laden respiratory droplets and aerosols travel through the air and lead to infection. In this Review, we discuss current evidence regarding the transmission of respiratory viruses by aerosols-how they are generated, transported, and deposited, as well as the factors affecting the relative contributions of droplet-spray deposition versus aerosol inhalation as modes of transmission. Improved understanding of aerosol transmission brought about by studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection requires a reevaluation of the major transmission pathways for other respiratory viruses, which will allow better-informed controls to reduce airborne transmission.


Assuntos
Microbiologia do Ar , COVID-19/transmissão , Infecções Respiratórias/transmissão , SARS-CoV-2 , Viroses/transmissão , Fenômenos Fisiológicos Virais , Aerossóis , COVID-19/virologia , Transmissão de Doença Infecciosa , Humanos , Viabilidade Microbiana , Tamanho da Partícula , Sistema Respiratório/virologia , Infecções Respiratórias/virologia , SARS-CoV-2/isolamento & purificação , SARS-CoV-2/fisiologia , Carga Viral , Viroses/virologia , Vírus/isolamento & purificação
8.
Am J Ther ; 28(3): e299-e318, 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-34375047

RESUMO

BACKGROUND: After COVID-19 emerged on U.S shores, providers began reviewing the emerging basic science, translational, and clinical data to identify potentially effective treatment options. In addition, a multitude of both novel and repurposed therapeutic agents were used empirically and studied within clinical trials. AREAS OF UNCERTAINTY: The majority of trialed agents have failed to provide reproducible, definitive proof of efficacy in reducing the mortality of COVID-19 with the exception of corticosteroids in moderate to severe disease. Recently, evidence has emerged that the oral antiparasitic agent ivermectin exhibits numerous antiviral and anti-inflammatory mechanisms with trial results reporting significant outcome benefits. Given some have not passed peer review, several expert groups including Unitaid/World Health Organization have undertaken a systematic global effort to contact all active trial investigators to rapidly gather the data needed to grade and perform meta-analyses. DATA SOURCES: Data were sourced from published peer-reviewed studies, manuscripts posted to preprint servers, expert meta-analyses, and numerous epidemiological analyses of regions with ivermectin distribution campaigns. THERAPEUTIC ADVANCES: A large majority of randomized and observational controlled trials of ivermectin are reporting repeated, large magnitude improvements in clinical outcomes. Numerous prophylaxis trials demonstrate that regular ivermectin use leads to large reductions in transmission. Multiple, large "natural experiments" occurred in regions that initiated "ivermectin distribution" campaigns followed by tight, reproducible, temporally associated decreases in case counts and case fatality rates compared with nearby regions without such campaigns. CONCLUSIONS: Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.


Assuntos
COVID-19 , Ivermectina/farmacologia , SARS-CoV-2/efeitos dos fármacos , Antiparasitários/farmacologia , COVID-19/tratamento farmacológico , COVID-19/prevenção & controle , COVID-19/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Resultado do Tratamento
9.
Medicine (Baltimore) ; 100(31): e26841, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397855

RESUMO

ABSTRACT: Smear-positive pulmonary tuberculosis (SPPTB) is the major contributor to the spread of tuberculosis (TB) infection, and it creates high morbidity and mortality worldwide. The objective of this study was to determine the predictors of delayed sputum smear conversion at the end of the intensive phase of TB treatment in Kota Kinabalu, Malaysia.This retrospective study was conducted utilising data of SPPTB patients treated in 5 TB treatment centres located in Kota Kinabalu, Malaysia from 2013 to 2018. Pulmonary TB (PTB) patients included in the study were those who had at least completed the intensive phase of anti-TB treatment with sputum smear results at the end of the 2nd month of treatment. The factors associated with delayed sputum smear conversion were analyzed using multiple logistic regression analysis. Predictors of sputum smear conversion at the end of intensive phase were evaluated.A total of 2641 patients from the 2013 to 2018 periods were included in this study. One hundred eighty nine (7.2%) patients were identified as having delayed sputum smear conversion at the end of the intensive phase treatment. Factors of moderate (advanced odd ratio [aOR]: 1.7) and advanced (aOR: 2.7) chest X-ray findings at diagnosis, age range of >60 (aOR: 2.1), year of enrolment 2016 (aOR: 2.8), 2017 (aOR: 3.9), and 2018 (aOR: 2.8), smokers (aOR: 1.5), no directly observed treatment short-course (DOTS) supervisor (aOR: 6.9), non-Malaysian citizens (aOR: 1.5), and suburban home locations (aOR: 1.6) were associated with delayed sputum smear conversion at the end of the intensive phase of the treatment.To improve sputum smear conversion success rate, the early detection of PTB cases has to be fine-tuned so as to reduce late or severe case presentation during diagnosis. Efforts must also be in place to encourage PTB patients to quit smoking. The percentage of patients assigned with DOTS supervisors should be increased while at the same time ensuring that vulnerable groups such as those residing in suburban localities, the elderly and migrant TB patients are provided with proper follow-up treatment and management.


Assuntos
Antituberculosos/uso terapêutico , Tuberculose Latente , Mycobacterium tuberculosis , Escarro/microbiologia , Tuberculose Pulmonar , Assistência ao Convalescente/métodos , Assistência ao Convalescente/normas , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Tuberculose Latente/diagnóstico , Tuberculose Latente/etiologia , Tuberculose Latente/prevenção & controle , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/isolamento & purificação , Determinação de Necessidades de Cuidados de Saúde , Radiografia Torácica/métodos , Radiografia Torácica/estatística & dados numéricos , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/terapia , Tuberculose Pulmonar/transmissão
10.
FEMS Microbiol Lett ; 368(16)2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34459482

RESUMO

Limited research exists on the potential for leather to act as a fomite of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or endemic coronaviruses including human coronavirus (HCoV) OC43; this is important for settings such as the shoe manufacturing industry. Antiviral coating of leather hides could limit such risks. This study aimed to investigate the stability and transfer of HCoVOC43 on different leathers, as a surrogate for SARS-CoV-2, and assess the antiviral efficacy of a silver-based leather coating. The stability of HCoV-OC43 (6.6 log10) on patent, full-grain calf, corrected grain finished and nubuck leathers (silver additive-coated and uncoated) was measured by titration on BHK-21 cells. Transfer from leather to cardboard and stainless steel was determined. HCoV-OC43 was detectable for 6 h on patent, 24 h on finished leather and 48 h on calf leather; no infectious virus was recovered from nubuck. HCoV-OC43 transferred from patent, finished and calf leathers onto cardboard and stainless steel up to 2 h post-inoculation (≤3.1-5.5 log10), suggesting that leathers could act as fomites. Silver additive-coated calf and finished leathers were antiviral against HCoV-OC43, with no infectious virus recovered after 2 h and limited transfer to other surfaces. The silver additive could reduce potential indirect transmission of HCoV-OC43 from leather.


Assuntos
Infecções por Coronavirus/transmissão , Coronavirus Humano OC43/isolamento & purificação , Fômites/virologia , Animais , Antivirais/farmacologia , COVID-19/transmissão , Linhagem Celular , Coronavirus Humano OC43/efeitos dos fármacos , Cricetinae , Transmissão de Doença Infecciosa/prevenção & controle , Fômites/classificação , Humanos , SARS-CoV-2/efeitos dos fármacos , SARS-CoV-2/isolamento & purificação , Prata/farmacologia
11.
Ann Med ; 53(1): 1569-1575, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34463165

RESUMO

OBJECTIVES: To explore the potential of SARS-CoV-2 spread during air travel and the risk of in-flight transmission. METHODS: We enrolled all passengers and crew suspected of being infected with SARS-CoV-2, who bounded for Beijing on international flights. We specified the characteristics of all confirmed cases of COVID-19 infection and utilised Wells-Riley equation to estimate the infectivity of COVID-19 during air travel. RESULTS: We screened 4492 passengers and crew with suspected COVID-19 infection, verified 161 confirmed cases (mean age 28.6 years), and traced two confirmed cases who may have been infected in the aircraft. The estimated infectivity was 375 quanta/h (range 274-476), while the effective infectivity was only 4 quanta/h (range 2-5). The risk of per-person infection during a 13 h air travel in economy class was 0.56‰ (95% CI 0.41‰-0.72‰). CONCLUSION: We found that the universal use of face masks on the flight, together with the plane's ventilation system, significantly decreased the infectivity of COVID-19.KEY MESSAGESThe COVID-19 pandemic is changing the lifestyle in the world, especially air travel which has the potential to spread SARS-CoV-2.The universal use of face masks on the flight, together with the plane's ventilation system, significantly decreased the infectivity of COVID-19 on an aircraft.Our findings suggest that the risk of infection in aircraft was negligible.


Assuntos
Viagem Aérea/estatística & dados numéricos , COVID-19/epidemiologia , Transmissão de Doença Infecciosa/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , COVID-19/diagnóstico , COVID-19/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Masculino , Modelos Teóricos , Fatores de Risco , Comportamento de Redução do Risco , SARS-CoV-2/isolamento & purificação
12.
S Afr Fam Pract (2004) ; 63(1): e1-e3, 2021 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-34212752

RESUMO

The use of hand sanitisers is common practice to prevent the spread of coronavirus disease 2019 (COVID-19). However, the safety thereof requires consideration as this may be hazardous in children. Recent studies have shown that the misuse and increased unsupervised availability of alcohol-based hand sanitisers may result in adverse events in children such as skin irritation, dryness, cracking and peeling. Unintentional or intentional ingestion of hand sanitisers in children under the age of 12 years may occur because of the colour, smell and flavour added to it. Consumption of alcohol in children may result in hypoglycaemia, apnoea and acidosis. This allows the invasion of other bacterial and viral infections. Children may also rub their eyes with sanitised hands and cause ocular injury. Therefore, the use of hand sanitisers in general needs to be revised in both children and adults. Other interventions on lowering the risk of adverse events because of misuse of hand sanitiser should be practised more often. These include promoting washing of hands over sanitisers where possible, training children on how to use hand sanitisers and creating awareness of the dangers if ingested or in contact with the eyes.


Assuntos
COVID-19 , Transmissão de Doença Infecciosa/prevenção & controle , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Higienizadores de Mão , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Criança , Saúde da Criança , Controle de Doenças Transmissíveis/métodos , Uso Indevido de Medicamentos/efeitos adversos , Uso Indevido de Medicamentos/prevenção & controle , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Oftalmopatias/induzido quimicamente , Oftalmopatias/prevenção & controle , Desinfecção das Mãos/métodos , Higienizadores de Mão/farmacologia , Higienizadores de Mão/toxicidade , Humanos , Risco Ajustado/métodos , SARS-CoV-2/efeitos dos fármacos , Dermatopatias/induzido quimicamente , Dermatopatias/prevenção & controle
13.
J Alzheimers Dis ; 83(1): 43-49, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34219720

RESUMO

We aimed to explore the awareness and preparedness of dementia caregivers and people with mild cognitive deficits on how to prevent COVID-19 infection and cope with the indirect consequences of the pandemic. A total of 139 patient-caregiver dyads received a telephone survey and 109 completed the survey. The majority of respondents reported having a moderate-to-good knowledge of the typical manifestations of COVID-19. Conversely, only few of them were informed of the atypical presentations and on how to recognize emergency warning signs. Filling the knowledge gaps on COVID-19 in the most vulnerable people may represent a significant resource to tackle the pandemic.


Assuntos
COVID-19 , Cuidadores , Demência/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Letramento em Saúde , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Cuidadores/educação , Cuidadores/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/métodos , Letramento em Saúde/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Itália/epidemiologia , Masculino , SARS-CoV-2 , Inquéritos e Questionários , Avaliação de Sintomas/métodos
14.
S Afr Fam Pract (2004) ; 63(1): e1-e3, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34212751

RESUMO

In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the links between poor hygiene, unclean environments and human health cannot be overemphasised, particularly in South Africa with its high incidence of infectious diseases and overburdened health system. One very controllable factor that is often overlooked is the poor disposal of litter and waste management and its adverse effects on public health. By wearing masks, regular handwashing and sanitising, as well as making sure that neighbourhoods and public spaces are clean and safe, the spread of COVID-19 and other diseases can be prevented.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis/organização & administração , Saúde Ambiental/organização & administração , Recuperação e Remediação Ambiental , Saúde Pública/métodos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Higiene/normas , Condições Sociais , Determinantes Sociais da Saúde , África do Sul/epidemiologia
16.
Front Immunol ; 12: 708820, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34249017

RESUMO

During the COVID19 pandemic, a range of vaccines displayed high efficacy in preventing disease, severe outcomes of infection, and mortality. However, the immunological correlates of protection, the duration of immune response, the transmission risk over time from vaccinated individuals are currently under active investigation. In this brief report, we describe the case of a vaccinated Healthcare Professional infected with a variant of Sars-CoV-2, who has been extensively investigated in order to draw a complete trajectory of infection. The patient has been monitored for the whole length of infection, assessing the temporal viral load decay, the quantification of viral RNA and subgenomic mRNA, antibodies (anti Sars-CoV-2, IgA, IgG, IgM) and cell-mediated (cytokine, B- and T-cell profiles) responses. Overall, this brief report highlights the efficacy of vaccine in preventing COVID19 disease, accelerating the recovery from infection, reducing the transmission risk, although the use of precautionary measures against Sars-CoV-2 spreading still remain critical.


Assuntos
Linfócitos B/imunologia , Vacinas contra COVID-19/imunologia , COVID-19/imunologia , Pessoal de Saúde , SARS-CoV-2/fisiologia , Linfócitos T/imunologia , Adulto , Doenças Assintomáticas , COVID-19/diagnóstico , COVID-19/prevenção & controle , COVID-19/transmissão , Transmissão de Doença Infecciosa , Feminino , Humanos , Imunidade Humoral , Itália , RNA Viral/análise , Risco , Vacinação , Carga Viral
17.
Drug Deliv ; 28(1): 1496-1500, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34259091

RESUMO

COVID-19 can cause serious respiratory complications resulting in the need for invasive ventilatory support and concurrent aerosol therapy. Aerosol therapy is considered a high risk procedure for the transmission of patient derived infectious aerosol droplets. Critical-care workers are considered to be at a high risk of inhaling such infectious droplets. The objective of this work was to use noninvasive optical methods to visualize the potential release of aerosol droplets during aerosol therapy in a model of an invasively ventilated adult patient. The noninvasive Schlieren imaging technique was used to visualize the movement of air and aerosol. Three different aerosol delivery devices: (i) a pressurized metered dose inhaler (pMDI), (ii) a compressed air driven jet nebulizer (JN), and (iii) a vibrating mesh nebulizer (VMN), were used to deliver an aerosolized therapeutic at two different positions: (i) on the inspiratory limb at the wye and (ii) on the patient side of the wye, between the wye and endotracheal tube, to a simulated intubated adult patient. Irrespective of position, there was a significant release of air and aerosol from the ventilator circuit during aerosol delivery with the pMDI and the compressed air driven JN. There was no such release when aerosol therapy was delivered with a closed-circuit VMN. Selection of aerosol delivery device is a major determining factor in the release of infectious patient derived bioaerosol from an invasively mechanically ventilated patient receiving aerosol therapy.


Assuntos
Aerossóis , COVID-19 , Transmissão de Doença Infecciosa/prevenção & controle , Inaladores Dosimetrados , Nebulizadores e Vaporizadores , Respiração Artificial/métodos , Terapia Respiratória , Aerossóis/administração & dosagem , Aerossóis/efeitos adversos , COVID-19/fisiopatologia , COVID-19/terapia , COVID-19/transmissão , Terapia Combinada , Sistemas de Liberação de Medicamentos/instrumentação , Sistemas de Liberação de Medicamentos/métodos , Sistemas de Liberação de Medicamentos/normas , Humanos , Exposição Ocupacional/prevenção & controle , Projetos de Pesquisa , Terapia Respiratória/efeitos adversos , Terapia Respiratória/instrumentação , Terapia Respiratória/métodos , Gestão de Riscos , SARS-CoV-2
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