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OBJECTIVE: To provide a comprehensive overview of the epidemiologic characteristics, outcomes, and risk factors of COVID-19-related deaths in children and adolescents in Brazil. STUDY DESIGN: We conducted a population-based, retrospective cohort study that included all patients aged <18 years with laboratory-confirmed, symptomatic SARS-CoV-2 infection as registered in official Brazilian national surveillance systems for COVID-19 between February 2020 and February 2023. The primary outcome was COVID-19-related deaths. Odds ratios (ORs) of risk factors associated with death were estimated using multivariable logistic regression. RESULTS: Over a 3-year period, 2 855 704 pediatric patients with symptomatic SARS-CoV-2 infection were registered in Brazil. Of these, 59 179 (2.1%) were hospitalized, 13 844 (0.48%) were admitted to the intensive care unit, and 4943 (0.17%) received mechanical ventilation. A total of 4740 (0.17%) patients had fatal outcomes. The case fatality rate increased to 7.9% among patients who required hospitalization; 2102 (44.3%) patients who died did not receive advanced critical support. Notably, 2 (65%, 95% CI 58-71) or 3 doses (86%, 95% CI 81-89) of the vaccine provided strong protection against death. The following adjusted covariates were significantly associated with increased odds of death: age (0-4 and 11-17 years), ethnicity (Brown and Indigenous), region (Northeast or North), dyspnea, nosocomial infection, and comorbidities. Conversely, living in the South or Central-West regions, admission in the later period of the pandemic, and receiving a vaccine were all associated with protection against death. CONCLUSIONS: Our findings suggest that a complex interplay between individual factors and social inequities has shaped the impact of COVID-19 on Brazilian children and adolescents.
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Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancy-safe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-and-middle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain the risk of vertical toxoplasmosis transmission in the Western Region of El Salvador. Of 198 enrolled mothers at the time of childbirth, 6.6% had evidence of recent T. gondii infection-85% of these cases were identified using digital PCR. Neonates born to these acutely infected mothers were significantly more likely to meconium aspiration syndrome and mothers were more likely to experience labor and delivery complications. Multivariable logistic regression found higher maternal T. gondii infection odds were associated with the presence of pet cats, the definitive T. gondii host. In closing, this study provides evidence of maternal T. gondii infection, vertical transmission and deleterious fetal outcomes in a vulnerable population near the El Salvador-Guatemala border. Further, this is the first published study to show clinical utility potential of digital PCR for accurate diagnosis of congenital toxoplasmosis cases.
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Transmisión Vertical de Enfermedad Infecciosa , Reacción en Cadena de la Polimerasa , Toxoplasma , Toxoplasmosis , Humanos , Estudios Transversales , Femenino , El Salvador/epidemiología , Embarazo , Toxoplasma/genética , Toxoplasma/inmunología , Toxoplasma/aislamiento & purificación , Adulto , Recién Nacido , Reacción en Cadena de la Polimerasa/métodos , Toxoplasmosis/diagnóstico , Toxoplasmosis/epidemiología , Toxoplasmosis/transmisión , Toxoplasmosis/parasitología , Adulto Joven , Gatos , Complicaciones Parasitarias del Embarazo/diagnóstico , Complicaciones Parasitarias del Embarazo/epidemiología , Complicaciones Parasitarias del Embarazo/parasitología , Animales , Toxoplasmosis Congénita/diagnóstico , Toxoplasmosis Congénita/epidemiología , MasculinoRESUMEN
BACKGROUND: The outbreak of the COVID-19 pandemic has had a profound impact on the circulation of seasonal respiratory viruses. This study aimed to compare the outcomes of SARS-CoV-2 and seasonal viruses in adults hospitalized with severe acute respiratory infection during the COVID-19 pandemic. METHODS: This population-based cohort study included patients aged >18 years hospitalized for severe acute respiratory infection in Brazil between February 2020 and February 2023. The primary outcome was in-hospital mortality. A competing risk analysis was used to account for competing events. RESULTS: In total, 2 159 171 patients were included in the study. SARS-CoV-2 was the predominant virus (98.7%). Among patients testing positive, the cumulative incidence of in-hospital mortality was 33.1% for SARS-CoV-2, 31.5% for adenovirus, 21.0% for respiratory syncytial virus, 18.7% for influenza, and 18.6% for other viruses. SARS-CoV-2 accounted for 99.3% of the deaths. Older age, male sex, comorbidities, hospitalization in the northern region, and oxygen saturation <95% were the common risk factors for death among all viruses. CONCLUSIONS: In this large cohort study, individuals infected with SARS-CoV-2 or adenovirus had the highest risk of mortality. Irrespective of the virus type, older age, male sex, comorbidities, hospitalization in vulnerable regions, and low oxygen saturation were associated with an increased risk of fatality.
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COVID-19 , Mortalidad Hospitalaria , Hospitalización , SARS-CoV-2 , Humanos , COVID-19/mortalidad , COVID-19/epidemiología , Brasil/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Hospitalización/estadística & datos numéricos , Anciano , Adulto , Estudios de Cohortes , Estaciones del Año , Factores de Riesgo , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Infecciones del Sistema Respiratorio/mortalidad , Comorbilidad , Anciano de 80 o más Años , Adulto Joven , Gripe Humana/epidemiología , Gripe Humana/mortalidad , Gripe Humana/virologíaRESUMEN
Tick-borne disease burdens are increasing globally, impacting mostly rural and vulnerable communities. Among the most important emerging tick-borne pathogens are the Rickettsia species within the spotted fever group (SFGR) because of their genetic diversity and high lethality rate. Colombia is highly affected by SFGR despite not being reportable diseases; thus, research and clinical management are neglected. Although some departments have demonstrated high seroprevalence rates, in others, such as Boyacá Department, seroprevalence is unknown. Rickettsioses have not been described in Boyacá since 1943, and conversations with local physicians raised suspicions of recent undiagnosed disease compatible with rickettsiosis in some rural areas of the department, warranting epidemiological investigation. Using biobanked human and canine samples from a previous 2021 vector-borne disease study in Miraflores municipality, Boyacá, we had an opportunity to unearth SFGR's exposure in the region. Samples were evaluated using IgG indirect fluorescent assays against SFGR and complemented by survey questionnaires evaluating associated factors. Findings yielded first-time SFGR serological evidence in Boyacá with a 26.5% seroprevalence among dogs and a 20.4% among humans. Human and dog seroprevalences were positively associated, suggesting the presence of domestic transmission. Owning a greater number of domestic animals (prevalence ratio adjusted for all measured factors [aPR], 1.52) and living near crop fields (aPR, 7.77) were associated with an increased likelihood of household seropositivity. Our findings are consistent with the literature in Colombia, uncovering a suspected region where the disease is endemic. Future studies are warranted to continue defining high-risk areas to determine public health intervention plans.
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Anticuerpos Antibacterianos , Enfermedades de los Perros , Rickettsia , Rickettsiosis Exantemáticas , Perros , Animales , Estudios Seroepidemiológicos , Humanos , Colombia/epidemiología , Estudios Transversales , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/microbiología , Masculino , Femenino , Adulto , Anticuerpos Antibacterianos/sangre , Rickettsiosis Exantemáticas/epidemiología , Rickettsiosis Exantemáticas/microbiología , Persona de Mediana Edad , Rickettsia/inmunología , Adolescente , Adulto Joven , Anciano , Niño , Inmunoglobulina G/sangreRESUMEN
Spotted fever group Rickettsia spp. (SFGR) are a large group of tick-borne bacteria causing important emerging and re-emerging diseases that affect animals and humans. While SFGR are found worldwide, a lack of surveillance and misdiagnosis particularly affect South American countries. Colombia is a high burdened country in South America, yet rickettsioses are not deemed a nationally reportable condition limiting disease-specific public health resources. As mortality rates are high for one Rickettsia pathogen species, there is a great need to better understand the epidemiological and ecological factors that increase SFGR transmission risk regionally. This literature review provides an overview of Colombia-based SFGR studies connecting knowledge about both vectors and hosts.
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BACKGROUND AND OBJECTIVES: Understanding how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interacts with other respiratory viruses is crucial for developing effective public health strategies in the postpandemic era. This study aimed to compare the outcomes of SARS-CoV-2 and seasonal viruses in children and adolescents hospitalized with severe acute respiratory infection (SARI). METHODS: This population-based, retrospective cohort study included children and adolescents hospitalized with SARI from February 2020 to February 2023 in Brazil. The main exposure of interest was viral etiology. The primary outcome was in-hospital mortality. Competing risk analysis was used to account for time dependency and competing events. RESULTS: A total of 235 829 patients had available results of the viral tests, with SARS-CoV-2 predominance. According to the competing-risk survival analysis, the estimated probability of a fatal outcome at 30 days of hospitalization according to the viral strain was 6.5%, 3.4%, 2.9%, 2.3%, 2.1%, and 1.8%, for SARS-CoV-2, coinfection, adenovirus, influenza, other viruses, and respiratory syncytial virus, respectively. Individuals with a positive test for SARS-CoV-2 had hazard of death 3 times higher than subjects with a negative test (hazard ratio, 3.3; 95% confidence interval, 3.1-3.5). After adjustment by the competing-risk multivariable analysis, admission in Northeast and North regions, oxygen saturation <95%, and the presence of comorbidities were risk factors for death in all viral strains. CONCLUSIONS: SARS-CoV-2 infection had the highest hazard of in-hospital mortality in this pediatric cohort hospitalized with SARI. Regardless of viral etiology, the presence of underlying medical conditions was a risk factor for death.
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COVID-19 , Gripe Humana , Virus , Adolescente , Humanos , Niño , SARS-CoV-2 , Brasil/epidemiología , Estudios Retrospectivos , Estaciones del AñoRESUMEN
Congenital Chagas disease is a growing concern, prioritized by the World Health Organization for public health action. El Salvador is home to some of the highest Chagas disease (Trypanosoma cruzi infection) burdens in the Americas, yet pregnancy screening remains neglected. This pilot investigation performed a maternal T. cruzi surveillance study in Western El Salvador among women presenting for labor and delivery. From 198 consented and enrolled pregnant women, 6% were T. cruzi positive by serology or molecular diagnosis. Half of the infants born to T. cruzi-positive women were admitted to the NICU for neonatal complications. Geospatial statistical clustering of cases was noted in the municipality of Jujutla. Older women and those knowing an infected relative or close friend were significantly more likely to test positive for T. cruzi infection at the time of parturition. In closing, maternal T. cruzi infections were significantly higher than national HIV or syphilis maternal rates, creating an urgent need to add T. cruzi to mandatory pregnancy screening programs.
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Neglected bacterial zoonoses are a group of Neglected Tropical Diseases (NTDs) that are commonly underdiagnosed and underreported due to their undifferentiated febrile illness symptomology. Spotted fever group rickettsioses (SFGR), a subset of tick-borne bacterial zoonoses, belong in this group. There is a dichotomy in the reporting and recognition of these pathogens in Central America: countries with reduced human development scores-like El Salvador-have little to no research or surveillance dedicated to these pathogens and the diseases they cause. This was the third-ever tick survey in El Salvador, highlighting the knowledge gap in this country. A total of 253 ticks were collected from 11 animals at two farm sites and one veterinary office. Standard and quantitative PCR were used to detect presence of SFGR, Ehrlichia, and Anaplasma sp. pathogens in ticks. Ehrlichia sp. were detected in 2.4% of all collected ticks and Anaplasma sp. were detected in 5.5% of all ticks. Rickettsia rickettsii was amplified in 18.2% of ticks, and amplicons similar to R. parkeri, and R. felis were found in 0.8% and 0.4%, of collected ticks, respectively. This is the first report of these pathogenic bacterial species in El Salvador. This study emphasizes the need for further surveillance and research including incorporating additional human seroprevalence and testing to understand the public health burden in this country.
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Rickettsia , Enfermedades por Picaduras de Garrapatas , Garrapatas , Animales , Humanos , Rickettsia/genética , Ehrlichia/genética , Garrapatas/microbiología , Anaplasma/genética , Zoonosis Bacterianas , El Salvador , Estudios Seroepidemiológicos , Enfermedades por Picaduras de Garrapatas/epidemiologíaRESUMEN
The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.(AU)
As costas rochosas entremarés no Chile continental apresentam alta diversidade de espécies, principalmente no norte do país (18-27 ° S), e uma das espécies mais difundidas é o gastrópode Echinolittorina peruviana (Lamarck, 1822). O objetivo do presente estudo é fazer uma primeira caracterização da distribuição espacial de E. peruviana no costão rochoso da cidade de Antofagasta no norte do Chile. Os indivíduos foram contados em nove locais diferentes onde também foram determinadas suas propriedades espectrais usando técnicas de sensoriamento remoto (LANDSAT ETM +). Os resultados revelaram que os locais sem intervenção humana marcada apresentam maior abundância em comparação aos locais localizados no município. Também em todos os locais estudados foi encontrado um padrão agregado, sendo que em seis desses locais foi encontrada uma distribuição binomial negativa. A baixa densidade relacionada a sites com intervenção humana é suportada quando as propriedades espectrais para sites foram incluídas. Esses resultados concordariam com outros resultados semelhantes para costões rochosos no norte e no sul do Chile.(AU)
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Animales , Gastrópodos/crecimiento & desarrollo , Ambiente Marino , Costas (Litoral) , Tecnología de Sensores Remotos , Distribución BinomialRESUMEN
Abstract The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.
Resumo As costas rochosas entremarés no Chile continental apresentam alta diversidade de espécies, principalmente no norte do país (18-27 ° S), e uma das espécies mais difundidas é o gastrópode Echinolittorina peruviana (Lamarck, 1822). O objetivo do presente estudo é fazer uma primeira caracterização da distribuição espacial de E. peruviana no costão rochoso da cidade de Antofagasta no norte do Chile. Os indivíduos foram contados em nove locais diferentes onde também foram determinadas suas propriedades espectrais usando técnicas de sensoriamento remoto (LANDSAT ETM +). Os resultados revelaram que os locais sem intervenção humana marcada apresentam maior abundância em comparação aos locais localizados no município. Também em todos os locais estudados foi encontrado um padrão agregado, sendo que em seis desses locais foi encontrada uma distribuição binomial negativa. A baixa densidade relacionada a sites com intervenção humana é suportada quando as propriedades espectrais para sites foram incluídas. Esses resultados concordariam com outros resultados semelhantes para costões rochosos no norte e no sul do Chile.
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Humanos , Animales , Ecosistema , Gastrópodos , ChileRESUMEN
The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.
As costas rochosas entremarés no Chile continental apresentam alta diversidade de espécies, principalmente no norte do país (18-27 ° S), e uma das espécies mais difundidas é o gastrópode Echinolittorina peruviana (Lamarck, 1822). O objetivo do presente estudo é fazer uma primeira caracterização da distribuição espacial de E. peruviana no costão rochoso da cidade de Antofagasta no norte do Chile. Os indivíduos foram contados em nove locais diferentes onde também foram determinadas suas propriedades espectrais usando técnicas de sensoriamento remoto (LANDSAT ETM +). Os resultados revelaram que os locais sem intervenção humana marcada apresentam maior abundância em comparação aos locais localizados no município. Também em todos os locais estudados foi encontrado um padrão agregado, sendo que em seis desses locais foi encontrada uma distribuição binomial negativa. A baixa densidade relacionada a sites com intervenção humana é suportada quando as propriedades espectrais para sites foram incluídas. Esses resultados concordariam com outros resultados semelhantes para costões rochosos no norte e no sul do Chile.
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Animales , Ambiente Marino , Costas (Litoral) , Gastrópodos/crecimiento & desarrollo , Tecnología de Sensores Remotos , Distribución BinomialRESUMEN
Abstract The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.
Resumo As costas rochosas entremarés no Chile continental apresentam alta diversidade de espécies, principalmente no norte do país (18-27 ° S), e uma das espécies mais difundidas é o gastrópode Echinolittorina peruviana (Lamarck, 1822). O objetivo do presente estudo é fazer uma primeira caracterização da distribuição espacial de E. peruviana no costão rochoso da cidade de Antofagasta no norte do Chile. Os indivíduos foram contados em nove locais diferentes onde também foram determinadas suas propriedades espectrais usando técnicas de sensoriamento remoto (LANDSAT ETM +). Os resultados revelaram que os locais sem intervenção humana marcada apresentam maior abundância em comparação aos locais localizados no município. Também em todos os locais estudados foi encontrado um padrão agregado, sendo que em seis desses locais foi encontrada uma distribuição binomial negativa. A baixa densidade relacionada a sites com intervenção humana é suportada quando as propriedades espectrais para sites foram incluídas. Esses resultados concordariam com outros resultados semelhantes para costões rochosos no norte e no sul do Chile.
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Spotted fever group rickettsioses (SFGR) are caused by a group of tick-borne pathogens that are increasing in incidence globally. These diseases are typically underreported and undiagnosed in low- and middle-income countries, and thus, have been classified as neglected bacterial pathogens. Countries with high poverty, low human development index score, and limited health infrastructure-like El Salvador in Central America-lack necessary surveillance for SFGR and other tick-borne pathogens. This paucity of baseline SFGR infection prevalence leaves vulnerable populations at risk of misdiagnosis. Further, tick-borne disease burdens in El Salvador are severely limited. To lay the foundation for tick-borne disease epidemiology in El Salvador, our team conducted two different enzyme-linked immunosorbent assays (ELISA) on banked human sera samples from a cohort of approximately 1000 pediatric participants from a high-risk vector-borne disease population. Eleven percent of all tested banked pediatric sera were positive for at least one ELISA assay at the time of enrollment: 10.7% were positive for only IgM antibodies (acute SFGR infection), and 2.5% were positive for IgG antibodies (a past SFGR infection). Older, male, children enrolled during the wet season, with a household history of infectious disease and higher maternal education level had higher odds of SFGR antibodies. Additionally, children from households with domestic poultry birds and previous knowledge of other vector-borne diseases had significantly reduced odds of SFGR antibodies. The large percentage of acute SFGR infections indicates that it continues to remain an underreported and undiagnosed issue in El Salvador and the Central American region. Much is still unknown regarding the complexity of the tick, animal host, and human host ecology transmission cycle of SFGR in El Salvador.
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The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.
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Ecosistema , Gastrópodos , Animales , Chile , HumanosRESUMEN
The species of Pugilina cochlidium (Linnaeus, 1758) and P. erecta (Vermeij & Raben, 2009) has been studied in the present study. The female can be differentiated from the male by the absence of the cephalic penis and a complicated genital aparatus visible through the mantle skirt in both the sexes. In other aspects of the external features of female are quite to males. In both species the digestive system was similar with few differences in structure between each other. It consists of buccal mass, proboscis, salivary glands, accessory salivary glands, oesophagus, stomach, intestine, rectum and anus. The nervous system in both P. cochlidium and P. erecta is constituted by six ganglia which forms the circumoesophgeal ganglionic ring. Among the neogastropods there is a similarity in the organization of the reproductive systems. The female reproductive system is more complicated than that of male. The sexes are separated in these two species. The gross morphology of the reproductive system of P. cochlidium and P. erecta was almost similar. The present study aims to describe the digestive system, nervous system and reproductive system of two gastropods species P. cochlidium and P. erecta.(AU)
As espécies de Pugilina cochlidium (Linnaeus, 1758) e P. erecta (Vermeij & Raben, 2009) foram tomadas no presente estudo. A fêmea pode ser diferenciada do macho pela ausência do pênis cefálico e um complicado complexo genital visível através da saia do manto em ambos os sexos. Em outros aspectos das características externas da fêmea são bastante semelhantes aos dos machos. Em ambas as espécies, o sistema digestivo era semelhante, com poucas diferenças de estrutura entre si. Consiste em massa bucal, probóscide, glândulas salivares, glândulas salivares acessórias, esôfago, estômago, intestino, reto e ânus. O sistema nervoso em P. cochlidium e P. erecta é constituído por seis gânglios que formam um anel ganglionar circunoesofágico. Entre os neogastrópodes, há uma semelhança na organização dos sistemas reprodutivos. O sistema reprodutivo feminino é mais complicado que o masculino. Os sexos são separados nessas duas espécies. A morfologia macroscópica do sistema reprodutivo de P. cochlidium e P. erecta foi quase similar. O presente estudo tem como objetivo descrever o sistema digestivo, sistema nervoso e sistema reprodutivo de duas espécies, P. cochlidium e P. erecta.(AU)
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Gastrópodos/anatomía & histología , Biodiversidad , IndiaRESUMEN
OBJECTIVES: This study examines the response of a group of volunteers in Ribeirão Preto, Brazil, as the city faced an unprecedented demand for face masks during the onset of the COVID-19 crisis in 2020. The performance of artisanal-produced masks was compared with industry equivalents. STUDY DESIGN: Case report with comparative testing. METHODS: A comparison was made between two parallel projects that produced single-use masks for healthcare workers and reusable masks for the community. Mask samples were tested for filtration efficiency (FE) and breathability (pressure drop). RESULTS: Results for FE averaged 40-60% for healthcare masks and 10% for community masks; both types of masks were tested for particle sizes of 0.3 âµm. CONCLUSIONS: While performance was inferior to standard comparators, the masks investigated in this study afforded a level of protection in the absence of alternatives, especially in non-aerosol generating contexts. The findings of this study are useful for communities with limited resources in other developing countries. In addition, insights can be gained from the experiences in Ribeirão Preto in terms of how to respond to future health emergencies.
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The species of Pugilina cochlidium (Linnaeus, 1758) and P. erecta (Vermeij & Raben, 2009) has been studied in the present study. The female can be differentiated from the male by the absence of the cephalic penis and a complicated genital aparatus visible through the mantle skirt in both the sexes. In other aspects of the external features of female are quite to males. In both species the digestive system was similar with few differences in structure between each other. It consists of buccal mass, proboscis, salivary glands, accessory salivary glands, oesophagus, stomach, intestine, rectum and anus. The nervous system in both P. cochlidium and P. erecta is constituted by six ganglia which forms the circumoesophgeal ganglionic ring. Among the neogastropods there is a similarity in the organization of the reproductive systems. The female reproductive system is more complicated than that of male. The sexes are separated in these two species. The gross morphology of the reproductive system of P. cochlidium and P. erecta was almost similar. The present study aims to describe the digestive system, nervous system and reproductive system of two gastropods species P. cochlidium and P. erecta.
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Bahías , Gastrópodos , Animales , Femenino , India , Masculino , Glándulas SalivalesRESUMEN
The species of Pugilina cochlidium (Linnaeus, 1758) and P. erecta (Vermeij & Raben, 2009) has been studied in the present study. The female can be differentiated from the male by the absence of the cephalic penis and a complicated genital aparatus visible through the mantle skirt in both the sexes. In other aspects of the external features of female are quite to males. In both species the digestive system was similar with few differences in structure between each other. It consists of buccal mass, proboscis, salivary glands, accessory salivary glands, oesophagus, stomach, intestine, rectum and anus. The nervous system in both P. cochlidium and P. erecta is constituted by six ganglia which forms the circumoesophgeal ganglionic ring. Among the neogastropods there is a similarity in the organization of the reproductive systems. The female reproductive system is more complicated than that of male. The sexes are separated in these two species. The gross morphology of the reproductive system of P. cochlidium and P. erecta was almost similar. The present study aims to describe the digestive system, nervous system and reproductive system of two gastropods species P. cochlidium and P. erecta.
As espécies de Pugilina cochlidium (Linnaeus, 1758) e P. erecta (Vermeij & Raben, 2009) foram tomadas no presente estudo. A fêmea pode ser diferenciada do macho pela ausência do pênis cefálico e um complicado complexo genital visível através da saia do manto em ambos os sexos. Em outros aspectos das características externas da fêmea são bastante semelhantes aos dos machos. Em ambas as espécies, o sistema digestivo era semelhante, com poucas diferenças de estrutura entre si. Consiste em massa bucal, probóscide, glândulas salivares, glândulas salivares acessórias, esôfago, estômago, intestino, reto e ânus. O sistema nervoso em P. cochlidium e P. erecta é constituído por seis gânglios que formam um anel ganglionar circunoesofágico. Entre os neogastrópodes, há uma semelhança na organização dos sistemas reprodutivos. O sistema reprodutivo feminino é mais complicado que o masculino. Os sexos são separados nessas duas espécies. A morfologia macroscópica do sistema reprodutivo de P. cochlidium e P. erecta foi quase similar. O presente estudo tem como objetivo descrever o sistema digestivo, sistema nervoso e sistema reprodutivo de duas espécies, P. cochlidium e P. erecta.
Asunto(s)
Animales , Masculino , Femenino , Sistema Digestivo/anatomía & histología , Gastrópodos/anatomía & histología , Genitales/anatomía & histología , Sistema Nervioso/anatomía & histología , Glándulas Salivales , Bahías , IndiaRESUMEN
Abstract The species of Pugilina cochlidium (Linnaeus, 1758) and P. erecta (Vermeij & Raben, 2009) has been studied in the present study. The female can be differentiated from the male by the absence of the cephalic penis and a complicated genital aparatus visible through the mantle skirt in both the sexes. In other aspects of the external features of female are quite to males. In both species the digestive system was similar with few differences in structure between each other. It consists of buccal mass, proboscis, salivary glands, accessory salivary glands, oesophagus, stomach, intestine, rectum and anus. The nervous system in both P. cochlidium and P. erecta is constituted by six ganglia which forms the circumoesophgeal ganglionic ring. Among the neogastropods there is a similarity in the organization of the reproductive systems. The female reproductive system is more complicated than that of male. The sexes are separated in these two species. The gross morphology of the reproductive system of P. cochlidium and P. erecta was almost similar. The present study aims to describe the digestive system, nervous system and reproductive system of two gastropods species P. cochlidium and P. erecta.
Resumo As espécies de Pugilina cochlidium (Linnaeus, 1758) e P. erecta (Vermeij & Raben, 2009) foram tomadas no presente estudo. A fêmea pode ser diferenciada do macho pela ausência do pênis cefálico e um complicado complexo genital visível através da saia do manto em ambos os sexos. Em outros aspectos das características externas da fêmea são bastante semelhantes aos dos machos. Em ambas as espécies, o sistema digestivo era semelhante, com poucas diferenças de estrutura entre si. Consiste em massa bucal, probóscide, glândulas salivares, glândulas salivares acessórias, esôfago, estômago, intestino, reto e ânus. O sistema nervoso em P. cochlidium e P. erecta é constituído por seis gânglios que formam um anel ganglionar circunoesofágico. Entre os neogastrópodes, há uma semelhança na organização dos sistemas reprodutivos. O sistema reprodutivo feminino é mais complicado que o masculino. Os sexos são separados nessas duas espécies. A morfologia macroscópica do sistema reprodutivo de P. cochlidium e P. erecta foi quase similar. O presente estudo tem como objetivo descrever o sistema digestivo, sistema nervoso e sistema reprodutivo de duas espécies, P. cochlidium e P. erecta.
RESUMEN
BACKGROUND: Inflammatory bowel diseases (IBD) have been associated with a low quality of life (QoL) and a negative impact on work productivity compared to the general population. Information about disease control, patient-reported outcomes (PROs), treatment patterns and use of healthcare resources is relevant to optimizing IBD management. AIM: To describe QoL and work productivity and activity impairment (WPAI), treatment patterns and use of healthcare resources among IBD patients in Brazil. METHODS: A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn's disease (CD) or ulcerative colitis (UC). At enrolment, active CD and UC were defined as having a Harvey Bradshaw Index ≥ 8 or a CD Activity Index ≥ 220 or calprotectin > 200 µg/g or previous colonoscopy results suggestive of inadequate control (per investigator criteria) and a 9-point partial Mayo score ≥ 5, respectively. The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L, the Inflammatory Bowel Disease Questionnaire (IBDQ), and the WPAI questionnaire. Information about healthcare resources and treatment during the previous 3 years was collected from medical records. Chi-square, Fisher's exact and Student's t-/Mann-Whitney U tests were used to compare PROs, treatment patterns and the use of healthcare resources by disease activity (α = 0.05). RESULTS: Of the 407 patients in this study (CD/UC: 64.9%/35.1%, mean age 42.9/45.9 years, 54.2%/56.6% female, 38.3%/37.1% employed), 44.7%/25.2% presented moderate-to-severe CD/UC activity, respectively, at baseline. Expressed in median values for CD/UC, respectively, the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2, the EQ-visual analog scale score was 80.0/70.0, and the IBDQ overall score was 164.0/165.0. Moderate to severe activity, female gender, being unemployed, a lower educational level and lower income were associated with lower QoL (P < 0.05). Median work productivity impairment was 20% and 5% for CD and UC patients, respectively, and activity impairment was 30%, the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity (75.0% vs 10.0%, P < 0.001). For CD/UC patients, respectively, 25.4%/2.8% had at least one surgery, 38.3%/19.6% were hospitalized, and 70.7%/77.6% changed IBD treatment at least once during the last 3 years. The most common treatments at baseline were biologics (75.3%) and immunosuppressants (70.9%) for CD patients and 5-ASA compounds (77.5%) for UC patients. CONCLUSION: Moderate to severe IBD activity, especially among CD patients, is associated with a substantial impact on QoL, work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.