Monitoramento das Produções

Title: COVID-19, Social Isolation and Human Stress Comparative Behavior & Welfare
Authors: Oliveira, G. M.; Rossi, M. I. D.

Title: Genomic detection of a virus lineage replacement event of dengue virus serotype 2 in Brazil, 2019
Authors: Jesus, Jaqueline Goes de; Dutra, Karina Rocha; Sales, Flavia Cristina da Silva; Claro, Ingra Morales; Terzian, Ana Carolina; Candido, Darlan da Silva; Hill, Sarah C.; Thezé, Julien; Torres, Celeste; D`Agostini, Tatiana Lang; Felix, Alvina Clara; Reis, Andreia F. Negri; Alcantara, Luiz Carlos Junior; Abreu, André L. de; Croda, Júlio H. R.; Oliveira, Wanderson K. de; Filipis, Ana Maria de Bispo de; Camis, Maria do Carmo Rodrigues dos Santos; Romano, Camila Malta; Loman, Nick J.; Pybus, Oliver G.; Sabino, Ester Cerdeira; Nogueira, Mauricio L.; Faria, Nuno Rodrigues

Title: COVID-19: intensive care units, mechanical ventilators, and latent mortality profiles associated with case-fatality in Brazil
Authors: Moreira, Rafael da Silveira
Abstract: O acelerado aumento do número de casos de doença pelo novo coronavírus (COVID-19) exige que os países aumentem as vagas nas unidades de terapia intensiva (UTI). Doenças respiratórias, neoplasias, cardiopatias, hipertensão e diabetes aumentam sua letalidade. O estudo objetivou identificar tanto as regiões com as maiores taxas de mortalidade específica por essas doenças quanto as com maior escassez de UTI e ventiladores pulmonares. Foi realizado um estudo ecológico transversal, as unidades de análise foram as Regiões de Saúde no Brasil. A fonte de dados foi o Departamento de Informática do SUS –
DATASUS (Cadastro Nacional de Estabelecimentos de Saúde – 2019, Sistemas de Informação de Mortalidade – 2017 e Projeções Populacionais – 2017). Foram calculadas as taxas por 100 mil habitantes de mortalidade específica para hipertensão, neoplasias, diabetes, doenças cardíacas e respiratórias, leitos de UTI total, leitos de UTI privados, leitos de UTI do Sistema Único de Saúde (SUS) e ventiladores do SUS. O perfil de mortalidade foi determinado pela análise de perfis latentes, e a análise de clusters dos leitos e ventiladores foi feita pelo método de varredura espacial. Mapas de Kernel foram construídos para a visualização dos dados. O nível de significância foi de 5%. Observou-se quatro perfis latentes de mortalidade. As regiões de saúde com as maiores médias na mortalidade estão localizadas em regiões cuja escassez de leitos de UTI e de ventiladores foi visualizada, especialmente, em partes das regiões Nordeste, Sudeste e Sul. A localização espacial das regiões com maior mortalidade e com escassez de leitos de UTI/ventiladores requer a atenção dos gestores e planejadores públicos, para o enfrentamento eficiente e equânime da epidemia no Brasil.

Title: Ferramenta de bolso para agentes de saúde e cuidadores na ativa em defesa da vida na epidemia Covid-19
Authors: Leal, Amanda Linhares Gonçalves; Souza, Ana Iara Valeriano de; Ferreira, Augusto Cesar Rosito; Santos, Daise Kelly; Silva, Gessey Jesuíno da; Martins, Heloisa Passos e; Caetano, Karina; Santos, Katia Cristina Duarte dos; Matos, Marcos Paulo de Oliveira; Souza, Marilia Albuquerque Nunes de; Soalheiro, Nina Isabel; Tavares, Raquel; Raposo, Renata Armondi S.; Neves, Rodrigo; Bessa, Rosângela
Abstract: Muito se fala sobre as pessoas em situação de risco, idosos, diabéticos, doentes cardíacos, sobre os que estão em estado grave, sobre adultos, jovens e crianças em isolamento social vivendo novas experiências e a incerteza do futuro. Muito se fala também do agradecimento aos profissionais de saúde, tratando-os como os nossos super-heróis de branco! Contudo, não se fala o suficiente de como esse trabalhador deve se proteger, como deve fazer para se cuidar, como deve buscar escuta e apoio para lidar com as situações limite, a doença, a morte e as ameaças das mortes em grande escala! Essa publicação tem por objetivo disponibilizar uma pequena contribuição para que esses profissionais de saúde consigam se proteger, se cuidar e buscar apoio e ajuda nos momentos de sufoco!!!

Title: O que mais podemos saber sobre o novo coronavírus e a Covid-19?
Authors: Bornstin, Vera Joana; Goldschmidt, Irene Leonore; Travassos, Ronaldo dos Santos
Abstract: Esse folheto foi feito pela equipe de Educação Popular da Escola Politécnica de Saúde Joaquim Venâncio e é dirigido aos agentes de saúde, que têm um papel fundamental na educação em saúde com a população, assim como na busca ativa de casos suspeitos, identificação e acompanhamento de pessoas com agravos. Todos temos recebido muitas informações sobre esta nova doença − a Covid-19 −, sobre seus sintomas e o que fazer para prevenir o contágio. Consideramos importante que os agentes tenham acesso a mais informações sobre este vírus, para que, entendendo como se dá a transmissão da doença, adotem e recomendem medidas eficazes para impedir ou dificultar esta transmissão, e assim proteger a si, sua família, e a comunidade.

Title: Orientações para cuidadores domiciliares de pessoa idosa na epidemia do Coronavírus − Covid-19
Authors: Groisman, Daniel; Santos, Ana Gilda Soares dos; Chagas, Daiana Crús; Lordello, Íris Maria da Silva; Bernardo, Maria Helena; Duarte, Yeda A. de Oliveira
Abstract: As pessoas idosas que necessitam de cuidados constituem um dos principais grupos de risco diante da epidemia do novo coronavírus − Covid-19. As informações desta publicação pretendem trazer orientações para as pessoas que são cuidadoras, visando à prevenção do contágio, promoção da saúde e proteção aos direitos sociais, tanto de quem é cuidado como de quem cuida. Esta cartilha foi elaborada tendo em vista o cuidado domiciliar, podendo ser utilizada tanto por cuidadoras contratadas como por familiares que exercem essa função.

Title: Tratamentos clínico e farmacológico da Covid-19: desafios e impasses
Abstract: Três respeitados pesquisadores – Glória Teixeira, da Universidade Federal da Bahia (UFBA), Licio Velloso, da Universidade Estadual de Campinas (Unicamp) e Adriano Andricopulo, da Universidade de São Paulo (USP), juntamente com os jornalistas de ciência, Herton Escobar, do Jornal da USP e Mariluce Moura, do Ciência na rua, conversam virtualmente com jornalistas, comunicadores populares e outros interessados sobre desafios e impasses do tratamento da Covid-19.

Title: Arquitetura prisional e saúde em tempos de COVID-19: o uso de contêiners se justifica?
Authors: Santos, Mauro; Salsamendi, Eduardo Sanches; Sánchez, Alexandra; Larouzé, Bernard
Abstract: O artigo lembra que, em abril de 2020, o Departamento Penitenciário Nacional do Ministério da Justiça e Segurança Pública (DEPEN) divulgou o documento em que defende a utilização de contêineres como solução para o enfrentamento da pandemia do Covid-19 nos presídios de todo o país. O uso de contêineres estaria indicado, segundo o DEPEN, tanto para realizar o isolamento daqueles presos integrantes do grupo de risco, como para abrigar aqueles contaminados pelo Covid-19, receber instalações temporárias para atendimento médico e, posteriormente à pandemia, serem utilizados permanentemente para triagem e admissão de presos. No Brasil, cerca de 750 mil pessoas estão encarceradas em celas coletivas, superlotadas e mal ventiladas, responsáveis por elevada frequência de doenças, especialmente as de transmissão aérea, como a tuberculose que apresenta taxas de incidência e de mortalidade nas prisões até 38 vezes e 9 vezes superiores às da população geral, respectivamente: “Essas condições de encarceramento, que sem dúvida serão agravadas em caso de utilização de contêineres, são altamente favoráveis à transmissão do SARS-Cov-2, vírus causador da Covid-19, transmitido por via aérea, por contato inter-humano e através de superfícies e objetos contaminados.”

Title: Experiência em cuidado intensivo de Covid 19 em Londres
Abstract: O professor de medicina intensiva da University College London, Mervyn Singer, fala sobre a experiência de cuidados intensivos nos pacientes com Coronavírus na Inglaterra.
Description: Convidados: Maurício Barreto, Ricardo Sales, Mervyn Singer e Ceuci Nunes.

by Yohannes Kebede, Yimenu Yitayih, Zewdie Birhanu, Seblework Mekonen, Argaw Ambelu
Background Novel-coronavirus disease-2019 (COVID-19) is currently a pandemic and public health emergency of international concern, as avowed by the World Health Organization (WHO). Ethiopia has become one of the affected countries as of March 15, 2020. Objective This study aimed to assess the knowledge, perceptions, and practices among the Jimma University medical center (JUMC) visitors in Jimma town. Methods A cross-sectional study was conducted on 247 sampled visitors, from 20–24 March 2020. Consecutive sampling was used to recruit the participants. The study tools were adapted from WHO resources. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics were used to describe the status of knowledge, perception, and practices. Logistic regression was executed to assess the predictors of dominant preventive practices. Results Of the 247 respondents, 205 (83.0%) knew the main clinical symptoms of COVID-19. 72.0% knew that older people who have chronic illnesses are at high risk of developing a severe form of COVID-19. About 95.1% knew that the COVID-19 virus spreads via respiratory droplets of infected people, while 77 (31.2%) of the respondents knew about the possibility of asymptomatic transmission. Only 15 (6.1%) knew that children and young adults had to involve preventive measures. Overall, 41.3% of the visitors had high knowledge. The majority, 170(68.8%), felt self-efficacious to controlling COVID-19. 207(83.3%) believed that COVID-19 is a stigmatized disease. Frequent hand washing (77.3%) and avoidance of shaking hands (53.8%) were the dominant practices. Knowledge status and self-efficacy (positively), older age, and unemployment (negatively) predicted hand washing and avoidance of handshaking. Conclusions The status of knowledge and desirable practices were not sufficient enough to combat this rapidly spreading virus. COVID-19 risk communication and public education efforts should focus on building an appropriate level of knowledge while enhancing the adoption of recommended self-care practices with special emphasis on high-risk audience segments.

by Arina Anis Azlan, Mohammad Rezal Hamzah, Tham Jen Sern, Suffian Hadi Ayub, Emma Mohamad

In an effort to mitigate the outbreak of COVID-19, many countries have imposed drastic lockdown, movement control or shelter in place orders on their residents. The effectiveness of these mitigation measures is highly dependent on cooperation and compliance of all members of society. The knowledge, attitudes and practices people hold toward the disease play an integral role in determining a society’s readiness to accept behavioural change measures from health authorities. The aim of this study was to determine the knowledge levels, attitudes and practices toward COVID-19 among the Malaysian public. A cross-sectional online survey of 4,850 Malaysian residents was conducted between 27th March and 3rd April 2020. The survey instrument consisted of demographic characteristics, 13 items on knowledge, 3 items on attitudes and 3 items on practices, modified from a previously published questionnaire on COVID-19. Descriptive statistics, chi-square tests, t-tests and one-way analysis of variance (ANOVA) were conducted. The overall correct rate of the knowledge questionnaire was 80.5%. Most participants held positive attitudes toward the successful control of COVID-19 (83.1%), the ability of Malaysia to conquer the disease (95.9%) and the way the Malaysian government was handling the crisis (89.9%). Most participants were also taking precautions such as avoiding crowds (83.4%) and practising proper hand hygiene (87.8%) in the week before the movement control order started. However, the wearing of face masks was less common (51.2%). This survey is among the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Malaysia. The results highlight the importance of consistent messaging from health authorities and the government as well as the need for tailored health education programs to improve levels of knowledge, attitudes and practices.

Title: Social media: friend or foe in the COVID-19 pandemic?
Authors: Lima, Diego Laurentino; Lopes, Maria Antonieta Albanez A. de Medeiros; Brito, Ana Maria

by Fan-Yun Lan, Chih-Fu Wei, Yu-Tien Hsu, David C. Christiani, Stefanos N. Kales
Objective There is limited evidence of work-related transmission in the emerging coronaviral pandemic. We aimed to identify high-risk occupations for early coronavirus disease 2019 (COVID-19) local transmission. Methods In this observational study, we extracted confirmed COVID-19 cases from governmental investigation reports in Hong Kong, Japan, Singapore, Taiwan, Thailand, and Vietnam. We followed each country/area for 40 days after its first locally transmitted case, and excluded all imported cases. We defined a possible work-related case as a worker with evidence of close contact with another confirmed case due to work, or an unknown contact history but likely to be infected in the working environment (e.g. an airport taxi driver). We calculated the case number for each occupation, and illustrated the temporal distribution of all possible work-related cases and healthcare worker (HCW) cases. The temporal distribution was further defined as early outbreak (the earliest 10 days of the following period) and late outbreak (11th to 40th days of the following period). Results We identified 103 possible work-related cases (14.9%) among a total of 690 local transmissions. The five occupation groups with the most cases were healthcare workers (HCWs) (22%), drivers and transport workers (18%), services and sales workers (18%), cleaning and domestic workers (9%) and public safety workers (7%). Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases). Occupations at risk varied from early outbreak (predominantly services and sales workers, drivers, construction laborers, and religious professionals) to late outbreak (predominantly HCWs, drivers, cleaning and domestic workers, police officers, and religious professionals). Conclusions Work-related transmission is considerable in early COVID-19 outbreaks, and the elevated risk of infection was not limited to HCW. Implementing preventive/surveillance strategies for high-risk working populations is warranted.

by Jun Xing, Ning Sun, Jun Xu, Shuling Geng, Yuqian Li

This paper studied the relationship between personality traits and mental health conditions of medical personnel to provide a basis and reference for the implementation of targeted education on mental health. A self-report inventory, the Symptom Checklist-90 (SCL-90), was used to investigate the mental health status of 548 medical personnel dealing with the new coronavirus pneumonia in eight provinces and cities of China. The overall mean SCL-90 score and mean values of factors (somatization, obsessive-compulsive, anxiety, phobic anxiety, and psychoticism) of the medical personnel were significantly higher than in the norm group (p 0.05), while their average interpersonal sensitivity score was significantly lower (p 0.01). In addition, personal factors affecting the mental health status of medical personnel were identified (all p 0.05). The overall mental health status of medical personnel responding to new coronavirus pneumonia is generally higher than that of the norm group in China. The results of this study should contribute to measures to alleviate the psychological pressures on medical personnel dealing with the new coronavirus epidemic in China.

by Chuan-min Zhou, Jian-wei Liu, Rui Qi, Li-zhu Fang, Xiang-rong Qin, Hui-ju Han, Rong-can Mo, Hao Yu, Yong-jun Jiao, Jian-yan Lin, Xue-jie Yu

Currently, Zika virus (ZIKV) is spreading across the world and no ZIKV infection cases have ever been reported in China. Here, we aimed to determine whether ZIKV infection exists in China. Blood samples of 273 healthy individuals were collected from Nanning City, Guangxi Province, China in March 2019. We found that 9.5% (26/273) and 1.8% (5/273) of healthy persons were positive to ZIKV total antibody (IgG and/or IgM) IgM antibody, respectively. All ZIKV positive plasma samples were negative to Dengue virus and West Nile virus. Among the ZIKV antibody positive plasma samples, 65.4% (17/26) exhibited neutralizing activity to ZIKV. Followed up studies showed that none had clinical symptoms of ZIKV infection and oversea experience. Together, our study indicates that endemic ZIKV infections emerge in China, which not only suggested that ZIKV posed a potential threat to public health in China, but also expand the ZIKV epidemic areas in East and Southeast Asia.

Title: Increase in reported prevalence of Microcephaly in infants born to women living in areas with confirmed Zika virus transmission during the first trimester of pregnancy - Brazil, 2015
Authors: Oliveira, Wanderson Kleber de; Cortez-Escalante, Juan José; Oliveira, Wanessa Tenório Gonçalves Holanda de; Carmo, Greice Madeleine Ikeda do; Henriques, Cláudio Maierovitch Pessanha; Coelho, Giovanini Evelim; França, Giovanny Vinícius Araújo de
Description: Cláudio Maierovitch Pessanha Henriques - Autor vinculado à Fiocruz Brasília, mas não consta a informação no documento.

Title: Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation
Authors: França, Giovanny Vinícius Araújo de; Schuler-Faccini, Lavinia; Oliveira, Wanderson Kleber de; Henriques, Cláudio Maierovitch Pessanha; Carmo, Eduardo Hage; Pedi, Vaneide Daciane; Nunes, Marília L.; Castro, Marcia C.; Serruya, Suzanne Jacob; Silveira, Mariângela F.; Barros, Fernando C.; Victora, Cesar G.
Description: Claudio M. P. Henriques e Eduardo H. Carmo - Autores vinculados à Fiocruz Brasília, mas não consta a informação no documento.

by Doug E. Brackney, Maria A. Correa, Duncan W. Cozens

Macroautophagy is an evolutionarily conserved cellular process critical for maintaining cellular homeostasis. It can additionally function as an innate immune response to viral infection as has been demonstrated for a number of arthropod-borne (arbo-) viruses. Arboviruses are maintained in a transmission cycle between vertebrate hosts and invertebrate vectors yet the majority of studies assessing autophagy-arbovirus interactions have been limited to the mammalian host. Therefore we evaluated the role of autophagy during arbovirus infection of the invertebrate vector using the tractable Aag2 Aedes aegypti mosquito cell culture system. Our data demonstrates that autophagy is significantly induced in mosquito cells upon infection with two divergent arboviruses: dengue virus-2 (DENV-2; Flaviviridae, Flavivirus) and chikungunya virus (CHIKV; Togaviridae, Alphavirus). While assessing the role of autophagy during arbovirus infection, we observed a somewhat paradoxical outcome. Both induction and suppression of autophagy via torin-1 and spautin-1, respectively, resulted in increased viral titers for both viruses, yet suppression of autophagy-related genes had no effect. Interestingly, chemical modulators of autophagy had either no effect or opposite effects in another widely used mosquito cell line, C6/36 Aedes albopictus cells. Together, our data reveals a limited role for autophagy during arbovirus infection of mosquito cells. Further, our findings suggest that commonly used chemical modulators of autophagy alter mosquito cells in such a way as to promote viral replication; however, it is unclear if this occurs directly through autophagic manipulation or other means.

by Yiwu Zhou, Yanqi He, Huan Yang, He Yu, Ting Wang, Zhu Chen, Rong Yao, Zongan Liang
Background Since December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan and spread across the globe. The objective of this study is to build and validate a practical nomogram for estimating the risk of severe COVID-19. Methods A cohort of 366 patients with laboratory-confirmed COVID-19 was used to develop a prediction model using data collected from 47 locations in Sichuan province from January 2020 to February 2020. The primary outcome was the development of severe COVID-19 during hospitalization. The least absolute shrinkage and selection operator (LASSO) regression model was used to reduce data size and select relevant features. Multivariable logistic regression analysis was applied to build a prediction model incorporating the selected features. The performance of the nomogram regarding the C-index, calibration, discrimination, and clinical usefulness was assessed. Internal validation was assessed by bootstrapping. Results The median age of the cohort was 43 years. Severe patients were older than mild patients by a median of 6 years. Fever, cough, and dyspnea were more common in severe patients. The individualized prediction nomogram included seven predictors: body temperature at admission, cough, dyspnea, hypertension, cardiovascular disease, chronic liver disease, and chronic kidney disease. The model had good discrimination with an area under the curve of 0.862, C-index of 0.863 (95% confidence interval, 0.801–0.925), and good calibration. A high C-index value of 0.839 was reached in the interval validation. Decision curve analysis showed that the prediction nomogram was clinically useful. Conclusion We established an early warning model incorporating clinical characteristics that could be quickly obtained on admission. This model can be used to help predict severe COVID-19 and identify patients at risk of developing severe disease.

Title: COVID-19: an overview of worldwide recommendations for management of patients with liver diseases or liver transplantation
Authors: Perazzo, Hugo; Piedade, Juliana; Castro, Rodolfo; Pinto, Laura; Veloso, Valdiléa G.; Grinsztejn, Beatriz; Pereira, Gustavo; Fernandes, Flavia F.

by Huiyao Wang, Qian Xia, Zhenzhen Xiong, Zhixiong Li, Weiyi Xiang, Yiwen Yuan, Yaya Liu, Zhe Li

As the epidemic outbreak of 2019 coronavirus disease (COVID-19), general population may experience psychological distress. Evidence has suggested that negative coping styles may be related to subsequent mental illness. Therefore, we investigate the general population’s psychological distress and coping styles in the early stages of the COVID-19 outbreak. A cross-sectional battery of surveys was conducted from February 1–4, 2020. The Kessler 6 psychological distress scale, the simplified coping style questionnaire and a general information questionnaire were administered on-line to a convenience sample of 1599 in China. A multiple linear regression analysis was performed to identify the influence factors of psychological distress. General population’s psychological distress were significant differences based on age, marriage, epidemic contact characteristics, concern with media reports, and perceived impacts of the epidemic outbreak (all p

by Wayne Gao, Mattia Sanna, Min Kuang Tsai, Chi Pang Wen
Introduction The COVID-19 outbreak is posing an unprecedented challenge to healthcare workers. This study analyzes the geo-temporal effects on disease severity for the 1,688 Chinese healthcare workers infected with COVID-19. Methods Using the descriptive results recently reported by the Chinese CDC, we compare the percentage of infected healthcare workers in severe conditions over time and across three areas in China, and the fatality rate of infected healthcare workers with all the infected individuals in China aged 22–59 years. Results Among the infected Chinese healthcare workers whose symptoms onset appeared during the same ten-day period, the percentage of those in severe conditions decreased significantly from 19.7% (Jan 11–20) to 14.4% (Jan 21–31) to 8.7% (Feb 1–11). Across the country, there was also a significant difference in the disease severity, with Wuhan being the most severe (17.3%), followed by Hubei Province (10.2%), and the rest of China (6.6%). The case fatality rate for the 1,688 infected Chinese healthcare workers was significantly lower than that for the 29,798 infected patients aged 20–59 years—0.3% (5/1,688) vs. 0.65% (193/29,798), respectively. Conclusion The disease severity among infected healthcare workers improved considerably over a short period of time in China. The more severe conditions in Wuhan compared to the rest of the country may be attributable to the draconian lockdown. The clinical outcomes of infected Chinese healthcare workers may represent a more accurate estimation of the severity of COVID-19 for those who have access to quality healthcare.

by Olivia O’Connor, Elodie Calvez, Catherine Inizan, Nicolas Pocquet, Vincent Richard, Myrielle Dupont-Rouzeyrol

In New Caledonia (NC), Aedes aegypti is the only proven vector of dengue virus (DENV), which is the most prevalent arbovirosis in NC. Since World War II, the four DENV serotypes have circulated regularly in NC. The epidemiological profile, however, has evolved over the last ten years, with the persistence of DENV-1 circulation and the co-circulation of several DENV serotypes. The current study evaluated the ability of Ae. aegypti from NC to transmit four DENV serotypes (and two DENV-1 genotypes) isolated during recent outbreaks in NC. An Ae. aegypti F1 generation was twice independently orally challenged with each DENV strain (107 FFU/ml). Infection, dissemination and transmission rates and transmission efficiency were measured at day 7 and 14 post-exposure, as well as the quantity of infectious virus particles. Mosquito infection was observed as early as 7 days post-infection. Infection rates between 18 and 58% were measured for all DENV serotypes/genotypes tested. Although dissemination rates ranged from 78 to 100%, transmission efficiencies were low, with values not exceeding 21% at 14 days post-infection for all DENV strains. This study shows that NC Ae. aegypti are moderately competent for DENV in laboratory conditions. In link with epidemiological data, these results suggest implication of other factors in the sustained circulation of DENV-1 in New Caledonia.

Title: The COVID-19 pandemic in Brazil: chronicle of a health crisis foretold
Authors: Werneck, Guilherme Loureiro; Carvalho, Marilia Sá

Title: Cuidar em tempos da COVID-19 (novo coronavírus)
Authors: Souza, Claudia Teresa Vieira de; Santana, C. S.; Guimarães, A. C. F.; Bistene, A. F.; Pinto, K. D.; Gouvea, M. I. F. S; Teixeira, M. L. B; Teixeira, J. L.
Description: Projeto - Plataforma de Saberes: envolvimento e participação da comunidade em práticas inovadoras de promoção da saúde e produção de conhecimento.

Title: Pitfalls in acute febrile illness diagnosis: Interobserver agreement of signs and symptoms during a dengue outbreak
Authors: Buonora, Sibelle Nogueira; Passos, Sonia Regina Lambert; Daumas, Regina Paiva; Machado, Matheus Garcia Lago; Berardinelli, Guilherme Miguéis; Oliveira, Diana Neves Rodrigues; Oliveira, Raquel de Vasconcellos Carvalhaes

by Christie L. Walker, Noah Ehinger, Brittney Mason, Elizabeth Oler, Marie-Térèse E. Little, Eric O. Ohuma, Aris T. Papageorghiou, Unzila Nayeri, Christine Curry, Kristina M. Adams Waldorf

Zika virus (ZIKV) is a mosquito-transmitted flavivirus, recently linked to microcephaly and central nervous system anomalies following infection in pregnancy. Striking findings of disproportionate growth with a smaller than expected head relative to body length have been observed more commonly among fetuses with exposure to ZIKV in utero compared to pregnancies without ZIKV infection regardless of other signs of congenital infection including microcephaly. This study’s objective was to determine the diagnostic accuracy of femur-sparing profile of intrauterine growth restriction for the identification of ZIKV-associated congenital injuries on postnatal testing. A retrospective cohort study of pregnant women with possible or confirmed ZIKV infection between January 1, 2016 and December 31, 2017 were included. Subjects were excluded if no prenatal ultrasound was available. A femur-sparing profile of growth restriction determined using INTERGROWTH-21st sonographic standard for head circumference to femur length (HC: FL). Congenital injuries were determined postnatally by imaging, comprehensive eye exam and standard newborn hearing screen. A total of 111 pregnant women diagnosed with ZIKV infection underwent fetal ultrasound and 95 neonates had complete postnatal evaluation. Prenatal microcephaly was detected in 5% of fetuses (6/111). Postnatal testing detected ZIKV-associated congenital injuries in 25% of neonates (24/95). A HC: FL Z-score ≤ -1.3 had a 52% specificity (95% CI 41–63%), 82% negative predictive value (NPV, 95% CI 73–88%) for the detection of ZIKV-associated congenital injuries in the neonatal period. A more stringent threshold with a Z-score ≤ -2 was associated with a 90% specificity (95% CI 81–95%), 81% NPV (95% CI 77–85%). Excluding cases of fetal microcephaly, HC: FL (Z-score ≤ -2) demonstrated a similar specificity (89%, 95% CI 81–95%) with superior NPV (87%, 95% CI 84–90%). The sonographic recognition of a normally proportioned fetus may be useful prenatally to exclude a wider spectrum of ZIKV-associated congenital injuries detected postnatally.

Title: Novo coronavírus: a Fiocruz tem um recado para você
Description: Participaram desse vídeo profissionais do Laboratório de Vírus Respiratórios e do Sarampo do Instituto Oswaldo Cruz (IOC/Fiocruz).

Title: Extended use or reuse of N95 respirators during COVID-19 pandemic: An overview of national regulatory authority recommendations
Authors: Kobayash, Leticia Mitiko; Marins, Bianca Ramos; Costa, Patrícia Cristina dos Santos; Perazzo, Hugo; Castro, Rodolfo

Title: Brasil já perdeu mais profissionais de enfermagem para o coronavírus do que Itália e Espanha juntas
Authors: Informe ENSP
Abstract: De acordo com o Conselho Federal de Enfermagem (Cofen), até o dia 6 de maio foram identificados 73 óbitos de profissionais pela covid-19 no país. São vítimas jovens: a maior parte (41) tinha menos de 60 anos, sendo uma delas de apenas 29 anos. A cidade de São Paulo, maior epicentro da crise sanitária no país, lidera o ranking com 18 mortos, seguida por Rio de Janeiro, com 14 casos. O Cofen laçou uma plataforma para monitorar as mortes na enfermagem em todo o Brasil, com o auxílio dos Conselhos Regionais. Além destas vítimas, outros 16 óbitos envolvendo trabalhadores da área ainda estão sob análise, aguardando resultado de testes. Para efeito de comparação, os Estados Unidos, país com maior número vítimas da pandemia (mais de 71.000), perdeu 46 profissionais de enfermagem, segundo entidades de classe. A Itália, segunda nação mais afetada pela doença com mais de 29.000 vítimas, teve 35 óbitos, de acordo com informações da Federazione Nazionale degli Ordini delle Professioni Infermieristiche, entidade equivalente ao Cofen no país europeu. A Espanha, que vem logo atrás com mais de 25.000 mortos, teve apenas quatro óbitos entre profissionais da área, segundo o Consejo General de Enfermería. Os dois países europeus tiveram o início da crise antes que o Brasil e já passaram do pico de casos. “Um dos fatores [para a alta mortalidade] é que boa parte dos serviços de Saúde não afastou profissionais com idade avançada, acima de 60 anos, e com comorbidades. Eles continuam atuando na linha de frente da pandemia quando deveriam estar em serviços de retaguarda ou afastados”, afirma Manoel Neri, presidente do Cofen. Foi este o caso da enfermeira Maria Aparecida Duarte, 63, conhecida pelos colegas como Cidinha. Ela continuou trabalhando praticamente na porta de um pronto-socorro em Carapicuiba, na Região Metropolitana de São Paulo, apesar de ser parte do grupo de risco. Contraiu a doença e morreu em 3 de abril.