Objectives Contact tracing and quarantine are common measures used in the management of infectious disease outbreaks. However, few studies have measured their impact on the control of the COVID-19 pandemic. This study aimed to assess the effectiveness of those measures on reducing transmission of SARS-CoV-2 in a community setting. Study Design Retrospective cohort study. Methods A retrospective cohort study of COVID-19 cases notified in Eastern Porto from March 1 st to April 30 th , 2020 was performed. Intervention and control cohorts were defined based on whether cases were subjected to contact tracing and quarantine measures before the laboratory confirmation of disease. The number of secondary cases per index case and the proportion of cases with subsequent secondary cases were the primary outcomes. Secondary outcomes included the time from symptom onset to specimen collection and the number of close contacts. The analysis was stratified according to whether national lockdown measures had already been implemented. Results The intervention and control cohorts comprised 98 and 453 cases, respectively. No differences were observed concerning primary outcomes. The intervention group had a shorter time between symptom onset and specimen collection (median: 3 days, IQR 1-6, vs. median: 5 days, IQR 2-7, p-value=0.004) and fewer close contacts (median: 0, IQR 0-2, vs. median: 2, IQR 1-4, p-value<0.001). The stratified analysis returned similar results. Conclusion Local public health measures were effective in reducing the time between symptom onset and laboratory diagnosis and the number of close contacts per case. No effect was apparent on secondary case figures, suggesting that further measures may be required.
Summary:Purpose: To investigate the risk of illnesses in a cohort of patients with epilepsy and in matched nonepilepsy controls, by type and complications.Methods: A total of 951 children and adults with idiopathic, cryptogenic, or remote symptomatic epilepsy and 904 matched controls seen in secondary and tertiary centers in eight European countries (England, Estonia, Germany, Italy, the Netherlands, Portugal, Russia, Slovenia) were followed prospectively for 17,484 and 17,206 person-months and asked to report any spontaneous complaint requiring medical attention (illness), its type and complications (hospitalization, absence from work or school, medical action). Risk assessment was done by actuarial methods, relative risks (RR), and 95% confidence intervals (CIs).Results: During the study period 644 patients (68%) and 504 controls (56%) reported an illness (p < 0.0001); 30% were seizure related. The cumulative probability of illness at 12 and 24 months was 49 and 86% in the cases and 39 and 75% in the controls (p < 0.0001). The largest differences regarded disorders affecting the nervous system (NS) (RR, 3.3; 95% CI, 2.3-4.2) and ear, nose, and throat (ENT) (RR, 1.3; 95% CI, 1.0-1.6). In patients with epilepsy, an NS illness was more likely to be followed by hospital admission, work absence, or medical intervention. All risks were significantly reduced after excluding seizure-related events.Conclusions: Patients with epilepsy are at higher risk of NS and ENT illnesses and complications than the general population. However, the risk of illness is significantly reduced when seizure-related events are excluded. Key Words: EpilepsyMorbidity-Illnesses.Patients with epilepsy have been thought to have a higher risk of illness than the general population, but comorbidity in epilepsy has been investigated in few population-based prevalence or analytic studies. Other clinical conditions and disabilities were reported by 47% of adults with epilepsy in Sweden, with psychiatric, cardiovascular, pulmonary, systemic, and renal diseases in decreasing order (1). Lifetime mental and gastric disorders were reported by 7 and 3% of adults with childhoodonset epilepsy in the Czech Republic (2). In Finland, somatic comorbidity was found in 84-95% of patients with childhood-onset epilepsy and 67-74% of controls (3). In a multicenter European cohort study of children and adults with idiopathic, cryptogenic, or remote symptomatic epilepsy, we found one or more illnesses at entry in 30% of cases compared with 17% of age-and sex-matched controls (4).These contrasting results may be explained by differences in the study populations and in the study design and methods. In addition, the morbidity risk attributable Accepted September 14, 2003. Address correspondence and reprint requests to Dr. E. Beghi at Istituto di Ricerche Farmacologiche "Mario Negri," Via Eritrea 62, 20157 Milano, Italy. E-mail: beghi@marionegri.it to the disease cannot be explored in studies on the prevalence of other clinical conditions in epilepsy. For these reasons, i...
Coronaviruses are enveloped viruses that can cause respiratory, gastrointestinal, hepatic, and neurological diseases. In December 2019, a new highly contagious coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China. SARS-CoV-2 causes a potentially lethal human respiratory infection, COVID-19, that is associated with fever and cough and can progress to pneumonia and dyspnea in severe cases. Since the virus emerged, it has spread rapidly, reaching all continents around the world. A previous study has shown that, despite being the best alternative in the current pandemic context, social distancing measures alone may not be sufficient to prevent COVID-19 spread, and the overall impact of the virus is of great concern. The present study aims to describe the demographic and socioeconomic characteristics of 672 cities with cases of COVID-19, as well as to determine a predictive model for the number of cases. We analyzed data from cities with at least 1 reported case of COVID-19 until June 26, 2020. It was observed that cities with confirmed cases of the disease are present in all Brazilian states, affecting 36.5% of the municipalities in Rio de Janeiro State. The inhabitants in cities with reported cases of COVID-19 represent more than 73.1% of the Brazilian population. Stratifying the age groups of the inhabitants and accounting for the percentage of women and men does not affect COVID-19 incidence (confirmed cases/100,000 inhabitants). The demographic density, the MHDI and the per capita income of the municipalities with cases of COVID-19 do not affect disease incidence. In addition, if conditions are maintained, our model predicts 2,358,703 (2,172,930 to 2,544,477) cumulative cases on July 25, 2020.
O artigo apresenta a experiência do desenvolvimento de um software de gestão de biotérios em uma instituição pública e as estratégias utilizadas para colocá-lo em uso a fim de gerar inovação. A metodologia de natureza qualitativa teve abordagem predominantemente exploratória com coleta de informações. Utilizou-se da observação e análise de documentos registrados desde o início do desenvolvimento até o final da parceria comercial e de codesenvolvimento com uma instituição privada. Vários desafios para disponibilizar no mercado o software se apresentaram, como os escassos recursos e a falta de cultura tecnológica dos gestores de biotérios, além da dificuldade de encontrar um modelo de negócios viável para comercialização, visto que a maioria dos biotérios é pública. A transferência de tecnologia ainda é um desafio para uma Instituição Científica, Tecnológica e de Inovação (ICTs) no Brasil. Dessa forma, as lições aprendidas neste caso podem ser úteis para gestores e pesquisadores envolvidos com inovação.
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