Dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare institutions affects both patients and health-care workers (HCW), as well as the institutional capacity to provide essential health services. Here, we investigated an outbreak of SARS-CoV-2 in a “non-COVID-19” hospital ward unveiled by massive testing, which challenged the reconstruction of transmission chains. The contacts network during the 15-day period before the screening was investigated, and positive SARS-CoV-2 RNA samples were subjected to virus genome sequencing. Of the 245 tested individuals, 48 (21 patients and 27 HCWs) tested positive for SARS-CoV-2. HCWs were mostly asymptomatic, but the mortality among patients reached 57.1% (12/21). Phylogenetic reconstruction revealed that all cases were part of the same transmission chain. By combining contact tracing and genomic data, including analysis of emerging minor variants, we unveiled a scenario of silent SARS-CoV-2 dissemination, mostly driven by the close contact within the HCWs group and between HCWs and patients. This investigation triggered enhanced prevention and control measures, leading to more timely detection and containment of novel outbreaks. This study shows the benefit of combining genomic and epidemiological data for disclosing complex nosocomial outbreaks, and provides valuable data to prevent transmission of COVID-19 in healthcare facilities.
Optical coherence tomography (OCT) is one of the most important imaging modalities for biophotonics applications. In this work, an important step towards the clinical use of OCT in dental practice is reported, by following‐up patients treated from periodontal disease (PD). A total of 147 vestibular dental sites from 14 patients diagnosed with PD were evaluated prior and after treatment, using a swept‐source OCT and two periodontal probes (Florida probe and North Carolina) for comparison. The evaluation was performed at four stages: day 0, day 30, day 60 and day 90. Exceptionally one patient was evaluated 1‐year after treatment. It was possible to visualize in the two‐dimensional images the architectural components that compose the periodontal anatomy, and identify the improvements in biofilm and dental calculus upon treatment. In the follow‐up after the treatment, it was observed in some cases decrease of the gingival thickness associated with extinction of gingival calculus. In some cases, the improvement of both depth of probing with the traditional probes and the evidence in the images of the region was emphasized. The study evidenced the ability of OCT in the identification of periodontal structures and alterations, being an important noninvasive complement or even alternative for periodontal probes for treatment follow‐up.
OCT system being used in a clinical environment. Above OCT image (left) prior treatment and (right) 30 days after treatment.
Background. Dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare institutions affects both patients and health-care workers (HCW), as well as the institutional capacity to provide essential health services.
Methods. We conducted an investigation of a cluster of SARS-CoV-2 positive cases detected in a 'non-COVID-19' hospital ward during Summer 2020. The magnitude of the nosocomial outbreak was disclosed by massive testing, challenging the retrospective reconstruction of the introduction and transmission events. An in-depth contact tracing investigation was carried out to identify the contacts network during the 15-day period before the screening. In parallel, positive SARS-CoV-2 RNA samples were subjected to virus genome sequencing.
Results. Of the 245 tested individuals, 48 (21 patients and 27 HCWs) tested positive for SARS-CoV-2. HCWs were mostly asymptomatic, but the mortality among the vulnerable patient group reached 57.1% (12/21). Phylogenetic reconstruction revealed that all cases were part of the same transmission chain, thus confirming a single origin behind this nosocomial outbreak. By combining vast epidemiological and genomic data, including analysis of emerging minor variants, we unveiled a scenario of silent SARS-CoV-2 dissemination within the hospital ward, mostly driven by the close contact within the HCWs group and between HCWs and patients. This investigation triggered enhanced prevention and control measures, leading to a more timely detection and containment of novel nosocomial outbreaks.
Conclusions. The present study shows the benefit of combining genomic and epidemiological data for the investigation of complex nosocomial outbreaks, and provides valuable data to minimize the risk of transmission of COVID-19 in healthcare facilities.
Definida pelo acúmulo de tecido adiposo em quantidade que pode representar danos à saúde, a obesidade apresenta taxas de crescimento alarmantes ao redor do mundo, contribuindo com o desenvolvimento de inúmeras importantes comorbidades como cardiopatias, diabetes, hipertensão entre outras. Por outro lado, a COVID-19, desencadeada pela infecção pelo vírus SARS-CoV-2, considerada uma pandemia, tem infectado milhões de indivíduos ao redor do mundo resultando em um número crescente de mortes. Considerando que ambas as doenças apresentam risco para o desenvolvimento de alterações sistêmicas, esse artigo busca abordar e discutir os mecanismos fisiopatológicos inerentes aos principais fatores de risco que levam ao pior prognóstico observado em pacientes obesos com COVID-19. Para isso foi realizada uma busca na literatura empregando as palavras chaves "Obesidade", "COVID-19", "Fatores de Risco" em português, e seus equivalentes em inglês "Obesity", "COVID-19", "Risk Factors". Para dados estatísticos foram consultados conceituados sites institucionais nacionais e internacionais. Sumarizando, confirmou-se que a obesidade e suas comorbidades estão relacionadas aos principais fatores de risco para a COVID-19. A inflamação sistêmica característica de ambas as doenças, assim como a disfunção tecidual advinda da invasão celular pelo SARS-CoV-2 propiciada pelo seu receptor na membrana celular, são críticos para o pior prognóstico da COVID-19 em pacientes obesos.
Introdução: Novos regimes de terapia antirretroviral (TARV) para HIV podem melhorar os resultados clínicos para os pacientes e de alterar a história natural da infecção. Os guidelines nacionais e internacionais recomendam atualmente a iniciar o tratamento dos indivíduos infectados para prevenir a deterioração do sistema imunológico e controlar a replicação viral, e consequente prevenção da transmissão da infecção pelo HIV. Objetivo: Analisar o uso da terapia antirretroviral que incluem Atazanavir/ritonavir (ATV/r) ou Efavirenz (EFV) na primeira linha de tratamento de pacientes adultos vivendo com HIV. Material e Métodos: O presente trabalho consiste em um estudo coorte retrospectivo. A coleta de dados ocorreu no período de agosto de 2019 a julho de 2020 e se concentrou no Serviço de Imunologia Clínica/Hospital-Dia do Instituto de Medicina Integral Prof. Fernando Figueira - IMIP. Os dados foram retirados dos prontuários selecionados de maneira aleatória e registrados em questionários padronizados com posterior transcrição em planilhas computadorizadas. O projeto foi aprovado pelo Comitê de Ética em Pesquisa em Seres Humanos (CEP) do IMIP/PE. Os dados foram transcritos no programa Excel, analisados no Epi Info™. Resultados: 131 pacientes participaram do estudo utilizando EFV ou ATV/r como terceira droga do esquema antirretroviral, sendo 73,3% pacientes EFV e 26,7% usando ATV/r. A supressão viral inicial foi observada em 88% (p > 0,05) dos pacientes, independentemente do esquema utilizado. Esquemas contendo ATV/r apresentaram uma prevalência de 47,1% de efeitos adversos e EFV 52,1% (p < 0,001). Conclusão: Os achados do desse estudo sugerem que tanto ATV/r quanto o EFV apresentaram efetividade semelhante quando utilizados como primeira linha de tratamento.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.