Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3&nbsp;e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Potencial erosivo de soluções com diferentes pHs e graus de acidez titulável em esmalte e dentina

Ainda é questionável a importância relativa do pH e da acidez titulável no potencial erosivo de bebidas ácidas. Portanto, o objetivo deste estudo foi de avaliar o efeito in situ do pH e da acidez titulável no processo de erosão de esmalte dental e dentina. Em um estudo de quatro fases, cruzado, duplo cego, 12 voluntários adultos utilizaram dispositivos palatinos contendo blocos de dente bovino, três de esmalte e três de dentina dispostos no centro do dispositivo, inicialmente por um período de 2h para permitir a formação da película adquirida. Os blocos foram removidos do dispositivo e tiveram sua dureza superficial determinada, após o qual foram reinseridos no dispositivo para realização dos desafios erosivos. Quatro soluções teste, contendo 20% sacarose, foram utilizadas, duas com pH 2,5 e duas com pH 3,5. Duas das soluções não foram tamponadas (pH ajustado para pH 2,5 ou 3,5 utilizando HCl) e as outras duas soluções tamponadas com 25 mM de ácido cítrico antes do ajuste do pH. Sacarose foi empregada para evitar alterações no fluxo salivar durante o experimento devido ao estímulo gustatório. Em cada fase, 15 mL de cada solução teste foi colocada na boca do voluntário por 10s e expectorada; este procedimento foi repetido 20 vezes, com 2 minutos de intervalo entre cada exposição. Os blocos foram removidos dos dispositivos, e a dureza superficial novamente determinada, e a percentagem de perda de dureza foi calculada como indicador de erosão inicial. Análise de variância demonstrou que ambos o pH e acidez titulável da solução produziram efeitos significativos na erosão de esmalte e dentina, com maior PDS% (média±DP; n=12; esmalte e dentina, respectivamente) observada para a solução com 25 mM de ácido cítrico com pH 2,5 (31.9±20.2 and 44.9±13.6%) e menor para a solução sem tampão pH 3,5 (2.5±2.5 and 1.1±6.8%) (p<0.05). Os resultados sugerem que ambos pH e acidez titulável tem um papel significante no potencial erosivo de bebidas ácidas.There is still some debate on the relative importance of pH and titratable acidity on the erosive potential of beverages. Thus, the aim of this study was to evaluate in situ the effect of pH and titratable acidity on erosion of enamel and dentin. In a 4-phase crossover, double-blind design, 12 adult volunteers wore a palatal appliance containing bovine blocks, three of enamel and three of dentin, initially for 2 h to allow the formation of acquired pellicle. Blocks were removed from the appliance to determine surface hardness (SH) and reinserted for the erosive test. Four test solutions, containing 20% sucrose, were used, two of them at pH 2.5 and two at 3.5. Two of the solutions were not buffered (pH adjusted to 2.5 or 3.5 with HCl) and of the other two were buffered with 25 mM citric acid before pH adjustment. Sucrose was used to avoid major differences in salivary flow rate during the trial due to gustatory stimulus. In each phase, 15 mL of one of tested solutions was kept in the volunteers mouth for 10 s and expectorated; this procedure was repeated 20 times, with a 2 min interval between each exposure. The blocks were removed from the appliances, SH was again determined and the percentage of loss (%SHL) was calculated as an indicator of initial erosion. Two-way ANOVA revealed that both pH and titratable acidity had significant effects on enamel and dentin erosion, with the highest %SHL (Avg±SD; n=12; enamel and dentin, respectively) observed for the 25 mM citric acid solution at pH 2.5 (31.9±20.2 and 44.9±13.6%) and the lowest for the unbuffered pH 3.5 solution (2.5±2.5 and 1.1±6.8%) (p<0.05). The results suggest that both pH and titratable acidity play a significant role on the erosive potential of acidic beverages

Titratable acidity of beverages influences salivary pH recovery

A low pH and a high titratable acidity of juices and cola-based beverages are relevant factors that contribute to dental erosion, but the relative importance of these properties to maintain salivary pH at demineralizing levels for long periods of time after drinking is unknown. In this crossover study conducted in vivo, orange juice, a cola-based soft drink, and a 10% sucrose solution (negative control) were tested. These drinks differ in terms of their pH (3.5 ± 0.04, 2.5 ± 0.05, and 5.9 ± 0.1, respectively) and titratable acidity (3.17 ± 0.06, 0.57 ± 0.04 and < 0.005 mmols OH- to reach pH 5.5, respectively). Eight volunteers with a normal salivary flow rate and buffering capacity kept 15 mL of each beverage in their mouth for 10 s, expectorated it, and their saliva was collected after 15, 30, 45, 60, 90, and 120 s. The salivary pH, determined using a mini pH electrode, returned to the baseline value at 30 s after expectoration of the cola-based soft drink, but only at 90 s after expectoration of the orange juice. The salivary pH increased to greater than 5.5 at 15 s after expectoration of the cola drink and at 30 s after expectoration of the orange juice. These findings suggest that the titratable acidity of a beverage influences salivary pH values after drinking acidic beverages more than the beverage pH

Titratable acidity of beverages influences salivary pH recovery

A low pH and a high titratable acidity of juices and cola-based beverages are relevant factors that contribute to dental erosion, but the relative importance of these properties to maintain salivary pH at demineralizing levels for long periods of time after drinking is unknown. In this crossover study conductedin vivo, orange juice, a cola-based soft drink, and a 10% sucrose solution (negative control) were tested. These drinks differ in terms of their pH (3.5 ± 0.04, 2.5 ± 0.05, and 5.9 ± 0.1, respectively) and titratable acidity (3.17 ± 0.06, 0.57 ± 0.04 and < 0.005 mmols OH- to reach pH 5.5, respectively). Eight volunteers with a normal salivary flow rate and buffering capacity kept 15 mL of each beverage in their mouth for 10 s, expectorated it, and their saliva was collected after 15, 30, 45, 60, 90, and 120 s. The salivary pH, determined using a mini pH electrode, returned to the baseline value at 30 s after expectoration of the cola-based soft drink, but only at 90 s after expectoration of the orange juice. The salivary pH increased to greater than 5.5 at 15 s after expectoration of the cola drink and at 30 s after expectoration of the orange juice. These findings suggest that the titratable acidity of a beverage influences salivary pH values after drinking acidic beverages more than the beverage pH

Lung ultrasound in children with pneumonia: inter-operator agreement on specific thoracic regions

Sem informação54632019-09-28European-Respiratory-Society (ERS) International CongressMadrid, Espanh