High levels of immunosuppression are related to unfavourable outcomes in hospitalised patients with rheumatic diseases and COVID-19 : first results of ReumaCoV Brasil registry

Objectives To evaluate risk factors associated with unfavourable outcomes: emergency care, hospitalisation, admission to intensive care unit (ICU), mechanical ventilation and death in patients with immune-mediated rheumatic disease (IMRD) and COVID-19. Methods Analysis of the first 8 weeks of observational multicentre prospective cohort study (ReumaCoV Brasil register). Patients with IMRD and COVID-19 according to the Ministry of Health criteria were classified as eligible for the study. Results 334 participants were enrolled, a majority of them women, with a median age of 45 years; systemic lupus erythematosus (32.9%) was the most frequent IMRD. Emergency care was required in 160 patients, 33.0% were hospitalised, 15.0% were admitted to the ICU and 10.5% underwent mechanical ventilation; 28 patients (8.4%) died. In the multivariate adjustment model for emergency care, diabetes (prevalence ratio, PR 1.38; 95% CI 1.11 to 1.73; p=0.004), kidney disease (PR 1.36; 95% CI 1.05 to 1.77; p=0.020), oral glucocorticoids (GC) (PR 1.49; 95% CI 1.21 to 1.85; p50 years (PR 1.89; 95% CI 1.26 to 2.85; p=0.002), no use of tumour necrosis factor inhibitor (TNFi) (PR 2.51;95% CI 1.16 to 5.45; p=0.004) and methylprednisolone pulse therapy (PR 2.50; 95% CI 1.59 to 3.92; p<0.001); for ICU admission, oral GC (PR 2.24; 95% CI 1.36 to 3.71; p<0.001) and pulse therapy with methylprednisolone (PR 1.65; 95% CI 1.00 to 2.68; p<0.043); the two variables associated with death were pulse therapy with methylprednisolone or cyclophosphamide (PR 2.86; 95% CI 1.59 to 5.14; p<0.018). Conclusions Age >50 years and immunosuppression with GC and cyclophosphamide were associated with unfavourable outcomes of COVID-19. Treatment with TNFi may have been protective, perhaps leading to the COVID-19 inflammatory process

African Journal of Business Management FDI inflows, transfer of knowledge, and absorptive capacity: The case of Mozambique

The literature has discussed the impact of Foreign Direct Investment (FDI) on host economies, but has overlooked the case of the least-developed countries (LDCs) and, in particular, the transfer of knowledge to these economies. Drawing on different streams of the literature (FDI impact, knowledge transfer, and absorption capacity), this paper analyzes how a country&apos;s absorptive capacity may moderate the transfer of knowledge. By collecting and analyzing secondary data of FDI inflows and education, we examine the case of Mozambique. Data show that a country&apos;s low educational level, and thus low absorptive capacity, may prevent effective knowledge transfer. We argue that policies that are aimed at expatriation, emigration, and tertiary education can help to increase the potential impact of FDI inflows. The main contribution of this paper to the literature is to examine how absorptive capacity and transfer of knowledge inter-relate within LDCs

The accuracy of the Clinician-Administered PTSD Scale (CAPS) to identify PTSD cases in victims of urban violence

As a consequence of the increasing urban violence in Brazil, many cases of posttraumatic stress disorder (PTSD) are now seen in the community and clinical settings. the main aim of this article is to assess the psychometric properties of the Clinician-Administered PTSD Scale (CAPS) to study factors related to the etiology, prognosis, and efficacy of interventions of PTSD in civilian populations. PTSID outpatients from a program of victims of violence and subjects identified in an epidemiological survey conducted in the city of São Paulo completed a battery of validated instruments and the CAPS. Instrument reliability and validity were measured. the comparison between the CAPS scores and the Structured Clinical Interview for DSM IV (SCID) interview resulted in the following validity coefficients: sensitivity = 90%, specificity = 95%, and misclassification rate = 7.1%. the area under the receiver operating characteristic (ROC) curve was 0.97. There was a positive correlation between CAPS scores with Beck Depression Inventory (BDI; 0.70) and Beck Anxiety Inventory (BAI; 0.76) scores. the Kappa coefficients were all higher than 0.63 for all CAPS items. the internal consistency for all CAPS items resulted in a Cronbach's alpha coefficient of 0.97. the CAPS showed to be both an accurate and a reliable research instrument to identify PTSD cases in a civilian population. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo, Dept Psiquiatria, BR-04026001 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psiquiatria, BR-04026001 São Paulo, BrazilFAPESP: 2004/15039-0CNPq: 420122/2005-2CAPES: 27909024886Web of Scienc

Low concern rate with oral health and associated factors among older persons: a cross-sectional study

OBJECTIVE: This study aimed to assess the prevalence of concern with oral health and associated factors among older adults. METHODS: Individuals aged &gt;60 years were included from the cities Cruz Alta and Veranopolis, Brazil. Oral health examination and a structured questionnaire were applied in 569 individuals. The main outcome was concern with oral health (yes or no), which was determined by a validated questionnaire. Uni- and multivariate analyses were conducted by Poisson regression with robust variance to assess the association between outcome and independent variables. RESULTS: The prevalence of concern with oral health was 30.58% (n = 174). Non-white individuals presented significantly higher prevalence ratio (PR) of being concerned about their oral health (PR = 1.28; 95% confidence interval [CI] 1.01-1.62). Individuals with medium or high level of education, not retired and without any health problems presented higher PR of being concerned with their oral health when compared to their controls (p &lt; 0.05). Moreover, those that reported toothbrushing frequency &gt; 2 times/day (PR = 1.58; 95%CI 1.01 - 2.48) and non-edentulous (PR = 1.50; 95%CI 1.12 -2.01) also presented higher PR of being concern with their oral health. Older adults that were not concerned with tooth alignment (PR = 0.57; 95%CI 0.44 - 0.74) or tooth color (PR = 0.41; 95%CI 0.31 - 0.54) demonstrated lower concern with their oral health. CONCLUSION: Prevalence of concern with oral health among the older adults was low and associated with non-white individuals, medium and high level of education, individuals not retired, absence of health problems, higher toothbrushing frequency, mild temporomandibular disorder (TMD) and non-edentulism. Additionally, concern with esthetical aspects may be related with this outcome.</p

Rapid tests for the toxicity evaluation of soil contaminated by lead-acid batteries manufacture

Lead-acid battery manipulation is one of the major sources of environmental contamination of lead in developing and underdeveloped countries. For the preliminary investigation of the soil ecotoxicological potential of a mechanical workshop with deposit of lead-acid battery tailings, the avoidance behavior response test with Eisenia andrei and the phytotoxicity test with Lactuca sativa were made. The quantification of cadmium, copper, lead, zinc, manganese, iron and arsenic, was also performed. The level of lead found in the test soil was 56 times higher than the permitted value in Brazilian legislation, but the soil only showed toxicity in the avoidance behavior response test with earthworms. None of the phytotoxicity tests showed toxicity to lettuce seeds in germination rate and seedling length. This preliminary study confirms the contamination of these sites by lead and indicates that this contamination can cause damages to the edaphic fauna, suggesting further studies in areas contaminated by tailings of lead-acid batteries