Avaliação de Sintomas Psiquiátricos Durante o Confinamento no Contexto da Pandemia COVID‑19 numa População Clínica Pedopsiquiátrica

The COVID‑19 pandemic implied the lockdown of the paediatric population at home, conditioning changes in academic and leisure activities and relations with peers and family. Children and young people with mental illness have specific vulnerabilities, which can be affected in a particular way. This study aims to evaluate the evolution of psychiatric symptoms ‑ in the domains of mood, anxiety and behavioral changes ‑ in a child and adolescent psychiatry (CAP) population during the lockdown due to COVID‑19. Data were collected through a telephone interview with the main caregiver of children/young people (for psychiatric symptoms and qualitative variables) and online filling of the Strengths and Difficulties Questionnaire (SDQ). Data were subsequently analyzed statistically in SPSS. The final sample consists of a total of 502 patients. There was a global increase in screen hours, along with changes in hours of physical activity and sleep. Additionally, there was an increase in symptoms of sadness, irritability, anxiety and behavior. It was demonstrated that these symptomatic variations were statistically correlated with the caregiver’s perception of the variation in the quality of the relationship during lockdown. With specific vulnerabilities, this population can be affected differently depending on the diagnosis and on the social and family context. Longitudinal studies are justified, as well as analyzes that identify risk and protective factors.A pandemia devida à COVID‑19 implicou o confinamento da população pediátrica no domicílio, condicionando alterações das rotinas académicas, das atividades de lazer e das relações com pares e familiares. As crianças e jovens com doença mental apresentam vulnerabilidades específicas, podendo ser afetadas de forma particular. O presente estudo pretende avaliar a evolução da sintomatologia psiquiátrica ‑ nos domínios do humor, ansiedade e alterações de comportamento ‑ numa população pedopsiquiátrica durante o confinamento devido à COVID‑19. Procedeu‑se à colheita de dados através de uma entrevista telefónica ao principal cuidador das crianças/jovens (para sintomas psiquiátricos e variáveis qualitativas) e do preenchimento online do questionário Strengths and Difficulties Questionnaire (SDQ). Os dados foram posteriormente trabalhados estatisticamente em SPSS. A amostra final é constituída por um total de 502 pacientes. Constatou‑se um aumento global das horas de ecrã, paralelamente a alterações nas horas de atividade física e no sono. Adicionalmente, apurou‑se um agravamento dos sintomas de tristeza, irritabilidade, ansiedade e em menor escala, do comportamento. Verificou‑se que estas variações sintomáticas estavam estatisticamente correlacionadas com a perceção do cuidador relativamente à variação da qualidade da relação durante o confinamento. Apresentando vulnerabilidades específicas, esta população pode ser afetada diferencialmente consoante o diagnóstico e o contexto sociofamiliar. Estudos longitudinais são justificáveis, bem como análises que permitam identificar fatores de risco e fatores protetores

Counseling and surveillance of obstetric risks for female childhood, adolescent, and young adult cancer survivors: recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group

Female childhood, adolescent, and young adult cancer survivors have an increased risk of adverse pregnancy outcomes related to their cancer- or treatment-associated sequelae. Optimal care for childhood, adolescent, and young adult cancer survivors can be facilitated by clinical practice guidelines that identify specific adverse pregnancy outcomes and the clinical characteristics of at-risk subgroups. However, national guidelines are scarce and vary in content. Here, the International Late Effects of Childhood Cancer Guideline Harmonization Group offers recommendations for the counseling and surveillance of obstetrical risks of childhood, adolescent, and young adult survivors. A systematic literature search in MEDLINE database (through PubMed) to identify all available evidence published between January 1990 and December 2018. Published articles on pregnancy and perinatal or congenital risks in female cancer survivors were screened for eligibility. Study designs with a sample size larger than 40 pregnancies in childhood, adolescent, and young adult cancer survivors (diagnosed before the age of 25 years, not pregnant at that time) were eligible. This guideline from the International Late Effects of Childhood Cancer Guideline Harmonization Group systematically appraised the quality of available evidence for adverse obstetrical outcomes in childhood, adolescent, and young adult cancer survivors using Grading of Recommendations Assessment, Development, and Evaluation methodology and formulated recommendations to enhance evidence-based obstetrical care and preconception counseling of female childhood, adolescent, and young adult cancer survivors. Healthcare providers should discuss the risk of adverse obstetrical outcomes based on cancer treatment exposures with all female childhood, adolescent, and young adult cancer survivors of reproductive age, before conception. Healthcare providers should be aware that there is no evidence to support an increased risk of giving birth to a child with congenital anomalies (high-quality evidence). Survivors treated with radiotherapy to volumes exposing the uterus and their healthcare providers should be aware of the risk of adverse obstetrical outcomes such as miscarriage (moderate-quality evidence), premature birth (high-quality evidence), and low birthweight (high-quality evidence); therefore, high-risk obstetrical surveillance is recommended. Cardiomyopathy surveillance is reasonable before pregnancy or in the first trimester for all female survivors treated with anthracyclines and chest radiation. Female cancer survivors have increased risks of premature delivery and low birthweight associated with radiotherapy targeting the lower body and thereby exposing the uterus, which warrant high-risk pregnancy surveillance

Multi-messenger searches via IceCube’s high-energy neutrinos and gravitational-wave detections of LIGO/Virgo

We summarize initial results for high-energy neutrino counterpart searches coinciding with gravitational-wave events in LIGO/Virgo\u27s GWTC-2 catalog using IceCube\u27s neutrino triggers. We did not find any statistically significant high-energy neutrino counterpart and derived upper limits on the time-integrated neutrino emission on Earth as well as the isotropic equivalent energy emitted in high-energy neutrinos for each event

IceCube Search for Earth-traversing ultra-high energy Neutrinos

The search for ultra-high energy neutrinos is more than half a century old. While the hunt for these neutrinos has led to major leaps in neutrino physics, including the detection of astrophysical neutrinos, neutrinos at the EeV energy scale remain undetected. Proposed strategies for the future have mostly been focused on direct detection of the first neutrino interaction, or the decay shower of the resulting charged particle. Here we present an analysis that uses, for the first time, an indirect detection strategy for EeV neutrinos. We focus on tau neutrinos that have traversed Earth, and show that they reach the IceCube detector, unabsorbed, at energies greater than 100 TeV for most trajectories. This opens up the search for ultra-high energy neutrinos to the entire sky. We use ten years of IceCube data to perform an analysis that looks for secondary neutrinos in the northern sky, and highlight the promise such a strategy can have in the next generation of experiments when combined with direct detection techniques